Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2014-06-01

Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress. Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140  mmHg (SBP) or 90  mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort. We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects. Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

Work, family, support, and depression: employed mothers in Israel, Korea, and the United States.

PubMed

O'Brien, Karen M; Ganginis Del Pino, Heather V; Yoo, Sung-Kyung; Cinamon, Rachel Gali; Han, Young-Joo

2014-07-01

Our research revealed differences in work-family constructs for employed mothers in 3 countries, Israel (N = 105), Korea (N = 298), and the United States (N = 305). Although levels of work-family conflict were comparable, the Korean women had the lowest levels of work-family enrichment compared with the Israeli and American mothers. Moreover, Korean women reported the most depression and the least support from both spouses and employers. Spousal support mediated the relationship between work-family conflict and depression for employed mothers in Israel, Korea, and the United States. As hypothesized by conservation of resources theory (Hobfoll, 1989, 1998, 2001), threat of resource loss (operationalized as work-family conflict) was related to depression more strongly than was resource gain (i.e., work-family enrichment). PsycINFO Database Record (c) 2014 APA, all rights reserved.

Masonry: Construction Industry Series: Preparation Level: Student Manual and Instructor's Guide.

ERIC Educational Resources Information Center

Texas Education Agency, Austin. Dept. of Occupational Education and Technology.

The guide is an outline of training experiences designed to lead a student to at least entry-level job proficiency in the masonry trades within the construction industry. Teaching units cover concrete working, brick and block layering, plastering, and tile and terrazzo working. Each unit has several overall objectives which are divided into…

Do nurse and patient injuries share common antecedents? An analysis of associations with safety climate and working conditions.

PubMed

Taylor, Jennifer A; Dominici, Francesca; Agnew, Jacqueline; Gerwin, Daniel; Morlock, Laura; Miller, Marlene R

2012-02-01

Safety climate and nurses' working conditions may have an impact on both patient outcomes and nurse occupational health, but these outcomes have rarely been examined concurrently. To examine the association of unit-level safety climate and specific nurse working conditions with injury outcomes for both nurses and patients in a single hospital. A cross-sectional study was conducted using nursing-unit level and individual-level data at an urban, level-one trauma centre in the USA. Multilevel logistic regressions were used to examine associations among injury outcomes, safety climate and working conditions on 29 nursing units, including a total of 723 nurses and 28 876 discharges. Safety climate was measured in 2004 using the Safety Attitudes Questionnaire (SAQ). Working conditions included registered nursing hours per patient day (RNHPPD) and unit turnover. Patient injuries included 290 falls, 167 pulmonary embolism/deep vein thrombosis (PE/DVT), and 105 decubitus ulcers. Nurse injury was defined as a reported needle-stick, splash, slip, trip, or fall (n=78). Working conditions and outcomes were measured in 2005. The study found a negative association between two SAQ domains, Safety and Teamwork, with the odds of both decubitus ulcers and nurse injury. RNHPPD showed a negative association with patient falls and decubitus ulcers. Unit turnover was positively associated with nurse injury and PE/DVT, but negatively associated with falls and decubitus ulcers. Safety climate was associated with both patient and nurse injuries, suggesting that patient and nurse safety may actually be linked outcomes. The findings also indicate that increased unit turnover should be considered a risk factor for nurse and patient injuries.

Work environment, job satisfaction, stress and burnout among haemodialysis nurses.

PubMed

Hayes, Bronwyn; Douglas, Clint; Bonner, Ann

2015-07-01

To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing. © 2013 John Wiley & Sons Ltd.

Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a Job Demand-Control survey.

PubMed

Trousselard, Marion; Dutheil, Frédéric; Naughton, Geraldine; Cosserant, Sylvie; Amadon, Sylvie; Dualé, Christian; Schoeffler, Pierre

2016-02-01

The nurse stress literature reports an overwhelming culture of acceptance and expectation of work stressors, ironically linked to the control of the workplace to effectively and proactively manage stress. The stressors involved in delivering "stress management" have been well studied in nursing-related workplaces, especially in acute care settings in accordance with the Karasek Job Demand-Control-Support (JDCS) model. However, little is known about the effects of specificity of an acute care unit and the level of qualifications on stress experienced by nurses. A survey using the JDCS model was conducted among 385 nurses working in three different acute care units (anesthesiology, emergency and intensive care unit) from a university hospital. Specific questions explored variables such as gender, acute care units, level of qualification and working experience. Two hundred questionnaires were returned. A high level of job strain was highlighted without a gender effect and in the absence of isostrain. Nurses from acute care units were located in the high stress quadrant of the JDCS model. Conversely, other nurses were commonly located in the "active" quadrant. Independent of acute care settings, the highest level of education was associated with the highest job strain and the lowest level of control. In an acute care setting, a high level of education was a key factor for high job stress and was associated with a perception of a low control in the workplace, both of which may be predictors of adverse mental health. In particular, the lack of control has been associated with moral distress, a frequently reported characteristic of acute care settings. To enhance the personal and professional outcomes of the advanced registered nurses, strategies for supporting nurses manage daily stressors in acute care are urgently required.

Level 2 Foundation Units. Key Stage 3: National Strategy.

ERIC Educational Resources Information Center

Department for Education and Skills, London (England).

These foundation units are aimed at pupils working within Level 2 entry to Year 7. They are designed to remind pupils what they know and take them forward. The units also will teach phonics knowledge from consonant-vowel-consonant (CVC) words to long vowel phonemes. The writing units focus on developing the following skills: understanding what a…

The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction.

PubMed

Lin, Blossom Yen-Ju; Hsu, Chung-Ping C; Juan, Chi-Wen; Lin, Cheng-Chieh; Lin, Hung-Jung; Chen, Jih-Chang

2011-01-01

The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. Three instruments were designed to assess leader behaviors, unit performance and employee satisfaction in these hospital-based EDs. A mail survey revealed that task-oriented leader behavior was positively related to ED unit performance. Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction. Copyright © 2010 Elsevier Ltd. All rights reserved.

Relationship of health workers with their organization and work: a cross-cultural study.

PubMed

Yepes-Baldó, Montserrat; Romeo, Marina; Berger, Rita

2016-01-01

We analyzed the differences, by Student's t-test and ANOVA, between nurses and physicians from Portugal, Poland, Spain, and United Kingdom regarding their relationship with their work and organization. In total, 1,401 professionals answered the HSA-QHPR questionnaire. There are different levels of connection between physicians and nurses. The United Kingdom has the lowest levels of connection with the work while Portugal has the highest levels of relationship with the organization. The results provide guidelines for the development of policies and differential strategies aimed at improving the quality of healthcare service.

Relationship of health workers with their organization and work: a cross-cultural study

PubMed Central

Yepes-Baldó, Montserrat; Romeo, Marina; Berger, Rita

2016-01-01

ABSTRACT We analyzed the differences, by Student’s t-test and ANOVA, between nurses and physicians from Portugal, Poland, Spain, and United Kingdom regarding their relationship with their work and organization. In total, 1,401 professionals answered the HSA-QHPR questionnaire. There are different levels of connection between physicians and nurses. The United Kingdom has the lowest levels of connection with the work while Portugal has the highest levels of relationship with the organization. The results provide guidelines for the development of policies and differential strategies aimed at improving the quality of healthcare service. PMID:27191154

Unit-level voluntary turnover rates and customer service quality: implications of group cohesiveness, newcomer concentration, and size.

PubMed

Hausknecht, John P; Trevor, Charlie O; Howard, Michael J

2009-07-01

Despite substantial growth in the service industry and emerging work on turnover consequences, little research examines how unit-level turnover rates affect essential customer-related outcomes. The authors propose an operational disruption framework to explain why voluntary turnover impairs customers' service quality perceptions. On the basis of a sample of 75 work units and data from 5,631 employee surveys, 59,602 customer surveys, and organizational records, results indicate that unit-level voluntary turnover rates are negatively related to service quality perceptions. The authors also examine potential boundary conditions related to the disruption framework. Of 3 moderators studied (group cohesiveness, group size, and newcomer concentration), results show that turnover's negative effects on service quality are more pronounced in larger units and in those with a greater concentration of newcomers.

The association between spiritual well-being and burnout in intensive care unit nurses: A descriptive study.

PubMed

Kim, Hyun Sook; Yeom, Hye-Ah

2018-06-01

To describe the spiritual well-being and burnout of intensive care unit nurses and examine the relationship between these factors. This was a cross-sectional descriptive study. The participants were 318 intensive care unit recruited from three university hospitals in South Korea. The survey questionnaire included demographic information, work-related characteristics and end-of-life care experience, along with the Spiritual Well-Being Scale and Burnout Questionnaire. The data were analysed using descriptive statistics, t-tests, ANOVA with Scheffé test and a multiple regression analysis. The burnout level among intensive care unit nurses was 3.15 out of 5. A higher level of burnout was significantly associated with younger age, lower education level, single marital status, having no religion, less work experience and previous end-of-life care experience. Higher levels of spiritual well-being were associated with lower levels of burnout, even after controlling for the general characteristics in the regression model. Intensive care unit nurses experience a high level of burnout in general. Increased spiritual well-being might reduce burnout among intensive care unit nurses. Younger and less experienced nurses should receive more attention as a vulnerable group with lower spirituality and greater burnout in intensive care unit settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Managing Highway Maintenance: Standards for Maintenance Work, Part 3, Unit 8, Level 2.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit explains various uses of maintenance standards and how standards should be interpreted and communicated to formen and crew leaders. Several examples are given of the decisions made when applying the standards to routine work. The preceding units on standards (parts 1 and 2)…

Native American Career Education Unit. Putting Your Money to Work.

ERIC Educational Resources Information Center

Far West Lab. for Educational Research and Development, San Francisco, CA.

One of twelve instructional units in the Native American Career Education (NACE) program, this unit is intended to help Indian junior high school students understand how to manage money resources, both on a personal level and in the world of work. In five activities, students do exercises and small group activities in which they consider how money…

The effect of nurses' empowerment perceptions on job safety behaviours: a research study in Turkey.

PubMed

Yıldız, Ahmet; Kaya, Sıdıka; Teleş, Mesut; Korku, Cahit

2018-05-03

This study aimed to investigate the effect of nurses' empowerment perceptions on job safety behaviours. A survey of 377 nurses working in five hospitals in Turkey was conducted using the conditions of work effectiveness questionnaire, psychological empowerment instrument, universal precautions compliance scale and occupational health and safety obligations compliance scale. Relations between variables were tested using Pearson's correlation and path analysis. There was a moderate and statistically significant relationship between psychological and structural empowerment and complying with universal safety measures and meeting occupational health and safety obligations. Also, an increase of 1 unit on the level of psychological empowerment was found to correspond to an increase of 0.37 units on the level of universal precautions compliance and to an increase of 0.46 units on the level of occupational health and safety obligations compliance. As such, an increase of 1 unit in structural empowerment corresponds to an increase of 0.53 units on the level of universal precautions compliance and to an increase of 0.36 units (total effect) on the level of occupational health and safety obligations compliance. The findings reveal that empowerment is a valuable tool for nurses' positive job safety behaviours.

A Comparative Study on Retirement Process in Korea, Germany, and the United States: Identifying Determinants of Retirement Process.

PubMed

Cho, Joonmo; Lee, Ayoung; Woo, Kwangho

2016-10-01

This study classifies the retirement process and empirically identifies the individual and institutional characteristics determining the retirement process of the aged in South Korea, Germany, and the United States. Using data from the Cross-National Equivalent File, we use a multinomial logistic regression with individual factors, public pension, and an interaction term between an occupation and an education level. We found that in Germany, the elderly with a higher education level were more likely to continue work after retirement with a relatively well-developed social support system, while in Korea, the elderly, with a lower education level in almost all occupation sectors, tended to work off and on after retirement. In the United States, the public pension and the interaction terms have no statistically significant impact on work after retirement. In both Germany and Korea, receiving a higher pension decreased the probability of working after retirement, but the influence of a pension in Korea was much greater than that of Germany. In South Korea, the elderly workers, with lower education levels, tended to work off and on repeatedly because there is no proper security in both the labor market and pension system. © The Author(s) 2016.

Effect of occupation on lipid peroxidation and antioxidant status in coal-fired thermal plant workers.

PubMed

Kaur, Sandeep; Gill, Manmeet Singh; Gupta, Kapil; Manchanda, Kc

2013-07-01

Air pollution from coal-fired power units is large and varied, and contributes to a significant number of negative environmental and health effects. Reactive oxygen species (ROS) have been implicated in the pathogenesis of coal dust-induced toxicity in coal-fired power plants. The aim of the study was to measure free radical damage and the antioxidant activity in workers exposed to varying levels of coal dust. The study population consisted of workers in coal handling unit, turbine unit, and boiler unit (n = 50 each), working in thermal power plant; and electricians (n = 50) from same department were taken as controls. Lipid peroxidation was measured by malondialdehyde (MDA) levels and antioxidant activity was determined by superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels. Statistical analysis was carried out by Student's unpaired t-test. MDA levels showed significant increase (P > 0.001) in the thermal power plant workers than the electricians working in the city. The levels of SOD and GPx were significantly higher (P > 0.001) in electricians as compared to subjects working in thermal plant. Among the thermal plant workers, the coal handling unit workers showed significant increase (P > 0.001) in MDA and significant decrease in SOD and GPx than the workers of boiler and turbine unit workers. Oxidative stress due to increase in lipid peroxidation and decrease in antioxidant activity results from exposure to coal dust and coal combustion products during thermal plant activities.

Associations Among Nursing Work Environment and Health-Promoting Behaviors of Nurses and Nursing Performance Quality: A Multilevel Modeling Approach.

PubMed

Cho, Hyeonmi; Han, Kihye

2018-05-14

This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma Theta Tau International.

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2012 CFR

2012-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

48 CFR 3452.224-70 - Release of information under the Freedom of Information Act.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: (1) Unit prices, including labor rates; (2) Statements of Work/Performance Work Statements generated by the contractor; (3) Performance requirements, including incentives, performance standards, quality levels, and service level agreements; (4) Reports, deliverables, and work products delivered in...

Psychosocial factors and mental work load: a reality perceived by nurses in intensive care units1

PubMed Central

Ceballos-Vásquez, Paula; Rolo-González, Gladys; Hérnandez-Fernaud, Estefanía; Díaz-Cabrera, Dolores; Paravic-Klijn, Tatiana; Burgos-Moreno, Mónica

2015-01-01

OBJECTIVE: To analyse the perception of psychosocial factors and mental workload of nurses who work in intensive care units. It is hypothesised that nurses in these units could perceive psychosocial risks, manifesting in a high mental work load. The psychosocial dimension related to the position's cognitive demands is hypothesised to mostly explain mental work load. METHOD: Quantitative study, with a descriptive, cross-sectional, and comparative design. A total of 91% of the intensive care unit populations of three Chilean hospitals was surveyed, corresponding to 111 nurses. The instruments utilised included (A) a biosociodemographic history questionnaire; (b) the SUSESO-ISTAS 21 questionnaire; and (c) the Mental Work Load Subjective Scale (ESCAM, in Spanish). RESULTS: In total, 64% and 57% of participants perceived high levels of exposure to the psychosocial risks Psychosocial demands and Double shift, respectively. In addition, a medium-high level of overall mental load was observed. Positive and significant correlations between some of the SUSESO-ISTAS 21 and ESCAM dimensions were obtained. Using a regression analysis, it was determined that three dimensions of the psychosocial risk questionnaire helped to explain 38% of the overall mental load. CONCLUSION: Intensive care unit nurses felt that inadequate psychosocial factors and mental work overload existed in several of the tested dimensions. PMID:26039303

Psychosocial factors and mental work load: a reality perceived by nurses in intensive care units.

PubMed

Ceballos-Vásquez, Paula; Rolo-González, Gladys; Hérnandez-Fernaud, Estefanía; Díaz-Cabrera, Dolores; Paravic-Klijn, Tatiana; Burgos-Moreno, Mónica

2015-01-01

To analyse the perception of psychosocial factors and mental workload of nurses who work in intensive care units. It is hypothesised that nurses in these units could perceive psychosocial risks, manifesting in a high mental work load. The psychosocial dimension related to the position's cognitive demands is hypothesised to mostly explain mental work load. Quantitative study, with a descriptive, cross-sectional, and comparative design. A total of 91% of the intensive care unit populations of three Chilean hospitals was surveyed, corresponding to 111 nurses. The instruments utilised included (A) a biosociodemographic history questionnaire; (b) the SUSESO-ISTAS 21 questionnaire; and (c) the Mental Work Load Subjective Scale (ESCAM, in Spanish). In total, 64% and 57% of participants perceived high levels of exposure to the psychosocial risks Psychosocial demands and Double shift, respectively. In addition, a medium-high level of overall mental load was observed. Positive and significant correlations between some of the SUSESO-ISTAS 21 and ESCAM dimensions were obtained. Using a regression analysis, it was determined that three dimensions of the psychosocial risk questionnaire helped to explain 38% of the overall mental load. Intensive care unit nurses felt that inadequate psychosocial factors and mental work overload existed in several of the tested dimensions.

Why managers should care about fairness: the effects of aggregate justice perceptions on organizational outcomes.

PubMed

Simons, Tony; Roberson, Quinetta

2003-06-01

This work examines the aggregation of justice perceptions to the departmental level and the business-unit level, the impact of these aggregate perceptions on business-unit-level outcomes, and the usefulness of the distinction between procedural and interpersonal justice at different levels of analysis. Latent variables analyses of individual-level and department-level data from 4,539 employees in 783 departments at 97 hotel properties showed that the 2 justice types exercise unique paths of impact on employees' organizational commitment and thus on turnover intentions and discretionary service behavior. Business-unit-level analyses further demonstrate paths of association between aggregate justice perceptions, aggregate commitment levels, and the business-unit-level outcomes of employee turnover rates and customer satisfaction ratings.

The roles of unit leadership and nurse-physician collaboration on nursing turnover intention.

PubMed

Galletta, Maura; Portoghese, Igor; Battistelli, Adalgisa; Leiter, Michael P

2013-08-01

To report a study of the relationship between variables at the group and individual level with nurses' intention to leave their unit. Workplaces are collective environments where workers constantly interact with each other. The quality of working relationship employees develop at the unit-level influences both employee outcomes and unit performance by shaping employee attitudes. The study was a cross-sectional design with self-administered questionnaires. A questionnaire including measures of leader-member exchange and nurse-physician collaboration analysed at group-level and affective commitment and turnover intention analysed at individual level, was administered individually to 1018 nurses in five Italian hospitals. Data were collected in 2009. A total of 832 nurses (81·7% response rate) completed questionnaires. The results showed that affective commitment at individual level completely mediated the relationship between leader-member exchange at group-level and nursing turnover intention. Furthermore, the cross-level interaction was significant: at individual level, the nurses with high levels of individual affective commitment towards their unit showed low levels of turnover intention and this relationship was stronger when the nurse-physician collaboration at group-level was high. This study showed the importance for organizations to implement management practices that promote both high-quality nurse-supervisor and nurse-physician relationships, because they increase nurses' identification with their units. Individual affective commitment is an important quality for retaining a workforce and good nurses' relationship at group-level relationships with both supervisors and physicians are instrumental in developing identification with the work unit. Thus, the quality of relationship among staff members is an important factor in nurses' decision to leave. © 2012 Blackwell Publishing Ltd.

Organizational effects on patient satisfaction in hospital medical-surgical units.

PubMed

Bacon, Cynthia Thornton; Mark, Barbara

2009-05-01

The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients' satisfaction with nursing care in hospitals. Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. The data source for this study was the Outcomes Research in Nursing Administration Project, a multisite organizational study conducted to investigate relationships among nurse staffing, organizational context and structure, and patient outcomes. The sample for this study was 2,720 patients and 3,718 RNs in 286 medical-surgical units in 146 hospitals. Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status, and better symptom management were also associated with higher levels of patient satisfaction. Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses' work engagement and effective symptom management, are important influences on patient satisfaction.

[Prevention of ventilator-associated pneumonia: a comparison of level of knowledge in three critical care units].

PubMed

Pujante-Palazón, I; Rodríguez-Mondéjar, J J; Armero-Barranco, D; Sáez-Paredes, P

2016-01-01

To determine the level of knowledge of the prevention of ventilator-associated pneumonia guidelines of nurses working in three intensive care units (ICU) in 3 university hospitals in a Spanish region, and evaluate the relationship between this level of knowledge and years worked in the ICU. A descriptive, prospective, cross-sectional, multicentre study was conducted using a validated and reliable questionnaire, made up by 9 questions with closed answers drawn from the EVIDENCE study. A total of 98 questionnaires were collected from ICU nurses of the three university hospitals (A, B, and C) from January to April 2014. The sample from hospital A responded the most, in contrast with the sample from hospital B, which was the one with the less participation. The Pearson correlation was calculated in order to determine the relationship between nurse years worked in ICU and level of knowledge. Hospital A obtained in the best mean score in the questionnaire, 6.33 (SD 1.4) points, followed by hospital C with 6.21 (SD 1.4), and finally, the hospital B with 6.06 (SD 1.5) points. A p=.08 was obtained on relating years worked with the level of knowledge. The results showed a high level of knowledge compared other studies. There was a tendency between the years worked in the unit and the level of knowledge in ventilator-associated pneumonia prevention. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Linking hospital workers' organisational work environment to depressive symptoms: A mediating effect of effort-reward imbalance? The ORSOSA study.

PubMed

Jolivet, Anne; Caroly, Sandrine; Ehlinger, Virgine; Kelly-Irving, Michelle; Delpierre, Cyrille; Balducci, Franck; Sobaszek, Annie; De Gaudemaris, Régis; Lang, Thierry

2010-08-01

Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index - Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers' depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also have a longer-lasting impact than individual approaches. Copyright 2010 Elsevier Ltd. All rights reserved.

Career Readiness in the United States 2015. ACT Insights in Education and Work

ERIC Educational Resources Information Center

LeFebvre, Mary

2015-01-01

ACT has conducted over 20,000 job analyses for occupations across a diverse array of industries and occupations since 1993. This report highlights the levels of career readiness for various subgroups of ACT Work Keys® examinees in the United States and provides career readiness benchmarks for selected ACT WorkKeys cognitive skills by career…

Mission (IM) possible? Nurse civility in the NICU.

PubMed

Simons, Sherri Lee

2008-01-01

Nurses will work in a unit and choose to stay because they feel pride in their work and are respected. Eliminating horizontal hostility at the unit level begins with a commitment from the NICU's leadership. Establishing and maintaining an environment of civility is essential if the unit is to successfully recruit and maintain the best staff to care for the patients entrusted to it.

Estimating and preventing hospital internal turnover of newly licensed nurses: A panel survey.

PubMed

Kovner, Christine T; Djukic, Maja; Fatehi, Faridaben K; Fletcher, Jason; Jun, Jin; Brewer, Carol; Chacko, Thomas

2016-08-01

Registered nurse job turnover is an ongoing problem in the USA resulting in significant financial costs to both organizations and society. Most research has focused on organizational turnover with few studies about internal or unit-level turnover. Turnover of new nurses in hospitals has particular importance as almost 80% of new nurses work in hospitals and have higher turnover rates when compared to experienced nurses. This paper focuses on new nurses' unit-level turnover rates in hospitals. The purpose of this study is to: (1) identify factors that predict new nurses staying in the same units, positions, and job titles to inform unit-level retention strategies, and (2) examine the changes in work environment perceptions over time between nurses who remain in the same unit, position, and title to those who changed unit, position and/or title. A panel survey design was used to analyze changes over time. Participants were newly licensed registered nurses who were licensed for the first time between August 1st, 2004 and July 31st, 2005. The nurses came from metropolitan statistical areas or rural areas that were nested to reflect a nationally representative USA sample (58% response rate). The analytic sample for this study was 1335. Data were collected in January 2006 and 2007 following the Dillman total design approach. All potential respondents received paper surveys and non-responders received repeated mailings. Using multinomial regression the five variables with the largest effects on unit retention were (1) variety (positive), (2) having another job for pay (negative), (3) first basic degree (having a bachelors or higher degree increased the probability of staying), (4) negative affectivity (positive), and (5) job satisfaction (positive). Nurses who changed unit, and/or position, and/or title reported more positive change scores on a variety of work attitudes. Almost 30% of new nurses working in hospitals leave their unit, and/or position, and/or title during their first year of work. Our results point to the variables on which managers can focus to improve unit-level retention of new nurses. Although participants were from a nationally representative sample of nurses who were newly licensed in 2004-2005, with the geographical shifts in the USA population in the last 10 years the sample may not be geographically representative of new nurses who graduated in 2015. Copyright © 2016. Published by Elsevier Ltd.

Cross-boundary rotational working for neonatal nurses.

PubMed

Kane, Tina

2007-05-01

Neonatal services in England and Wales are undergoing significant changes as a result of technological advances as well as the development of new networks. These changes have had a dramatic effect on the neonatal workforce. The skills of the available staff govern the level of activity of neonatal units: many units have had to re-evaluate the services they can safely deliver with the available workforce. This has resulted in the re-configuration of some neonatal units and changes in the dependency levels of many. Units have had to undertake reviews of the patterns of working of their staff to ensure that a skilled and competent workforce is available to provide the level of care each neonatal service requires. Shortages in some areas have meant that units have had to find new ways to retain and update skilled staff. This article describes a rotational programme developed with the aim of providing a continued clinical development pathway for neonatal nursing staff. The programme incorporates competency assessments of emergency skills and clinical and technological advances in neonatal care.

A comparison of career satisfaction amongst dental healthcare professionals across three health care systems: Comparison of data from the United Kingdom, New Zealand and Trinidad & Tobago

PubMed Central

Naidu, Rahul; Newton, J Tim; Ayers, Katie

2006-01-01

Background The aim of this study was to compare the expressed levels of career satisfaction of three groups of comparable dental healthcare professionals, working in Trinidad, the United Kingdom and New Zealand. Methods Three questionnaire surveys were carried out of comparable dental healthcare professionals. Dental nurses in Trinidad and dental therapists in the UK and New Zealand. Questionnaires were sent to all registered dental nurses or dental therapists. Results Career satisfaction was lowest amongst Dental Therapists working in Trinidad and Tobago. Approximately 59% of the Therapists working in New Zealand reported stated that they felt they were not a valued member of the dental team, the corresponding proportion in the United Kingdom was 32%, and for Trinidad 39%. Conclusion Dental therapists working in different healthcare systems report different levels of satisfaction with their career. PMID:16536870

Social Policy in Social Work PhD Programs in the United States

ERIC Educational Resources Information Center

Lightfoot, Elizabeth; Gal, John; Weiss-Gal, Idit

2018-01-01

While there has been a long-standing concern about the role of policy within social work education and social work practice, most of the emphasis has been on social work education at the BSW and MSW levels. This article examines policy education at the PhD level. It first explores how policy is taught in social work PhD programs in the United…

Using evidence-based leadership initiatives to create a healthy nursing work environment.

PubMed

Nayback-Beebe, Ann M; Forsythe, Tanya; Funari, Tamara; Mayfield, Marie; Thoms, William; Smith, Kimberly K; Bradstreet, Harry; Scott, Pamela

2013-01-01

In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.

Differences in nursing practice environment among US acute care unit types: a descriptive study.

PubMed

Choi, JiSun; Boyle, Diane K

2014-11-01

The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered to achieve an excellent nursing practice environment in all hospital units. Copyright © 2014 Elsevier Ltd. All rights reserved.

Self-reported environmental health risks of nurses working in hospital surgical units.

PubMed

Azizoğlu, F; Köse, A; Gül, H

2018-06-21

This study investigated the occupational health risk factors among nurses who work in public hospital surgical units. Nursing has a significant place in healthcare systems around the world. Surgical units are environments with certain risks, especially because of the possibility of exposure to various chemical, biologic or physical hazards. This study was conducted with 229 nurses who were working in the 11 surgery units of a big university hospital. In this cross-sectional study, a personal information form and an occupational risk factors scale were administered to respondents. We performed factor and reliability analyses for the scale; the overall reliability of the 41 items was α = 0.924, and the factor analysis found the scale was feasible. Biologic and psychological risk factor levels were found to be high. Physical, chemical, ergonomic and radiation risk factor levels were moderate. The general occupational risk factor score was moderate. Nurses working night duty were confronted with physical and psychological risk factors at a higher rate compared with those working in the daytime. Reported occupational health problems by nurses were correlated with the descriptive properties of the nurses including age, sex, marital status, education level, working hours, mode of working and status of occupational health and safety training. Nurses experience different occupational risks. If these risks are identified, healthier working environments can be provided to the nurses by taking necessary precautions. The health care provided by nurses who work in a healthy environment would be more efficient and of better quality, which will result in better economic and social outcomes for individual and communities. © 2018 International Council of Nurses.

Environmental congruence and work-related stress in acute care hospital medical/surgical units: a descriptive, correlational study.

PubMed

Dendaas, Nancy

2011-01-01

To describe the degree to which Environmental Congruence (EC) is present in sampled units and considered important/desirable by staff RNs; staff RNs' reported level of work-related stress (WRS); the perceived contribution of the physical environment to WRS; and the relationship between existing levels of EC and WRS. Few studies have focused on how the physical environment might contribute to nurses' WRS and chronic nursing shortages. The construct of EC can be used, within a Person Environment (PE)-Fit framework, to assess the fit among nurses, nursing work, the physical work environment, and WRS. EC was measured using investigator-developed, literature/criterion-based survey instruments. Staff RNs reported WRS variables by using two single-item self-report measures. The final convenience sample consisted of 471 staff RNs from 39 medical/surgical units from 12 hospitals in the upper Midwest. Data were collected over a 7-month period. The mean level of existing EC in the sample was roughly 70% percent of highest capacity and that of important/desired EC in the sample was 93%. Staff RNs' mean level of WRS was 6.7; the mean contribution of the physical environment to WRS was 5.8. Moderate negative correlations were found between EC and WRS (r = -.41, p < .05), and between physical environment contribution to WRS and EC (r = -.55, p <.001). Staff RNs in the sampled units wanted a significantly higher level of EC. They rated their WRS moderately high and the contribution of the physical environment to it as moderate. A moderately negative relationship was found between EC and WRS. EC may be a useful construct in research that attempts to improve hospital nursing work environments.

Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees.

PubMed

Jensen, Johan Høy; Flachs, Esben Meulengracht; Skakon, Janne; Rod, Naja Hulvej; Bonde, Jens Peter

2018-05-14

We investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees. The study population comprised employees from the Capital Region of Denmark (n=14 388). Data on reorganisation at the work-unit level (merger, demerger, relocation, change of management, employee layoff or budget cut) between July and December 2013 were obtained via surveys distributed to the managers of each work unit. Individual-level data on work-unit exit, total and long-term sickness absence (≥29 days) in 2014 were obtained from company registries. For exposure to any, each type or number of reorganisations (1, 2 or ≥3), the HRs and 95% CIs for subsequent work-unit exit were estimated by Cox regression, and the risk for total and long-term sickness absence were estimated by zero-inflated Poisson regression. Reorganisation was associated with subsequent work-unit exit (HR 1.10, 95% CI 1.01 to 1.19) in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes (HR 1.52, 95% CI 1.30 to 1.79), merger (HR 1.29, 95% CI 1.12 to 1.49), demerger (HR 1.41, 95% CI 1.16 to 1.71) or change of management (HR 1.24, 95% CI 1.11 to 1.38). Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence (OR 1.15, 95% CI 1.00 to 1.33), which was particularly important for merger (OR 1.31, 95% CI 1.00 to 1.72) and employee layoff (OR 1.31, 95% CI 1.08 to 1.59). Specific types of reorganisation seem to have a dual impact on subsequent work-unit exit and sickness absence in the year after change. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Nurse Burnout and Patient Satisfaction

PubMed Central

Vahey, Doris C.; Aiken, Linda H.; Sloane, Douglas M.; Clarke, Sean P.; Vargas, Delfino

2010-01-01

Background Amid a national nurse shortage, there is growing concern that high levels of nurse burnout could adversely affect patient outcomes. Objectives This study examines the effect of the nurse work environment on nurse burnout, and the effects of the nurse work environment and nurse burnout on patients' satisfaction with their nursing care. Research Design/Subjects We conducted cross-sectional surveys of nurses (N = 820) and patients (N = 621) from 40 units in 20 urban hospitals across the United States. Measures Nurse surveys included measures of nurses' practice environments derived from the revised Nursing Work Index (NWI-R) and nurse outcomes measured by the Maslach Burnout Inventory (MBI) and intentions to leave. Patients were interviewed about their satisfaction with nursing care using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Results Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction. Conclusions Improvements in nurses' work environments in hospitals have the potential to simultaneously reduce nurses' high levels of job burnout and risk of turnover and increase patients' satisfaction with their care. PMID:14734943

Managing Highway Maintenance: Budget Preparation, Unit 9, Level 3.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit describes the essential steps in developing a maintenance budget, or performance budget, based on the work to be done. It is designed for field engineers and supervisors who assist department officials in preparing work programs and budgets. The format is a programed,…

Construction Cluster Volume II [Masonry Work].

ERIC Educational Resources Information Center

Pennsylvania State Dept. of Justice, Harrisburg. Bureau of Correction.

The document is the second of a series, to be integrated with a G.E.D. program, containing instructional materials at the basic skills level for the construction cluster. The volume focuses on masonry and consists of 20 instructional units which require a month of study. The units include: (1) historical aspects of masonry work and occupational…

Coordinating Units at the Candy Depot

ERIC Educational Resources Information Center

Norton, Anderson; Boyce, Steven; Hatch, Jennifer

2015-01-01

In general, units coordination refers to the relationships that students can maintain between various units when working within a numerical situation. It is critical that middle school students learn to coordinate three levels of units not only because of their importance in understanding fractions but also because of their implications for…

Shadows, An Environmental Investigation.

ERIC Educational Resources Information Center

National Wildlife Federation, Washington, DC.

This environmental unit is one of a series designed for integration within an existing curriculum. The units are self-contained and require minimal teacher preparation. The philosophy behind the units is based on an experience-oriented process that encourages self-paced independent work. This unit on shadows is designed for all elementary levels,…

Optimal maintenance policy incorporating system level and unit level for mechanical systems

NASA Astrophysics Data System (ADS)

Duan, Chaoqun; Deng, Chao; Wang, Bingran

2018-04-01

The study works on a multi-level maintenance policy combining system level and unit level under soft and hard failure modes. The system experiences system-level preventive maintenance (SLPM) when the conditional reliability of entire system exceeds SLPM threshold, and also undergoes a two-level maintenance for each single unit, which is initiated when a single unit exceeds its preventive maintenance (PM) threshold, and the other is performed simultaneously the moment when any unit is going for maintenance. The units experience both periodic inspections and aperiodic inspections provided by failures of hard-type units. To model the practical situations, two types of economic dependence have been taken into account, which are set-up cost dependence and maintenance expertise dependence due to the same technology and tool/equipment can be utilised. The optimisation problem is formulated and solved in a semi-Markov decision process framework. The objective is to find the optimal system-level threshold and unit-level thresholds by minimising the long-run expected average cost per unit time. A formula for the mean residual life is derived for the proposed multi-level maintenance policy. The method is illustrated by a real case study of feed subsystem from a boring machine, and a comparison with other policies demonstrates the effectiveness of our approach.

The working lives of nurse teachers in mainland China and the United Kingdom: a questionnaire survey.

PubMed

Gui, Li; Gu, Shen; Barriball, K Louise; While, Alison E; Chen, Guoliang

2014-05-01

Nurse education has undergone considerable changes creating new opportunities and challenges for nurse teachers. Limited comparative research of the working lives of nurse teachers has been reported, thus similarities and differences that may exist are unidentified. This paper reports a study of the working lives of nurse teachers in mainland China and the United Kingdom. A cross-sectional questionnaire survey. Census sample of nurse teachers working in four nursing schools in mainland China (n=3) and the United Kingdom (n=1). The overall response rate was 56.8% (China=61, 61.0%, UK=60, 53.1%). Completion of questionnaire specifically developed for the study but comprising six validated tools to collecting data on: job satisfaction, sense of coherence, role conflict and role ambiguity, work empowerment and professional identification. Data on self-reported roles and personal details were also collected. Data were collected between September 2008 and January 2009. Both samples were satisfied with their jobs overall but reported low levels of satisfaction with promotion. Chinese nurse teachers working full-time reported the lowest level for sense of coherence and professional identification. Nurse teachers working full-time in the United Kingdom reported the highest role conflict score. Sense of coherence and work empowerment were significantly and positively correlated to job satisfaction. Role conflict and role ambiguity were negatively correlated (but not always significantly) to job satisfaction and its facets. For respondents in mainland China, professional identification was significantly and positively correlated with overall job satisfaction and its facets. Strategies to improve job satisfaction with promotion opportunities for both samples are indicated. Respondents working full-time in both mainland China and the United Kingdom experienced greater challenges at work than their part-time colleagues. © 2013.

Workplace Determinants of Social Capital: Cross-Sectional and Longitudinal Evidence from a Finnish Cohort Study

PubMed Central

Oksanen, Tuula; Kawachi, Ichiro; Kouvonen, Anne; Takao, Soshi; Suzuki, Etsuji; Virtanen, Marianna; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2013-01-01

Objective To examine which contextual features of the workplace are associated with social capital. Methods This is a cohort study of 43,167 employees in 3090 Finnish public sector workplaces who responded to a survey of individual workplace social capital in 2000–02 (response rate 68%). We used ecometrics approach to estimate social capital of work units. Features of the workplace were work unit's demographic and employment patterns and size, obtained from employers' administrative records. We used multilevel-multinomial logistic regression models to examine cross-sectionally whether these features were associated with social capital between individuals and work units. Fixed effects models were used for longitudinal analyses in a subsample of 12,108 individuals to examine the effects of changes in workplace characteristics on changes in social capital between 2000 and 2004. Results After adjustment for individual characteristics, an increase in work unit size reduced the odds of high levels of individual workplace social capital (odds ratio 0.94, 95% confidence interval 0.91–0.98 per 30-person-year increase). A 20% increase in the proportion of manual and male employees reduced the odds of high levels of social capital by 8% and 23%, respectively. A 30% increase in temporary employees and a 20% increase in employee turnover were associated with 11% (95% confidence interval 1.04–1.17) and 24% (95% confidence interval 1.18–1.30) higher odds of having high levels of social capital respectively). Results from fixed effects models within individuals, adjusted for time-varying covariates, and from social capital of the work units yielded consistent results. Conclusions These findings suggest that workplace social capital is contextually patterned. Workplace demographic and employment patterns as well as the size of the work unit are important in understanding variations in workplace social capital between individuals and workplaces. PMID:23776555

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study.

PubMed

Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol

2016-06-01

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Development and Validation of A Scheduled Shifts Staffing (ASSiST) Measure of Unit-Level Staffing in Nursing Homes.

PubMed

Cummings, Greta G; Doupe, Malcolm; Ginsburg, Liane; McGregor, Margaret J; Norton, Peter G; Estabrooks, Carole A

2017-06-01

To (a) describe A Scheduled Shifts Staffing measure (ASSiST) to derive care aide worked hours per resident day (HCA WHRD) at facility and unit levels in nursing homes, (b) report reliability through comparisons to administrative staffing data; (c) report validity by examining associations between HCA WHRD, staff outcomes (job satisfaction, emotional exhaustion), and resident quality indicators (QIs) (e.g. falls, delirium, stage 2+ pressure ulcers), and (d) explore intrafacility variation in staffing intensity levels related to unit-level variation in resident and staff outcomes. We used data from 40 care units in 12 Canadian nursing homes between 2007 and 2012. Descriptive statistics and tests of association and difference described relationships of two measures of staffing with resident and staff outcomes. Annualized rates of HCA WHRD from both data sources compared well at the facility level (Pearson Product Correlation; R = 0.847, p < .001), and were correlated similarly to staff work life and many QIs. Using ASSiST data, we show that staffing levels can vary by up to 40% at the unit-level within nursing homes. ASSiST is easy to collect, more timely to retrieve than administrative data, has good criterion and construct validity, and reflects intrafacility variation in health care aide staffing levels. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Situational and dispositional influences on nurses' workplace well-being: the role of empowering unit leadership.

PubMed

Spence Laschinger, Heather K; Finegan, Joan; Wilk, Piotr

2011-01-01

Unit-level leadership and structural empowerment play key roles in creating healthy work environments, yet few researchers have examined these contextual effects on nurses' well-being. The aim of this study was to test a multilevel model of structural empowerment examining the effect of nursing unit leadership quality and structural empowerment on nurses' experiences of burnout and job satisfaction and to examine the effect of a personal dispositional variable, core self-evaluation, on these nurse experiences. Nurses (n = 3,156) from 217 hospital units returned surveys that included measures of leader-member exchange, structural empowerment, burnout, core self-evaluation, and job satisfaction. Multilevel structural equation modeling was used to test the model. Nurses' shared perceptions of leader-member exchange quality on their units positively influenced their shared perceptions of unit structural empowerment (Level 2), which resulted in significantly higher levels of individual nurse job satisfaction (Level 1). Unit-level leader-member exchange quality also directly influenced individual nurse job satisfaction. Unit leader-member exchange quality and structural empowerment influenced emotional exhaustion and cynicism differentially. Higher unit-level leader-member exchange quality was associated with lower cynicism; higher unit-level structural empowerment was associated with lower emotional exhaustion. At Level 1, higher core self-evaluation was associated with lower levels of both emotional exhaustion and cynicism, both of which were associated with lower job satisfaction. This study provides a theoretical understanding of how unit leadership affects both unit- and individual-level outcomes.

Organizational change, psychosocial work environment, and non-disability early retirement: a prospective study among senior public employees.

PubMed

Breinegaard, Nina; Jensen, Johan Høy; Bonde, Jens Peter

2017-05-01

Objective This study examines the impact of organizational change and psychosocial work environment on non-disability early retirement among senior public service employees. Methods In January and February 2011, Danish senior public service employees aged 58-64 years (N=3254) from the Capital Region of Denmark responded to a survey assessing psychosocial work environment (ie, social capital, organizational justice, and quality of management). Work-unit organizational changes (ie, change of management, merging, demerging, and relocation) were recorded from January 2009 to March 2011. Weekly data on non-disability early retirement transfer were obtained from the DREAM register database, which holds weekly information about all public benefit payments in Denmark. Hazard ratios (HR) for early retirement following employees' 60 th birthday were estimated with Cox regression adjusted for age, gender, and socioeconomic status. Results Exposure to change of management [HR 1.37, 95% confidence interval (95% CI) 1.13-1.66], mergers (HR 1.23, 95% CI 1.02-1.48), and relocation of work unit (HR 1.24, 95% CI 1.01-1.54) increased rate of non-disability early retirement, while demerging of work unit did not (HR 1.03, 95% CI 0.79-1.33). Work units with lower levels of social capital (HR 1.22, 95% CI 1.05-1.41), organizational justice, (HR 1.18, 95% CI 1.04-1.32), and quality of management (HR 1.14, 95% CI 1.02-1.25) increased rate of early retirement. Conclusion Organizational change and poor psychosocial work environment contribute to non-disability early retirement among senior public service employees, measured at work-unit level.

A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units.

PubMed

Carayon, Pascale; Gürses, Ayşe P

2005-10-01

In this paper, we review the literature on nursing workload in intensive care units (ICUs) and its impact on patient safety and quality of working life of nurses. We then propose a conceptual framework of ICU nursing workload that defines causes, consequences and outcomes of workload. We identified four levels of nursing workload (ICU/unit level, job level, patient level, and situation level), and discuss measures associated with each of the four levels. A micro-level approach to ICU nursing workload at the situation level is proposed and recommended in order to reduce workload and mitigate its negative impact. Performance obstacles are conceptualized as causes of ICU nursing workload at the situation level.

Industrial Work Experience I. Curriculum Guide. General Related Study Units.

ERIC Educational Resources Information Center

Virginia Polytechnic Inst. and State Univ., Blacksburg. Div. of Vocational-Technical Education.

The primary purpose of this guide is to present basic sample instructional materials for the Industrial Work Experience (IWE) Program. It is designed to aid those charged with local administration and coordination of programs in secondary level trade and industrial education, referred to as the IWE training program. The guide contains 10 units of…

Compared to Palliative Care, Working in Intensive Care More than Doubles the Chances of Burnout: Results from a Nationwide Comparative Study

PubMed Central

Teixeira, Carla Margarida; Carvalho, Ana Sofia; Hernández-Marrero, Pablo

2016-01-01

Introduction Professionals working in intensive and palliative care units, hence caring for patients at the end-of-life, are at risk of developing burnout. Workplace conditions are determinant factors to develop this syndrome among professionals providing end-of-life care. Objectives To identify and compare burnout levels between professionals working in intensive and palliative care units; and to assess which workplace experiences are associated with burnout. Methods A nationwide, multicentre quantitative comparative survey study was conducted in Portugal using the following instruments: Maslach Burnout Inventory–Human Services Survey, Questionnaire of workplace experiences and ethical decisions, and Questionnaire of socio-demographic and professional characteristics. A total of 355 professionals from 10 intensive care and 9 palliative care units participated in the survey. A series of univariate and multivariate logistic regression analyses were performed; odds ratio sidelong with 95% confidence intervals were calculated. Results 27% of the professionals exhibited burnout. This was more frequent in intensive care units (OR = 2.525, 95% CI: 1.025–6.221, p = .006). Univariate regression analyses showed that higher burnout levels were significantly associated with conflicts, decisions to withhold/withdraw treatment, and implementing palliative sedation. When controlling for socio-demographic and educational characteristics, and setting (intensive care units versus palliative care units), higher burnout levels were significantly and positively associated with experiencing conflicts in the workplace. Having post-graduate education in intensive/palliative care was significantly but inversely associated to higher burnout levels. Conclusions Compared to palliative care, working in intensive care units more than doubled the likelihood of exhibiting burnout. Experiencing conflicts (e.g., with patients and/or families, intra and/or inter-teams) was the most significant determinant of burnout and having post-graduate education in intensive/palliative care protected professionals from developing this syndrome. This highlights the need for promoting empowering workplace conditions, such as team empowerment and conflict management. Moreover, findings suggest the need for implementing quality improvement strategies and organizational redesign strategies aimed at integrating the philosophy, principles and practices of palliative care in intensive care units. PMID:27612293

Psychological and Social Work Factors as Predictors of Mental Distress and Positive Affect: A Prospective, Multilevel Study.

PubMed

Finne, Live Bakke; Christensen, Jan Olav; Knardahl, Stein

2016-01-01

Occupational health research has mainly addressed determinants of negative health effects, typically employing individual-level self-report data. The present study investigated individual- and department-level (means of each work unit) effects of psychological/social work factors on mental distress and positive affect. Employees were recruited from 63 Norwegian organizations, representing a wide variety of job types. A total of 4158 employees, in 918 departments, responded at baseline and at follow-up two years later. Multilevel linear regressions estimated individual- and department-level effects simultaneously, and accounted for clustering of data. Baseline exposures and average exposures over time ([T1+T2]/2) were tested. All work factors; decision control, role conflict, positive challenge, support from immediate superior, fair leadership, predictability during the next month, commitment to organization, rumors of change, human resource primacy, and social climate, were related to mental distress and positive affect at the individual and department level. However, analyses of baseline exposures adjusted for baseline outcome, demonstrated significant associations at the individual level only. Baseline "rumors of change" was related to mental distress only and baseline "predictability during the next month" was not a statistical significant predictor of either outcome when adjusted for outcome at baseline. Psychological and social work factors were generally related to mental distress and positive affect in a mirrored way. Impact of exposures seemed most pervasive at the individual level. However, department-level relations were also discovered. Supplementing individual-level measures with aggregated measures may increase understanding of working conditions influence on employees`health and well-being. Organizational improvements focusing on the work factors in the current study should be able to reduce distress and enhance positive affect. Furthermore, both targeting individual employees and redesigning working conditions at the work unit level seems important.

Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study.

PubMed

Vahedian-Azimi, Amir; Hajiesmaeili, Mohammadreza; Kangasniemi, Mari; Fornés-Vives, Joana; Hunsucker, Rita L; Rahimibashar, Farshid; Pourhoseingholi, Mohammad A; Farrokhvar, Leily; Miller, Andrew C

2017-01-01

Health care is a demanding field, with a high level of responsibility and exposure to emotional and physical danger. High levels of stress may result in depression, anxiety, burnout syndrome, and in extreme cases, post-traumatic stress disorder. The aim of this study was to determine which personal, professional, and organizational variables are associated with greater perceived stress among critical care nurses for purposes of developing integrative solutions to decrease stress in the future. We conducted a correlation research survey using a cross-sectional design and an in-person survey method. The questionnaire consisted of 2 parts: (1) socioeconomic, professional, and institutional variables and (2) work stressors. Surveys were conducted between January 1, 2011, and December 1, 2015. Multistage cluster random sampling was utilized for data collection. Inclusion criteria were (1) age ≥18 years, (2) registered nurse, (3) works in the intensive care unit (ICU), and (4) willing and able to complete the survey. We surveyed 21 767 ICU nurses in Iran and found that male sex, lower levels of peer collaboration, working with a supervisor in the unit, nurse-patient ratios, and working in a surgical ICU were positively associated with greater stress levels. Increasing age and married status were negatively associated with stress. Intensive care unit type (semi-closed vs open), ICU bed number, shift time, working on holidays, education level, and demographic factors including body mass index, and number of children were not significantly associated with stress levels. As the largest study of its kind, these findings support those found in various European, North, and South American studies. Efforts to decrease workplace stress of ICU nurses by focusing on facilitating peer collaboration, improving resource availability, and staffing ratios are likely to show the greatest impact on stress levels.

The HMI Report on Advanced Level Work in Business Education and Economics 1991.

ERIC Educational Resources Information Center

Butler, John

1992-01-01

Evaluates 1991 report of Her Majesty's Inspectorate (HMI) on advanced level work in business education and economics for levels 16-19 in United Kingdom. Discusses areas of improvement and specific examples of good practice identified by HMI. Reports HMI's desire for better, more formalized departmental organization and the need for more in-service…

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

Effect of stress management interventions on job stress among nurses working in critical care units.

PubMed

Light Irin, C; Bincy, R

2012-01-01

Stress in nurses affects their health and increases absenteeism, attrition rate, injury claims, infection rates and errors in treating patients. This in turn significantly increases the cost of employment in healthcare units. Proper management of stress ensures greater efficiency at work place and improved wellbeing of the employee. Therefore, a pre-experimental study was conducted among 30 Critical Care Unit nurses working inMedical College Hospital, Thiruvananthapuram, (Kerala) to assess the effect of stress management interventions such as Job Stress Awareness, Assertiveness Training, Time Management, andProgressive Muscle Relaxation on job stress. The results showed that caring for patients, general job requirements and workload were the major sources of stress for the nurses. The level of severe stress was reduced from 60 percent to 20 percent during post-test. The Stress Management Interventions were statistically effective in reducing the stress of nurses at p<0.001 level.

Stress, burnout, and job satisfaction in 470 health professionals in 98 apheresis units in Italy: A SIdEM collaborative study.

PubMed

Tremolada, Marta; Schiavo, Simone; Tison, Tiziana; Sormano, Emilia; De Silvestro, Giustina; Marson, Piero; Pierelli, Luca

2015-10-01

In Italian and international background, there are no studies focusing on stress, burnout indicators, and job satisfaction in health professionals working in the apheresis units. This study aims to fill this void both for scientific and clinical reasons. The participants were 470 health professionals (220 physicians, 250 nurses), mostly female (73.4%), with an average age of 48.09 (with the 5° percentile under 32 years and the 95° percentile over 60), working in the Apheresis Units in the North (228), in the Center (131) and in the Southern-islands of Italy (111). The health professionals' years on the job were principally between one and 10 years (40.2%) or from 11 to 20 years (33.2%). The prevalent activity was therapeutic apheresis (48.5%). The self-report questionnaires were proposed electronically by a protected online site. Important stress levels were identified in the health professionals. Physicians principally showed medium (47.5%) and high (35.8%) stress levels. Stress levels of nurses were mostly low (57.7%) or medium (25.7%). Female gender in nurses [t(268) = -3.29; P = 0.001] and in physician professions [t(217) = -3.01; P = 0.03] was a risk factor for stress. Both job categories were placed at a high risk level for burnout syndrome comparing with normative scales, especially the health professionals working in the center of Italy for the scales "Emotional exhaustion" [F(2) = 4.39; P = 0.013] and "Professional inefficacy" [F(2) = 4.38; P = 0.013]. Health professionals working in the apheresis unit show high stress levels and burnout risk. New preventive programs and specific clinical interventions should be constructed. © 2015 Wiley Periodicals, Inc.

Managing Highway Maintenance: Standards for Maintenance Work, Part 2, Unit 8, Level 2.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit describes the ways maintenance standards are developed and some of the factors which are considered in setting standards; the preceding unit on standards (part 1) should be completed before reading this unit. The format is a programed, self-instruction approach in which…

Nuffield Foundation 'Resources for Learning' Project. A Multi-Media Programmed Approach to Environmental Studies.

ERIC Educational Resources Information Center

Kefford, Colin W.

This description of a unit for teaching about the environment at the junior high level is an experimental study. The focus of the program is the integration of several media; films and tapes play a large role in the unit. Students perform a combination of classroom work, field work, and simulated exercises; assessment procedures are described.…

Stress Levels of Nurses in Oncology Outpatient Units.

PubMed

Ko, Woonhwa; Kiser-Larson, Norma

2016-04-01

Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.

Nurse work environment and quality of care by unit types: A cross-sectional study.

PubMed

Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E

2015-10-01

Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit type differences exist in the overall quality of care as well as achievement in improving quality of care. The low rates of nurses reporting improvement in the quality of nursing care to patients suggest that further interventions focusing at the unit-level are needed for achieving high care quality. Findings from our study also suggest that improving nurse work environments can be an effective strategy to improve quality of care. Copyright © 2015 Elsevier Ltd. All rights reserved.

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

Work stress of primary care physicians in the US, UK and German health care systems.

PubMed

Siegrist, Johannes; Shackelton, Rebecca; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-07-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.

Work stress of primary care physicians in the US, UK and German health care systems

PubMed Central

Siegrist, Johannes; Link, Carol; Marceau, Lisa; von dem Knesebeck, Olaf; McKinlay, John

2010-01-01

Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005–2007. Results demonstrate country-specific differences in work stress- with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. PMID:20494505

Attention to change: A multilevel theory on the process of emergent continuous organizational change.

PubMed

Wee, Elijah X M; Taylor, M Susan

2018-01-01

Increasingly, continuous organizational change is viewed as the new reality for organizations and their members. However, this model of organizational change, which is usually characterized by ongoing, cumulative, and substantive change from the bottom up, remains underexplored in the literature. Taking a multilevel approach, the authors develop a theoretical model to explain the mechanisms behind the amplification and accumulation of valuable, ongoing work-unit level changes over time, which then become substantial changes at the organizational level. Drawing on the concept of emergence, they first focus on the cognitive search mechanisms of work-unit members and managers to illustrate how work-unit level routine changes may be amplified to the organization through 2 unique processes: composition and compilation emergence. The authors then discuss the managers' role in creating a sense of coherence and meaning for the accumulation of these emergent changes over time. They conclude this research by discussing the theoretical implications of their model for the existing literature of organizational change. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Level of burnout in a small population of Australian midwives.

PubMed

Jordan, Kayleen; Fenwick, Jennifer; Slavin, Valerie; Sidebotham, Mary; Gamble, Jenny

2013-06-01

The aim of the study was to describe the level of burnout in midwives working at a maternity unit in South East Queensland, Australia. A self-administered questionnaire was distributed to all registered midwives (N=110) working at the study site during November 2011. The questionnaire included a demographic survey and the Copenhagen Burnout Inventory. Fifty-eight (52.7%) staff completed the package. Data was entered into SPSS database version 19 and descriptive statistics were used to determine means, ranges and frequencies. Almost 30% of the sample experienced moderate to high levels of burnout some 50% of participants scored moderate to high for personal burnout with a similar number scoring high for work-related burnout. In comparison, burnout related to working with clients was very low. Differences between participants were associated with years of experience, area of work and employment position (FT/PT, level of position and work area). Participants aged 35years or younger and with less than 10years midwifery experience scored highest on the personal and work-related domains whereas participants over 35years scored highest within the client-related domain. Midwives at level 1 (lowest pay group) scored highest for work-related burnout and client-related burnout. Midwives in more senior positions (level 2 and above) scored highest for personal burnout. Personal and work-related burnout was high in this group of midwives while burnout related to caring for women was low. These results provide insight into the emotional health of midwives in one maternity unit. While more work is needed, strategies to decrease and/or prevent burnout may include clinical mentorship and reorganising models of maternity care to increase work satisfaction and autonomy and strengthen relationships between midwives and women. Copyright © 2013 Australian College of Midwives. All rights reserved.

In the Middle: Work-Life Integration Experiences of Mid-Level Women Leaders in a Rural Community College System in the Northeastern United States

ERIC Educational Resources Information Center

McGill-O'Rourke, Andrea

2012-01-01

Research indicates that work-life integration is linked with career satisfaction for women administrators in higher education. This study focuses on mid-level women leaders who are an essential component of higher education organizations. Employing a qualitative design that drew upon phenomenological methods, I explored the work-life integration…

Work engagement as a key driver of quality of care: a study with midwives.

PubMed

Freeney, Yseult; Fellenz, Martin R

2013-01-01

Against a backdrop of increased work intensification within maternity hospitals, the purpose of this paper is to examine the role of work engagement in the quality of care delivered to patients and in general health of the midwives delivering care, as reported by midwives and nurses. Quantitative questionnaires consisting of standardised measures were distributed to midwives in two large maternity hospitals. These questionnaires assessed levels of work engagement, supervisor and colleague support, general health and quality of care. Structural equation modelling analysis revealed a best-fit model that demonstrated work engagement to be a significant partial mediator between organisational and supervisor support and quality of care, and as a significant predictor of self-reported general health. Together, supervisor support, social support and organisational resources, mediated by work engagement, explained 38 per cent of the variance in quality of care at the unit level and 23 per cent of variance in general health among midwives (chi2(67) = 113; p < 0.01, CFI = 0.961, RMSEA = 0.06). The study is limited in that it uses self-report measures of quality of care and lacks objective indicators of patient outcomes. The cross-sectional design also does not allow for causal inferences to be drawn from the data. This study provides evidence for the links between individual levels of work engagement and both health and self-reports of unit level quality of care. The results support the importance of health services organisations and managers deploying organisational resources to foster employee work engagement. The results also highlight the significant role of the immediate nurse manager and suggest training and development for such roles is a valuable investment. These results are the first to link work engagement and performance in health care contexts and point to the value of work engagement for both unit performance and for individual employee well-being in health organisations.

Independent Learning Project for Advanced Chemistry (ILPAC). Teachers' and Technicians' Notes for First Year Units.

ERIC Educational Resources Information Center

Inner London Education Authority (England).

The Independent Learning Project for Advanced Chemistry (ILPAC) has produced units of study for students in A-level chemistry. Students completing ILPAC units assume a greater responsibility for their own learning and can work, to some extent, at their own pace. By providing guidance, and detailed solutions to exercises in the units, supported by…

Preparedness of International Students from the British Bologna Process Degree for the Completion of a Master of Science Degree in the United States

ERIC Educational Resources Information Center

Heaster, Dwight W.

2010-01-01

The study evaluated the impact the Bologna (3-year European) degrees have had on graduate international students enrolled in a private university in the United States. The evaluation focused on the students' preparedness for graduate level work. The research involved the graduate faculty who had experience working with the international graduate…

The Lack of Common Goals and Communication Within a Level I Trauma System: Assessing the Silo Effect Among Trauma Center Employees.

PubMed

Mace-Vadjunec, Daneen; Hileman, Barbara M; Melnykovich, M Ben; Hanes, Marina C; Chance, Elisha A; Emerick, Eric S

2015-01-01

We assessed our level I trauma center's employees' perception of inter- and intradepartmental relationships to determine whether employees who work less often with patients feel less involved-the silo effect. We prospectively evaluated employees who provide direct patient care using the Trauma System Survey tool. Of 1155 employees, 699 responded. Combined interdepartmental relationships showed that 93% believed their unit communicated well with other units, and 86% thought other units communicated well with their unit. However, 69% experienced miscommunication between units. To reduce silos, communication is key. Training and multiunit events may help reduce these silos further.

Comparison of Reasons for Nurse Turnover in Magnet® and Non-Magnet Hospitals.

PubMed

Park, Shin Hye; Gass, Stephanie; Boyle, Diane K

2016-05-01

The aim of this study is to compare rates and reasons for registered nurse (RN) turnover by Magnet® status. Although lower RN turnover rates in Magnet hospitals have been documented well in the literature, little is known about specific separation reasons for RN turnover and whether the reasons differ between Magnet and non-Magnet hospitals. This descriptive, correlational study analyzed unit-level 2013 National Database of Nursing Quality Indicators® turnover data (2,958 units; 497 hospitals). Poisson regression and Wilcoxon-Mann-Whitney test were used. Registered nurse turnover due to environment-related reasons was higher on units in non-Magnet hospitals than units in Magnet hospitals. Units in non-Magnet hospitals had 4.684 times higher turnover rates due to staffing/workload and 1.439 times higher rates due to work schedules than did units in Magnet hospitals. Nursing administrators in both Magnet and non-Magnet hospitals need to continually strive to improve unit work environments, particularly staffing and workload conditions and work scheduling.

Developing nurse and physician questionnaires to assess primary work areas in intensive care units.

PubMed

Rashid, Mahbub; Boyle, Diane K; Crosser, Michael

2014-01-01

The objective of the study was to develop instruments for describing and assessing some aspects of design of the primary work areas of nurses and physicians in intensive care units (ICUs). Separate questionnaires for ICU physicians and nurses were developed. Items related to individual- and unit-level design features of the primary work areas of nurses and physicians were organized using constructs found in the literature. Items related to staff satisfaction and staff use of time in relation to primary work area design were also included. All items and constructs were reviewed by experts for content validity and were modified as needed before use. The final questionnaires were administered to a convenience sample of 4 ICUs in 2 large urban hospitals. A total of 55 nurses and 29 physicians completed the survey. The Cronbach α was used to measure internal consistency, and factor analysis was used to provide construct-related validity. Convergent and discriminant validity were assessed through examining bivariate correlations between relevant scales/items. Analysis of variance was used to identify whether the between-group member responses were significant among the 4 units. The Cronbach α values for all except 3 preliminary scales indicated acceptable reliability. Factor analysis indicated that some preliminary scales could be partitioned into subscales for finer descriptions of the primary work areas. Correlational analysis provided strong evidence of convergent and discriminant validity of all the scales and subscales. The significance level of F-statistics showed that the units were significantly different from each other, providing evidence of more between-unit variance than within-unit variance. Therefore, the questionnaires developed in the study offer a promising departure point for rigorous description and evaluation of the primary work areas in relation to staff satisfaction and use of time in ICUs at a time when the importance of such studies is growing.

Is organizational justice climate at the workplace associated with individual-level quality of care and organizational affective commitment? A multi-level, cross-sectional study on dentistry in Sweden.

PubMed

Berthelsen, Hanne; Conway, Paul Maurice; Clausen, Thomas

2018-02-01

The aim of this study is to investigate whether organizational justice climate at the workplace level is associated with individual staff members' perceptions of care quality and affective commitment to the workplace. The study adopts a cross-sectional multi-level design. Data were collected using an electronic survey and a response rate of 75% was obtained. Organizational justice climate and affective commitment to the workplace were measured by items from Copenhagen Psychosocial Questionnaire and quality of care by three self-developed items. Non-managerial staff working at dental clinics with at least five respondents (n = 900 from 68 units) was included in analyses. A set of Level-2 random intercept models were built to predict individual-level organizational affective commitment and perceived quality of care from unit-level organizational justice climate, controlling for potential confounding by group size, gender, age, and occupation. The results of the empty model showed substantial between-unit variation for both affective commitment (ICC-1 = 0.17) and quality of care (ICC-1 = 0.12). The overall results showed that the shared perception of organizational justice climate at the clinical unit level was significantly associated with perceived quality of care and affective commitment to the organization (p < 0.001). Organizational justice climate at work unit level explained all variation in affective commitment among dental clinics and was associated with both the individual staff members' affective commitment and perceived quality of care. These findings suggest a potential for that addressing organizational justice climate may be a way to promote quality of care and enhancing affective commitment. However, longitudinal studies are needed to support causality in the examined relationships. Intervention research is also recommended to probe the effectiveness of actions increasing unit-level organizational justice climate and test their impact on quality of care and affective commitment.

Plated wire random access memories

NASA Technical Reports Server (NTRS)

Gouldin, L. D.

1975-01-01

A program was conducted to construct 4096-work by 18-bit random access, NDRO-plated wire memory units. The memory units were subjected to comprehensive functional and environmental tests at the end-item level to verify comformance with the specified requirements. A technical description of the unit is given, along with acceptance test data sheets.

[A cross-level analysis of the links between service quality and disconfirmation of expectations and customer satisfaction].

PubMed

Sánchez-Hernández, Rosa M; Martínez-Tur, Vicente; González-Morales, M Gloria; Ramos, José; Peiró, José M

2009-08-01

This article examines links between disconfirmation of expectations and functional and relational service quality perceived by employees and customer satisfaction. A total of 156 employees, who were working in 52 work units, participated in the research study. In addition, 517 customers who were assisted by these work units were surveyed. Using a cross-level approach, we used a random coefficient model to test the aforementioned relationships. A strong relationship between disconfirmation of expectations and customer satisfaction was observed. Also, the results confirmed that functional service quality maintains an additional and significant association with customer satisfaction. In contrast, there were no significant relationships between relational service quality and customer satisfaction. The article concludes with a discussion of these results.

The relationship between safety climate and recent accidents: behavioral learning and cognitive attributions.

PubMed

Desai, Vinit M; Roberts, Karlene H; Ciavarelli, Anthony P

2006-01-01

The association between accidents and subsequent work unit safety perceptions was assessed to address cognitive and behavioral changes following accidents. Many studies attempt to predict accident rates using measures of work unit safety, but effects vary considerably. Conversely, this study examined whether recent accidents may be positively associated with work unit safety perceptions, as suggested by behavioral learning mechanisms (increases in safety investments following accidents) or cognitive mechanisms (defensive attributions regarding accident causality). Lagged squadron-level accident experience was correlated with work unit safety perceptions obtained through a 61-question safety climate survey administered to 6,361 individuals in U.S. Navy flight squadrons. Positive associations between minor or intermediately severe accidents and future safety climate scores were found, although no effect was found for major accidents. We suggest that accident history should be considered when examining work unit safety perceptions because recent accidents may be associated with higher safety climate scores. We did not find that this varies systematically with accident severity, and longitudinal research on additional samples is needed to further test this possibility. This research may be used to refine measurement of work unit safety and to examine impacts of accidents or safety violations on workers' cognitive processes and group behavioral changes.

Psychological and Social Work Factors as Predictors of Mental Distress and Positive Affect: A Prospective, Multilevel Study

PubMed Central

Finne, Live Bakke; Christensen, Jan Olav; Knardahl, Stein

2016-01-01

Occupational health research has mainly addressed determinants of negative health effects, typically employing individual-level self-report data. The present study investigated individual- and department-level (means of each work unit) effects of psychological/social work factors on mental distress and positive affect. Employees were recruited from 63 Norwegian organizations, representing a wide variety of job types. A total of 4158 employees, in 918 departments, responded at baseline and at follow-up two years later. Multilevel linear regressions estimated individual- and department-level effects simultaneously, and accounted for clustering of data. Baseline exposures and average exposures over time ([T1+T2]/2) were tested. All work factors; decision control, role conflict, positive challenge, support from immediate superior, fair leadership, predictability during the next month, commitment to organization, rumors of change, human resource primacy, and social climate, were related to mental distress and positive affect at the individual and department level. However, analyses of baseline exposures adjusted for baseline outcome, demonstrated significant associations at the individual level only. Baseline “rumors of change” was related to mental distress only and baseline “predictability during the next month” was not a statistical significant predictor of either outcome when adjusted for outcome at baseline. Psychological and social work factors were generally related to mental distress and positive affect in a mirrored way. Impact of exposures seemed most pervasive at the individual level. However, department-level relations were also discovered. Supplementing individual-level measures with aggregated measures may increase understanding of working conditions influence on employees`health and well-being. Organizational improvements focusing on the work factors in the current study should be able to reduce distress and enhance positive affect. Furthermore, both targeting individual employees and redesigning working conditions at the work unit level seems important. PMID:27010369

Characteristics of unit-level patient safety culture in hospitals in Japan: a cross-sectional study.

PubMed

Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

2014-10-22

Patient safety culture (PSC) has an important role in determining safety and quality in healthcare. Currently, little is known about the status of unit-level PSC in hospitals in Japan. To develop appropriate strategies, characteristics of unit-level PSC should be investigated. Work units may be classified according to the characteristics of PSC, and common problems and appropriate strategies may be identified for each work unit category. This study aimed to clarify the characteristics of unit-level PSC in hospitals in Japan. In 2012, a cross-sectional study was conducted at 18 hospitals in Japan. The Hospital Survey on Patient Safety Culture questionnaire, developed by the United States Agency for Healthcare Research and Quality, was distributed to all healthcare workers (n =12,076). Percent positive scores for 12 PSC sub-dimensions were calculated for each unit, and cluster analysis was used to categorise the units according to the percent positive scores. A generalised linear mixed model (GLMM) was used to analyse the results of the cluster analysis, and odds ratios (ORs) for categorisation as high-PSC units were calculated for each unit type. A total of 9,124 respondents (75.6%) completed the questionnaire, and valid data from 8,700 respondents (72.0%) were analysed. There were 440 units in the 18 hospitals. According to the percent positive scores for the 12 sub-dimensions, the 440 units were classified into 2 clusters: high-PSC units (n =184) and low-PSC units (n =256). Percent positive scores for all PSC sub-dimensions for high-PSC units were significantly higher than those for low-PSC units. The GLMM revealed that the combined unit type of 'Obstetrics and gynaecology ward, perinatal ward or neonatal intensive care unit' was significantly more likely to be categorised as high-PSC units (OR =9.7), and 'Long-term care ward' (OR =0.2), 'Rehabilitation unit' (OR =0.2) and 'Administration unit' (OR =0.3) were significantly less likely to be categorised as high-PSC units. Our study findings demonstrate that PSC varies considerably among different unit types in hospitals in Japan. Factors contributing to low PSC should be identified and possible measures for improving PSC should be developed and initiated.

10 CFR 35.690 - Training for use of remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2010 CFR

2010-01-01

... measurement of radioactivity; and (D) Radiation biology; and (ii) 500 hours of work experience, under the... section, and has achieved a level of competency sufficient to function independently as an authorized user...

Mexican American Social Workers' Perceptions of Doctoral Education and Academia

ERIC Educational Resources Information Center

Tijerina, Mary; Deepak, Anne C.

2014-01-01

An increase in Latinos in the social work academy is critical due to current underrepresentation in social work education programs and rapid Latino population growth in the United States. In this qualitative study, perceptions of Mexican American master's of social work-level practitioners regarding social work doctoral education and academia were…

3 CFR 8886 - Proclamation 8886 of October 9, 2012. 50th Anniversary of the Office of the United States Trade...

Code of Federal Regulations, 2013 CFR

2013-01-01

... the United States Trade RepresentativeBy the President of the United States of America A Proclamation... jobs right here at home. Throughout its history, USTR has worked to level the playing field for... has supported America's commitment to market-based competition and innovation, helping draw good jobs...

Health care work environments, employee satisfaction, and patient safety: Care provider perspectives.

PubMed

Rathert, Cheryl; May, Douglas R

2007-01-01

Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction. The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors. We examined perceptions of nurses from three acute care hospitals in the eastern United States. Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units. Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.

Psychometric evaluation of a short measure of social capital at work.

PubMed

Kouvonen, Anne; Kivimäki, Mika; Vahtera, Jussi; Oksanen, Tuula; Elovainio, Marko; Cox, Tom; Virtanen, Marianna; Pentti, Jaana; Cox, Sara J; Wilkinson, Richard G

2006-10-13

Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work. Data were derived from the Finnish Public Sector Study (N = 48,592) collected in 2000-2002. Based on face validity, an expert unfamiliar with the data selected 8 questionnaire items from the available items for a scale of social capital. Reliability analysis included tests of internal consistency, item-total correlations, and within-unit (interrater) agreement by rwg index. The associations with theoretically related and unrelated constructs were examined to assess convergent and divergent validity (construct validity). Criterion-related validity was explored with respect to self-rated health using multilevel logistic regression models. The effects of individual level and work unit level social capital were modelled on self-rated health. The internal consistency of the scale was good (Cronbach's alpha = 0.88). The rwg index was 0.88, which indicates a significant within-unit agreement. The scale was associated with, but not redundant to, conceptually close constructs such as procedural justice, job control, and effort-reward imbalance. Its associations with conceptually more distant concepts, such as trait anxiety and magnitude of change in work, were weaker. In multilevel models, significantly elevated age adjusted odds ratios (ORs) of poor self-rated health (OR = 2.42, 95% confidence interval (CI): 2.24-2.61 for the women and OR = 2.99, 95% CI: 2.56-3.50 for the men) were observed for the employees in the lowest vs. highest quartile of individual level social capital. In addition, low social capital at the work unit level was associated with a higher likelihood of poor self-rated health. Psychometric techniques show our 8-item measure of social capital to be a valid tool reflecting the construct and displaying the postulated links with other variables.

Making a Laser Level

ERIC Educational Resources Information Center

Hawkins, Harry

2004-01-01

This article describes how to construct a laser level. This laser level can be made using a typical 4' (or shorter) bubble level and a small laser point. The laser unit is detachable, so the bubble level can also be used in the conventional way. However, the laser level works better than a simple bubble level. Making this inexpensive device is an…

Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

PubMed

Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

2015-05-03

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

Flattening the organization: implementing self-directed work groups.

PubMed

Brandon, G M

1996-01-01

In response to tremendous growth of managed care and threats to financial stability and job security, the Greater Baltimore Medical Center (GBMC) restructured itself into independent business units. The radiology department at GBMC resolved to reduce cost per unit-of-service, improve service, determine optimal staffing levels and reduce the number of layers of organization. It was decided to achieve those goals by implementing self-directed work groups. Staff buy-in was critical to success of the project. To begin, the staff was educated intensively about current trends in healthcare, managed care and potential changes in the job market. The radiology department was allowed to reduce the size of its staff through attrition and worked hard to focus staff concern on the impact each individual could have on the bottom line and the resultant effect on job security. Self-directed work groups were designed on a matrix that used small "service teams" in combinations to form larger "work groups." Actual work and daily activities occur at the service team level; information exchange and major decisions occue at the work group level. Seventeen months after beginning the project and 10 months after implementation, the organization has flattened, staff members have adjusted well to new roles, there have been no lay-offs, and the matrix system of small and large groups have proved particularly valuable.

Improving Community-Based Youth Work: Evaluation of an Action Research Approach

ERIC Educational Resources Information Center

VeLure Roholt, Ross; Rana, Sheetal

2011-01-01

Few formal post-secondary educational programs in the United States focus on youth work, thus youth workers often enter the field with diverse backgrounds and varying levels of experience working with youth. Drawing on mounting evidence that quality youth service requires skilled staff, professional-development opportunities have received…

Moral distress among nurses in medical, surgical and intensive-care units.

PubMed

Lusignani, Maura; Giannì, Maria Lorella; Re, Luca Giuseppe; Buffon, Maria Luisa

2017-09-01

To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used. The highest level of moral distress was associated with the provision of treatments and aggressive care that were not expected to benefit the patients and the competency of the health-care providers. Multivariate regression showed that nurses working in medical settings, nurses with lower levels of experience working in medical, surgical or intensive care settings, and nurses who intend to leave their job experienced the highest levels of moral distress. The present study indicates that nurses experience an overall moderate level of moral distress. Gaining further insight into the issue of moral distress among nurses and the clinical situations that most frequently cause this distress will enable development of strategies to reduce moral distress and to improve nurse satisfaction and, consequently, patient care. © 2016 John Wiley & Sons Ltd.

The Sexual Harassment-Suicide Connection in the U.S. Military: Contextual Effects of Hostile Work Environment and Trusted Unit Leaders.

PubMed

Griffith, James

2017-10-03

Sexual harassment has been associated with suicidal behaviors, and with the rise in suicides in the U.S. military, sexual harassment's role in suicide has been of growing interest. Lacking are studies that examine group- or unit-level variables in the relationship of sexual harassment to suicidal behaviors (thoughts, plans, and attempts). In this study, survey data from soldiers (12,567 soldiers in 180 company-sized units) who completed the Unit Risk Inventory administered during calendar year 2010 were analyzed using hierarchical linear modeling. At the individual level, sexual harassment was associated with a fivefold increase for risk of suicide. Reporting that leaders could be trusted was associated with a decreased suicide risk by about one-third. There was no statistically significant interaction between sexual harassment and trusted leaders in predicting the suicidal behaviors. At the group level, units or companies having higher levels of sexual harassment also had soldiers three times more at risk for suicide. A cross-leveling effect was also observed: Among units having higher levels of sexual harassment, the negative correlation (buffering effect of unit leaders on suicidal behaviors) was diminished. Implications of findings for preventing sexual harassment and suicide risk are discussed. © 2017 The American Association of Suicidology.

Staff working in hospital units with greater social capital experience less work-home conflict: Secondary analysis of a cross-sectional study.

PubMed

Nitzsche, Anika; Kuntz, Ludwig; Miedaner, Felix

2017-10-01

When the interplay between work and private life does not function correctly (work-home conflict), this constitutes a well-known risk factor for poorer health, increased absenteeism and lower work performance. Information about influencing factors of work-home conflict is therefore indispensable in order to avoid it. In this study, we analyse whether a good working atmosphere that fosters mutual trust, support and a 'sense of unity' (organizational social capital) can reduce an employee's conflict between work and private life. This study investigates the link between organizational social capital and work-home conflict in health professionals. This issue was investigated using a cross-sectional study conducted in 2013. Data from questionnaires completed by physicians and nurses (n=1733) were linked with structural data from 66 neonatal intensive care units in Germany. Using multi-level analyses, we investigated associations between organizational social capital at the ward level and work-home conflict at the level of individual employees, taking into account additional structural and individual characteristics. Employees on wards with greater social capital reported significantly less work-home conflict. Our results support the hypothesis that organizational social capital is an important collective resource. As such, more attention should be given to establishing a good working atmosphere that fosters mutual trust, support and a 'sense of unity', and this should be encouraged in a targeted fashion. Copyright © 2017 Elsevier Ltd. All rights reserved.

24 CFR 880.207 - Property standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... State and local laws, codes, ordinances and regulations. (g) Smoke detectors—(1) Performance requirement... smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system, designed for hearing-impaired persons...

24 CFR 880.207 - Property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... State and local laws, codes, ordinances and regulations. (g) Smoke detectors—(1) Performance requirement... smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system, designed for hearing-impaired persons...

24 CFR 880.207 - Property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... State and local laws, codes, ordinances and regulations. (g) Smoke detectors—(1) Performance requirement... smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system, designed for hearing-impaired persons...

24 CFR 880.207 - Property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... State and local laws, codes, ordinances and regulations. (g) Smoke detectors—(1) Performance requirement... smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system, designed for hearing-impaired persons...

24 CFR 880.207 - Property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... State and local laws, codes, ordinances and regulations. (g) Smoke detectors—(1) Performance requirement... smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system, designed for hearing-impaired persons...

Careers (A Course of Study). Unit IV: Applying for the Job.

ERIC Educational Resources Information Center

Turley, Kay

Designed to enable special needs students to write resumes and complete application forms with employable accuracy, this set of activities on applying for a job is the fourth unit in a nine-unit secondary level careers course intended to provide handicapped students with the knowledge and tools necessary to succeed in the world of work. Chapter 1…

Careers (A Course of Study). Unit VI: Interviewing for the Job.

ERIC Educational Resources Information Center

Turley, Kay

Designed to enable special needs students to arrange, complete, and follow up a job interview, this set of activities on job interviews is the sixth unit in a nine-unit secondary level careers course intended to provide handicapped students with the knowledge and tools necessary to succeed in the world of work. The eight activities in the first…

Team behavioral norms: a shared vision for a healthy patient care workplace.

PubMed

Parsons, Mickey L; Clark, Paul; Marshall, Michelle; Cornett, Patricia A

2007-01-01

Leaders are bombarded with healthy workplace articles and advice. This article outlines a strategy for laying the foundation for healthy patient care workplaces at the pivotal unit level. This process facilitates the nursing unit staff to create and implement a shared vision for staff working relationships. Fourteen acute care hospital units, all participants in a healthy workplace intervention, were selected for this analysis because they chose team behavioral norms as a top priority to begin to implement their vision for a desired future for their units, a healthy workplace. These units developed specific team behavioral norms for their expectations of each other. The findings revealed 3 major norm themes and attributes: norms for effective communication, positive attitude, and accountability. Attributes of each norm are described to assist nurses to positively influence their core unit work culture.

Job satisfaction of neonatal intensive care nurses.

PubMed

McDonald, Katie; Rubarth, Lori Baas; Miers, Linda J

2012-08-01

The purpose of this study was to describe the job satisfaction of neonatal intensive care unit (NICU) nurses in the Midwestern United States. The factors explored in job satisfaction were monetary compensation (pay), job stress, caring for patients in stressful situations, level of autonomy, organizational support, level of knowledge of the specialty, work environment, staffing levels, communication with physicians, communication with neonatal nurse practitioners, interdisciplinary communication, team spirit, and the amount of required "floating" to other nursing units. Participants were 109 NICU nurses working as either staff nurses (n = 72) or advanced practice nurses (n = 37). Of the participants, 96% worked in a level 3 NICU. A descriptive, correlational design was used to study job satisfaction among NICU nurses. Nurses were recruited at 2 regional NICU conferences in 2009 and 2010. The questionnaire was a researcher-developed survey consisting of 14 questions in a Likert-type response rating 1 to 5, with an area for comments. Descriptive statistics and correlations were used to analyze the resulting data. The majority of participants were moderately satisfied overall in their current position and workplace (mean ranking = 4.07 out of 5.0). Kendall's Tau b (TB) revealed that the strongest positive correlations were between organizational support and team spirit with overall job satisfaction (TB = 0.53). : The individual factors with the highest mean scores were caring for patients in a stressful situation, level of autonomy, and communication between nurses and neonatal nurse practitioners. This indicates that our population of NICU nurses feels most satisfied caring for patients in stressful situations (m = 4.48), are satisfied with their level of autonomy (M = 4.17), and are satisfied with the interdisciplinary communication in their units (m = 4.13). Nurses in the NICU are relatively satisfied with their jobs. The small sample size (n = 109) of Midwest NICU nurses proves to be a limitation for generalization. Additional research is needed to further evaluate nursing role, educational level, and job satisfaction in the NICU.

The TurboLAN project. Phase 1: Protocol choices for high speed local area networks. Phase 2: TurboLAN Intelligent Network Adapter Card, (TINAC) architecture

NASA Technical Reports Server (NTRS)

Alkhatib, Hasan S.

1991-01-01

The hardware and the software architecture of the TurboLAN Intelligent Network Adapter Card (TINAC) are described. A high level as well as detailed treatment of the workings of various components of the TINAC are presented. The TINAC is divided into the following four major functional units: (1) the network access unit (NAU); (2) the buffer management unit; (3) the host interface unit; and (4) the node processor unit.

Noise level in a neonatal intensive care unit in Santa Marta - Colombia.

PubMed

Garrido Galindo, Angélica Patricia; Camargo Caicedo, Yiniva; Velez-Pereira, Andres M

2017-09-30

The environment of neonatal intensive care units is influenced by numerous sources of noise emission, which contribute to raise the noise levels, and may cause hearing impairment and other physiological and psychological changes on the newborn, as well as problems with care staff. To evaluate the level and sources of noise in the neonatal intensive care unit. Sampled for 20 consecutive days every 60 seconds in A-weighting curves and fast mode with a Type I sound level meter. Recorded the average, maximum and minimum, and the 10th, 50th and 90th percentiles. The values are integrated into hours and work shift, and studied by analysis of variance. The sources were characterized in thirds of octaves. The average level was 64.00 ±3.62 dB(A), with maximum of 76.04 ±5.73 dB(A), minimum of 54.84 ±2.61dB(A), and background noise of 57.95 ±2.83 dB(A). We found four sources with levels between 16.8-63.3 dB(A). Statistical analysis showed significant differences between the hours and work shift, with higher values in the early hours of the day. The values presented exceed the standards suggested by several organizations. The sources identified and measured recorded high values in low frequencies.

[Job satisfaction vs. occupational stress - Quantitative analysis of 3 organizational units of a public sector institution].

PubMed

Rogozińska-Pawełczyk, Anna

2018-05-22

The influence of subjective perception of occupational stress and its individual factors on the overall level of job satisfaction was analyzed. The respondents were also asked to answer the question of the potential differences in terms of variables in managers and non-managers, and in various demographic factors. This article presents the results of a study conducted among 5930 people employed in 3 units of the examined public sector institution. The research was conducted using computer-assisted web interview method. The parameters of the polynomial model of ordered categories were estimated. The results showed a statistically significant effect between the variables and the differences between the groups of subjects. Analyzes showed slight differences between men and women. Employees with a low level of stress and high job satisfaction were noted in the oldest group, aged over 55 years, and in managers. Low levels of stress and job satisfaction were observed in young employees with the shortest period of employment. Among those least satisfied with the work and experiencing high levels of stress there were respondents with 6-15 years of employment in non-managerial positions. While the highest levels of stress and high satisfaction were found in people aged 46-55 years, with more than 20 years of work experience. The results of the estimation of the polynomial model parameters of ordered categories indicate that the level of perceived stress is related to the level of job satisfaction. The lower the level of stress and stressors in the workplace, the greater the job satisfaction in the surveyed unit. Med Pr 2018;69(3):301-315. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Effort-reward imbalance as a risk factor for disability pension: the Finnish Public Sector Study.

PubMed

Juvani, Anne; Oksanen, Tuula; Salo, Paula; Virtanen, Marianna; Kivimäki, Mika; Pentti, Jaana; Vahtera, Jussi

2014-05-01

Job strain has previously been shown to predict disability pension, but it is unknown whether effort-reward imbalance (ERI), another major stress model, is also associated with disability pension. We examined ERI as a risk factor for diagnosis-specific disability pension in a cohort of 51 874 public-sector employees in Finland. To control for reporting bias, work unit-level scores of ERI (based on the survey responses of 35 260 employees in 2000-2002) were constructed and linked to all eligible employees. A sub-cohort of the respondents was analyzed also with individual-level ERI. Disability pension data were derived from national pension registers with no loss to follow-up. The outcomes were all-cause disability pension and disability pension due to depression, musculoskeletal diseases, and ischemic heart diseases (IHD). Multivariate Cox proportional hazard models (adjusted for sociodemographic factors, baseline health, and work-related characteristics) were used for analyses. During a mean 8.9 years of follow-up, 4542 participants were granted disability pension. An increased risk for disability pension due to depression was detected for both high work unit- and individual-level ERI [hazard ratio (HR) 1.63, 95% confidence interval (95% CI) 1.31-2.04 and HR 1.90, 95% CI 1.51-2.40, respectively]. High individual-level ERI increased the risk of disability pension due to musculoskeletal diseases (HR 1.32, 95% CI 1.13-1.53), but no association was observed for work unit-level ERI (HR 1.02, 95% CI 0.88-1.19). ERI was not associated with disability pension due to IHD. The present study showed a consistent association between high ERI and an increased risk of disability pension due to depression.

INFOSAM: A Sample Database Management System.

DTIC Science & Technology

1981-12-01

PROGRAM ELEMENT. PROJECT, TASA Sloan School of Management AREA WORK UNIT NUMBERS Massachusetts Institute of Technology Cambridge, MA 02139 II...96 NSETCAT .. ............................. 96 Inter -level Communication Databases .... 99 DEEAR ...................... 100 DVAR...Conceptual level, and the External level. The Inter - nal level represents a union of Hsu’s proposed Unary and Binary levels. The rationale for combining the

Working Together. Policy and Practice in Scottish Early Childhood Centres

ERIC Educational Resources Information Center

Paton, Grace

2007-01-01

A key policy response to continuing concerns about levels of poverty and social exclusion in the United Kingdom has been the promotion of integrated children's services, involving professionals from education, social work, health and other fields working together on an inter-agency basis. This small-scale qualitative research project, using an…

Work-related frustration among senior nurses at a medical centre.

PubMed

Wang, Pei-Hern; Ku, Yan-Chiou; Chen, Chi-Chi; Jeang, Shiow-Rong; Chou, Frank Huang-Chih

2016-07-01

To investigate the levels and causes of work-related frustration among senior nurses. Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. A cross-sectional questionnaire study. Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations. © 2016 John Wiley & Sons Ltd.

Safety culture in the maternity unit of hospitals in Ilam province, Iran: a census survey using HSOPSC tool.

PubMed

Akbari, Nahid; Malek, Marzieh; Ebrahimi, Parvin; Haghani, Hamid; Aazami, Sanaz

2017-01-01

Improving quality of maternal care as well as patients' safety are two important issues in health-care service. Therefore, this study aimed to assess the culture of patient safety at maternity units. This cross-sectional study was conducted among staffs working at maternity units in seven hospitals of Ilam city, Iran. The staffs included in this study were gynecologists and midwifes working in different positions including matron, supervisors, head of departments and staffs. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC). This study indicated that 59.1% of participants reported fair level of overall perceptions of safety and 67.1% declared that no event was reported during the past 12 months. The most positively perceived dimension of safety culture was teamwork within departments in view of managers (79.41) and personnel (81.10). However, the least positively perceived dimensions of safety culture was staffing levels. The current study revealed areas of strength (teamwork within departments) and weakness (staffing, punitive responses to error) among managers and personnel. In addition, we found that staffs in Ilam's hospitals accept the patient safety culture in maternity units, but, still are far away from excellent culture of patient safety. Therefore, it is necessary to promote culture of patient's safety among professions working in the maternity units of Ilam's hospitals.

National Forest System working circles: a question of size and ownership composition

Treesearch

Robert J. Hrubes

1976-01-01

Allowable-cut (potential yield) levels on National Forest land are determined for planning units called working circles. The size of working circles has been increased over the past 30 years to the present scale which is often coincident with National Forest boundaries. Larger working circles have recently been considered because of the anticipated impacts on timber...

Work Addiction and 21st Century Information Technologies in Traditional and Virtual Work Spaces in the United States

ERIC Educational Resources Information Center

Hunka, Patricia L.

2014-01-01

This study was completed to understand whether or not work addiction or work addiction intensity could be predicted from mobile technology use. The study further investigated whether or not gender, workspace, income, or education level would moderate the relationship. The sample used was drawn from service industry employees who are not in the…

Basic & Survival Consumer Economics for Adult Refugees.

ERIC Educational Resources Information Center

Carlston, Peter G.

Prepared to help teachers address the basic and survival level consumer needs of adult Vietnamese and Laotian refugees, this instructional guide consists of five units of instructional materials. Topics of the individual units are (1) how the monetary system works (cash, checks, postal money orders, banking); (2) the family consumer (personal and…

UNEP's Work to Implement Good Practice at a Regional Level: Contribution to the UNDESD

ERIC Educational Resources Information Center

Ogbuigwe, Akpezi

2010-01-01

This paper outlines the contribution made by the United Nations Environment Programme (UNEP) towards enhancing the integration of sustainable development concerns in Africa through its initiative, the Mainstreaming Environment and Sustainability in Africa (MESA) Universities Partnership, during the United Nations Decade of Education for…

CONFRONTING THE MODIFIABLE AREAL UNIT PROBLEM FOR INFERENCE ON NITRATE IN REGIONAL SHALLOW GROUND WATER

EPA Science Inventory

This work addresses a potentially serious problem in synthesis of
spatially explicit data on ground water quality from wells, known to
geographers as the modifiable areal unit problem (MAUP). Investigators
are faced with choosing a level of aggregation appropriate to
...

Building the United States National Vegetation Classification

USGS Publications Warehouse

Franklin, S.B.; Faber-Langendoen, D.; Jennings, M.; Keeler-Wolf, T.; Loucks, O.; Peet, R.; Roberts, D.; McKerrow, A.

2012-01-01

The Federal Geographic Data Committee (FGDC) Vegetation Subcommittee, the Ecological Society of America Panel on Vegetation Classification, and NatureServe have worked together to develop the United States National Vegetation Classification (USNVC). The current standard was accepted in 2008 and fosters consistency across Federal agencies and non-federal partners for the description of each vegetation concept and its hierarchical classification. The USNVC is structured as a dynamic standard, where changes to types at any level may be proposed at any time as new information comes in. But, because much information already exists from previous work, the NVC partners first established methods for screening existing types to determine their acceptability with respect to the 2008 standard. Current efforts include a screening process to assign confidence to Association and Group level descriptions, and a review of the upper three levels of the classification. For the upper levels especially, the expectation is that the review process includes international scientists. Immediate future efforts include the review of remaining levels and the development of a proposal review process.

Compassion satisfaction, burnout, and secondary traumatic stress in heart and vascular nurses.

PubMed

Young, Jennifer L; Derr, Denise M; Cicchillo, Vikki J; Bressler, Sonya

2011-01-01

Objectives for this project were to determine the prevalence of compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) in heart and vascular nurses to confirm whether differences exist between intensive care and intermediate care nurses. The Professional Quality of Life Scale Compassion Satisfaction and Compassion Fatigue: Version 5 developed by Stamm (2009) was used. Results showed that nurses who work in the heart and vascular intermediate care unit had average to high scores of CS, low to average levels of burnout, and low to average levels of STS. Nurses who work in the heart and vascular intensive care unit had average to high levels of CS, low to average levels of burnout, and low to average levels of STS. These findings suggest that leadership should be aware of the prevalence of STS and burnout in heart and vascular nurses. Raising awareness of STS and burnout in intensive care and intermediate care nurses can help in targeting more specific strategies that may prevent the onset of developing these symptoms.

Nursing teamwork, staff characteristics, work schedules, and staffing.

PubMed

Kalisch, Beatrice J; Lee, Hyunhwa

2009-01-01

This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.

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.

[Triage evaluation making in a pediatric emergency department of a tertiary hospital].

PubMed

Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

2014-03-01

Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p < 0.001). Among the nurses working in the unit more than 7 years did not register pain level 472 (12.3%), identified inappropriate principal symptoms 197 (5%) and did not register hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

Stress among Accounting Educators in the United States.

ERIC Educational Resources Information Center

Seiler, Robert E.; Pearson, Della A.

1984-01-01

Stress among accounting educators was investigated and relationships between stress levels and work satisfaction levels, personality traits, and stress-coping techniques were examined. The most important personality charcteristics of higher stress individuals were impatience, assertiveness, workaholism, and idealism. (Author/MLW)

Organizational factors impacting job strain and mental quality of life in emergency and critical care units.

PubMed

Bellagamba, Gauthier; Gionta, Guillaume; Senergue, Julie; Bèque, Christine; Lehucher-Michel, Marie-Pascale

2015-01-01

This study measures the association between hospital staff's job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer's efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Examining the Influence of Perceptions of a Supervisor's Leadership Style on Levels of Psychological Ownership among Entry Level Professionals

ERIC Educational Resources Information Center

Shouse, Reggie L.

2017-01-01

The purpose of this study was to explore the relationship between the perceived leadership behaviors of upper-level student affairs officers and levels of psychological ownership among entry-level employees working in student services roles in higher education in the United States. Specifically, this study identified whether there are leadership…

Configurations of leadership practices in hospital units.

PubMed

Meier, Ninna

2015-01-01

The purpose of this paper is to explore how leadership is practiced across four different hospital units. The study is a comparative case study of four hospital units, based on detailed observations of the everyday work practices, interactions and interviews with ten interdisciplinary clinical managers. Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied here, especially in more unpredictable work settings. Practices of symbolic work and emotional support to staff were particularly important when patients were severely ill. Based on a study conducted with qualitative methods, these results cannot be expected to apply in all clinical settings. Future research is invited to extend the findings presented here by exploring leadership practices from a micro-level perspective in additional health care contexts: particularly the embedded and emergent nature of such practices. This paper shows leadership practices to be primarily embedded in the clinical work and often shared across organizational or professional boundaries. This paper demonstrated how leadership practices are embedded in the everyday work in hospital units. Moreover, the analysis shows how configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested "configurations of practice" as a way to carve out similarities and differences in leadership practices across settings.

Psychometric evaluation of a short measure of social capital at work

PubMed Central

Kouvonen, Anne; Kivimäki, Mika; Vahtera, Jussi; Oksanen, Tuula; Elovainio, Marko; Cox, Tom; Virtanen, Marianna; Pentti, Jaana; Cox, Sara J; Wilkinson, Richard G

2006-01-01

Background Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work. Methods Data were derived from the Finnish Public Sector Study (N = 48,592) collected in 2000–2002. Based on face validity, an expert unfamiliar with the data selected 8 questionnaire items from the available items for a scale of social capital. Reliability analysis included tests of internal consistency, item-total correlations, and within-unit (interrater) agreement by rwg index. The associations with theoretically related and unrelated constructs were examined to assess convergent and divergent validity (construct validity). Criterion-related validity was explored with respect to self-rated health using multilevel logistic regression models. The effects of individual level and work unit level social capital were modelled on self-rated health. Results The internal consistency of the scale was good (Cronbach's alpha = 0.88). The rwg index was 0.88, which indicates a significant within-unit agreement. The scale was associated with, but not redundant to, conceptually close constructs such as procedural justice, job control, and effort-reward imbalance. Its associations with conceptually more distant concepts, such as trait anxiety and magnitude of change in work, were weaker. In multilevel models, significantly elevated age adjusted odds ratios (ORs) of poor self-rated health (OR = 2.42, 95% confidence interval (CI): 2.24–2.61 for the women and OR = 2.99, 95% CI: 2.56–3.50 for the men) were observed for the employees in the lowest vs. highest quartile of individual level social capital. In addition, low social capital at the work unit level was associated with a higher likelihood of poor self-rated health. Conclusion Psychometric techniques show our 8-item measure of social capital to be a valid tool reflecting the construct and displaying the postulated links with other variables. PMID:17038200

Moral distress in Turkish intensive care nurses.

PubMed

Karagozoglu, Serife; Yildirim, Gulay; Ozden, Dilek; Çınar, Ziynet

2017-03-01

Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue. The study aims to (a) validate the Turkish version of the Moral Distress Scale-Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses' moral distress level. The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale-Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. In parallel with the original scale, Turkish version of Moral Distress Scale-Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Turkish version of Moral Distress Scale-Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care.

Effort/reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort

PubMed Central

Kouvonen, A; Kivimäki, M; Elovainio, M; Pentti, J; Linna, A; Virtanen, M; Vahtera, J

2006-01-01

Objectives To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifestyle. Methods Cross sectional data from the ongoing Finnish Public Sector Study related to 30 433 women and 7718 men aged 17–64 were used (n = 35 918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as <2.00 metabolic equivalent task (MET) hours/day. Logistic regression with generalised estimating equations was used as an analysis method to include both individual and work unit level predictors in the models. Adjustments were made for age, marital status, occupational status, job contract, smoking, and heavy drinking. Results Twenty five per cent of women and 27% of men had a sedentary lifestyle. High individual level ERI was associated with a higher likelihood of sedentary lifestyle both among women (odds ratio (OR) = 1.08, 95% CI 1.01 to 1.16) and men (OR = 1.17, 95% CI 1.02 to 1.33). These associations were not explained by relevant confounders and they were also independent of work unit level job strain measured as a ratio of job demands and control. Conclusions A mismatch between high occupational effort spent and low reward received in turn seems to be associated with an increased risk of sedentary lifestyle, although this association is relatively weak. PMID:16497854

Effort/reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort.

PubMed

Kouvonen, A; Kivimäki, M; Elovainio, M; Pentti, J; Linna, A; Virtanen, M; Vahtera, J

2006-06-01

To investigate the association between effort/reward imbalance (ERI) at work and sedentary lifestyle. Cross sectional data from the ongoing Finnish Public Sector Study related to 30,433 women and 7718 men aged 17-64 were used (n = 35,918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as <2.00 metabolic equivalent task (MET) hours/day. Logistic regression with generalised estimating equations was used as an analysis method to include both individual and work unit level predictors in the models. Adjustments were made for age, marital status, occupational status, job contract, smoking, and heavy drinking. Twenty five per cent of women and 27% of men had a sedentary lifestyle. High individual level ERI was associated with a higher likelihood of sedentary lifestyle both among women (odds ratio (OR) = 1.08, 95% CI 1.01 to 1.16) and men (OR = 1.17, 95% CI 1.02 to 1.33). These associations were not explained by relevant confounders and they were also independent of work unit level job strain measured as a ratio of job demands and control. A mismatch between high occupational effort spent and low reward received in turn seems to be associated with an increased risk of sedentary lifestyle, although this association is relatively weak.

40 CFR Appendix B to Subpart E of... - Federal Guidelines-User Charges for Operation and Maintenance of Publicly Owned Treatment Works

Code of Federal Regulations, 2014 CFR

2014-07-01

... characteristics; i.e., levels of biochemical oxygen demand, suspended solids, etc. Each class is then assigned its... all users per unit of time. Bc = O&M cost for treatment of a unit of biochemical oxygen demand (BOD... only in cases where the water charge is based on a constant cost per unit of consumption. [39 FR 5270...

40 CFR Appendix B to Subpart E of... - Federal Guidelines-User Charges for Operation and Maintenance of Publicly Owned Treatment Works

Code of Federal Regulations, 2012 CFR

2012-07-01

... characteristics; i.e., levels of biochemical oxygen demand, suspended solids, etc. Each class is then assigned its... all users per unit of time. Bc = O&M cost for treatment of a unit of biochemical oxygen demand (BOD... only in cases where the water charge is based on a constant cost per unit of consumption. [39 FR 5270...

40 CFR Appendix B to Subpart E of... - Federal Guidelines-User Charges for Operation and Maintenance of Publicly Owned Treatment Works

Code of Federal Regulations, 2013 CFR

2013-07-01

... characteristics; i.e., levels of biochemical oxygen demand, suspended solids, etc. Each class is then assigned its... all users per unit of time. Bc = O&M cost for treatment of a unit of biochemical oxygen demand (BOD... only in cases where the water charge is based on a constant cost per unit of consumption. [39 FR 5270...

Managing Highway Maintenance: Standards for Maintenance Work, Part 1, Unit 8, Level 2.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit is about maintenance standards and is designed for superintendents and senior foremen who are responsible for scheduling and controlling routine maintenance. It describes different kinds of standards, why and how standards are developed, and how standards are to be used and…

Managing Highway Maintenance: Maintenance Management--by Objectives, Unit 10, Level 2.

ERIC Educational Resources Information Center

Federal Highway Administration (DOT), Washington, DC. Offices of Research and Development.

Part of the series "Managing Highway Maintenance," the unit deals with management by objectives--its definition, how it works, and necessary steps for application. It is designed for maintenance supervisors who are familiar with maintenance management systems. The format is a programed, self-instructional approach in which questions are…

Patient Care Assisting. A Curriculum for Career Entry in the Nursing Homes of Georgia.

ERIC Educational Resources Information Center

Crawford, Sharon; Bailey, Nancy

This curriculum guide contains 16 units aimed at training entry-level workers as patient care assistants in nursing homes. The units cover the following topics: the role of patient care assistants; psychosocial needs of geriatric patients; work ethics; legal issues; communication skills; infection control; safety issues; patient hygiene; patient…

Fact Sheet on Women of Spanish Origin in the United States.

ERIC Educational Resources Information Center

Employment Standards Administration (DOL), Washington, DC. Women's Bureau.

March 1971 data are given for women of Spanish origin in the United States. Country of origin, population, family composition, educational attainment, labor force participation, type of work, income, and low income level are covered. Where separate data for women are not available, data for both sexes are shown. (KM)

A Virtual Dig--Joining Archaeology and Fiction to Promote Critical and Historical Thinking

ERIC Educational Resources Information Center

Cooper, David

2003-01-01

In this article, the author describes "Dr. Gesundheit and the Mysteries of Snake Valley," a mini-unit that he designed so that his middle-level students could learn to interpret archaeological diagrams, work cooperatively to discover relationships among their observations, and draw well-founded conclusions. The unit requires approximately four…

PRIMARY LEVEL RESOURCE GUIDE FOR EDUCABLE MENTALLY RETARDED. "WE DO IT THIS WAY" SERIES, VOLUME 1.

ERIC Educational Resources Information Center

BLESSING, KENNETH R.; AND OTHERS

THIS RESOURCE GUIDE PRESENTS CONTENT AREAS (READING, SPEECH AND LANGUAGE DEVELOPMENT, HANDWRITING AND SPELLING, ARITHMETIC, SCIENCE, HEALTH, SAFETY, SOCIAL STUDIES, SOCIAL LIVING, PHYSICAL EDUCATION, ARTS AND HANDICRAFTS, MUSIC, PRACTICAL ARTS, AND WORK EXPERIENCE PROGRAMS) AS A PART OF UNIT TOPICS. THE SPECIAL UNITS PRESENTED INCLUDE LEARNING TO…

34 CFR 361.13 - State agency for administration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... least 90 percent of whom are employed full time on the rehabilitation work of the organizational unit; and (iv) Is located at an organizational level and has an organizational status within the State agency comparable to that of other major organizational units of the agency. (2) In the case of a State...

The Recurring Author: William Shakespeare, a Case Study through Content Analysis.

ERIC Educational Resources Information Center

Harrison, Robert L., Jr.

The "recurring author" is one whose works appear many times at different levels in instructional units found in literature textbook series. A descriptive case study discussed the treatment of a recurring author, William Shakespeare, using units in a sample of six literature textbook series. Developed to describe, to code, and to analyze…

Advanced Respite Care: Medically Challenged. Teacher Edition. Respite Care Series.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This curriculum guide is designed to help teachers to provide advanced-level training for care providers who want to work with individuals who are chronically or terminally ill and require specialized care. The curriculum contains seven units. Each of the instructional units includes some or all of these basic components: performance objectives,…

Blogging to Learn: Educational Blogs and U.S. History

ERIC Educational Resources Information Center

Manfra, Meghan McGlinn; Gray, George E., Jr.; Lee, John K.

2010-01-01

Social studies teachers assess their students in a number of ways. Among these are formative assessments, authentic assessments, and summative low-level multiple-choice tests. Working with two classrooms of low-achieving U.S. history students, the authors compared student experiences in traditional units to those in units that integrated an…

A method for work modeling at complex systems: towards applying information systems in family health care units.

PubMed

Jatobá, Alessandro; de Carvalho, Paulo Victor R; da Cunha, Amauri Marques

2012-01-01

Work in organizations requires a minimum level of consensus on the understanding of the practices performed. To adopt technological devices to support the activities in environments where work is complex, characterized by the interdependence among a large number of variables, understanding about how work is done not only takes an even greater importance, but also becomes a more difficult task. Therefore, this study aims to present a method for modeling of work in complex systems, which allows improving the knowledge about the way activities are performed where these activities do not simply happen by performing procedures. Uniting techniques of Cognitive Task Analysis with the concept of Work Process, this work seeks to provide a method capable of providing a detailed and accurate vision of how people perform their tasks, in order to apply information systems for supporting work in organizations.

ECOREGION DELINEATION IN TEXAS

EPA Science Inventory

Level III ecoregions are being refined and subdivided into level IV for the state of Texas. This work is consistent with ecoregion revision and subdivision that has been completed or is on-going in 37 of the conterminous United States. The two-year project is collaborative, inv...

Contribution of radon and radon daughters to respiratory cancer.

PubMed Central

Harley, N; Samet, J M; Cross, F T; Hess, T; Muller, J; Thomas, D

1986-01-01

This article reviews studies on the contribution of radon and radon daughters to respiratory cancer and proposes recommendations for further research, particularly a national radon survey. The steady-state outdoor radon concentration averages 200 pCi/m3, and indoor levels are about 4 times higher. The primary source of radon in homes is the underlying soil; entry depends on multiple variables and reduced ventilation for energy conservation increases indoor radon levels. Occupational exposures are expressed in units of radon daughter potential energy concentration or working level (WL). Cumulative exposure is the product of the working level and the time exposed. The unit for cumulative exposure is the working level month (WLM). The occupational standard for radon exposure is 4 WLM/year, and 2 WLM/year has been suggested as a guideline for remedial action in homes. Epidemiologic studies show that miners with cumulative radon daughter exposures somewhat below 100 WLM have excess lung cancer mortality. Some 3% to 8% of miners studied have developed lung cancer attributable to radon daughters. All of the underground mining studies show an increased risk of lung cancer with radon daughter exposure. All cell types of lung cancer increased with radon exposure. If radon and smoking act in a multiplicative manner, then the risk for smokers could be 10 times that for nonsmokers. The potential risk of lung cancer appears to be between 1 and 2 per 10,000/WLM, which yields a significant number of lung cancers as some 220 million persons in the United States are exposed on average to 10 to 20 WLM/lifetime. PMID:3830103

Longitudinal Associations between Maternal Work Stress, Negative Work-Family Spillover, and Depressive Symptoms

PubMed Central

Goodman, W. Benjamin; Crouter, Ann C.

2009-01-01

The current study examined associations over an 18-month period between maternal work stressors, negative work-family spillover, and depressive symptoms in a sample of 414 employed mothers with young children living in six predominantly nonmetropolitan counties in the Eastern United States. Results from a one-group mediation model revealed that a less flexible work environment and greater work pressure predicted higher levels of depressive symptoms, and further, that these associations were mediated by perceptions of negative work-family spillover. Additionally, results from a two-group mediation model suggested that work pressure predicted greater perceptions of spillover only for mothers employed full-time. Findings suggest the need for policies that reduce levels of work stress and help mothers manage their work and family responsibilities. PMID:20161088

Longitudinal Associations between Maternal Work Stress, Negative Work-Family Spillover, and Depressive Symptoms.

PubMed

Goodman, W Benjamin; Crouter, Ann C

2009-07-01

The current study examined associations over an 18-month period between maternal work stressors, negative work-family spillover, and depressive symptoms in a sample of 414 employed mothers with young children living in six predominantly nonmetropolitan counties in the Eastern United States. Results from a one-group mediation model revealed that a less flexible work environment and greater work pressure predicted higher levels of depressive symptoms, and further, that these associations were mediated by perceptions of negative work-family spillover. Additionally, results from a two-group mediation model suggested that work pressure predicted greater perceptions of spillover only for mothers employed full-time. Findings suggest the need for policies that reduce levels of work stress and help mothers manage their work and family responsibilities.

Noise level in a neonatal intensive care unit in Santa Marta - Colombia.

PubMed Central

Garrido Galindo, Angélica Patricia; Velez-Pereira, Andres M

2017-01-01

Abstract Introduction: The environment of neonatal intensive care units is influenced by numerous sources of noise emission, which contribute to raise the noise levels, and may cause hearing impairment and other physiological and psychological changes on the newborn, as well as problems with care staff. Objective: To evaluate the level and sources of noise in the neonatal intensive care unit. Methods: Sampled for 20 consecutive days every 60 seconds in A-weighting curves and fast mode with a Type I sound level meter. Recorded the average, maximum and minimum, and the 10th, 50th and 90th percentiles. The values are integrated into hours and work shift, and studied by analysis of variance. The sources were characterized in thirds of octaves. Results: The average level was 64.00 ±3.62 dB(A), with maximum of 76.04 ±5.73 dB(A), minimum of 54.84 ±2.61dB(A), and background noise of 57.95 ±2.83 dB(A). We found four sources with levels between 16.8-63.3 dB(A). Statistical analysis showed significant differences between the hours and work shift, with higher values in the early hours of the day. Conclusion: The values presented exceed the standards suggested by several organizations. The sources identified and measured recorded high values in low frequencies. PMID:29213154

Work-related road safety in Australia, the United Kingdom and the United States of America: an overview of regulatory approaches and recommendations to enhance strategy and practice

PubMed Central

Stuckey, R; Pratt, SG; Murray, W

2015-01-01

Work-related travel and transport by road is fundamental for industry, government and organisations. Traditionally, road safety interventions at societal level have focussed on improving road and vehicle engineering and changing road-user behaviour through transport laws and safety campaigns. Crash data indicate that significant numbers of road-user fatalities occur while driving to or for work. Therefore, workplace initiatives can improve both road and worker safety. This paper reviews regulatory approaches to work-related road safety (WRRS) in Australia, the United Kingdom and United States, identifying significant and consistent gaps in policy, management and research. In all three countries, responsibility for managing and regulating WRRS is spread across government agencies, without a single coordinating body. This paper makes the case that integrating management of WRRS into regulatory and non-regulatory occupational health and safety (OHS) initiatives would foster and support collaboration between research and practice communities, ensuring a comprehensive evidence base for future programs. PMID:26279686

Sustaining Excellence.

ERIC Educational Resources Information Center

Moorse, Rosemary; Reisenberger, Anna

This publication outlines prerequisites for success, critical factors in achieving excellence, and strategies for sustaining excellence once high levels of performance have been achieved. It considers how quality and improvement models might be used to support colleges in this work and draws on the work of 10 colleges in the United Kingdom that…

Work-family spillover and metabolic syndrome indicators: Findings from a national sample.

PubMed

Versey, H Shellae; Tan, Mingxuan

2018-03-01

This study examines the link between negative work-family spillover and metabolic risk factors over a 9-year period. Data from two waves of the Midlife in the United States Survey were used to explore relationships between negative work-family spillover and four indicators of metabolic syndrome-blood pressure, triglycerides, body mass index, and glucose levels. In a sample of full-time working men and women ( N = 630), increased negative spillover at baseline significantly predicted higher body mass index nearly a decade later, with a marginally significant effect for triglyceride levels. Increases in spillover also body mass index and glucose levels at follow-up. This study extends research tying work-life spillover to health and suggests that further investigation is needed to fully understand the long-term effects of work stress.

Characteristics of the Nursing Practice Environment Associated With Lower Unit-Level RN Turnover.

PubMed

Nelson-Brantley, Heather V; Park, Shin Hye; Bergquist-Beringer, Sandra

2018-01-01

The aim of this study is to examine characteristics of the nursing practice environment associated with lower RN turnover. Identifying characteristics of the practice environment that contribute to lower RN turnover is important for meeting the national quality strategy priority of reducing healthcare costs. Data from 1002 adult care units in 162 National Database of Nursing Quality Indicators participating hospitals were analyzed using multivariate linear regression. The Practice Environment Scale of the Nursing Work Index was used to measure practice environment characteristics. RN turnover was measured at the unit level. Nursing units with higher overall ratings of the nursing practice environment had lower rates of RN turnover. Units with higher RN perceived staffing and resource adequacy experienced significantly lower RN turnover. Unit managers and hospital administrators should consider RN perception of staffing and resource adequacy and the overall practice environment when developing targeted strategies for decreasing RN turnover.

Developing conjugated polymers with high electron affinity by replacing a C-C unit with a B←N unit.

PubMed

Dou, Chuandong; Ding, Zicheng; Zhang, Zijian; Xie, Zhiyuan; Liu, Jun; Wang, Lixiang

2015-03-16

The key parameters of conjugated polymers are lowest unoccupied molecular orbital (LUMO) and highest occupied molecular orbital (HOMO) energy levels. Few approaches can simultaneously lower LUMO and HOMO energy levels of conjugated polymers to a large extent (>0.5 eV). Disclosed herein is a novel strategy to decrease both LUMO and HOMO energy levels of conjugated polymers by about 0.6 eV through replacement of a C-C unit by a B←N unit. The replacement makes the resulting polymer transform from an electron donor into an electron acceptor, and is proven by fluorescence quenching experiments and the photovoltaic response. This work not only provides an effective approach to tune the LUMO/HOMO energy levels of conjugated polymers, but also uses organic boron chemistry as a new toolbox to develop conjugated polymers with high electron affinity for polymer optoelectronic devices. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Role of motor unit structure in defining function

NASA Technical Reports Server (NTRS)

Monti, R. J.; Roy, R. R.; Edgerton, V. R.

2001-01-01

Motor units, defined as a motoneuron and all of its associated muscle fibers, are the basic functional units of skeletal muscle. Their activity represents the final output of the central nervous system, and their role in motor control has been widely studied. However, there has been relatively little work focused on the mechanical significance of recruiting variable numbers of motor units during different motor tasks. This review focuses on factors ranging from molecular to macroanatomical components that influence the mechanical output of a motor unit in the context of the whole muscle. These factors range from the mechanical properties of different muscle fiber types to the unique morphology of the muscle fibers constituting a motor unit of a given type and to the arrangement of those motor unit fibers in three dimensions within the muscle. We suggest that as a result of the integration of multiple levels of structural and physiological levels of organization, unique mechanical properties of motor units are likely to emerge. Copyright 2001 John Wiley & Sons, Inc.

A multi-level simulation platform of natural gas internal reforming solid oxide fuel cell-gas turbine hybrid generation system - Part II. Balancing units model library and system simulation

NASA Astrophysics Data System (ADS)

Bao, Cheng; Cai, Ningsheng; Croiset, Eric

2011-10-01

Following our integrated hierarchical modeling framework of natural gas internal reforming solid oxide fuel cell (IRSOFC), this paper firstly introduces the model libraries of main balancing units, including some state-of-the-art achievements and our specific work. Based on gPROMS programming code, flexible configuration and modular design are fully realized by specifying graphically all unit models in each level. Via comparison with the steady-state experimental data of Siemens-Westinghouse demonstration system, the in-house multi-level SOFC-gas turbine (GT) simulation platform is validated to be more accurate than the advanced power system analysis tool (APSAT). Moreover, some units of the demonstration system are designed reversely for analysis of a typically part-load transient process. The framework of distributed and dynamic modeling in most of units is significant for the development of control strategies in the future.

Effects of learning climate and registered nurse staffing on medication errors.

PubMed

Chang, Yunkyung; Mark, Barbara

2011-01-01

Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

ATWS analysis for Browns Ferry Nuclear Plant Unit 1

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

Dallman, R.J.; Jouse, W.C.

1985-01-01

Analyses of postulated Anticipated Transients Without Scram (ATWS) were performed at the Idaho National Engineering Laboratory (INEL). The Browns Ferry Nuclear Plant Unit 1 (BFNP1) was selected as the subject of this work because of the cooperation of the Tennessee Valley Authority (TVA). The work is part of the Severe Accident Sequence Analysis (SASA) Program of the US Nuclear Regulatory Commission (NRC). A Main Steamline Isolation Valve (MSIV) closure served as the transient initiator for these analyses, which proceeded a complete failure to scram. Results from the analyses indicate that operator mitigative actions are required to prevent overpressurization of themore » primary containment. Uncertainties remain concerning the effectiveness of key mitigative actions. The effectiveness of level control as a power reduction procedure is limited. Power level resulting from level control only reduce the Pressure Suppression Pool (PSP) heatup rate from 6 to 4F/min.« less

Decreased Stress Levels in Nurses: A Benefit of Quiet Time.

PubMed

Riemer, Heather C; Mates, Joanna; Ryan, Linda; Schleder, Bonnie J

2015-09-01

The benefits of quiet time, a therapeutic method of improving the health care environment, have been evaluated in patients, but only a few studies have examined the effects of quiet time on intensive care nurses. To evaluate the effects of implementing quiet time in a medical-surgical intensive care unit on levels of light, noise, and nurses' stress. Quiet time consisted of turning down the unit lights for a designated time. Levels of light, noise, and nurses' stress were measured. Nurses' stress levels were measured by using a 100-point visual analog scale; unit noise, by using a digital sound level meter (model 407736, Extech Instruments); and unit light, by using an illumination light meter (model 615, Huygen Corporation). Measurements were obtained 30 minutes before and 30 minutes, 1 hour, and 2 hours after implementation of quiet time. Analysis of variance and comparisons of means indicated that both light levels and nurses' stress levels were significantly decreased after quiet time (both P < .001). Noise levels were also decreased after quiet time, but the decrease was not significant (P = .08). Use of quiet time resulted in decreased light levels and decreased stress levels among nurses. Quiet time is an easily performed energy-saving intervention to promote a healthy work environment. ©2015 American Association of Critical-Care Nurses.

Assessment of PTSD symptoms in emergency room, intensive care unit, and general floor nurses.

PubMed

Kerasiotis, Bernadina; Motta, Robert W

2004-01-01

A total of 125 registered nurses participated in an investigation of Posttraumatic Stress Disorder (PTSD) related symptoms and various levels of nursing care. The sample included 43 emergency room nurses (ER), 51 intensive care unit nurses (ICU), and 31 general floor nurses (GF). All participants were assessed on measures of PTSD, social support, dissociation, anxiety, depression, and demographics. Contrary to expectations, the ER nurses were not found to be uniquely stressed by their work when compared to the other nursing groups. Results indicated that all nurses experienced a significant level of anxiety but were not in the clinically significant range for PTSD, depression, or dissociation. It was inferred that social support played a significant role in helping nurses cope with work-related stress. Nevertheless, the high anxiety levels of all nurses were highlighted as a concern. It was suggested that exposure to numerous traumatic experiences over a lifetime of nursing, and a lack of control over these experiences, contributed to the high anxiety levels seen in all nursing groups.

[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.

The Orthodontist, Our Friend: World of Work Project: Fifth Grade: Health.

ERIC Educational Resources Information Center

Anderson, Nancy

The document is one of the teaching units developed by the Utah World of Work Project, designed to integrate career awareness into the regular curriculum at the elementary level. The fifth grade guide is tied to the health education area and focuses on the work of the orthodontist in terms of understanding what an orthodontist does, learning what…

No Way Out: Working Poor Women in the United States.

ERIC Educational Resources Information Center

National Commission on Working Women, Washington, DC.

This report examines the situation of the one-half of the nation's nine million working poor who are female. It begins by looking at just who the working poor are. Two areas of study are education levels and types of jobs. The discussion then shifts to minimum wage earners and their characteristics, the current status of the minimum wage, and the…

Fission Surface Power Technology Demonstration Unit

NASA Image and Video Library

2016-11-09

NASA Glenn Technician Mark Springowski works on a 10-kilowatt Stirling Power Conversion Unit, which is part of the Fission Surface Power Technology Demonstration Unit. This is a system level demonstration of a surface power system, which could potentially be used to support manned missions to the moon or Mars. A flight system would use 180 kilowatt nuclear fission reactor and four Stirling PCU’s to produce 40 kW of electricity for manned surface missions.

Careers (A Course of Study). Unit VII: Now that You've Got the Job--How Do You Keep It?

ERIC Educational Resources Information Center

Turley, Kay

Designed to enable special needs students to learn how to hold a job and how to change jobs when necessary, this set of activities is the seventh unit in a nine-unit secondary level course intended to provide handicapped students with the knowledge and tools necessary to succeed in the world of work. In the first chapter entitled "How Do I Keep My…

Operationally Defining Work, Individualized Teacher Preparation.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Dept. of Science Education.

This publication is one of 14 modules prepared for training pre- and in-service teachers to teach Intermediate Science Curriculum Study (ISCS) materials. The organization of this publication is centered around the first unit at level I discussing the broad physics concept of "work." Various activities are suggested for teachers. This…

Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP).

PubMed

Vogel, Barbara; De Geest, Sabina; Fierz, Katharina; Beckmann, Sonja; Zúñiga, Franziska

2017-03-01

Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors. This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes. Care workers' stress was measured with a shortened version of the Health Professions Stress Inventory. Generalized estimating equation models were used to assess care worker stress and its relationships with three unit types (special care units and others with high or low proportions of residents with dementia), work environment factors, and aggressive resident behavior. After including all potential stressors in the models, no significant differences between the three unit types regarding care worker stress were found. However, increased care worker stress levels were significantly related to lower ratings of staffing and resources adequacy, the experience of verbal aggression, and the observation of verbal or physical aggression among residents. Although the unit type plays only a minor role regarding care worker stress, this study confirms that work environment and aggressive behavior of residents are important factors associated with work-related stress. To prevent increases of care worker stress, interventions to improve the work environment and strengthen care workers' ability to cope with aggressive behavior are suggested.

Perceptions and characteristics of registered nurses' involvement in decision making.

PubMed

Mangold, Kara L; Pearson, Kristina K; Schmitz, Julie R; Scherb, Cindy A; Specht, Janet P; Loes, Jean L

2006-01-01

This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.

Languages for Specific Purposes Business Curriculum Creation and Implementation in the United States

ERIC Educational Resources Information Center

Fryer, T. Bruce

2012-01-01

After the United States emerged as the major world economic leader following World War II, language curricula for specific purposes in international business were put into practice at the college and university levels. This article documents the work of the major players in the development of coursework and materials for business languages for…

Discovering Animal Ways, Elementary School Science, Level Three, Teaching Manual.

ERIC Educational Resources Information Center

Hale, Helen E.

This pilot teaching unit is one of a series developed for use in elementary school science programs. This unit is designed to promote children's natural curiosity and to help those who show a reluctance to work with animals to overcome some of their fears. The student activities employ important scientific processes, such as observation,…

Alternation between Work and Education. A Study of Educational Leave of Absence at Enterprise Level.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

The study reported here involves six countries (Germany, Italy, Yugoslavia, United Kingdom, United States, and Sweden) and focuses on the ways in which those who are actively employed have access to opportunities to alternate education and training with their employment. The first chapter discusses the study structure and defines the field covered…

The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-09-01

Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically significant factors related to implicit rationing of care were the perception of lower staffing resources, teamwork and safety climate, and higher work stressors. Unit staffing and turnover levels were not related to rationing activities. Improving teamwork and reducing work stressors could possibly lead to less implicit rationing of nursing care. Further research on the relationship of implicit rationing of nursing care and resident and care worker outcomes in nursing homes is requested. Copyright © 2015 Elsevier Ltd. All rights reserved.

Bridge Failure Due to Inadequate Design of Bed Protection

NASA Astrophysics Data System (ADS)

Gupta, Yogita; Kaur, Suneet; Dindorkar, Nitin

2017-12-01

The shallow foundation is generally provided on non-erodible strata or where scour depth is less. It is also preferable for low perennial flow or standing water condition. In the present case study shallow foundation is adopted for box type bridge. The total length of the bridge is 132.98 m, consisting of eight unit of RCC box. Each unit is composed of three cell box. The bottom slab of box unit is acted as raft foundation, founded 500 mm below ground level. River bed protection work is provided on both upstream and downstream side along the whole length of the bridge as it is founded above scour level. The bridge collapsed during the monsoon just after two years of service. The present paper explains the cause of failure. This study on failure of the bridge illustrates the importance of bridge inspection before and after monsoon period and importance of the timely maintenance. Standard specifications of Indian Road Congress for the river bed protection work are also included.

Joint influences of individual and work unit abusive supervision on ethical intentions and behaviors: a moderated mediation model.

PubMed

Hannah, Sean T; Schaubroeck, John M; Peng, Ann C; Lord, Robert G; Trevino, Linda K; Kozlowski, Steve W J; Avolio, Bruce J; Dimotakis, Nikolaos; Doty, Joseph

2013-07-01

We develop and test a model based on social cognitive theory (Bandura, 1991) that links abusive supervision to followers' ethical intentions and behaviors. Results from a sample of 2,572 military members show that abusive supervision was negatively related to followers' moral courage and their identification with the organization's core values. In addition, work unit contexts with varying degrees of abusive supervision, reflected by the average level of abusive supervision reported by unit members, moderated relationships between the level of abusive supervision personally experienced by individuals and both their moral courage and their identification with organizational values. Moral courage and identification with organizational values accounted for the relationship between abusive supervision and followers' ethical intentions and unethical behaviors. These findings suggest that abusive supervision may undermine moral agency and that being personally abused is not required for abusive supervision to negatively influence ethical outcomes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Nurses' work-related stress in China: a comparison between psychiatric and general hospitals.

PubMed

Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K

2014-01-01

Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p < .001) and patient care (p < .001), but lower workload and time (p < .001).Multivariate analyses revealed that college or higher level of education(b = .1, p < .001), exposure to violence in the past 6 months (b = .2, p < .001),longer working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p < .001). Considering the harmful effects of work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.

Historical Analysis and Charaterization of Ground Level Ozone for Canada and United State

NASA Astrophysics Data System (ADS)

Lin, H.; Li, H.; Auld, H.

2003-12-01

Ground-level ozone has long been recognized as an important health and ecosystem-related air quality concern in Canada and the United States. In this work we seek to understand the characteristics of ground level ozone conditions for Canada and United States to support the Ozone Annex under the Canada-U.S. Air Quality Agreement. Our analyses are based upon the data collected by Canadian National Air Pollution Surveillance (NAPS, the NAPS database has also been expanded to include U.S. EPA ground level ozone data) network. Historical ozone data from 1974 to 2002 at a total of 538 stations (253 Canadian stations and 285 U.S. stations) were statistically analyzed using several methodologies including the Canada Wide Standard (CWS). A more detailed analysis including hourly, daily, monthly, seasonally and yearly ozone concentration distributions and trends was undertaken for 54 stations.

Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

PubMed

Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

2016-09-01

The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

Immigration, Work, and Health: A Literature Review of Immigration Between Mexico and the United States

PubMed Central

Flynn, Michael A.; Carreón, Tania; Eggerth, Donald E.; Johnson, Antoinette I.

2015-01-01

Understanding the influence someone’s job or career has on their health goes beyond the physical, emotional and social hazards, risks and conditions that they face at work. One’s job or career also exerts a significant influence over other aspects of life that contribute or detract from their health and that of their family. Work is the major incentive for Latin American migration to the United States. Latino immigrants experience increasingly poorer outcomes for physical health and chronic diseases the longer they remain in the U.S. The strong link between work and immigration suggests that, for many Latin Americans, immigration can be understood as a career path which puts them, and their family members, in situations that can change their physical, emotional, and social health as a condition of their employment. Given the large number of Latin Americans who emigrate for work, it is essential that the unique physical, mental and social impacts of emigration are accounted for when working with clients impacted by emigration at the individual, family and community level as well as those social workers practicing at the system level. This paper is a literature review that explores the impact that emigrating for work has on the health of those that emigrate and their family members that stay behind. PMID:28260831

High Resolution Diffusion Tensor Imaging of Cortical-Subcortical White Matter Tracts in TBI

DTIC Science & Technology

2009-10-01

other words, CT perfusion is a change in CT intensity (or Hounsfield Unit , HU) over time following a bolus of iodine based contrast agent. Although...E-Mail: little@uic.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT...estimates of the eigenvalues and decrease the signal-to-noise ratio, a background noise level of 125 (MR Units ) was applied prior to calculation of

U.S. Army Leader’s Handbook: Trauma in the Unit

DTIC Science & Technology

2007-01-01

Implications For Leadership 39 Implications For Working With Families 39 Part VI. Understanding The Impact Of War Zone Deployments 40 6.1 Stressors Of...unit families. Arrange Public Affairs Office (PAO) to provide guidance to unit families on dealing with the media. Talk with families about the ...a level of functioning equal to or greater than before the stressor event. To achieve this, an individual must be able to be flexible and stay

Group cohesion and social support of the nurses in a special unit and a general unit in Korea.

PubMed

Ko, Yu Kyung

2011-07-01

To identify the degree of group cohesion and social support of nurses in special and general units in hospitals in Korea, and to compare group cohesion and social support between the two groups. The level of commitment nurses have to their organizations has been shown to correlate with work group cohesion and social support. The participants were 1751 nurses who were working in Korean hospitals. Data were collected using a structured questionnaire and were analysed using SAS. The statistical methods included: descriptive statistics, t-test, anova and Pearson's correlation coefficients. Group cohesion of nurses on special wards was significantly higher than for nurses on general wards. No significant difference was found between types of units in terms of social support. The degree of group cohesion was significantly different in terms of the respondents' clinical experience, position, religion, job satisfaction, number of supportive superiors and number of supportive peers. A statistically significant correlation was found between group cohesion scores and degree of social support. Hospital management can accomplish their goals more effectively through knowledge of the level of group cohesion, superior support and peer support for nursing staff in accordance with unit specialty. © 2011 The Author. Journal compilation © 2011 Blackwell Publishing Ltd.

Neonatal Intensive Care Unit Layout and Nurses' Work.

PubMed

Doede, Megan; Trinkoff, Alison M; Gurses, Ayse P

2018-01-01

Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located. Many studies reported both positive and negative effects on nurses' work and were therefore sorted by their cited advantages and disadvantages. Advantages included improved quality of the physical environment; improved quality of patient care; improved parent interaction; and improvements in nurse job satisfaction, stress, and burnout. Disadvantages included decreased interaction among the NICU patient care team, increased nurse workload, decreased visibility on the unit, and difficult interactions with family. This review suggests that single-family room NICUs introduce a complex situation in which trade-offs occur for nurses, most prominently the trade-off between visibility and privacy. Additionally, the literature is clear on what elements of nurses' work are impacted, but how the built environment influences these elements, and how these elements interact during nurses' work, is not as well understood. The current level of research and directions for future research are also discussed.

Training Level, Acculturation, Role Ambiguity, and Multicultural Discussions in Training and Supervising International Counseling Students in the United States

ERIC Educational Resources Information Center

Ng, Kok-Mun; Smith, Shannon D.

2012-01-01

This research partially replicated Nilsson and Anderson's "Professional Psychology: Research and Practice" (2004) study on training and supervising international students. It investigated the relationships among international counseling students' training level, acculturation, supervisory working alliance (SWA), counseling self-efficacy (COSE),…

Perceived Effectiveness and Reported Use of Career Strategies in a Service Organization.

ERIC Educational Resources Information Center

Bachiochi, Peter D.; Barnes-Farrell, Janet L.

A survey of 80 management, supervisory, and administrative level employees in a small private hospital (32 responses) in the northeastern United States examined beliefs about the relative effectiveness of different career strategies and worker characteristics, such as age, work experience, company experience, organizational level, and gender,…

Faces and Future of the Nonmetro Workforce.

ERIC Educational Resources Information Center

Swanson, Linda L.; Butler, Margaret A.

Due largely to outmigration of young people, the nonmetropolitan United States has a lower proportion of people in the prime working ages of 20-44 than do metropolitan areas. Discouraged workers and high levels of work-preventing disabilities have contributed to lower rates of nonmetropolitan labor force participation for each age group between 20…

Supporting Women Returning to Work: A European Perspective.

ERIC Educational Resources Information Center

Shepherd, Jan; Saxby-Smith, Sue

A 2-year project examined the effectiveness of courses for returning workers in enabling women to make a sustained return to paid employment in the following countries: France; Spain; Ireland; and the United Kingdom. In each country, a short foundation-level program and a longer accredited return-to-work program were selected for evaluation.…

Fatigue in Intensive Care Nurses and Related Factors.

PubMed

Çelik, Sevim; Taşdemir, Nurten; Kurt, Aylin; İlgezdi, Ebru; Kubalas, Özge

2017-10-01

Fatigue negatively affects the performance of intensive care nurses. Factors contributing to the fatigue experienced by nurses include lifestyle, psychological status, work organization and sleep problems. To determine the level of fatigue among nurses working in intensive care units and the related factors. This descriptive study was conducted with 102 nurses working in intensive care units in the West Black Sea Region of Turkey. Data were collected between February and May 2014 using a personal information form, the Visual Analogue Scale for Fatigue (VAS-F), the Hospital Anxiety and Depression Scale and the Pittsburg Sleep Quality Index. The intensive care nurses in the study were found to be experiencing fatigue. Significant correlations were observed between scores on the VAS-F Fatigue and anxiety (p=0.01), depression (p=0.002), and sleep quality (p<0.001). Anxiety, depression and quality of sleep were significantly affected by the intensive care nurses' levels of fatigue. These results can be of benefit in taking measures which may be used to reduce fatigue in nurses, especially the fatigue related to work organization and social life.

[Comparative study of burnout in Intensive Care and Emergency Care nursing staff].

PubMed

Ríos Risquez, M I; Godoy Fernández, C; Peñalver Hernández, F; Alonso Tovar, A R; López Alcaraz, F; López Romera, A; Garnés González, S; Salmerón Saura, E; López Real, M D; Ruiz Sánchez, R; Simón Domingo, P; Manzanera Nicolás, J L; Menchón Almagro, M A; Liébanas Bellón, R

2008-01-01

To assess and compare the burnout level between Intensive Care Unit and Emergency Unit, and study its association with the sociodemographic and work characteristics of the professionals surveyed. Cross-sectional, descriptive study. Emplacement. Intensive Care Unit of the university hospital Morales Meseguer, Murcia-Spain. STUDIED SAMPLE: 97 nursing professionals: 55 professionals belong to the Emergency Department, and 42 professionals belong to the Intensive Care Department. Two evaluation tools were used: a sociodemographic and work survey, and the Maslach Burnout Inventory, 1986. Quantitative variables expressed as mean +/- SD compared with the Student's T test and qualitative variables compared with the chi2 test. SPSS 12.0(c). The comparative analysis of the burnout dimensions shows that emotional exhaustion level is significantly higher in the intensive care service than in the emergency one (25.45 +/- 11.15 vs 22.09 +/- 10.99) p < 0.05. The rest of burnout dimensions do not show significant differences between both departments. The masculine gender obtains a higher score in the depersonalization dimension of burnout (10.12 +/- 5.38) than female one (6.7 +/- 5.21) p < 0.01. There is greater vulnerability to emotional exhaustion among the professional group with more than 15 years of work experience (F = 3.592; p = 0.031). The burnout levels are moderate to high among the nursing professionals studied. A total of 5.15% of the sample studied achieves a high score in the three dimensions of the burnout syndrome. The intensive care professionals are the most vulnerable to suffering high levels of emotional exhaustion, and the masculine gender is more susceptible to depersonalization attitudes.

Work-Family Context and the Longevity Disadvantage of US Women

PubMed Central

Montez, Jennifer Karas; Martikainen, Pekka; Remes, Hanna; Avendano, Mauricio

2015-01-01

Female life expectancy is currently shorter in the United States than in most high-income countries. This study examines work-family context as a potential explanation. While work-family context changed similarly across high-income countries during the past half century, the United States has not implemented institutional supports, such as universally available childcare and family leave, to help Americans contend with these changes. We compare the United States to Finland—a country with similar trends in work-family life but generous institutional supports—and test two hypotheses to explain US women's longevity disadvantage: (1) US women may be less likely than Finnish women to combine employment with childrearing; and (2) US women's longevity may benefit less than Finnish women's longevity from combining employment with childrearing. We used data from women aged 30–60 years during 1988–2006 in the US National Health Interview Survey Linked Mortality File and harmonized it with data from Finnish national registers. We found stronger support for hypothesis 1, especially among low-educated women. Contrary to hypothesis 2, combining employment and childrearing was not less beneficial for US women's longevity. In a simulation exercise, more than 75 percent of US women's longevity disadvantage was eliminated by raising their employment levels to Finnish levels and reducing mortality rates of non-married/non-employed US women to Finnish rates. PMID:27773947

Fiscal Relations across Levels of Government in the United States. OECD Economics Department Working Papers, No. 462

ERIC Educational Resources Information Center

Laubach, Thomas

2005-01-01

This paper discusses the current state of fiscal relations between the federal, state and local governments in the United States and suggests directions for improvement. The significant degree of fiscal autonomy of the states and, to a lesser extent, of local governments has had several beneficial effects, including the responsiveness of public…

Foods of the Pacific Northwest. Project 2. Leader Guide [and] Member Manual.

ERIC Educational Resources Information Center

Hillers, Val; Hiller, Jan

These two documents are manuals for an intermediate level 4-H food and nutrition project. The leader's guide includes an introduction, 10 units, and a supplemental unit. The introduction includes a discussion of 4-H philosophy, sources of help, working with middle school boys and girls, how the guide is organized, and how to organize meetings.…

Food: The Challenge to Manage. [Project ECOLogy ELE Pak, Roush Pak].

ERIC Educational Resources Information Center

Roush, Judy

This is one of a series of units for environmental education developed by the Highline Public Schools. The unit is designed for students at the senior high level who have a basic knowledge of nutrition, some experience in menu planning, and who are ready to put this knowledge of nutrition to work in selecting foods to attain maximum nutrition with…

Teaching English as an Additional Language in the Global Classroom: A Transnational Study in the United States and United Kingdom

ERIC Educational Resources Information Center

McEachron, Gail; Bhatti, Ghazala

2015-01-01

Global research has shown the persistence of inequality with regard to accessing curriculum with a view to obtaining suitable work and making useful contributions to society. The intersection of race, gender, language and low socio-economic levels creates situations which often marginalize ethnic minorities in school settings (Freire, 1968; Nieto…

Computer Use in the United States: 1989. Current Population Reports, Special Studies.

ERIC Educational Resources Information Center

Kominski, Robert

1991-01-01

This report provides statistical information on computer use in the United States in 1989, including home, work, and school use, and use according to socioeconomic status, race, and sex. The data show that between 1984 and 1989 there was a substantial increase in the levels of computer ownership and use. Fifteen percent of all U.S. households…

Structure and work process in primary care and hospitalizations for sensitive conditions

PubMed Central

Araujo, Waleska Regina Machado; Queiroz, Rejane Christine de Sousa; Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thumé, Elaine; Tomasi, Elaine; Facchini, Luiz Augusto; Thomaz, Erika Barbara Abreu Fonseca

2017-01-01

ABSTRACT OBJECTIVE The objective of this study is to investigate whether the characteristics of the structure of primary health units and the work process of primary care teams are associated with the number of hospitalizations for primary care sensitive conditions. METHODS In this ecological study, we have analyzed data of Brazilian municipalities related to sociodemographic characteristics, coverage of care programs, structure of primary health units, and work process of primary care teams. We have obtained the data from the first cycle of the Brazilian Program for Improving Access and Quality of the Primary Care, of the Department of Information Technology of the Brazilian Unified Health System, the Brazilian Institute of Geography and Statistics, and the United Nations Development Programme. The associations have been estimated using negative binomial regression coefficients (β) and respective 95% confidence intervals, with a hierarchical approach in three levels (alpha = 5%). RESULTS In the adjusted analysis for the outcome in 2013, in the distal level, the coverage of the Bolsa Família Program (β = -0.001) and private insurance (β = -0.01) had a negative association, and the human development index (β = 1.13), the proportion of older adults (β = 0.05) and children under the age of five (β = 0.05), and the coverage of the Community Health Agent Strategy (β = 0.002) showed positive association with hospitalizations for primary care sensitive conditions. In the intermediate level, minimum hours (β = -0.14) and availability of vaccines (β = -0.16) showed a negative association, and availability of medications showed a positive association (β = 0.16). In the proximal level, only the variable of matrix support (β = 0.10) showed a positive association. The variables in the adjusted analysis of the number of hospitalizations for primary care sensitive conditions in 2014 presented the same association as in 2013. CONCLUSIONS The characteristics of the structure of primary health units and the work process of the primary care teams impact the number of hospitalizations for primary care sensitive conditions in Brazilian municipalities. PMID:28832757

Working under pressure: a pilot study of nurse work in a postoperative setting.

PubMed

Willis, Karen; Brown, Claire R; Sahlin, Ingrid; Svensson, Björn; Arnetz, Bengt B; Arnetz, Judith E

2005-01-01

Postoperative services provide an excellent setting to study nursing work due to the patients' needing highly technical, yet highly comforting, care. The current study examined nursing work in postoperative services in an attempt to discern how nursing work is structured. Observations of nursing interactions in a 14-bed postoperative unit of a large Swedish university hospital found that nursing work in this setting is highly intensive and multidimensional. The need to provide nursing interactions that are caring and respectful of patients, while at the same time ensuring a high level of technical capacity, was obvious throughout all stages of patient stays in this unit. Furthermore, although each interaction is necessarily time-limited there is a caring relationship sustained with each patient. There is a pattern of caring that emerges that can be encapsulated as a "contingent routine." Nursing work cannot be broken down into "dimensions of caring." The work is high-pressure and involves, by necessity, multitasking. There are many dimensions of nursing care, but, usually, these are supplied simultaneously.

Violence or Nonviolence: Which do We Choose?

ERIC Educational Resources Information Center

Schafer, John

2005-01-01

A large mass of research on violence now exists, yet the utilitarian value of this vast amount of scientific endeavor may be rated as low, comparing it to the levels of violence at all levels abounding in the world today. The author calls for centralizing funding and work on violence at the national level in the United States, perhaps forming a…

Understanding work contextual factors: a short-cut to evidence-based practice?

PubMed

Wallin, Lars; Ewald, Uwe; Wikblad, Karin; Scott-Findlay, Shannon; Arnetz, Bengt B

2006-01-01

It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.

Well-being of nursing staff on specialized units for older patients with combined care needs.

PubMed

Collet, J; de Vugt, M E; Schols, J M G A; Engelen, G J J A; Winkens, B; Verhey, F R J

2018-03-01

Working in long-term care is seen as a stressful, physically and mentally demanding occupation, and thus, nursing staff are at risk for work and stress-related diseases. In older patients, psychiatric illnesses often occur in combination with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nurses is unknown. Nursing staff working on specialized units for patients with combined care needs experience high levels of self-efficacy in combination with strong feelings of self-rated competence. Although levels of burnout are relatively low, mental healthcare nursing staff is more at risk for burnout when working in specialized settings for patients with combined care needs than nursing home staff working in specialized settings for these patients. Nursing staff characteristics, such as years of working experience and age, seem more important in relation to staff well-being than patient characteristics in specialized settings for combined care needs. Staff well-being might benefit from specializing care, so that patients with similar care needs are placed together and care is focused. The presence of specialized care units for older patients with combined care needs can allow for both targeted and focused allocation of nursing staff to these units and provision of specific training. Introduction In older patients, psychiatric illnesses frequently exist in tandem with physical illnesses, requiring nursing care that is specific to these combined care needs. The impact of caring for these patients on the mental well-being of nursing staff is unknown. To investigate whether care characteristics of patients with combined care needs are related to the mental well-being of nursing staff. Well-being of nursing staff was studied within a larger exploratory observational cross-sectional study that examined the differences and similarities of specialized combined care units in Dutch mental healthcare and nursing home settings. Nursing staff across settings, with more than 5 years of work experience, felt competent in caring for patients with combined care needs. No significant effects of care characteristics of patients with combined care needs on the work-related well-being of nursing staff were shown. Both mental health nursing staff and older employees, however, were found to be more at risk for burnout. Staff well-being might benefit from placing patients with combined care needs together, so care is focused. The presence of specialized care units can allow for both targeted and focused allocation of nursing staff to these units and provision of specific training. © 2017 John Wiley & Sons Ltd.

Striving for Optimum Noise-Decreasing Strategies in Critical Care: Initial Measurements and Observations.

PubMed

Disher, Timothy C; Benoit, Britney; Inglis, Darlene; Burgess, Stacy A; Ellsmere, Barbara; Hewitt, Brenda E; Bishop, Tanya M; Sheppard, Christopher L; Jangaard, Krista A; Morrison, Gavin C; Campbell-Yeo, Marsha L

To identify baseline sound levels, patterns of sound levels, and potential barriers and facilitators to sound level reduction. The study setting was neonatal and pediatric intensive care units in a tertiary care hospital. Participants were staff in both units and parents of currently hospitalized children or infants. One 24-hour sound measurements and one 4-hour sound measurement linked to observed sound events were conducted in each area of the center's neonatal intensive care unit. Two of each measurement type were conducted in the pediatric intensive care unit. Focus groups were conducted with parents and staff. Transcripts were analyzed with descriptive content analysis and themes were compared against results from quantitative measurements. Sound levels exceeded recommended standards at nearly every time point. The most common code was related to talking. Themes from focus groups included the critical care context and sound levels, effects of sound levels, and reducing sound levels-the way forward. Results are consistent with work conducted in other critical care environments. Staff and families realize that high sound levels can be a problem, but feel that the culture and context are not supportive of a quiet care space. High levels of ambient sound suggest that the largest changes in sound levels are likely to come from design and equipment purchase decisions. L10 and Lmax appear to be the best outcomes for measurement of behavioral interventions.

Mandatory overtime regulations and nurse overtime.

PubMed

Bae, Sung-Heui; Brewer, Carol

2010-05-01

A descriptive study used data from the 2004 National Sample Survey of Registered Nurses to examine the nature and occurrence of RN mandatory, voluntary overtime, paid on-call, and total work hours and their association with mandatory overtime regulations in United States. About half of the nurses worked more than 40 hrs per week. Nurses working in states regulating mandatory overtime reported lower levels of mandatory overtime hours than states without regulations or states restricting total work hours. The percent of RNs working 61 hrs and over per week in states without regulations was lower than that in states with regulations. Nurses working in nursing homes reported higher levels of the percentage of mandatory overtime hours worked than those working in hospitals. This suggested that governments need to continuously supervise healthcare institutions, including both hospitals and nursing homes, to ensure adherence to mandatory overtime regulations.

Organizational Factors Associated With Perceived Quality of Patient Care in Closed Intensive Care Units.

PubMed

McIntosh, Nathalie; Oppel, Eva; Mohr, David; Meterko, Mark

2017-09-01

Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context. To examine the relative importance of organizational factors associated with patient care quality in closed intensive care units. In a national exploratory, cross-sectional study focused on intensive care units at US Veterans Health Administration acute care hospitals, unit directors were surveyed about nurse and physician staffing, work resources and training, patient care coordination, rounding, and perceptions of patient care quality. Administrative records yielded data on patient volume and facility teaching status. Descriptive statistics, bivariate analyses, and regression modeling were used for data analysis. Sixty-nine completed surveys from directors of closed intensive care units were returned. Regression model results showed that better patient care coordination (β = 0.43; P = .01) and having adequate work resources (β = 0.26; P = .02) were significantly associated with higher levels of patient care quality in such units ( R 2 = 0.22). Augmenting work resources and/or focusing limited hospital resources on improving patient care coordination may be the most productive ways to improve patient care quality in closed intensive care units. ©2017 American Association of Critical-Care Nurses.

Organizational Climate and Work Addiction in Shahid Sadoughi University of Medical Sciences, 2014: a Case Study.

PubMed

Rafiee, Noora; Bahrami, Mohammad Amin; Zare, Vahid; Mohammadi, Mahan

2015-12-01

The occupational nature of employees in headquarters units of the University requires them to deal with support issues. Thus, there is some pressure on these employees to complete their assignments on time so that employees in the line units can accurately and expeditiously perform their duties. As a result, work addiction behaviors are sometimes observed among the headquarters personnel. Considering the importance of work addiction and recognizing the factors that intensify it, this study investigated the relationship between organizational climate and the work addiction of headquarters personnel at the Shahid Sadoughi University of Medical Sciences. This descriptive-analytic study was conducted using stratified random sampling of 151 University employees in 2014. The data collection tool was an organizational climate questionnaire, which was supplemented by the Work Addiction Risk Test (WART). The data were analyzed using the Pearson test, Spearman test, independent t-test, Mann-Whitney test, one-way analysis of variance (ANOVA), and the Kruskal-Wallis test using IBM-SPSS version 20. The findings of this study showed that the organizational climate was at a moderate level, and employees were in the danger level in terms of work addiction. In addition, among the dimensions of organizational climate, the risk dimension had a significant relationship with work addiction (p<0.05), and the dimensions of structure and responsibility were significantly different from occupational group and monthly salary (p<0.05). Single employees showed a significant difference from married employees in the two dimensions of criteria and conflict (p<0.05). Since the organizational climate score was low and the work addiction score was at the high-risk level, this issue demands more attention of senior managers and human resource officers of organizations to improve the organizational climate and increase employees' awareness of work addiction.

Laughing Gas in a Pediatric Emergency Department-Fun for All Participants: Vitamin B12 Status Among Medical Staff Working With Nitrous Oxide.

PubMed

Staubli, Georg; Baumgartner, Matthias; Sass, Jörn Oliver; Hersberger, Martin

2016-12-01

The efficiency of nitrous oxide in an equimolar mixture with oxygen or in concentrations up to 70% is approved for short painful procedures. Evaluation of the vitamin B12 levels in anesthetic staff applying nitrous oxide showed reduced vitamin B12 plasma levels. This study examines the vitamin B12 status of medical staff working with nitrous oxide in a pediatric emergency department (ED). Medical staff of the ED at the University Children's Hospital Zurich participated. The vitamin B12 status was evaluated by measuring homocysteine, methylmalonic acid, vitamin B12, blood count, and the MTHFR C677T genotype. As a control group, medical personnel working in the "nitrous oxide-free" pediatric intensive care unit were recruited. The parameters for the vitamin B12 status of all participants were in the reference range, and there were no significant differences for the 2 groups. By trend, the ED staff showed higher vitamin B12 levels. The ED staff members were slightly older (P = 0.07) and had higher hemoglobin levels (P < 0.04) compared with the pediatric intensive care unit staff. The use of nitrous oxide (50%-70%) with a demand valve is safe for the vitamin B12 status of medical personnel in the ED.

Federalism and social justice: implications for social work.

PubMed

Linhorst, Donald M

2002-07-01

Federalism is a system of government that divides power between two or more levels of government. During the current conservative political climate in the United States, power has shifted increasingly from the federal government to states, a move that has implications for the achievement of social justice. Consequently, it is now necessary for social workers to engage in political activity at the state and local levels, in addition to the federal level, to promote social justice. Implications for social work policy practice, research, and education for advancing social justice within the federal system of government are explored.

Human-centered design of a cyber-physical system for advanced response to Ebola (CARE).

PubMed

Dimitrov, Velin; Jagtap, Vinayak; Skorinko, Jeanine; Chernova, Sonia; Gennert, Michael; Padir, Taşkin

2015-01-01

We describe the process towards the design of a safe, reliable, and intuitive emergency treatment unit to facilitate a higher degree of safety and situational awareness for medical staff, leading to an increased level of patient care during an epidemic outbreak in an unprepared, underdeveloped, or disaster stricken area. We start with a human-centered design process to understand the design challenge of working with Ebola treatment units in Western Africa in the latest Ebola outbreak, and show preliminary work towards cyber-physical technologies applicable to potentially helping during the next outbreak.

Moral distress: levels, coping and preferred interventions in critical care and transitional care nurses.

PubMed

Wilson, Melissa A; Goettemoeller, Diana M; Bevan, Nancy A; McCord, Jennifer M

2013-05-01

To examine the level and frequency of moral distress in staff nurses working in two types of units in an acute care hospital and to gather information for future interventions addressing moral distress. In 2008, the American Association of Critical Care Nurses published a Position Statement on Moral Distress. Nurses working in units where critically ill patients are admitted may encounter distressing situations. Moral distress is the painful feelings and/or psychological disequilibrium that may occur when taking care of patients. An exploratory, descriptive design study was used to identify the type and frequency of moral distress experienced by nurses. The setting was an acute care hospital in which the subjects were sampled from two groups of nurses based on their unit assignment. A descriptive, questionnaire study was used. Nurses completed the 38-item moral distress scale, a coping questionnaire, and indicated their preferred methods for institutional support in managing distressing situations. A convenience sample of staff nurses was approached to complete the moral distress questionnaire. Overall, the nurses reported low levels of moral distress. Situations creating the highest levels of moral distress were those related to futile care. A significance between group differences was found in the physician practice dimension. Specific resources were identified to help guide future interventions to recognise and manage moral distress. Nurses reported lower levels and frequency of moral distress in these units but their open-ended responses appeared to indicate moral distress. Nurses identified specific resources that they would find helpful to alleviate moral distress. There are numerous studies that identify the situations and the impact of moral distress, but not many studies explore treatments and interventions for moral distress. This study attempted to identify nurse preferences for lessening the impact of moral distress. © 2013 Blackwell Publishing Ltd.

Non-Relative Value Unit-Generating Activities Represent One-Fifth of Academic Neuroradiologist Productivity.

PubMed

Wintermark, M; Zeineh, M; Zaharchuk, G; Srivastava, A; Fischbein, N

2016-07-01

A neuroradiologist's activity includes many tasks beyond interpreting relative value unit-generating imaging studies. Our aim was to test a simple method to record and quantify the non-relative value unit-generating clinical activity represented by consults and clinical conferences, including tumor boards. Four full-time neuroradiologists, working an average of 50% clinical and 50% academic activity, systematically recorded all the non-relative value unit-generating consults and conferences in which they were involved during 3 months by using a simple, Web-based, computer-based application accessible from smartphones, tablets, or computers. The number and type of imaging studies they interpreted during the same period and the associated relative value units were extracted from our billing system. During 3 months, the 4 neuroradiologists working an average of 50% clinical activity interpreted 4241 relative value unit-generating imaging studies, representing 8152 work relative value units. During the same period, they recorded 792 non-relative value unit-generating study reviews as part of consults and conferences (not including reading room consults), representing 19% of the interpreted relative value unit-generating imaging studies. We propose a simple Web-based smartphone app to record and quantify non-relative value unit-generating activities including consults, clinical conferences, and tumor boards. The quantification of non-relative value unit-generating activities is paramount in this time of a paradigm shift from volume to value. It also represents an important tool for determining staffing levels, which cannot be performed on the basis of relative value unit only, considering the importance of time spent by radiologists on non-relative value unit-generating activities. It may also influence payment models from medical centers to radiology departments or practices. © 2016 by American Journal of Neuroradiology.

Environmental issues and work: women with multiple chemical sensitivities.

PubMed

Lipson, Juliene G; Doiron, Nathalie

2006-08-01

Multiple chemical sensitivities (MCS) is an acquired condition in which exposure to low levels of chemicals causes symptoms in multiple organ systems. Some 12%-16% of the U.S. population has some level of chemical sensitivity, 80% of whom are women. Attempts to reduce chemical exposures leads to enormous life difficulties at home, school, and workplace. We base our article on an ethnographic study of MCS in the United States and Canada. We describe here themes related to work issues in terms of a general trajectory of becoming sick from work exposures, coping with toxic physical environments and dealing with coworkers and, when unable to continue working, applying for workers' compensation, or disability status, or both.

[NIC as a tool for assessing competences of nursing students in clinical placement at surgical units].

PubMed

Celma Vicente, Matilde; Ajuria-Imaz, Eloisa; Lopez-Morales, Manuel; Fernandez-Marín, Pilar; Menor-Castro, Alicia; Cano-Caballero Galvez, Maria Dolores

2015-01-01

This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Association between addiction treatment staff professional and educational levels and perceptions of organizational climate and resources.

PubMed

Krull, Ivy; Lundgren, Lena; Beltrame, Clelia

2014-01-01

Research studies have identified addiction treatment staff who have higher levels of education as having more positive attitudes about evidence-based treatment practices, science-based training, and the usefulness of evidence-based practices. This study examined associations between addiction treatment staff level of education and their perceptions of 3 measures of organizational change: organizational stress, training resources and staffing resources in their treatment unit. The sample included 588 clinical staff from community-based substance abuse treatment organizations who received Substance Abuse and Mental Health Services Administration (SAMHSA) funding (2003-2008) to implement evidence-based practices (EBPs). Bivariate analysis and regression modeling methods examined the relationship between staff education level (no high school education, high school education, some college, associate's degree, bachelor's degree, master's degree, doctoral degree, and other type of degree such as medical assistant, registered nurse [RN], or postdoctoral) and attitudes about organizational climate (stress), training resources, and staffing resources while controlling for staff and treatment unit characteristics. Multivariable models identified staff with lower levels of education as having significantly more positive attitudes about their unit's organizational capacity. These results contradict findings that addiction treatment staff with higher levels of education work in units with greater levels of organizational readiness for change. It cannot be inferred that higher levels of education among treatment staff is necessarily associated with high levels of organizational readiness for change.

Impact of overactive bladder on work productivity in the United States: results from EpiLUTS.

PubMed

Sexton, Chris C; Coyne, Karin S; Vats, Vasudha; Kopp, Zoe S; Irwin, Debra E; Wagner, Todd H

2009-03-01

Little research has focused on the impact of overactive bladder (OAB) on work productivity. Consequently, the impact of OAB and other lower urinary tract symptoms (LUTS) on work productivity was evaluated in employed men and women aged 40 to 65 in the United States. Data from a population-based, cross-sectional Internet survey were used to examine the impact of OAB symptoms on work productivity. US participants aged 40 to 65 working full- or part-time were included in the analysis. Participants were asked about the incidence of OAB and other LUTS and a series of questions about work productivity. Descriptive statistics and linear and logistic regressions were used to evaluate outcome differences for men and women by the OAB groups of no/minimal symptoms, continent OAB, and incontinent OAB. The response rate was 60%, and a total of 2876 men and 2820 women were analyzed. Men and women with incontinent OAB reported the lowest levels of work productivity and highest rates of daily work interference. Storage symptoms associated with OAB were most consistently associated with work productivity outcomes; however, significant associations were also found for other storage, voiding, and postmicturition LUTS. In this large US population-based study, OAB was highly prevalent and was associated with lower levels of work productivity. These findings add to the literature documenting the burden of OAB and other LUTS, underscoring the need for increased screening and treatment.

Harassing under the influence: the prevalence of male heavy drinking, the embeddedness of permissive workplace drinking norms, and the gender harassment of female coworkers.

PubMed

Bacharach, Samuel B; Bamberger, Peter A; McKinney, Valerie M

2007-07-01

Drawing from the literature linking alcohol consumption and aggressive behavior, the authors examine the degree to which the risk of gender harassment toward female workers may be associated with the drinking behaviors and perceived workplace drinking norms of their male coworkers. Using multilevel analyses to examine data from 1,301 workers (including 262 women employed in 58 work units in the manufacturing, service and construction sectors), our findings indicate that, even when controlling for a variety of other demographic and unit-level factors, there is a significant association between the proportion of males in a work unit identified as being heavy or "at-risk" drinkers and the probability of gender harassment toward unit females. Our findings further indicate that this association is amplified as a function of the embeddedness of permissive workplace drinking norms among males' referent others. Copyright 2007 APA

SPSS and SAS programs for addressing interdependence and basic levels-of-analysis issues in psychological data.

PubMed

O'Connor, Brian P

2004-02-01

Levels-of-analysis issues arise whenever individual-level data are collected from more than one person from the same dyad, family, classroom, work group, or other interaction unit. Interdependence in data from individuals in the same interaction units also violates the independence-of-observations assumption that underlies commonly used statistical tests. This article describes the data analysis challenges that are presented by these issues and presents SPSS and SAS programs for conducting appropriate analyses. The programs conduct the within-and-between-analyses described by Dansereau, Alutto, and Yammarino (1984) and the dyad-level analyses described by Gonzalez and Griffin (1999) and Griffin and Gonzalez (1995). Contrasts with general multilevel modeling procedures are then discussed.

The mediating role of organizational justice in the relationship between transformational leadership and nurses' quality of work life: a cross-sectional questionnaire survey.

PubMed

Gillet, Nicolas; Fouquereau, Evelyne; Bonnaud-Antignac, Angélique; Mokounkolo, René; Colombat, Philippe

2013-10-01

The importance of transformational leadership for nurses' well-being is increasingly acknowledged. However, there is a paucity of research examining the mechanisms that may explain the relationships between transformational leadership and nurses' quality of work life. First, to examine two possible psychological mechanisms that link transformational leadership behaviors to nurses' quality of work life. Second, to study the relationship between nurses' quality of work life and their work engagement. Cross-sectional study design. The study took place in 47 different hematology, oncology, and hematology/oncology units in France. Participants were nurses and auxiliary nurses. 343 nurses completed the questionnaire. Surveys were sent to all nurses working in the units. 95% were female, the average age was 36.30 years. Nurses were asked to rate their supervisor's transformational leadership style and their perceptions of distributive and interactional justice in the unit. They were also asked to evaluate their own level of quality of work life and their work engagement. Distributive justice and interactional justice were found to fully mediate the relationship between transformational leadership and nurses' quality of work life. In addition, nurses' quality of work life positively related to their work engagement. Transformational leaders may help ensure nurses' quality of work life which in turn increases their work engagement. These leadership practices are thus beneficial for both employees and organization. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ozone Control Strategies | Ground-level Ozone | New ...

EPA Pesticide Factsheets

2017-09-05

The Air Quality Planning Unit's primary goal is to protect your right to breathe clean air. Guided by the Clean Air Act, we work collaboratively with states, communities, and businesses to develop and implement strategies to reduce air pollution from a variety of sources that contribute to the ground-level ozone or smog problem.

Qualifications at Level 5: Progressing in a Career or to Higher Education. Working Paper No 23

ERIC Educational Resources Information Center

Grm, Slava Pevec; Bjørnåvold, Jens

2014-01-01

This study addresses qualifications at level 5 of the European qualifications framework (EQF) in 15 countries (Belgium (Flanders), the Czech Republic, Denmark, Estonia, Ireland, France, Croatia, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Austria, Portugal, the United Kingdom (EWNI and Scotland) that had linked their national…

Individualized Instruction and Unipacs.

ERIC Educational Resources Information Center

Kohut, Sylvester, Jr.

Individualized instruction is an educational program in which grade levels and time units are designed to permit the student to work at his own pace and level with the use of unipacs. The unipac, a "unique package," is a specially designed group of learning activities based on specific behavioral objectives chosen by the student. Unipacs consist…

Working in America and in Hawaii--A Humanities Guide.

ERIC Educational Resources Information Center

Hawaii Committee for the Humanities, Honolulu.

This eight-page tabloid-style report presents an overview of past and present working conditions in the United States as a whole and in Hawaii in particular, with emphasis on women and on lower-level workers. The seven articles in the paper cover the following topics: "A Brief History of Labor in Hawaii" (William J. Puette); "The…

Clocking in: The Organization of Work Time and Health in the United States

ERIC Educational Resources Information Center

Kleiner, Sibyl; Pavalko, Eliza K.

2010-01-01

This article assesses the health implications of emerging patterns in the organization of work time. Using data from the National Longitudinal Survey of Youth 1979, we examine general mental and physical health (SF-12 scores), psychological distress (CESD score), clinical levels of obesity, and the presence of medical conditions, at age 40.…

Where the Butterfly Alights: The Global Location of eWork. EMERGENCE. IES Report 378.

ERIC Educational Resources Information Center

Huws, U.; Jagger, N.; Bates, P.

This study forms part of the EMERGENCE project, which is designed to measure and map information and communications technology-related employment (eWork) relocation on a global level. Information collected by Eurostat and the United Kingdom Labour Force Survey were the primary sources of data analyzed. Twelve factors identified as influencing…

Forest Services: World of Work Project: Fifth Grade: Science.

ERIC Educational Resources Information Center

Utah State Board for Vocational Education, Salt Lake City.

The document is one of the teaching units developed by the Utah World of Work Project, designed to integrate career awareness into the regular curriculum at the elementary level. The fifth grade guide is tied to the science area and focuses on conservation as practiced by Forest Service workers; the growth cycle of forests and the management of…

Occupational Therapy Students' Attitudes towards Individuals with Disabilities: A Comparison between Australia, Taiwan, the United Kingdom, and the United States

ERIC Educational Resources Information Center

Brown, Ted; Mu, Keli; Peyton, Claudia G.; Rodger, Sylvia; Stagnitti, Karen; Hutton, Eve; Casey, Jackie; Watson, Callie; Hong, Chia Swee; Huang, Yan-hua; Wu, Chin-yu

2009-01-01

Introduction: Students who are enrolled in professional education programs such as occupational therapy may have inherent attitudes towards the future clients they work with. These attitudes may be influenced by the level of their professional education as well as cultural values of their country of origin. Purpose: The purpose of the study was to…

Klondike Gold Rush, 1897-98: An Educator's Guide to America's "Last Grand Adventure."

ERIC Educational Resources Information Center

Remick, Scott; Cook, Cathy

This student handbook provides an overview of the Klondike Alaska Gold Rush of 1897-98. The unit was designed for junior high school students but can be modified for different grade levels. A vocabulary list and worksheet accompanies the unit, along with a time line and map activity. A group activity requires students to work in teams to get their…

Knowledge levels of intensive care nurses on prevention of ventilator-associated pneumonia.

PubMed

Akın Korhan, Esra; Hakverdioğlu Yönt, Gülendam; Parlar Kılıç, Serap; Uzelli, Derya

2014-01-01

Ventilator-associated pneumonia constitutes a significant concern for ventilated patients in the intensive care unit. This study was planned to evaluate the knowledge of nurses working in general intensive care units concerning evidence-based measures for the prevention of ventilator-associated pneumonia. This study design is cross-sectional. It was carried out on nurses working in the general intensive care units of anesthiology and re-animation clinics. Collection of research data was performed by means of a Nurse Identification Form and a Form of Evidence-Based Knowledge concerning the Prevention of Ventilator-Associated Pneumonia. Characterization statistics were shown by percentage, median and interquartile range. Chi-square and Wilcoxon tests and Kruskal-Wallis tests were used as appropriate. The median value of total points scored by nurses on the questionnaire was 4.00 ± 2.00. The difference between the nurses' education levels, duration of work experience and participation in in-service training programmes on ventilator-associated pneumonia prevention and the median value of their total scores on the questionnaire was found to be statistically significant (p < 0.05). The conclusion of the study was that critical care nurses' knowledge about ventilator-associated pneumonia prevention is poor. © 2013 British Association of Critical Care Nurses.

Multigrid method for stability problems

NASA Technical Reports Server (NTRS)

Taasan, Shlomo

1988-01-01

The problem of calculating the stability of steady state solutions of differential equations is treated. Leading eigenvalues (i.e., having maximal real part) of large matrices that arise from discretization are to be calculated. An efficient multigrid method for solving these problems is presented. The method begins by obtaining an initial approximation for the dominant subspace on a coarse level using a damped Jacobi relaxation. This proceeds until enough accuracy for the dominant subspace has been obtained. The resulting grid functions are then used as an initial approximation for appropriate eigenvalue problems. These problems are being solved first on coarse levels, followed by refinement until a desired accuracy for the eigenvalues has been achieved. The method employs local relaxation on all levels together with a global change on the coarsest level only, which is designed to separate the different eigenfunctions as well as to update their corresponding eigenvalues. Coarsening is done using the FAS formulation in a non-standard way in which the right hand side of the coarse grid equations involves unknown parameters to be solved for on the coarse grid. This in particular leads to a new multigrid method for calculating the eigenvalues of symmetric problems. Numerical experiments with a model problem demonstrate the effectiveness of the method proposed. Using an FMG algorithm a solution to the level of discretization errors is obtained in just a few work units (less than 10), where a work unit is the work involved in one Jacobi relization on the finest level.

Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions.

PubMed

Abu-El-Noor, Nasser Ibrahim; Aljeesh, Yousef Ibrahim; Radwan, AbdalKarim Said; Abu-El-Noor, Mysoon Khalil; Qddura, Ibrahim Abdel-Ilhady; Khadoura, Khalid Jamal; Alnawajha, Samer Khader

2016-04-01

This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers following Israeli offensives against Gaza Strip in 2014. A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip and worked with victims of the last war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal. The results showed that 291 (89.8%) of 324 participants had scores more than 35 (threshold cut-off point) on the Impact Event Scale-Revised. Scores ranged from zero to 80 with a mean of 52.13. Females had higher levels of stress (55.79) than males (51.63) and nurses (54.85) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was "avoidance" (mean=20.04), followed by "intrusion" (mean=17.83), and then "hyper-arousal" (mean=14.27). Levels of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma. The findings showed that health care providers suffered from severe posttraumatic symptoms after exposure to prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war. Copyright © 2015 Elsevier Inc. All rights reserved.

Skin and surface lead contamination, hygiene programs, and work practices of bridge surface preparation and painting contractors.

PubMed

Virji, M Abbas; Woskie, Susan R; Pepper, Lewis D

2009-02-01

A 2005 regulatory review of the lead in construction standard by the Occupational Safety and Health Administration (OSHA) noted that alternative pathways of exposure can be as significant as inhalation exposure and that noncompliance with the standard pertaining to hygiene facilities and practices was the second most commonly violated section of the standard. Noncompliance with provisions of the standard and unhealthy work and hygiene practices likely increase the likelihood of take-home lead via contaminated clothing, automobiles, and skin, thus contributing to elevated blood lead levels (BLL) among construction workers and their family members. We performed a cross-sectional study of bridge painters working for small contractors in Massachusetts to investigate causes of persistent elevated BLLs and to assess lead exposures. Thirteen work sites were evaluated for a 2-week period during which surface and skin wipe samples were collected and qualitative information was obtained on personal hygiene practices, decontamination and hand wash facilities, and respiratory protection programs. Results showed lead contamination on workers' skin, respirators, personal automobiles, and the decontamination unit, indicating a significant potential for take-home lead exposure. Overall, the geometric mean (GM) skin lead levels ranged from 373 microg on workers' faces at end of shift to 814 microg on hands at break time. The overall GM lead level inside respirators was 143 microg before work and 286 microg after work. Lead contamination was also present inside workers' personal vehicles as well as on surfaces inside the clean side of the decontamination unit. Review of the respiratory protection programs, work site decontamination and hand wash facilities, and personal hygiene practices indicated that these factors had significant impact on skin and surface contamination levels and identified significant opportunities for improving work site facilities and personal practices. Elevated lead exposure and BLL can be minimized by strict adherence to the OSHA provisions for functioning decontamination and hygiene facilities and healthy personal hygiene practices.

[Applying situational leadership in emergency nursing].

PubMed

Wehbe, Grasiela; Galvão, Cristina Maria; Galvão, Maria Cristina

2005-01-01

This study aimed to identify the correspondence of opinions between nurses and nursing staff members who work at the emergency unit regarding the leadership style performed by nurses and the style nurses must adopt considering the maturity level of nursing staff members and the care provided at the unit. Situational Leadership was adopted as a theoretical reference framework. In order to achieve these goals, instruments were elaborated and applied to 24 research participants. Results demonstrated that the leadership style nurses most frequently perform was E3 (participating), and that nurses should adopt leadership style E4 (delegating) in view of the nursing staff's level of maturity, suggesting that staff members present a high level of maturity (M4).

Role of adiponectin in delayed embryonic development of the short-nosed fruit bat, Cynopterus sphinx.

PubMed

Anuradha; Krishna, Amitabh

2014-12-01

The aim of this study was to evaluate the role of adiponectin in the delayed embryonic development of Cynopterus sphinx. Adiponectin receptor (ADIPOR1) abundance was first observed to be lower during the delayed versus non-delayed periods of utero-embryonic unit development. The effects of adiponectin treatment on embryonic development were then evaluated during the period of delayed development. Exogenous treatment increased the in vivo rate of embryonic development, as indicated by an increase in weight, ADIPOR1 levels in the utero-embryonic unit, and histological changes in embryonic development. Treatment with adiponectin during embryonic diapause showed a significant increase in circulating progesterone and estradiol concentrations, and in production of their receptors in the utero-embryonic unit. The adiponectin-induced increase in estradiol synthesis was correlated with increased cell survival (BCL2 protein levels) and cell proliferation (PCNA protein levels) in the utero-embryonic unit, suggesting an indirect effect of adiponectin via estradiol synthesis by the ovary. An in vitro study further confirmed the in vivo findings that adiponectin treatment increases PCNA levels together with increased uptake of glucose by increasing the abundance of glucose transporter 8 (GLUT8) in the utero-embryonic unit. The in vitro study also revealed that adiponectin, together with estradiol but not alone, significantly increased ADIPOR1 protein levels. Thus, adiponectin works in concert with estradiol to increase glucose transport to the utero-embryonic unit and promote cell proliferation, which together accelerate embryonic development. © 2014 Wiley Periodicals, Inc.

Preventive care utilization: Association with individual- and workgroup-level policy and practice perceptions.

PubMed

Sabbath, Erika L; Sparer, Emily H; Boden, Leslie I; Wagner, Gregory R; Hashimoto, Dean M; Hopcia, Karen; Sorensen, Glorian

2018-06-01

Preventive medical care may reduce downstream medical costs and reduce population burden of disease. However, although social, demographic, and geographic determinants of preventive care have been studied, there is little information about how the workplace affects preventive care utilization. This study examines how four types of organizational policies and practices (OPPs) are associated with individual workers' preventive care utilization. We used data collected in 2012 from 838 hospital patient care workers, grouped in 84 patient care units at two hospitals in Boston. Via survey, we assessed individuals' perceptions of four types of OPPs on their work units. We linked the survey data to a database containing detailed information on medical expenditures. Using multilevel models, we tested whether individual-level perceptions, workgroup-average perceptions, and their combination were associated with individual workers' preventive care utilization (measured by number of preventive care encounters over a two-year period). Adjusting for worker characteristics, higher individual-level perceptions of workplace flexibility were associated with greater preventive care utilization. Higher average unit-level perceptions of people-oriented culture, ergonomic practices, and flexibility were associated with greater preventive care utilization. Overall, we find that workplace policies and practices supporting flexibility, ergonomics, and people-oriented culture are associated with positive preventive care-seeking behavior among workers, with some policies and practices operating at the individual level and some at the group level. Improving the work environment could impact employers' health-related expenditures and improve workers' health-related quality of life. Copyright © 2018 Elsevier Inc. All rights reserved.

Electrostatic Discharge Issues in International Space Station Program EVAs

NASA Technical Reports Server (NTRS)

Bacon, John B.

2009-01-01

EVA activity in the ISS program encounters several dangerous ESD conditions. The ISS program has been aggressive for many years to find ways to mitigate or to eliminate the associated risks. Investments have included: (1) Major mods to EVA tools, suit connectors & analytical tools (2) Floating Potential Measurement Unit (3) Plasma Contactor Units (4) Certification of new ISS flight attitudes (5) Teraflops of computation (6) Thousands of hours of work by scores of specialists (7) Monthly management attention at the highest program levels. The risks are now mitigated to a level that is orders of magnitude safer than prior operations

Patient-centered care, nurse work environment and implicit rationing of nursing care in Swiss acute care hospitals: A cross-sectional multi-center study.

PubMed

Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael

2018-05-01

Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with sufficient information (β 0.403 [95%-CI: 0.03-0.77) and adapted treatment and care (β 0.462 [95%-CI: 0.04-0.88]). Furthermore, higher levels of implicit rationing of nursing care were associated with lower levels of patient-centered care, e.g., adapted treatment and care (β -0.912 [95%-CI: -1.50-0.33]). Our study shows a negative association between implicit rationing of nursing care and patient-centered care: i.e.the lower the level of implicit rationing of nursing care, the better patients understood nurses, felt sufficiently informed and recognized that they were receiving highly individualized treatment. To improve patient-centered care, the nurse work environment and the level of implicit rationing of nursing care should be taken into consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quality and strength of patient safety climate on medical-surgical units.

PubMed

Hughes, Linda C; Chang, Yunkyung; Mark, Barbara A

2009-01-01

Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units. Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate. Data came from a larger organizational study to investigate hospital and unit characteristics associated with organizational, nurse, and patient outcomes. The sample for this study was 3,689 RNs on 286 medical-surgical units in 146 hospitals. Nursing workgroup and managerial commitment to safety were the two most strongly positive attributes of the patient safety climate. However, issues surrounding the balance between job duties and safety compliance and nurses' reluctance to reveal errors continue to be problematic. Nurses in Magnet hospitals were more likely to communicate about errors and participate in error-related problem solving. Nurses on smaller units and units with lower work complexity reported greater safety compliance and were more likely to communicate about and reveal errors. Nurses on smaller units also reported greater commitment to patient safety and participation in error-related problem solving. Nursing workgroup commitment to safety is a valuable resource that can be leveraged to promote a sense of personal responsibility for and shared ownership of patient safety. Managers can capitalize on this commitment by promoting a work environment in which control over nursing practice and active participation in unit decisions are encouraged and by developing channels of communication that increase staff nurse involvement in identifying patient safety issues, prioritizing unit-level safety goals, and resolving day-to-day operational problems the have the potential to jeopardize patient safety.

Breastfeeding protection, promotion, and support in the United States: a time to nudge, a time to measure.

PubMed

Pérez-Escamilla, Rafael; Chapman, Donna J

2012-05-01

Strong evidence-based advocacy efforts have now translated into high level political support and concrete goals for improving breastfeeding outcomes among women in the United States. In spite of this, major challenge remain for promoting, supporting and especially for protecting breastfeeding in the country. The goals of this commentary are to argue in favor of: A) Changes in the default social and environmental systems, that would allow women to implement their right to breastfeed their infants, B) A multi-level and comprehensive monitoring system to measure process and outcomes indicators in the country. Evidence-based commentary. Breastfeeding rates in the United States can improve based on a well coordinated social marketing framework. This approach calls for innovative promotion through mass media, appropriate facility based and community based support (e.g., Baby Friendly Hospital Initiative, WIC-coordinated community based peer counseling), and adequate protection for working women (e.g., longer paid maternity leave, breastfeeding or breast milk extraction breaks during the working day) and women at large by adhering and enforcing the WHO ethics Code for the Marketing of Breast Milk Substitutes. Sound infant feeding practices monitoring systems, which include WIC administrative food package data, are needed. Given the current high level of political support to improve breastfeeding in the United States, a window of opportunity has been opened. Establishing breastfeeding as the social norm in the USA will take time, but the global experience indicates that it can be done.

English Language and Skills Training for Entry-Level Health Care Jobs. Program Guide.

ERIC Educational Resources Information Center

Vaidya, Elma

The guide describes a vocational English-as-a-Second-Language program for pre-employment training of Southeast Asians seeking work in entry-level health care jobs. The program was conducted in cooperation with a hospital in Massachusetts. The guide describes the program and its four instructional units in detail, and includes lesson plans,…

Transforming Service Employees and Climate: A Multilevel, Multisource Examination of Transformational Leadership in Building Long-Term Service Relationships

ERIC Educational Resources Information Center

Liao, Hui; Chuang, Aichia

2007-01-01

This longitudinal field study integrates the theories of transformational leadership (TFL) and relationship marketing to examine how TFL influences employee service performance and customer relationship outcomes by transforming both (at the micro level) the service employees' attitudes and (at the macro level) the work unit's service climate.…

Implementation of an Adaptive Learning System Using a Bayesian Network

ERIC Educational Resources Information Center

Yasuda, Keiji; Kawashima, Hiroyuki; Hata, Yoko; Kimura, Hiroaki

2015-01-01

An adaptive learning system is proposed that incorporates a Bayesian network to efficiently gauge learners' understanding at the course-unit level. Also, learners receive content that is adapted to their measured level of understanding. The system works on an iPad via the Edmodo platform. A field experiment using the system in an elementary school…

A Program Evaluation of an Alternative School in the Southeast United States

ERIC Educational Resources Information Center

Beam, Timothy W.

2012-01-01

Graduation from high school is now more important than ever because of fewer opportunities in the blue collar work sector or within family businesses. Students with behavioral or emotional disorders may not be able to perform in the traditional work setting as they do not meet an acceptable level of achievement in the regular classroom and…

Hearing Conservation Self-Study #12350

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

Chochoms, Michael

Occupational hearing loss is one of the most common work-related illnesses in the United States (US). From 22 to 30 million US workers are exposed to hazardous noise levels at work, and 25% of these workers will develop permanent hearing loss. Hearing loss from noise is slow and painless, and you can have a disability before you notice it. This course presents the hazards associated with workplace noise, the purpose and elements of the Los Alamos National Laboratory (LANL) Hearing Conservation Program (HCP), and controls that are available to reduce your exposure to hazardous levels of noise.

Hearing Conservation Live #2430

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

Chochoms, Michael

Occupational hearing loss is one of the most common work-related illnesses in the United States (US). From 22 to 30 million US workers are exposed to hazardous noise levels at work, and 25% of these workers will develop permanent hearing loss. Hearing loss from noise is slow and painless, and you can have a disability before you notice it. This course presents the hazards associated with workplace noise, the purpose and elements of the Los Alamos National Laboratory (LANL) Hearing Conservation Program (HCP), and controls that are available to reduce your exposure to hazardous levels of noise.

[Family doctor clinical aptitude confronting gestational diabetes patients].

PubMed

Pivaral, Carlos Enrique Cabrera; Clara, Elizabeth Rivera; Peña, Luz María Adriana Balderas; Centeno, Mayari Cabrera; Reynoso, Carlos Alonso

2008-02-01

Gestational diabetes mellitus complicates 7% of all pregnancies. Recognizing and treating this entity result in a diminished number of materno-fetal complications; this study explores the family physician clinical aptitude to identify risk factors, to diagnose and treat gestational diabetes. Identify clinical aptitude level of family physician to the treatment of diabetes gestational patients. Transversal study to describe the level of clinical aptitude in 85 family physicians working in Guadalajara. Were studied: speciality, genre, work condition, working years, working hours, and place of work. The evaluation instrument was designed to this specific purpose and validated by an expert group; were evaluated four indicators: 1) identification of risk factors, 2) diagnosis, 3) use of therapeutic resources and 4) use of paraclinic resources. Confidence coefficient to the assessment instrument was (21 formula from Kuder-Richardson) 0.92 in global evaluation. The global clinical aptitude in the four family medicine units studied was less than 21 points in 41% of physician population and very low (22 a 40 points) in 38% of the evaluated physicians. The clinical aptitude from family physician in gestational diabetes is low, this situation represents an urgent need to design a system to provide to these groups of health providers specialized continuous education to enhance the attention quality to this group of patients in family medicine units.

Identification and Therapeutic Targeting of Paracrine Senescence Factors in the Prostate Tumor Microenvironment

DTIC Science & Technology

2011-03-01

UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING...leading cause of cancer death in men in the United States - could be prevented with more effective treatments. Overcoming tumor cell resistance to...as described in prior reports. Recent work has focused on identification of possible functional effects of altered STC1 levels in the prostate tumor

Toward a Better Future: Evidence on Improving Employment Outcomes for Disadvantaged Youth in the United States

ERIC Educational Resources Information Center

Hossain, Farhana; Bloom, Dan

2015-01-01

In the aftermath of the Great Recession of 2007-2009, youth unemployment in the United States reached its highest level since the Second World War. Only about half of young people ages 16 to 24 held jobs in 2013, and recent estimates suggest that about one in five people in this age range were neither working nor in school. This paper draws from…

Underwater Web Work

ERIC Educational Resources Information Center

Wighting, Mervyn J.; Lucking, Robert A.; Christmann, Edwin P.

2004-01-01

Teachers search for ways to enhance oceanography units in the classroom. There are many online resources available to help one explore the mysteries of the deep. This article describes a collection of Web sites on this topic appropriate for middle level classrooms.

Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers.

PubMed

Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

2017-10-01

Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:00-16:00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex. © 2017 European Sleep Research Society.

Improving patient care through student leadership in team quality improvement projects.

PubMed

Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

2015-01-01

In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

Is Spending More Time Associated With Less Missed Care?: A Comparison of Time Use and Missed Care Across 15 Nursing Units at 2 Hospitals.

PubMed

McNair, Norma; Baird, Jennifer; Grogan, Tristan R; Walsh, Catherine M; Liang, Li-Jung; Worobel-Luk, Pamela; Needleman, Jack; Nuckols, Teryl K

2016-09-01

The aim of this study is to examine the relationship between nursing time use and perceptions of missed care. Recent literature has highlighted the problem of missed nursing care, but little is known about how nurses' time use patterns are associated with reports of missed care. In 15 nursing units at 2 hospitals, we assessed registered nurse (RN) perceptions of missed care, observed time use by RNs, and examined the relationship between time spent and degree of missed care at the nursing unit level. Patterns of time use were similar across hospitals, with 25% of time spent on documentation. For 6 different categories of nursing tasks, no association was detected between time use, including time spent on documentation, and the degree of missed care at the nursing unit level. Nursing time use cannot fully explain variation in missed care across nursing units. Further work is needed to account for patterns of missed care.

Prevalence of musculoskeletal symptoms among employees of Iranian petrochemical industries: October 2009 to December 2012.

PubMed

Choobineh, A R; Daneshmandi, H; Aghabeigi, M; Haghayegh, A

2013-10-01

Work-related musculoskeletal disorders (WMSDs) are a common health problem throughout the world and a major cause of disability in the workplace. To determine the prevalence rate of MSDs, assessment of ergonomics working conditions and identification of major risk factors associated with MSDs symptoms among employees of Iranian petrochemical industries between October 2009 and December 2012. In this study, we studied 1184 randomly selected employees of 4 Iranian petrochemical companies with at least one year of work experience in office or operational units. For those with office jobs, data were collected using Nordic Musculoskeletal disorders Questionnaire (NMQ) and ergonomics checklist for the assessment of working conditions. For those with operational jobs, NMQ and Quick Exposure Check (QEC) method were used for data collection. The most prevalent MSD symptoms were reported in lower back (41.5%) and neck (36.5%). The prevalence of MSDs in all body regions but elbows and thighs of the office staff was significantly higher than that of operational workers. Assessment of working conditions in office staff revealed that the lowest index was attributed to workstation. QEC technique among operational workers showed that in 73.8% of the workers studied, the level of exposure to musculoskeletal risks was "high" or "very high." MSDs were associated with type of job, age, body mass index, work experience, gender, marital status, educational level and type of employment. The prevalence of MSDs in the office staff was higher than that of operational workers. Level of exposure to MSDs risk was high in operational workers. Corrective measures are thus necessary for improving working conditions for both office and operational units.

Sample Size for Tablet Compression and Capsule Filling Events During Process Validation.

PubMed

Charoo, Naseem Ahmad; Durivage, Mark; Rahman, Ziyaur; Ayad, Mohamad Haitham

2017-12-01

During solid dosage form manufacturing, the uniformity of dosage units (UDU) is ensured by testing samples at 2 stages, that is, blend stage and tablet compression or capsule/powder filling stage. The aim of this work is to propose a sample size selection approach based on quality risk management principles for process performance qualification (PPQ) and continued process verification (CPV) stages by linking UDU to potential formulation and process risk factors. Bayes success run theorem appeared to be the most appropriate approach among various methods considered in this work for computing sample size for PPQ. The sample sizes for high-risk (reliability level of 99%), medium-risk (reliability level of 95%), and low-risk factors (reliability level of 90%) were estimated to be 299, 59, and 29, respectively. Risk-based assignment of reliability levels was supported by the fact that at low defect rate, the confidence to detect out-of-specification units would decrease which must be supplemented with an increase in sample size to enhance the confidence in estimation. Based on level of knowledge acquired during PPQ and the level of knowledge further required to comprehend process, sample size for CPV was calculated using Bayesian statistics to accomplish reduced sampling design for CPV. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The relationship between patient safety climate and occupational safety climate in healthcare - A multi-level investigation.

PubMed

Pousette, Anders; Larsman, Pernilla; Eklöf, Mats; Törner, Marianne

2017-06-01

Patient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains. The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare. The climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117units), primary healthcare (5units) and elderly care (28units) in western Sweden, which represented 56% of the original sample contacted. Within each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains. The results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate. Safety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Job related stress among nurses working in Jimma Zone public hospitals, South West Ethiopia: a cross sectional study.

PubMed

Dagget, Tadesse; Molla, Ashagre; Belachew, Tefera

2016-01-01

Occupational stress exists in every profession, nevertheless, the nursing profession appears to experience more stress at work compared to other health care workers. Unmanaged stress leads to high levels of employee dissatisfaction, illness, absenteeism, high turnover, and decreased productivity that compromise provision of quality service to clients. However, there is a scarcity of information about nurses' job stress in Jimma zone public hospital nurses. The aim of the present study was to assess job related stress and its predictors among nurses working in Jimma Zone public hospitals, South-West Ethiopia in 2014. An institution based cross sectional study was conducted from March 10 to April 10, 2014 through a census of nurses who are working in Jimma Zone public hospitals using a structured self-administered questionnaire. SPSS Statistics Version 20 used. For the outcome variable: overall job related stress, the participant's responses on each item score summed: a stress score ranging from a minimum of 26 and maximum score of 116. The higher the sum the more the stressed the nurse. The level of stress calculated through tertial the lower to low stress, the middle to moderate & the higher to high stress. Moreover, bivariate and multivariable linear regressions done to see the association between the predictor (sex, age, mutual understanding at work, Job satisfaction and working unit/department) and the outcome variable (Job related stress). A total of 341 nurses working in Jimma Zone public hospitals were given the questionnaire, and the response rate was 92.3 % (315). This study indicated an average overall job related stress level of 58.46 ± 12.62. The highest level of job related stress was on the sub scale of dealing with death & dying mean score of 62.94 % followed by uncertainty regarding patient treatment 57.72 % and workload 57.6 %. While job related stress from sexual harassment had the lowest mean score of 46.19 %. Overall job related stress varies across working unit. Working in a chronic illness follow up clinic, the mutual understanding at work between nurse & physician and job satisfaction were negatively associated predictors of job related stress.

Risk assessment analysis of the future technical unit dedicated to the evaluation and treatment of motor disabilities.

PubMed

Grelier, S; Thetio, M; Quentin, V; Achache, V; Sanchez, N; Leroux, V; Durand, E; Pequignot, R

2011-03-01

The National Hospital of Saint Maurice (HNSM) for Physical Medicine and Rehabilitation aims at strengthening its position as a pivot rehabilitation and physical therapy center. The opening in 2011 of a new unit for the evaluation and treatment of motor disabilities meets this objective. This project includes several parts: clinical, financial, architectural, organizational, applied clinical research as well as dealing with medical equipments and information system. This study focuses on the risk assessment of this future technical unit. This study was conducted by a group of professionals working for the hospital. It started with the design of a functional model to better comprehend the system to be analyzed. Risk assessment consists in confronting this functional model to a list of dangers in order to determine the vulnerable areas of the system. Then the team designed some scenarios to identify the causes, securities barriers and consequences in order to rank the risks. The analysis targeted various dangers, e.g. political, strategic, financial, economical, marketing, clinical and operational. The team identified more than 70 risky scenarios. For 75% of them the criticality level was deemed initially tolerable and under control or unacceptable. The implementation of an action plan for reducing the level of risks before opening this technical unit brought the system down to an acceptable level at 66%. A year prior to opening this technical unit for the evaluation and treatment of motor disabilities, conducting this preliminary risk assessment, with its exhaustive and rigorous methodology, enabled the concerned professionals to work together around an action plan for reducing the risks. 2011 Elsevier Masson SAS. All rights reserved.

Relationship between job stress level and coping strategies used by Hong Kong nurses working in an acute surgical unit.

PubMed

Wang, Wenru; Kong, Amelia Wai Man; Chair, Sek Ying

2011-11-01

The aim of this study is to explore the relationship between job stress and coping strategies of Hong Kong nurses working in an acute surgical unit. This is a descriptive correlational study. Data were collected from 98 Hong Kong surgical nurses using the Nursing Stress Scale and the Jalowiec Coping Scale. Results showed that workload (M = 15.36), lack of support (M = 13.32), and inadequate preparation (M = 12.33) are the most common stressors for Hong Kong surgical nurses. The most frequent strategies used by nurses to cope with stress can be characterized as evasive (M = 19.23), confrontive (M = 17.46), and optimistic (M = 15.81), all of which are also rated as the most effective strategies in reducing stress levels. Only the confrontive, optimistic, supportant, and emotive coping strategies reveal significant correlations (p < .05) with the stress levels of nurses, whereas the evasive, fatalistic, palliative, and self-reliant strategies showed no significant correlation with stress levels (p > .05). Recognizing the impacts of job-related stress and making use of effective coping methods play a vital role in reducing nurse's stress. A change in leadership styles from the managerial level and reallocation of manpower may help reduce job stress. The use of confrontive and optimistic coping strategies in reducing job-related stress for surgical nurses should be advocated and promoted in their daily work. Copyright © 2011 Elsevier Inc. All rights reserved.

Stress levels of critical care doctors in India: A national survey

PubMed Central

Amte, Rahul; Munta, Kartik; Gopal, Palepu B.

2015-01-01

Background: Doctors working in critical care units are prone to higher stress due to various factors such as higher mortality and morbidity, demanding service conditions and need for higher knowledge and technical skill. Aim: The aim was to evaluate the stress level and the causative stressors in doctors working in critical care units in India. Materials and Methods: A two modality questionnaire-based cross-sectional survey was conducted. In manual mode, randomly selected delegates attending the annual congress of Indian Society of Critical Care Medicine filled the questionnaire. In the electronic mode, the questionnaires were E-mailed to critical care doctors. These questionnaires were based on General Health Questionnaire-12 (GHQ-12). Completely filled 242 responses were utilized for comparative and correlation analysis. Results: Prevalence of moderate to severe stress level was 40% with a mean score of 2 on GHQ-12 scale. Too much responsibility at times and managing VIP patients ranked as the top two stressors studied, while the difficult relationship with colleagues and sexual harassment were the least. Intensivists were spending longest hours in the Intensive Care Unit (ICU) followed by pulmonologists and anesthetists. The mean number of ICU bed critical care doctors entrusted with was 13.2 ± 6.3. Substance abuse to relieve stress was reported as alcohol (21%), anxiolytic or antidepressants (18%) and smoking (14%). Conclusion: Despite the higher workload, stress levels measured in our survey in Indian critical care doctors were lower compared to International data. Substantiation of this data through a wider study and broad-based measures to improve the quality of critical care units and quality of the lives of these doctors is the need of the hour. PMID:25983431

Stress levels of critical care doctors in India: A national survey.

PubMed

Amte, Rahul; Munta, Kartik; Gopal, Palepu B

2015-05-01

Doctors working in critical care units are prone to higher stress due to various factors such as higher mortality and morbidity, demanding service conditions and need for higher knowledge and technical skill. The aim was to evaluate the stress level and the causative stressors in doctors working in critical care units in India. A two modality questionnaire-based cross-sectional survey was conducted. In manual mode, randomly selected delegates attending the annual congress of Indian Society of Critical Care Medicine filled the questionnaire. In the electronic mode, the questionnaires were E-mailed to critical care doctors. These questionnaires were based on General Health Questionnaire-12 (GHQ-12). Completely filled 242 responses were utilized for comparative and correlation analysis. Prevalence of moderate to severe stress level was 40% with a mean score of 2 on GHQ-12 scale. Too much responsibility at times and managing VIP patients ranked as the top two stressors studied, while the difficult relationship with colleagues and sexual harassment were the least. Intensivists were spending longest hours in the Intensive Care Unit (ICU) followed by pulmonologists and anesthetists. The mean number of ICU bed critical care doctors entrusted with was 13.2 ± 6.3. Substance abuse to relieve stress was reported as alcohol (21%), anxiolytic or antidepressants (18%) and smoking (14%). Despite the higher workload, stress levels measured in our survey in Indian critical care doctors were lower compared to International data. Substantiation of this data through a wider study and broad-based measures to improve the quality of critical care units and quality of the lives of these doctors is the need of the hour.

The associations of occupational hazards and injuries with work environments and overtime for nurses in China.

PubMed

Wu, Yan; Zheng, Jing; Liu, Ke; Baggs, Judith G; Liu, Jiali; Liu, Xu; You, Liming

2018-06-04

Occupational hazards (OHs) and occupational injuries (OIs) may contribute to nurses needing sick time and to a high financial burden for hospitals. There is little published literature about nurse-reported OHs/OIs and their relationships with work environments and working overtime in China. This study was designed to describe Chinese hospital registered nurses' OHs/OIs and to explore the associations between work environments, working overtime, and nurse-reported OHs/OIs. This cross-sectional study was conducted in Guangdong province in China in 2014. The sample included 1,517 nurses from 111 medical/surgical units in 23 hospitals. The Practice Environment Scale of the Nursing Work Index was used to measure work environment. Overtime was calculated by subtracting scheduled work hours from actual work hours. Six items were used to measure nurse-reported OHs/OIs. Descriptive statistics, Chi-square tests, and two-level logistic regression models were used to analyze the data. The percentages of nurses reporting OHs/OIs occurred in the year before the survey ranged from 47% to 80%. Nurses who worked in good (vs. poor) unit work environments were less likely to experience OHs/OIs (Odds ratio [OR] = 0.65-0.68, p < .05). Nurses who worked overtime (OR = 1.19-1.33, p < .05) and in Level 3 (largest) hospitals (OR = 1.45-1.80, p < .05) were more likely to experience OHs/OIs. We found that OHs/OIs were prevalent among hospital nurses in China. Better work environment and less nurse overtime were associated with fewer nurse OHs/OIs. © 2018 Wiley Periodicals, Inc.

Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses.

PubMed

Hunsaker, Stacie; Chen, Hsiu-Chin; Maughan, Dale; Heaston, Sondra

2015-03-01

The purpose of this study was twofold: (a) to determine the prevalence of compassion satisfaction, compassion fatigue, and burnout in emergency department nurses throughout the United States and (b) to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty. This was a nonexperimental, descriptive, and predictive study using a self-administered survey. Survey packets including a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses throughout the United States. The ProQOL 5 scale was used to measure the prevalence of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses. Multiple regression using stepwise solution was employed to determine which variables of demographics and work-related characteristics predicted the prevalence of compassion satisfaction, compassion fatigue, and burnout. The α level was set at .05 for statistical significance. The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction among this group of emergency department nurses. The low level of manager support was a significant predictor of higher levels of burnout and compassion fatigue among emergency department nurses, while a high level of manager support contributed to a higher level of compassion satisfaction. The results may serve to help distinguish elements in emergency department nurses' work and life that are related to compassion satisfaction and may identify factors associated with higher levels of compassion fatigue and burnout. Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses may prevent emotional exhaustion and help identify interventions that will help nurses remain empathetic and compassionate professionals. © 2015 Sigma Theta Tau International.

Work load and management in the delivery room: changing the direction of healthcare policy.

PubMed

Sfregola, Gianfranco; Laganà, Antonio Simone; Granese, Roberta; Sfregola, Pamela; Lopinto, Angela; Triolo, Onofrio

2017-02-01

Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy. Based on our results, we strongly suggest a change of direction of healthcare policy, oriented to increase the number of employed midwives, in order to let them fulfil their duties according to the international guidelines (especially one-to-one care). On the other hand, we encourage the adoption of standardised protocols in each work setting.

Job Stress in the United Kingdom: Are Small and Medium-Sized Enterprises and Large Enterprises Different?

PubMed

Lai, Yanqing; Saridakis, George; Blackburn, Robert

2015-08-01

This paper examines the relationships between firm size and employees' experience of work stress. We used a matched employer-employee dataset (Workplace Employment Relations Survey 2011) that comprises of 7182 employees from 1210 private organizations in the United Kingdom. Initially, we find that employees in small and medium-sized enterprises experience lower level of overall job stress than those in large enterprises, although the effect disappears when we control for individual and organizational characteristics in the model. We also find that quantitative work overload, job insecurity and poor promotion opportunities, good work relationships and poor communication are strongly associated with job stress in the small and medium-sized enterprises, whereas qualitative work overload, poor job autonomy and employee engagements are more related with larger enterprises. Hence, our estimates show that the association and magnitude of estimated effects differ significantly by enterprise size. Copyright © 2013 John Wiley & Sons, Ltd.

Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.

PubMed

Hallowell, Sunny G; Rogowski, Jeannette A; Spatz, Diane L; Hanlon, Alexandra L; Kenny, Michael; Lake, Eileen T

2016-01-01

Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Cross sectional analysis combining nurse survey data with infant discharge data. A national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997). Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p<0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor's degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p<0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p<0.001). Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data

PubMed Central

Hallowell, Sunny G.; Rogowski, Jeannette A.; Spatz, Diane L.; Hanlon, Alexandra L.; Kenny, Michael; Lake, Eileen T.

2016-01-01

Context Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. Objectives To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Design and setting Cross sectional analysis combining nurse survey data with infant discharge data. Participants A national sample of neonatal intensive care units (N = 97), nurses (N = 5614) and very low birth weight infants (N = 6997). Methods Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on “any human milk”) and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). Results The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p < 0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor’s degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p < 0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p = .056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p < 0.001). Conclusions Neonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge. PMID:26518107

USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

Cooperative Multi-Agent Mobile Sensor Platforms for Jet Engine Inspection: Concept and Implementation

NASA Technical Reports Server (NTRS)

Litt, Jonathan S.; Wong, Edmond; Krasowski, Michael J.; Greer, Lawrence C.

2003-01-01

Cooperative behavior algorithms utilizing swarm intelligence are being developed for mobile sensor platforms to inspect jet engines on-wing. Experiments are planned in which several relatively simple autonomous platforms will work together in a coordinated fashion to carry out complex maintenance-type tasks within the constrained working environment modeled on the interior of a turbofan engine. The algorithms will emphasize distribution of the tasks among multiple units; they will be scalable and flexible so that units may be added in the future; and will be designed to operate on an individual unit level to produce the desired global effect. This proof of concept demonstration will validate the algorithms and provide justification for further miniaturization and specialization of the hardware toward the true application of on-wing in situ turbine engine maintenance.

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

PubMed

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

2011-03-01

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

Physical and mental health factors associated with work engagement among Finnish female municipal employees: a cross-sectional study.

PubMed

Veromaa, Veera; Kautiainen, Hannu; Korhonen, Päivi Elina

2017-10-05

Work engagement is related to mental health, but studies of physical health's association with work engagement are scarce. This study aims to evaluate the relationship between physical health, psychosocial risk factors and work engagement among Finnish women in municipal work units. A cross-sectional study was conducted in 2014 among 726 female employees from 10 municipal work units of the city of Pori, Finland. Work engagement was assessed with the nine-item Utrecht Work Engagement Scale. The American Heart Association's concept of ideal cardiovascular health (CVH) was used to define physical health (non-smoking, body mass index <25.0 kg/m 2 , physical activity at goal, healthy diet, total cholesterol <5.18mmol/L, blood pressure <120/80 mm Hg, normal glucose tolerance). Psychosocial risk factors (social isolation, stress, depressive symptoms, anxiety, hostility and type D personality) were included as core questions suggested by 2012 European Guidelines on cardiovascular disease prevention. Of the study subjects, 25.2% had favourable 5-7 CVH metrics. The sum of CVH metrics, healthy diet and physical activity at goal were positively associated with work engagement. In subjects without psychosocial risk factors (36.7%), work engagement was high and stable. Presence of even one psychosocial risk factor was associated with a lower level of work engagement regardless of the sum of ideal CVH metrics. Both physical and mental health factors have a positive relationship with work engagement, whereas the presence of even one psychosocial risk factor has a negative association regardless of the level of classic cardiovascular risk factors. © 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.

Sector activities and lessons learned around initial implementation of the United States national physical activity plan.

PubMed

Evenson, Kelly R; Satinsky, Sara B

2014-08-01

National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans.

Sector Activities and Lessons Learned Around Initial Implementation of the United States National Physical Activity Plan

PubMed Central

Evenson, Kelly R.; Satinsky, Sara B.

2016-01-01

Background National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. Methods During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. Results The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. Conclusions These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans. PMID:24176800

The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2013-07-01

This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

Level-I Trauma Center Effects on Return-to-Work Outcomes

ERIC Educational Resources Information Center

Prada, Sergio I.; Salkever, David; MacKenzie, Ellen J.

2012-01-01

Background: Injury is the leading cause of death for persons aged 1-44 years in the United States. Injuries have a substantial economic cost. For that reason, regional systems of trauma care in which the more acutely injured patients are transported to Level-I (L-I) trauma centers (TCs) has been widely advocated. However, the cost of TC care is…

Does organisational justice protect from sickness absence following a major life event? A Finnish public sector study.

PubMed

Elovainio, M; Kivimäki, M; Linna, A; Brockner, J; van den Bos, K; Greenberg, J; Pentti, J; Virtanen, M; Vahtera, J

2010-05-01

It has been shown that fairness perceptions have a strong impact on health, especially under conditions of great work stress. The aim of this study was to extend previous research in studying whether working in high justice workplace would protect from health effects following environmental stressors outside work. Using a prospective longitudinal design, the relationships between organisational justice and sickness-related absences both before and after a major life event among 25 459 public sector employees working in 2551 work units were studied. Sickness absences covered the period from 36 months before the event until 30 months after the event. The increase in sickness absences after the event was larger and stayed at a higher level even 30 months after the event, among those who perceived the management practices in their work unit to be relatively unfair. Similar patterns were found for each of the distributive, procedural and interactional dimensions of organisational justice. Fair organisational and managerial procedures may buffer the negative health effects of psychosocial health risks outside work.

An Automated Individual Training Record Management System (Prototype) United States Marine Corps

DTIC Science & Technology

1984-03-01

PERFORMING ORG. REPORT NUMBER 7. AUTHO(a) 9. CONTRACT OR GRANT NUMBER(@) Ronald E. Pruiett David P. Haeusler 9. PERFORMING ORGANIZATION NAME AND ADDRESS...10. PROGRAM ELEMENT. PROJECT. TASK AREA & WORK UNIT NUMBERS Naval Postgraduate School Monterey, CA 93943 11. CONTROL.LING OFFICE NAME AND ADDRESS 12...ane individuel levels of performance . Since the focus is cn individual training ard individual testing, data m s atntained for each individual in a

FY 2011 United States Army Corps of Engineers Annual Financial Report. America’s Army: At a Strategic Crossroads.

DTIC Science & Technology

2011-01-01

Management Agency, the Department of Housing and Urban Development, the National Oceanic and Atmospheric Administration, aff ected state agencies...history, the United States has relied on the Civil Works program for help in times of national disaster. Emergency management continues to be an...agencies) and demonstrate the fact that project management , operations, and maintenance activities are performed at the local (district) level . Th e

Implementation Learning and Forgetting Curve to Scheduling in Garment Industry

NASA Astrophysics Data System (ADS)

Muhamad Badri, Huda; Deros, Baba Md; Syahri, M.; Saleh, Chairul; Fitria, Aninda

2016-02-01

The learning curve shows the relationship between time and the cumulative number of units produced which using the mathematical description on the performance of workers in performing repetitive works. The problems of this study is level differences in the labors performance before and after the break which affects the company's production scheduling. The study was conducted in the garment industry, which the aims is to predict the company production scheduling using the learning curve and forgetting curve. By implementing the learning curve and forgetting curve, this paper contributes in improving the labors performance that is in line with the increase in maximum output 3 hours productive before the break are 15 unit product with learning curve percentage in the company is 93.24%. Meanwhile, the forgetting curve improving maximum output 3 hours productive after the break are 11 unit product with the percentage of forgetting curve in the company is 92.96%. Then, the obtained 26 units product on the productive hours one working day is used as the basic for production scheduling.

T Cell Lipid Rafts and Complement Ligands for Diagnosis and Monitoring of SLE

DTIC Science & Technology

2011-05-01

including complete blood count, erythrocyte sedimentation rate , serum levels of C3 and C4, antinuclear autoantibodies (ANA), and anti-dsDNA level. Tests... sedimentation rate , serum levels of C3 and C4, antinuclear autoantibody (ANA) and anti-dsDNA antibody levels. In addition, each patient underwent history...6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES

The role of supervisor emotional support on individual job satisfaction: A multilevel analysis.

PubMed

Pohl, Sabine; Galletta, Maura

2017-02-01

Supervisor emotional support is a strong determinant of job satisfaction. There is no study examining the effect of supervisor emotional support at the group level on job satisfaction. Multilevel statistical techniques can help disentangle the effects of subjective assessments from those of group factors. The study's aim was to examine the moderating role of supervisor emotional support (group-level variable) on the relationship between work engagement and job satisfaction (individual-level variables). A cross-sectional study was performed in 39units from three Belgian hospitals. A total of 323 nurses completed a self-reported questionnaire. We carried out a multilevel analysis by using Hierarchical Linear Modeling. The results showed that the cross-level interaction was significant. Hence, at individual-level, the nurses with high levels of work engagement showed high levels of job satisfaction and this relationship was stronger when supervisor emotional support at group-level was high. Contextual differences among groups had an impact on the form of the work engagement-job satisfaction relationship. This relationship between work engagement and job satisfaction is an individual and group level phenomenon. Ways to enhance emotional supervisor support include training supervisors in providing support and enhancing communication between nurses and supervisors. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizational Climate and Work Addiction in Shahid Sadoughi University of Medical Sciences, 2014: a Case Study

PubMed Central

Rafiee, Noora; Bahrami, Mohammad Amin; Zare, Vahid; Mohammadi, Mahan

2015-01-01

Introduction The occupational nature of employees in headquarters units of the University requires them to deal with support issues. Thus, there is some pressure on these employees to complete their assignments on time so that employees in the line units can accurately and expeditiously perform their duties. As a result, work addiction behaviors are sometimes observed among the headquarters personnel. Considering the importance of work addiction and recognizing the factors that intensify it, this study investigated the relationship between organizational climate and the work addiction of headquarters personnel at the Shahid Sadoughi University of Medical Sciences. Methods This descriptive-analytic study was conducted using stratified random sampling of 151 University employees in 2014. The data collection tool was an organizational climate questionnaire, which was supplemented by the Work Addiction Risk Test (WART). The data were analyzed using the Pearson test, Spearman test, independent t-test, Mann-Whitney test, one-way analysis of variance (ANOVA), and the Kruskal-Wallis test using IBM-SPSS version 20. Results The findings of this study showed that the organizational climate was at a moderate level, and employees were in the danger level in terms of work addiction. In addition, among the dimensions of organizational climate, the risk dimension had a significant relationship with work addiction (p<0.05), and the dimensions of structure and responsibility were significantly different from occupational group and monthly salary (p<0.05). Single employees showed a significant difference from married employees in the two dimensions of criteria and conflict (p<0.05). Conclusion Since the organizational climate score was low and the work addiction score was at the high-risk level, this issue demands more attention of senior managers and human resource officers of organizations to improve the organizational climate and increase employees’ awareness of work addiction. PMID:26816586

Perceived and actual noise levels in critical care units.

PubMed

White, Brittany Lynn; Zomorodi, Meg

2017-02-01

To compare the noise levels perceived by critical care nurses in the Intensive Care Unit (ICU) to actual noise levels in the ICU. Following a pilot study (n=18) and revision of the survey tool, a random sample of nurses were surveyed twice in a 3-day period (n=108). Nurses perception of noise was compared to the actual sound pressure level using descriptive statistics. Nurses perceived the ICUs to be noisier than the actual values. The ICU was louder than the recommended noise level for resotrative sleep. This finding raises the question of how we can assist nurses to reduce what they perceive to be a loud environment. Future work is needed to develop interventions specifically for nurses to raise awareness of noise in the ICU and to provide them with skills to assist in noise reduction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient safety culture in obstetrics and gynecology and neonatology units: the nurses' and the midwives' opinion.

PubMed

Ribeliene, Janina; Blazeviciene, Aurelija; Nadisauskiene, Ruta Jolanta; Tameliene, Rasa; Kudreviciene, Ausrele; Nedzelskiene, Irena; Macijauskiene, Jurate

2018-04-22

Patients treated in health care facilities that provide services in the fields of obstetrics, gynecology, and neonatology are especially vulnerable. Large multidisciplinary teams of physicians, multiple invasive and noninvasive diagnostic and therapeutic procedures, and the use of advanced technologies increase the probability of adverse events. The evaluation of knowledge about patient safety culture among nurses and midwives working in such units and the identification of critical areas at a health care institution would reduce the number of adverse events and improve patient safety. The aim of the study was to evaluate the opinion of nurses and midwives working in clinical departments that provide services in the fields of obstetrics, gynecology, and neonatology about patient safety culture and to explore potential predictors for the overall perception of safety. We used the Hospital Survey on Patient Safety Culture (HSOPSC) to evaluate nurses' and midwives' opinion about patient safety issues. The overall response rate in the survey was 100% (n = 233). The analysis of the dimensions of safety on the unit level showed that the respondents' most positive evaluations were in the Organizational Learning - Continuous Improvement (73.2%) and Feedback and Communication about Error (66.8%) dimensions, and the most negative evaluations in the Non-punitive Response to Error (33.5%) and Staffing (44.6%) dimensions. On the hospital level, the evaluation of the safety dimensions ranged between 41.4 and 56.8%. The percentage of positive responses in the outcome dimensions Frequency of Events Reported was 82.4%. We found a significant association between the outcome dimension Frequency of Events Reported and the Hospital Management Support for Patient Safety and Feedback and Communication about Error Dimensions. On the hospital level, the critical domains in health care facilities that provide services in the fields of obstetrics, gynecology, and neonatology were Teamwork Across Hospital Units, and on the unit level - Communication Openness, Teamwork Within Units, Non-punitive Response to Error, and Staffing. The remaining domains were seen as having a potential for improvement.

Development of a neuro early mobilisation protocol for use in a neuroscience intensive care unit.

PubMed

Brissie, Megan A; Zomorodi, Meg; Soares-Sardinha, Sharmila; Jordan, J Dedrick

2017-10-01

Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit. Copyright © 2017 Elsevier Ltd. All rights reserved.

Level IV Ecoregions of the Conterminous United States

EPA Pesticide Factsheets

Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2005). Level IV ecoregions are further subdivisions of Level III ecoregions. Methods used to define the ecoregions are explained in Omernik (

Wheelchair ergometer. Development of a prototype with electronic braking.

PubMed

Forchheimer, F; Lundberg, A

1986-01-01

A new wheelchair ergometer is described, which compensates for the pulsating character of the work by an automatic control system. This makes it possible to maintain a constant level of power during wheelchair work. An automatic control system has been integrated in an electronically braked bicycle ergometer, and a pedal unit from Rodby Electronic bicycle ergometer RE 820 has been coupled to a modified test wheelchair. With this device, the physical working capacity during submaximal circumstances can be tested in handicapped persons.

Computer-Based Teleconferencing and Its Impact on Command and Staff Relationships within the United States Army

DTIC Science & Technology

1989-06-01

decision making process. 31 IV. LABOR vs. WORK Frederick Herzberg claims that, "people labor to avoid the growing pains of depravation, while they work...to create products that express grow- ing levels of ability.’ 18 To Dr. Herzberg and others, "... labor is related to the cyclical ... nature of man...collar’ versus "white collar" personnel still apply for measures of efficiency and 1.3 Frederick Herzberg . "Maximizing Work & Minimizing Labor" Industry

Transforming Care at the Bedside (TCAB): enhancing direct care and value-added care.

PubMed

Dearmon, Valorie; Roussel, Linda; Buckner, Ellen B; Mulekar, Madhuri; Pomrenke, Becky; Salas, Sheri; Mosley, Aimee; Brown, Stephanie; Brown, Ann

2013-05-01

The purpose of this study was to examine the effectiveness of a Transforming Care at the Bedside initiative from a unit perspective. Improving patient outcomes and nurses' work environments are the goals of Transforming Care at the Bedside. Transforming Care at the Bedside creates programs of change originating at the point of care and directly promoting engagement of nurses to transform work processes and quality of care on medical-surgical units. This descriptive comparative study draws on multiple data sources from two nursing units: a Transforming Care at the Bedside unit where staff tested, adopted and implemented improvement ideas, and a control unit where staff continued traditional practices. Change theory provided the framework for the study. Direct care and value-added care increased on Transforming Care at the Bedside unit compared with the control unit. Transforming Care at the Bedside unit decreased in incidental overtime. Nurses reported that the process challenged old ways of thinking and increased nursing innovations. Hourly rounding, bedside reporting and the use of pain boards were seen as positive innovations. Evidence supported the value-added dimension of the Transforming Care at the Bedside process at the unit level. Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital. © 2012 Blackwell Publishing Ltd.

Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units.

PubMed

da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

2015-01-01

To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome.

Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units

PubMed Central

da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

2015-01-01

Objective To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. Methods This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. Results The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (< 0.0001). The multivariate analysis adjusted for gender, age, educational level, weekly work duration, income, and thoughts about work during free time indicated that the categories associated with intermediate stress levels - active work (OR = 0.26; 95%CI = 0.09 - 0.69) and passive work (OR = 0.22; 95%CI = 0.07 - 0.63) - were protective factors for burnout syndrome. Conclusion Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome. PMID:26340152

Structural empowerment and patient safety culture among registered nurses working in adult critical care units.

PubMed

Armellino, Donna; Quinn Griffin, Mary T; Fitzpatrick, Joyce J

2010-10-01

The aim of the present study was to examine the relationship between structural empowerment and patient safety culture among staff level Registered Nurses (RNs) within adult critical care units (ACCU). There is literature to support the value of RNs' structurally empowered work environments and emerging literature towards patient safety culture; the link between empowerment and patient safety culture is being discovered. A sample of 257 RNs, working within adult critical care of a tertiary hospital in the United States, was surveyed. Instruments included a background data sheet, the Conditions of Workplace Effectiveness and the Hospital Survey on Patient Safety Culture. Structural empowerment and patient safety culture were significantly correlated. As structural empowerment increased so did the RNs' perception of patient safety culture. To foster patient safety culture, nurse leaders should consider providing structurally empowering work environments for RNs. This study contributes to the body of knowledge linking structural empowerment and patient safety culture. Results link structurally empowered RNs and increased patient safety culture, essential elements in delivering efficient, competent, quality care. They inform nursing management of key factors in the nurses' environment that promote safe patient care environments. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force "drone" operators.

PubMed

Chappelle, Wayne L; McDonald, Kent D; Prince, Lillian; Goodman, Tanya; Ray-Sannerud, Bobbie N; Thompson, William

2014-08-01

The goal of this study is to repeat a survey administered in 2010 to assess for changes in mental health among United States Air Force aircrew operating Predator/Reaper remotely piloted aircraft, also commonly referred to as "drones." Participants were assessed for self-reported sources of occupational stress, levels of clinical distress using the Outcome Questionnaire-45.2, and symptoms of post-traumatic stress disorder (PTSD) using the PTSD Checklist-Military Version. A total of 1,094 aircrew responded to the web-based survey composed of the commercially available standardized instruments mentioned above. The survey also contained nonstandardized items asking participants to report the main sources of their occupational stress, as well as questions addressing demographics and work-related characteristics. The estimated response rate to the survey was 49%. Study results reveal the most problematic self-reported stressors are operational: low manning, extra duties/administrative tasks, rotating shift work, and long hours. The results also reveal 10.72% of operators self-reported experiencing high levels of distress and 1.57% reported high levels of PTSD symptomology. The results are lower than findings from the 2010 survey and from soldiers returning from Iraq and Afghanistan. Implications of the study and recommendations for United States Air Force line leadership and mental health providers are discussed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers--a case study.

PubMed

Andersen, Gunn Robstad; Westgaard, Rolf H

2013-11-15

Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.

Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers – a case study

PubMed Central

2013-01-01

Background Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. Methods The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. Results The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Conclusions Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures. PMID:24238560

Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis.

PubMed

Brühl, Albert; Planer, Katarina; Hagel, Anja

2018-01-01

A validity test was conducted to determine how care level-based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level-based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance. We used observer-based measurement of assignable direct and indirect care time in 68 nursing units for 2028 residents across 2 working days. Organizational data were collected at the end of the quarter in which the observation was made. Data were collected from January to March, 2012. We used a null multilevel model with random intercepts and multilevel models with fixed and random slopes to analyze data at both the organization and resident levels. A total of 14% of the variance in total care time per day was explained by membership in nursing units. The impact of care levels on care time differed significantly between nursing units. Forty percent of residents at the lowest care level received less than the standard minimum registered nursing time per day. For facilities that have been significantly disadvantaged in the current staffing system, a higher minimum standard will function more effectively than a complex classification system without scientific controls.

Relationship between meaningful work and job performance in nurses.

PubMed

Tong, Ling

2018-04-01

The present study was designed to determine the relationship between meaningful work and job performance, and the impact of meaningful work on nursing care quality. Meaningful work has been suggested as a significant factor affecting job performance, but the relationship has never been studied in nurses in China. A descriptive correlational study was designed to assess the level of meaningful work, tasks, and contextual performance as well as their relationships. We used a stratified random-sampling approach to enrol nurses from hospitals. Multivariate regression analysis was applied to determine the relationship between meaningful work and their demographic data. There were significant, positive relationships between meaningful work and task performance and contextual performance. Education level, work unit, and employment type influenced meaningful work. The work motivation score of the nurses was lower than that of the other 2 dimensions, and a negative work motivation score negatively influenced job performance. Improving meaningful work and providing more support and assistance could improve nurse performance, thereby improving the quality of nursing care. © 2018 John Wiley & Sons Australia, Ltd.

A retrospective and prospective look at strategies to increase adolescent HPV vaccine uptake in the United States.

PubMed

Head, Katharine J; Biederman, Erika; Sturm, Lynne A; Zimet, Gregory D

2018-01-23

The HPV vaccine debuted more than ten years ago in the United States and many strategies have been evaluated to increase HPV vaccination rates, which include not only improving current vaccination behaviors but also sustaining these behaviors. Researchers and practitioners from a variety of backgrounds have engaged in this work, which has included efforts directed at public health and government policies, health education and health promotion programs, and clinical and patient-provider approaches, as well as work aimed to respond to and combat anti-HPV vaccination movements in society. Using a previously developed conceptual model to organize and summarize each of these areas, this paper also highlights the need for future HPV vaccine promotion work to adopt a multi-level and, when possible, integrated approach in order to maximize impact on vaccination rates.

Cost and unit cost calculations using step-down accounting.

PubMed

Conteh, Lesong; Walker, Damian

2004-03-01

There is paucity of unit cost data from low- and middle-income countries, although recent initiatives have emerged to help rectify this. The limited budgets assigned to health care facilities mean that health planners and managers must be able to account for the resources used in health facilities as well as use them efficiently. Step-down cost accounting (SDCA) offers a relatively simple method for generating cost and unit cost data at the facility level. However, to the best of our knowledge, there is a lack of clear and concise guidance on how to undertake SDCA. Therefore, this paper, using a worked example, illustrates the different steps involved to generate cost and unit costs for a small hospital.

Churn: patient turnover and case mix.

PubMed

Duffield, Christine; Diers, Donna; Aisbett, Chris; Roche, Michael

2009-01-01

Patient throughput and casemix changes on nursing wards are little understood aspects of nursing's responsibility for nursing wards/units as hospital operations. In this study, the movement of patients on and off wards in 27 Australian public hospitals (286 wards) were analyzed over a 5-year period. Casemix change at the nursing unit level was also examined. In the data here, medical/surgical patients moved on average more than twice in an average hospital stay of only about 4 days. The absence of ward-level metrics compromises the ability of nursing unit/ward managers to meet their own efficiency and quality standards. Measurements of churn would give nurses another way to talk about the work of nursing to senior management and would give nurse executives a way to describe hospital operations and throughput and the impact on staff, patients, and resource allocation.

Practicing Internal Medicine Onboard the USNS COMFORT in the Aftermath of the Haitian Earthquake

DTIC Science & Technology

2010-06-01

majority of patients had severe anemia . Hemoglobin values under 70 g/L were common. Hypo- albuminemia with albumin levels less than 20 g/L was rou- tine...Psychology: 1 Wound care: 1 Social work: 2 ED emergency department; ICU intensive care unit; NICU neonatal intensive care unit; PICU pediatric...design, with state-of-the-art monitoring and mechanical ventilation ca- pabilities. The adult, pediatric, and neonatal ICUs were initially located in

Elaboration of leadership and culture in high-performing nursing units of hospitals as perceived by staff nurses.

PubMed

Casida, Jesus M; Crane, Patrick C; Walker, Tara L; Wargo, Lisa M

2012-01-01

The leadership-culture phenomenon, a known explanatory construct for organizational performance, is understudied in nursing. Building on our previous work, we further addressed this knowledge gap through explorations of demographics and hospital variables which may have a significant influence on staff nurses' (SNs) perceptions of their nurse managers' (NMs) leadership and nursing unit culture. Furthermore, we explored the extent to which the NMs' leadership predicted specific cultures which typify nursing unit effectiveness. Using dissertation data provided by278 SNs, we found that SNs educated at the baccalaureate level or higher had favorable perceptions of their nursing unit performance and viewed their NMs' leadership differently than the SNs with diploma or associate degrees. The frequent portrayals of transformational (TFL) leadership behaviors (e.g., visionary) by the NMs were paramount in shaping culture traits which exemplify high performance outcomes. TFL leaders were more likely to shape unit cultures which are flexible and adaptive to the environmental challenges within and outside the nursing unit. Thus, the type of NMs' leadership and unit culture may provide an added value in explaining the performance level in patient care units which consequently affects the overall hospital/organizational outcomes. Implications for research and leadership practices are presented.

Carpentry: Blueprint Interpretation.

ERIC Educational Resources Information Center

Nikol, Vojkan; Poniatowski, Stephen J.

Designed to supplement any standard textbook in the first-year level of related drafting instruction for carpentry, this manual contains original illustrations on graphic representation, pictorial representation, working drawings, and structured building details (exterior and interior). It consists of five units with separate lessons for each: (1)…

Perspectives of physicians and nurses regarding end-of-life care in the intensive care unit.

PubMed

Festic, Emir; Wilson, Michael E; Gajic, Ognjen; Divertie, Gavin D; Rabatin, Jeffrey T

2012-02-01

The delivery of end-of-life care (EOLC) in the intensive care unit (ICU) varies widely among medical care providers. The differing opinions of nurses and physicians regarding EOLC may help identify areas of improvement. To explore the differences of physicians and nurses on EOLC in the ICU and how these differences vary according to self-reported proficiency level and primary work unit. Cross-sectional survey of 69 ICU physicians and 629 ICU nurses. Single tertiary care academic medical institution. A total of 50 physicians (72%) and 331 nurses (53%) participated in the survey. Significant differences between physicians and nurses were noted in the following areas: ability to safely raise concerns, do not resuscitate (DNR) decision making, discussion of health care directives, timely hospice referral, spiritual assessment documentation, utilization of social services, and the availability of EOLC education. In every domain of EOLC, physicians reported a more positive perception than nurses. Additional differences were noted among physicians based on experience, as well as among nurses based on their primary work unit and self-reported proficiency level. Even with an increased focus on improving EOLC, significant differences continue to exist between the perspectives of nurses and physicians, as well as physicians among themselves and nurses among themselves. These differences may represent significant barriers toward providing comprehensive, consistent, and coordinated EOLC in the ICU.

Module Curriculum Guide: A Study of Ourstory in Africa Pre and Post "His-story." Reference Works of Yosef Ben Jochannan.

ERIC Educational Resources Information Center

Alexander, E. Curtis

The published and unpublished works of Dr. Yosef ben-Jochannan serve as the basis for this reference guide to African history and culture. The guide is intended for use by curriculum developers and high school and college level classroom teachers as they develop and implement courses on African studies and/or units to be incorporated into existing…

Multilevel Analysis of Neighborhood Characteristics and Prostate Cancer

DTIC Science & Technology

2012-09-01

widely by a number of key factors that may influence one’s well-being, stress level, lifestyle , and ultimately, disease susceptibility. These factors...outcomes, our work is helping to identify many neighborhood affects on prostate cancer, which include SES and lifestyle factors. The mechanisms of...Charnita Zeigler-Johnson 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: czj@mail.med.upenn.edu 5f. WORK UNIT NUMBER 7. PERFORMING

Let's Get Real: Deeper Learning and the Power of the Workplace. Deeper Learning Research Series. Executive Summary

ERIC Educational Resources Information Center

Hoffman, Nancy

2015-01-01

In the United States, we tend to assume that young people should become educated and then go to work, as though the two were entirely separate stages of life. This dichotomy blinds us to the fact that work itself can be a powerful means of education. Indeed, the workplace is where many young people become most engaged in learning high-level skills…

Implications of discrimination based on sexuality, gender, and race/ethnicity for psychological distress among working-class sexual minorities: the United for Health Study, 2003-2004.

PubMed

Chae, David H; Krieger, Nancy; Bennett, Gary G; Lindsey, Jane C; Stoddard, Anne M; Barbeau, Elizabeth M

2010-01-01

This study investigated the distribution of demographic characteristics, the prevalence of discrimination based on sexuality, gender, and race, and relationships with psychological distress among 178 working-class sexual minorities (i.e., who identified as lesbian, gay, or bisexual (LGB) or had ever engaged in same-sex sexual behaviors) recruited to the United for Health Study (2003-2004). The results indicated considerable heterogeneity in responses to items assessing sexual orientation and sexual behavior, with a majority of sexual minority participants not identifying as LGB (74.2%). The authors found significant demographic differences in LGB identification by gender, race/ethnicity, nativity, and socioeconomic factors. In addition, LGB participants had higher levels of psychological distress than non-LGB-identified sexual minorities. Linear regression analyses revealed that reports of racial/ethnic discrimination and sexuality discrimination were associated with higher levels of psychological distress among sexual minority participants. The results underscore the need to collect multiple measures of sexuality in conducting research on racially diverse working-class communities; to consider demographic factors in collecting sexuality data; and to disaggregate information on sexuality by LGB identification. Findings also highlight the importance of addressing discrimination in ameliorating problematic mental health outcomes among working-class sexual minorities.

Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors.

PubMed

Andolhe, Rafaela; Barbosa, Ricardo Luis; Oliveira, Elaine Machado de; Costa, Ana Lúcia Siqueira; Padilha, Katia Grillo

2015-02-01

Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.

Working With Your School. A Handbook of the Texas Advisory Committee to the United States Commission on Civil Rights.

ERIC Educational Resources Information Center

Anchondo, Jose Jorge; And Others

Public education consists of various levels of laws, policies, regulations, rules, guidelines, and practices based on the U.S. Constitution. At each level, there is a set of "do's and don'ts" guiding the actions of people involved in public education. This handbook, written to help people understand their rights relating to public…

Women of Hispanic Origin in the United States Labor Force. Facts on Working Women. Fact Sheet No. 85-11.

ERIC Educational Resources Information Center

Department of Labor, Washington, DC.

A four-page synposis of data on women of Hispanic origin in the labor force is presented. Data included are numbers of Hispanic women in the labor force; percentage of Hispanics among women in labor force; percentage of Hispanic women in the labor force; median ages; unemployment rate; education level; income levels; types of jobs occupied…

Secukinumab Significantly Reduces Psoriasis-Related Work Impairment and Indirect Costs Compared With Ustekinumab and Etanercept in the United Kingdom.

PubMed

Warren, R B; Halliday, A; Graham, C N; Gilloteau, I; Miles, L; McBride, D

2018-05-30

Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (1) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (2) weekly/annual work productivity loss by PASI response level; (3) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (4) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different timepoints and with patient cohorts, including FIXTURE. In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI <50: 22.8%/7.60 hours; PASI 50-74: 13.3%/4.45 hours; PASI 75-89: 6.4%/2.14 hours; PASI ≥90: 4.9%/1.65 hours. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P=0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρ<0.0001). Average annual indirect cost savings with secukinumab were £355 versus ustekinumab and £1,061 versus etanercept. Results at 52 weeks were similar. Secukinumab significantly reduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the UK. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Effects of reflection on clinical decision-making of intensive care unit nurses.

PubMed

Razieh, Shahrokhi; Somayeh, Ghafari; Fariba, Haghani

2018-07-01

Nurses are one of the most influential factors in overcoming the main challenges faced by health systems throughout the world. Every health system should, hence, empower nurses in clinical judgment and decision-making skills. This study evaluated the effects of implementing Tanner's reflection method on clinical decision-making of nurses working in an intensive care unit (ICU). This study used an experimental, pretest, posttest design. The setting was the intensive care unit of Amin Hospital Isfahan, Iran. The convenience sample included 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). This clinical trial was performed on 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). The nurses were selected by census sampling and randomly allocated to either the case or the control group. Data were collected using a questionnaire containing demographic characteristics and the clinical decision-making scale developed by Laurie and Salantera (NDMI-14). The questionnaire was completed before and one week after the intervention. The data were analyzed using SPSS 21.0. The two groups were not significantly different in terms of the level and mean scores of clinical decision-making before the intervention (P = 0.786). Based on the results of independent t-test, the mean score of clinical decision-making one week after the intervention was significantly higher in the case group than in the control group (P = 0.009; t = -2.69). The results of Mann Whitney test showed that one week after the intervention, the nurses' level of clinical decision-making in the case group rose to the next level (P = 0.001). Reflection could improve the clinical decision-making of ICU nurses. It is, thus, recommended to incorporate this method into the nursing curriculum and care practices. Copyright © 2018. Published by Elsevier Ltd.

EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

PubMed

DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

Embedded piezoelectrics for sensing and energy harvesting in total knee replacement units

NASA Astrophysics Data System (ADS)

Wilson, Brooke E.; Meneghini, Michael; Anton, Steven R.

2015-04-01

The knee replacement is the second most common orthopedic surgical intervention in the United States, but currently only 1 in 5 knee replacement patients are satisfied with their level of pain reduction one year after surgery. It is imperative to make the process of knee replacement surgery more objective by developing a data driven approach to ligamentous balance, which increases implant life. In this work, piezoelectric materials are considered for both sensing and energy harvesting applications in total knee replacement implants. This work aims to embed piezoelectric material in the polyethylene bearing of a knee replacement unit to act as self-powered sensors that will aid in the alignment and balance of the knee replacement by providing intraoperative feedback to the surgeon. Postoperatively, the piezoelectric sensors can monitor the structural health of the implant in order to perceive potential problems before they become bothersome to the patient. Specifically, this work will present on the use of finite element modeling coupled with uniaxial compression testing to prove that piezoelectric stacks can be utilized to harvest sufficient energy to power sensors needed for this application.

[Stress in the nursing team of an emergency medical service].

PubMed

Panizzon, Cristiane; Luz, Anna Maria Hecker; Fensterseifer, Lísia Maria

2008-09-01

This exploratory study aimed at determining stress levels and stressors, verifying the association between stress and studied variables, and identifying the predictive stress factors in an emergency nursing team. Data were collected using a social-demographic questionnaire and a scale of labor pressure sources applied with 98 workers. Chi-square test and Spearman correlation test results showed a high stress level, and identified work load as the main stressor. All pressure sources at work had a positive significant correlation with stress leve, and the following predictors were identified: work load, problems related to the client, and organizational processes and structure. The results indicate the need of management changes in the emergency unit in order to reduce the stress of the nursing team.

An ethical leadership program for nursing unit managers.

PubMed

Jeon, Sang Hee; Park, Mihyun; Choi, Kyungok; Kim, Mi Kyoung

2018-03-01

The aims of this study were to evaluate the effect of an ethical leadership program (ELP) on ethical leadership, organizational citizenship behavior (OCB), and job outcomes of nursing unit managers (UMs) and to examine changes in staff nurses' perception about UMs' EL, OCB, job outcomes, and ethical work environments (EWEs) post-ELP. A quasi-experimental (pre- and post-test design) study conducted six-month intervention (ELP) using self-reported UM survey (n=44), and staff nurses (n=158) were randomly extracted by two steps. The Korean version of Ethical Leadership at Work for UMs' self-ethical leadership, the Ethical Leadership Scale for staff nurses' perceived ethical leadership, a 19-item OCB scale, and six dimensions of the medium-sized Copenhagen Psychosocial Questionnaire II for job outcomes and EWEs were administered at baseline and post-intervention. UMs' ethical leadership scores differed significantly over time in people orientation (p=0.041) and concern for ethical leadership sustainability (p=0.002) adjusting for UM experience duration and nursing unit type. Total mean and level of power-sharing of ethical leadership among UMs with <5years of UM experience improved significantly over time. Of staff nurses' perception changes about UMs' ethical leadership, OCB, job outcomes, and EWEs, significant improvement over time appeared only in EWEs' work influence level (p=0.007). This study provides useful information for clinical ELP development and examining the program's effect on leadership skills and followers' outcomes. Program facilitation relies on practical training methods, participant motivation, and assessment outcome designs by controlling clinical confounding factors. Findings have implications as an attempt for intervention to promote competencies related to ethical leadership of nursing unit managers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association of Resident Duty Hour Restrictions, Level of Trainee, and Number of Available Residents with Mortality in the Neonatal Intensive Care Unit.

PubMed

Beltempo, Marc; Clement, Karin; Lacroix, Guy; Bélanger, Sylvie; Julien, Anne-Sophie; Piedboeuf, Bruno

2018-02-08

 This article assesses the effect of reducing consecutive hours worked by residents from 24 to 16 hours on yearly total hours worked per resident in the neonatal intensive care unit (NICU) and evaluates the association of resident duty hour reform, level of trainee, and the number of residents present at admission with mortality in the NICU.  This is a 6-year retrospective cohort study including all pediatric residents working in a Level 3 NICU ( N  = 185) and infants admitted to the NICU ( N  = 8,159). Adjusted odds ratios (aOR) were estimated for mortality with respect to Epoch (2008-2011 [24-hour shifts] versus 2011-2014 [16-hour shifts]), level of trainee, and the number of residents present at admission.  The reduction in maximum consecutive hours worked was associated with a significant reduction of the median yearly total hours worked per resident in the NICU (381 hour vs. 276 hour, p  < 0.01). Early mortality rate was 1.2% (50/4,107) before the resident duty hour reform and 0.8% (33/4,052) after the reform (aOR, 0.57; 95% confidence interval [CI], 0.33-0.98). Neither level of trainee (aOR, 1.22; 95% CI, 0.71-2.10; junior vs. senior) nor the number of residents present at admission (aOR, 2.08; 95% CI, 0.43-10.02, 5-8 residents vs. 0-2 residents) were associated with early mortality. Resident duty hour reform was not associated with hospital mortality (aOR, 0.73; 95% CI, 0.50-1.07; after vs. before resident duty hour reform).  Resident duty hour restrictions were associated with a reduction in the number of yearly hours worked by residents in the NICU as well as a significant decrease in adjusted odds of early mortality but not of hospital mortality in admitted neonates. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Basic Facts about the United Nations.

ERIC Educational Resources Information Center

United Nations, New York, NY. Office of Public Information.

The work of the United Nations is described in summary form. Material is divided into sections on the origin, programs, purpose, principles, and structure of the United Nations; the United Nations at work for International Peace; the United Nations at Work for Economic and Social Development; The United Nations at Work for Decolonization; the…

Motion analysis and trials of the deep sea hybrid underwater glider Petrel-II

NASA Astrophysics Data System (ADS)

Liu, Fang; Wang, Yan-hui; Wu, Zhi-liang; Wang, Shu-xin

2017-03-01

A hybrid underwater glider Petrel-II has been developed and field tested. It is equipped with an active buoyancy unit and a compact propeller unit. Its working modes have been expanded to buoyancy driven gliding and propeller driven level-flight, which can make the glider work in strong currents, as well as many other complicated ocean environments. Its maximal gliding speed reaches 1 knot and the propelling speed is up to 3 knots. In this paper, a 3D dynamic model of Petrel-II is derived using linear momentum and angular momentum equations. According to the dynamic model, the spiral motion in the underwater space is simulated for the gliding mode. Similarly the cycle motion on water surface and the depth-keeping motion underwater are simulated for the level-flight mode. These simulations are important to the performance analysis and parameter optimization for the Petrel-II underwater glider. The simulation results show a good agreement with field trials.

Psychosocial safety climate moderates the job demand-resource interaction in predicting workgroup distress.

PubMed

Dollard, Maureen F; Tuckey, Michelle R; Dormann, Christian

2012-03-01

Psychosocial safety climate (PSC) arises from workplace policies, practices, and procedures for the protection of worker psychological health and safety that are largely driven by management. Many work stress theories are based on the fundamental interaction hypothesis - that a high level of job demands (D) will lead to psychological distress and that this relationship will be offset when there are high job resources (R). However we proposed that this interaction really depends on the organizational context; in particular high levels of psychosocial safety climate will enable the safe utilization of resources to reduce demands. The study sample consisted of police constables from 23 police units (stations) with longitudinal survey responses at two time points separated by 14 months (Time 1, N=319, Time 2, N=139). We used hierarchical linear modeling to assess the effect of the proposed three-way interaction term (PSC×D×R) on change in workgroup distress variance over time. Specifically we confirmed the interaction between emotional demands and emotional resources (assessed at the individual level), in the context of unit psychosocial safety climate (aggregated individual data). As predicted, high emotional resources moderated the positive relationship between emotional demands and change in workgroup distress but only when there were high levels of unit psychosocial safety climate. Results were confirmed using a split-sample analysis. Results support psychosocial safety climate as a property of the organization and a target for higher order controls for reducing work stress. The 'right' climate enables resources to do their job. Copyright © 2011 Elsevier Ltd. All rights reserved.

Association of the nurse work environment with nurse incivility in hospitals.

PubMed

Smith, Jessica G; Morin, Karen H; Lake, Eileen T

2018-03-01

To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.

The culture contributing to interruptions in the nursing work environment: An ethnography.

PubMed

Hopkinson, Susan G; Wiegand, Debra L

2017-12-01

To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.

The Effect of Personnel Stability on Organizational Performance: Do Battalions with Stable Command Groups Achieve Higher Training Proficiency at the National Training Center?

DTIC Science & Technology

2008-01-01

Graduate School and the students they work with on a routine basis. All three of my committee members have been superb mentors in helping me develop the...Deployable” and “Individual Replacement Induced Non-Deployable.” Wartime non-deployable status is provided to soldiers who are unavailable due to medical ...responder medical tasks, mastery of communication systems, and basic reporting requirements. The unit can progress to small-unit level collective training

Mammalian Survey Techniques for Level II Natural Resource Inventories on Corps of Engineers Projects (Part 1)

DTIC Science & Technology

2009-07-01

Part 1) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR (S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7...that could 2 ERDC TN-EMRRP-SI-34 July 2009 potentially affect human health. Diseases of concern include lyme disease, hantavirus , and rabies...University Press. Cockrum, E. L. 1997. Rabies, lyme disease, hantavirus and other animal-borne diseases in the United States and Canada. Fisher Books

Using the WEIS-SR to evaluate employee perceptions of their college work environment.

PubMed

Dorsey, Julie; Kaye, Miranda; Barratt, Jennifer; Biondi, Jennifer; Habrial, Amanda; Lane, Amanda; Marinelli, Victoria; Paulino, Tiffany; Singletary, Amanda

2016-04-06

Colleges have been experiencing reduced resource allocations, shifting student expectations, and organizational change. These changes increase employee stress at all levels. Ensuring that employee needs are being met and promoting a healthy and productive workforce has never been more important. To investigate employees' current perceptions of their work environments using the Work Environment Impact Scale-Self Rating (WEIS-SR). Full and part time employees on a small college campus in the United States were surveyed using the WEIS-SR through an online survey program to protect their anonymity. Perception of staffing levels, workplace support for a healthy lifestyle, number of supervisors, and personal health ratings contributed to employee perceptions of their work environment. There were also differences between staff, administration, and tenured and non-tenured faculty. From an occupational performance perspective, valuable information on employees' levels of volition, performance capacity and habituation, and perceptions of their physical and social environment in relation to their work environments was obtained. Further support for the use of the WEIS-SR and psychometric properties of the instrument (reliability and validity) was obtained.

ELV Payload Safety Program Workshop Green Propulsion Update

NASA Technical Reports Server (NTRS)

Robinson, Joel

2014-01-01

MSFC is engaged on the system solution: thrusters and power units; GRC is working plume diagnostics/modeling and independent thruster testing on GPIM.; GSFC is working slosh characteristics on GPIM tank.; JPL and ARC continually interested to infuse green propellant as potential replacement to hydrazine.; Mike Gazarik, AA of STMD, has requested MSFC lead the development of an Agency-level green propellant roadmap involving multiple Centers., Tentatively planned for August 2015 in Huntsville.

Guidelines for Guest Conductors of Honor Choirs: When Planning and Conducting Honor Ensembles, Focus on Creating a Rewarding Experience for All from Start to Finish

ERIC Educational Resources Information Center

Freer, Patrick K.

2007-01-01

Because there are hundreds, perhaps thousands, of honor choir events each year across the United States, most choir directors will likely be invited to conduct an honor choir at one point or another. Additionally, many conductors will work with honor choirs at the city, municipal, and county levels. Still others will work with ensembles from…

The Family. Preserving America's Future. A Report to the President from the White House Working Group on the Family.

ERIC Educational Resources Information Center

Domestic Policy Council, Washington, DC.

The White House Working Group on the Family was mandated to study how government at all levels could be made supportive of American families (i.e., how a pro-family policy could be implemented). This report on the status of family life in the United States opens with guidelines by which to judge public policy and its effects on the family. The…

Burnout contagion among intensive care nurses.

PubMed

Bakker, Arnold B; Le Blanc, Pascale M; Schaufeli, Wilmar B

2005-08-01

This paper reports a study investigating whether burnout is contagious. Burnout has been recognized as a problem in intensive care units for a long time. Previous research has focused primarily on its organizational antecedents, such as excessive workload or high patient care demands, time pressure and intensive use of sophisticated technology. The present study took a totally different perspective by hypothesizing that--in intensive care units--burnout is communicated from one nurse to another. A questionnaire on work and well-being was completed by 1849 intensive care unit nurses working in one of 80 intensive care units in 12 different European countries in 1994. The results are being reported now because they formed part of a larger study that was only finally analysed recently. The questionnaire was translated from English to the language of each of these countries, and then back-translated to English. Respondents indicated the prevalence of burnout among their colleagues, and completed scales to assess working conditions and job burnout. Analysis of variance indicated that the between-unit variance on a measure of perceived burnout complaints among colleagues was statistically significant and substantially larger than the within-unit variance. This implies that there is considerable agreement (consensus) within intensive care units regarding the prevalence of burnout. In addition, the results of multilevel analyses showed that burnout complaints among colleagues in intensive care units made a statistically significant and unique contribution to explaining variance in individual nurses' and whole units' experiences of burnout, i.e. emotional exhaustion, depersonalization and reduced personal accomplishment. Moreover, for both emotional exhaustion and depersonalization, perceived burnout complaints among colleagues was the most important predictor of burnout at the individual and unit levels, even after controlling for the impact of well-known organizational stressors as conceptualized in the demand-control model. Burnout is contagious: it may cross over from one nurse to another.

Role of physician assistants in dialysis units and nephrology.

PubMed

Anderson, J E; Torres, J R; Bitter, D C; Anderson, S C; Briefel, G R

1999-04-01

We surveyed physician assistants who work in nephrology to report their experience level, primary employer, salary, job responsibilities, and job satisfaction. Additional data were obtained from the Nephrology Manpower Study. The 67 responding physician assistants of 97 surveyed have 10.8 +/- 6.5 years (mean +/- standard deviation) total experience (6.2 +/- 5.0 years in nephrology). Typically, nephrologists (56.1%) or hospitals (30.3%) employ them. The majority (74%) earn $49,999 to $75,000; 79.1% work in outpatient units, 52.4% in inpatient units, 52.4% in hospitals, 43.3% in outpatient offices, and 23.9% in transplant units. In outpatient units, they manage 111 +/- 111 patients, mostly in free-standing (71.1%), for-profit (69.7%), corporately owned (87.3%) units in urban (80%) or suburban (18%) areas. Most (>85%) manage all dialysis- and nondialysis-related problems, including health maintenance; 84.3% are contacted first by staff, and 78% see patients more often than physicians. Of nephrologists who responded to the Manpower Study, 8.9% work with physician assistants and 20.7% work with nurse practitioners. Nephrologists in academic practice or private nephrology groups are more likely to use physician assistants (P < 0.05) and nurse practitioners (P < 0.005) than those in solo practice or multispecialty groups. Nephrologists with physician assistants (33.8 +/- 19.5 v 41.7 +/- 16.8 h/wk) or nurse practitioners (35.8 +/- 18.1 v 42.7 +/- 16.9 h/wk) tended to spend less time in direct patient care than those without physician extenders (P < 0.001). Nephrologists with renal fellows, however, spent the least time of all in direct patient care (30.0 +/- 15.9 v 47.3 +/- 14.9 h/wk; P < 0.001). Physician assistants can perform nearly all the medical tasks in dialysis units. They may offer one approach to providing effective and complete care for patients if nephrology manpower becomes limited.

Lee y trabaja: Libro de lectura 2, nivel 1 (Read and Work: Reader 2, Level 1).

ERIC Educational Resources Information Center

Martinez, Emiliano; and Others

This reading textbook, the second of a series, is an anthology of stories designed to relate to the natural interest of the elementary school child. On this level the number of words to memorize is increased (on the average, four per unit) while at the same time, the study of word variants is introduced to begin analysis exercises based on the…

A general approach for predicting the behavior of the Supreme Court of the United States

PubMed Central

Bommarito, Michael J.; Blackman, Josh

2017-01-01

Building on developments in machine learning and prior work in the science of judicial prediction, we construct a model designed to predict the behavior of the Supreme Court of the United States in a generalized, out-of-sample context. To do so, we develop a time-evolving random forest classifier that leverages unique feature engineering to predict more than 240,000 justice votes and 28,000 cases outcomes over nearly two centuries (1816-2015). Using only data available prior to decision, our model outperforms null (baseline) models at both the justice and case level under both parametric and non-parametric tests. Over nearly two centuries, we achieve 70.2% accuracy at the case outcome level and 71.9% at the justice vote level. More recently, over the past century, we outperform an in-sample optimized null model by nearly 5%. Our performance is consistent with, and improves on the general level of prediction demonstrated by prior work; however, our model is distinctive because it can be applied out-of-sample to the entire past and future of the Court, not a single term. Our results represent an important advance for the science of quantitative legal prediction and portend a range of other potential applications. PMID:28403140

Occupational stress and job satisfaction of healthcare staff in rehabilitation units.

PubMed

Fiabane, Elena; Giorgi, Ines; Musian, D; Sguazzin, Cinzia; Argentero, P

2012-01-01

Occupational stress and job dissatisfaction are recognized risk factors for healthcare professionals and can lead to a decrease in work performance and in the quality of care offered, and to poorer health of workers. Research in the rehabilitation care setting is very limited and needs to be explored. To investigate occupational stress, job satisfaction and their relationships with organizational factors among healthcare staff in rehabilitation units. A cross-sectional study of healthcare staff working in two rehabilitation units was conducted. They were sent two self-administered questionnaires, the Occupational Stress Indicator (OSI) and the Areas of Work life Scale (AWS), in order to assess occupational stress and job satisfaction. One-way ANOVA was used to explore work stress among two groups of workers, characterized by high and low job satisfaction levels. Stepwise multiple linear regression analysis was conducted to assess the association between job satisfaction and organizational risk factors. A total of 90 questionnaires were returned (response rate 53%). The main sources of stress were unfairness, conflict between personal and organizational values, lack of reward and workload Workers with low job satisfaction significantly scored higher in work-related stress in regard to various aspects of work, and in lower job control. Regression analysis showed that the most important predictors of job satisfaction were fairness and workload. The results of this study showed that job dissatisfaction is strongly associated with work stress and certain organizational risk factors. This study suggests the importance of focusing on the psychosocial factors in the work environment and job satisfaction in order to improve the well-being of rehabilitation healthcare staff.

[Professional Satisfaction within Family Health Units of Central Region].

PubMed

Passadouro, Rui; Ferreira, Pedro Lopes

2016-11-01

Job satisfaction, as an organizational climate indicator, is a complex and subjective phenomenon. It is prone to individual variation, social settings and suitable to multiple explanatory theories. It can impact productivity and absenteeism, predict well-being, and it is associated with mental health, self-esteem and perception of physical health. It is comprised as one of the National Health Service evaluation criteria. This study aimed to assess the level of job satisfaction in family health units of Central Region of the country. This was an observational, cross-sectional study with a descriptive analysis model and a correlational component. The Centro de Estudos e Investigação em Saúde da Universidade de Coimbra's Professional Satisfaction Assessment Instrument was selected as data collection instrument. Among a universe of 809 health professionals, a total of 774 professionals participated in this study population. The observed response rate was 66.4% at the Professional Satisfaction Assessment Instrument, corresponding to 514 professionals. Eighty two per cent of the respondents were female and 18% male. From the total subjects, 64.8% worked in model A units and the remaining 35.2% in model B units. Regarding professional categories, 34.2% were nurses, 39.8% were doctors and 26.0% clinical secretaries. The global level of satisfaction was 71.5% being 67.4% with the quality of the work setting, 78.3% with the quality of the care provided and 80.7% with the continuous improvement of quality. The sample was predominantly composed by female subjects (82%), in line with current gender distribution of professionals. Found levels of job satisfaction (71.5%) were 5.4% lower than previously recorded in 2009. We recommend systematic evaluation of job satisfaction in contracting regimens, similarly to user satisfaction.

Clinical microsystems, Part 3. Transformation of two hospitals using microsystem, mesosystem, and macrosystem strategies.

PubMed

Godfrey, Marjorie M; Melin, Craig N; Muething, Stephen E; Batalden, Paul B; Nelson, Eugene C

2008-10-01

Two hospitals-a large, urban academic medical center and a rural, community hospital-have each chosen a similar microsystem-based approach to improvement, customizing the engagement of the micro-, meso-, and macrosystems and the improvement targets on the basis of an understanding of the local context. CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (CCHMC): Since 2004, strategic changes have been developed to support microsystems and their leaders through (1) ongoing improvement training for all macro-, meso-, and microsystem leaders; (2) financial support for physicians who are serving as co-leaders of clinical microsystems; (3) increased emphasis on aligning academic pursuits with improvement work at the clinical front lines; (4) microsystem leaders' continuous access to unit-level data through the organization's intranet; and (5) encouragement of unit leaders to share outcomes data with families. CDH has moved from near closure to a survival-turnaround focus, significant engagement in quality and finally, a complete reframing of a quality focus in 2004. Since then, it has deployed the clinical microsystems approach in one pilot care unit (West 2, a medical surgery unit), broadened it to two, then six more, and is now spreading it organizationwide. In "2+2 Charters," interdisciplinary teams address two strategic goals set by senior leadership and two goals set by frontline microsystem leaders and staff CCHMC and CDH have had a clear focus on developing alignment, capability, and accountability to fuse together the work at all levels of the hospital, unifying the macrosystem with the mesosystem and microsystem. Their improvement experience suggests tips and actions at all levels of the organization that could be adapted with specific context knowledge by others.

USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

This map service displays the results data from the EPA's Environmental Quality Index. The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

26 CFR 801.6 - Business results measures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... IRS personnel provided accurate tax law and account information. (3) Other work units. The quality... data that does not contain information regarding the tax enforcement result reached in any case that...) Number or percentage of overage cases; (9) Inventory information; (10) Toll-free level of access; and (11...

BOTOX and our tax dollars at work

USDA-ARS?s Scientific Manuscript database

This seminar is intended for Masters level graduate students in biology at the University of the Pacific. Topics of the seminar will include information on USDA-ARS research at the Albany location and general background on botulism and neurotoxin biology. In addition, the following FCR unit botulinu...

Living in Space

NASA Technical Reports Server (NTRS)

Andrews, Sheila Briskin; Kirschenbaum, Audrey

1988-01-01

Operation Liftoff was designed to encourage pupils in the nation's elementary schools to take a greater interest in mathematics and science. Topics addressed include: food, clothing, health, housing, communication, and working. Each unit consists of background information, a teacher printout (lesson plan), and student liftoff (activities) for levels A, B, and C.

Peanut Roaster Temperatures Relative to Salmonella Kill

USDA-ARS?s Scientific Manuscript database

ARS, Market Quality and Handling Research Unit, Raleigh NC 27695 In response to the limited peanut butter contamination incident of 2006/7, studies were initiated to examine the effect of various time and temperature protocols on log kill levels for Salmonella on peanuts. The objective of the work ...

United States Marine Corps Motor Transport Mechanic-to-Equipment Ratio

DTIC Science & Technology

time motor transport equipment remains in maintenance at the organizational command level. This thesis uses a discrete event simulation model of the...applied to a single experiment that allows for assessment of risk of not achieving the objective. Inter-arrival time, processing time, work schedule

[Application of new technologies in the design, manufacture and use of technology deployment of field medical units and establishments].

PubMed

Iakovlev, S V; Sidorov, V A; Korniushko, I G; Medvedev, V R; Matveev, A G

2011-11-01

Presented data is about attendance means of deployment of field medical units and pieces of army-level medical services and disaster medicine Defense Ministry did not ensure compliance with requirements to create optimal conditions for highly effective work of the medical staff, placing the wounded, the use of modern aids and appliances. The prospects of creation of mobile unit for high-availability modular pre-fabricated on the basis of tent structures, pneumoconstructions and removable habitable bodies, containers, tents, pneumocovers till 2020 are analyzed. Livelihood systems provide armor protection against fragments, bullets, flames, damaging factors of chemical and biological weapons.

An international perspective: supporting adolescents with speech, language, and communication needs in the United Kingdom.

PubMed

Joffe, Victoria

2015-02-01

This article provides an overview of the education system in the United Kingdom, with a particular focus on the secondary school context and supporting older children and young people with speech, language, and communication needs (SLCNs). Despite the pervasive nature of speech, language, and communication difficulties and their long-term impact on academic performance, mental health, and well-being, evidence suggests that there is limited support to older children and young people with SLCNs in the United Kingdom, relative to what is available in the early years. Focus in secondary schools is predominantly on literacy, with little attention to supporting oral language. The article provides a synopsis of the working practices of pediatric speech and language therapists working with adolescents in the United Kingdom and the type and level of speech and language therapy support provided for older children and young people with SLCNs in secondary and further education. Implications for the nature and type of specialist support to adolescents and adults with SLCNs are discussed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Will musculoskeletal, visual and psychosocial stress change for visual display unit (VDU) operators when moving from a single-occupancy office to an office landscape?

PubMed

Helland, Magne; Horgen, Gunnar; Kvikstad, Tor Martin; Garthus, Tore; Aarås, Arne

2008-01-01

This study investigated the effect of moving from single-occupancy offices to a landscape environment. Thirty-two visual display unit (VDU) operators reported no significant change in visual discomfort. Lighting conditions and glare reported subjectively showed no significant correlation with visual discomfort. Experience of pain was found to reduce subjectively rated work capacity during VDU tasks. The correlation between visual discomfort and reduced work capacity for single-occupancy offices was rs=.88 (p=.000) and for office landscape rs=.82 (p=.000). Eye blink rate during habitual VDU work was recorded for 12 operators randomly selected from the 32 participants in the office landscape. A marked drop in eye blink rate during VDU work was found compared to eye blink rate during easy conversation. There were no significant changes in pain intensity in the neck, shoulder, forearm, wrist/hand, back or headache (.24

Predicted shortage of vascular surgeons in the United Kingdom: A matter for debate?

PubMed

Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

2016-10-01

Vascular surgery became a new independent surgical specialty in the United Kingdom (UK) in 2013. In this matter for debate we discuss the question, is there a "shortage of vascular surgeons in the United Kingdom?" We used data derived from the "Vascular Surgery United Kingdom Workforce Survey 2014", NHS Employers Electronic Staff Records (ESR), and the National Vascular Registry (NVR) surgeon-level public report to estimate current and predict future workforce requirements. We estimate there are approximately 458 Consultant Vascular Surgeons for the current UK population of 63 million, or 1 per 137,000 population. In several UK Regions there are a large number of relatively small teams (3 or less) of vascular surgeons working in separate NHS Trusts in close geographical proximity. In developed countries, both the number and complexity of vascular surgery procedures (open and endovascular) per capita population is increasing, and concerns have been raised that demand cannot be met without a significant expansion in numbers of vascular surgeons. Additional workforce demand arises from the impact of population growth and changes in surgical work-patterns with respect to gender, working-life-balance and 7-day services. We predict a future shortage of Consultant Vascular Surgeons in the UK and recommend an increase in training numbers and an expansion in the UK Consultant Vascular Surgeon workforce to accommodate population growth, facilitate changes in work-patterns and to create safe sustainable services. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Haemodialysis work environment contributors to job satisfaction and stress: a sequential mixed methods study.

PubMed

Hayes, Bronwyn; Bonner, Ann; Douglas, Clint

2015-01-01

Haemodialysis nurses form long term relationships with patients in a technologically complex work environment. Previous studies have highlighted that haemodialysis nurses face stressors related to the nature of their work and also their work environments leading to reported high levels of burnout. Using Kanters (1997) Structural Empowerment Theory as a guiding framework, the aim of this study was to explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses. Using a sequential mixed-methods design, the first phase involved an on-line survey comprising demographic and work characteristics, Brisbane Practice Environment Measure (B-PEM), Index of Work Satisfaction (IWS), Nursing Stress Scale (NSS) and the Maslach Burnout Inventory (MBI). The second phase involved conducting eight semi-structured interviews with data thematically analyzed. From the 417 nurses surveyed the majority were female (90.9 %), aged over 41 years of age (74.3 %), and 47.4 % had worked in haemodialysis for more than 10 years. Overall the work environment was perceived positively and there was a moderate level of job satisfaction. However levels of stress and emotional exhaustion (burnout) were high. Two themes, ability to care and feeling successful as a nurse, provided clarity to the level of job satisfaction found in phase 1. While two further themes, patients as quasi-family and intense working teams, explained why working as a haemodialysis nurse was both satisfying and stressful. Nurse managers can use these results to identify issues being experienced by haemodialysis nurses working in the unit they are supervising.

IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK

PubMed Central

Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M.; O’Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J. Michael; Casper, Lynne

2015-01-01

Purpose Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. Methodology/approach This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). Findings We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Practical implications Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health. Originality/value of the chapter We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work. PMID:25866431

IS WORK-FAMILY CONFLICT A MULTILEVEL STRESSOR LINKING JOB CONDITIONS TO MENTAL HEALTH? EVIDENCE FROM THE WORK, FAMILY AND HEALTH NETWORK.

PubMed

Moen, Phyllis; Kaduk, Anne; Kossek, Ellen Ernst; Hammer, Leslie; Buxton, Orfeu M; O'Donnell, Emily; Almeida, David; Fox, Kimberly; Tranby, Eric; Oakes, J Michael; Casper, Lynne

Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health. This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress). We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals' perceptions of their job conditions are better predictors of individuals' work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes. Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees' mental health. We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a "private trouble" and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work.

Practices during the active second stage of labor: A survey of French midwives.

PubMed

Barasinski, Chloé; Debost-Legrand, Anne; Lemery, Didier; Vendittelli, Françoise

2018-05-01

the principal objective of our study was to describe the practices reported by French midwives during the active second stage of labor (expulsion phase). this cross-sectional Internet survey questioned French midwives who attended at least one childbirth in 2013. this open survey was posted on a website from June 15 through December 1, 2014. 1496 midwives from 377 maternity units participated in the study. the midwives most often reported suggesting horizontal positions during the active second stage (supine with footholds, lithotomy, lithotomy with knees turned in, or lateral positions). Non-horizontal positions were more often proposed by midwives in level I units (p<0.0001). Almost half the midwives responding (46.4%), especially those working in level III units (51.1%, p = 0.006), advised Valsalva pushing. The mean maximum pushing time was 35.3 minutes±12.8 minutes. Nearly all the midwives favored the 'hands on' technique at childbirth (91.4%), and 24% reported using warm compresses on the perineum at childbirth. most midwives advised horizontal positions for childbirth. The practices of French midwives differed as a function of where they worked. The midwives, especially those in level III facilities, reported that they cannot always ensure 'physiological childbirth'. the practices of French midwives must become more evidence-based. The development of professional guidelines for midwives in France appears essential. This study also helps to prioritise national training for midwives. Copyright © 2018 Elsevier Ltd. All rights reserved.

The effect of training on noise reduction in neonatal intensive care units.

PubMed

Calikusu Incekar, Mujde; Balci, Serap

2017-07-01

Noise, an environmental stimulus, is especially important in the neurobehavioral development of newborns and brain development of infants at high risk. Conditions in the neonatal intensive care units (NICUs) may cause certain sensory stimuli that are not appropriate for the development of newborns, especially preterm infants. This study was conducted in order to determine noise levels in the NICU and to evaluate the effect of training provided for noise control. This study was conducted as a pretest-posttest quasiexperimental design between September and November 2014 in a 30-bed NICU of a tertiary hospital in Istanbul. A sample group consisting of 30 people (26 nurses, 4 care workers). Noise measurement devices were used in the Training Program of Noise Control. Of the health professionals, 96.7% were women, 86.7% were nurses, and 63.3% were university graduates. Some 36.7% of the health professionals had worked within the unit for more than 5 years. Noise measurements of full implementations were made over three 24-h periods. Noise measurements were taken before and after the training on Monday, Friday, and Sunday. Noise levels after training diminished in all three measurements, and the decrease was found statistically significant (P < 0.01). Planned Noise Control Training for health professionals who work in NICUs is an effective way of reducing noise. We recommend that this training should be given to NICU health professionals and noise levels should be determined through measurements at specific times. © 2017 Wiley Periodicals, Inc.

Critical care nurses' perceptions of the outcomes of working overtime in Canada.

PubMed

Lobo, Vanessa M; Ploeg, Jenny; Fisher, Anita; Peachey, Gladys; Akhtar-Danesh, Noori

Nursing overtime is being integrated into the normal landscape of practice to ensure optimal staffing levels and addresses variations in patient volume and acuity. This is particularly true in critical care where fluctuations in either are difficult to predict. The goal of this study was to explore critical care nurses' perceptions of the outcomes of working overtime. Sally Thorne's interpretive description guided the collection and analysis of data. Participants were recruited from 11 different critical care units within three large teaching hospitals in Southern Ontario, Canada. A total of 28 full- and part-time registered nurses who had worked in an intensive care unit for at least one year took part in this study. Data were collected through semistructured, audio-recorded, individual interviews that took place in rooms adjacent to participants' critical care units. Template analysis facilitated the determination and abstraction of themes using NVivo for Mac 10.1.1. Major themes highlighting the perceived outcomes of overtime included (a) physical effects, (b) impact on patient-centered care, (c) balancing family and work, (d) financial gain, and € safety is jeopardized. Nursing managers and institutions need to be accountable for staffing practices they institute, and nurses themselves may require further education regarding healthy work-life balance. There are both negative and positive consequences of nursing overtime for nurses and patients, but nurses at large valued the option to work it. Copyright © 2017 Elsevier Inc. All rights reserved.

Multi-level modeling of aspects associated with poor mental health in a sample of prehospital emergency professionals.

PubMed

Arial, Marc; Wild, Pascal; Benoit, Damien; Chouaniere, Dominique; Danuser, Brigitta

2011-11-01

The goal of this paper is to investigate the respective influence of work characteristics, the effort-reward ratio, and overcommitment on the poor mental health of out-of-hospital care providers. 333 out-of-hospital care providers answered a questionnaire that included queries on mental health (GHQ-12), demographics, health-related information and work characteristics, questions from the Effort-Reward Imbalance Questionnaire, and items about overcommitment. A two-level multiple regression was performed between mental health (the dependent variable) and the effort-reward ratio, the overcommitment score, weekly number of interventions, percentage of non-prehospital transport of patients out of total missions, gender, and age. Participants were first-level units, and ambulance services were second-level units. We also shadowed ambulance personnel for a total of 416 hr. With cutoff points of 2/3 and 3/4 positive answers on the GHQ-12, the percentages of potential cases with poor mental health were 20% and 15%, respectively. The effort-reward ratio was associated with poor mental health (P < 0.001), irrespective of age or gender. Overcommitment was associated with poor mental health; this association was stronger in women (β = 0.054) than in men (β = 0.020). The percentage of prehospital missions out of total missions was only associated with poor mental health at the individual level. Emergency medical services should pay attention to the way employees perceive their efforts and the rewarding aspects of their work: an imbalance of those aspects is associated with poor mental health. Low perceived esteem appeared particularly associated with poor mental health. This suggests that supervisors of emergency medical services should enhance the value of their employees' work. Employees with overcommitment should also receive appropriate consideration. Preventive measures should target individual perceptions of effort and reward in order to improve mental health in prehospital care providers. Copyright © 2011 Wiley Periodicals, Inc.

Air quality and human health impacts of grasslands and shrublands in the United States

NASA Astrophysics Data System (ADS)

Gopalakrishnan, Varsha; Hirabayashi, Satoshi; Ziv, Guy; Bakshi, Bhavik R.

2018-06-01

Vegetation including canopy, grasslands, and shrublands can directly sequester pollutants onto the plant surface, resulting in an improvement in air quality. Until now, several studies have estimated the pollution removal capacity of canopy cover at the level of a county, but no such work exists for grasslands and shrublands. This work quantifies the air pollution removal capacity of grasslands and shrublands at the county-level in the United States and estimates the human health benefits associated with pollution removal using the i-Tree Eco model. Sequestration of pollutants is estimated based on the Leaf Area Index (LAI) obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) derived dataset estimates of LAI and the percentage land cover obtained from the National Land Cover Database (NLCD) for the year 2010. Calculation of pollution removal capacity using local environmental data indicates that grasslands and shrublands remove a total of 6.42 million tonnes of air pollutants in the United States and the associated monetary benefits total 268 million. Human health impacts and associated monetary value due to pollution removal was observed to be significantly high in urban areas indicating that grasslands and shrublands are equally critical as canopy in improving air quality and human health in urban regions.

Effects of grapevine sap phenolics on the in vitro growth of Xylella fastidiosa

USDA-ARS?s Scientific Manuscript database

Pierce’s disease, caused by the bacterium Xylella fastidiosa, poses a serious threat to grape production in the United States. Previous work indicated that grapevines infected with Xylella fastidiosa respond by producing greater levels of phenolic compounds in xylem sap and tissues, presumably to l...

Women at Work

ERIC Educational Resources Information Center

Dyer, Susan K., Ed.

2003-01-01

During the second half of the 20th century, the U.S. economy experienced unprecedented levels of growth and expansion. Most notably, the United States shifted from an industrial, goods-producing economy to one dominated by service industries and, more recently, by the emerging knowledge-based field of information technology. The increase of these…

Quien es Quien: A Who's Who of Spanish-Heritage Librarians in the United States.

ERIC Educational Resources Information Center

Trejo, Arnulfo D., Ed.; Lodwick, Kathleen L.

Identified are 245 librarians who speak Spanish, come from Hispanic backgrounds, and hold degrees in librarianship. Names are listed alphabetically. Each listing includes birthdate, source of degree, level of fluency in Spanish, professional specialization, work experience, professional memberships, publications, honors, home address, and present…

Inflammatory Effects of Woodsmoke Exposure among Wildland Firefighters Working at Prescribed Burns at the Savannah River Site, SC

EPA Science Inventory

Objectives: Wildland firefighters in the United States are occupationally exposed to high levels of woodsmoke. Results from experimental studies show that exposure to woodsmoke induces inflammation. Therefore, a study was conducted to investigate the effect of occupational woodsm...

Industrialism and Modernity: Economic and Noneconomic Orientations

ERIC Educational Resources Information Center

Sofranko, Andrew J.; Fliegel, Frederick C.

1977-01-01

The impact of employment at four different levels of industry on workers' value orientations in Ghana, India, Brazil, and the United States were assessed. Using data from workers in the different work settings, two modernity indexes were developed to test hypotheses on value change and on cross-cultural convergence. (Author/NQ)

Drafting. A Bilingual Text = Dibujo Mecanico. Un Texto Bilingue.

ERIC Educational Resources Information Center

Los Angeles Unified School District, CA. Div. of Career and Continuing Education.

This bilingual instructional text, one in a series of six texts covering various vocational and technical topics, provides secondary level English and Spanish instruction in drafting. Addressed in the individual units are the following topics: safety, drafting tools and techniques, sketching, geometric construction, working drawings, sectioning,…

Get Real: Work-Related Teaching and Learning.

ERIC Educational Resources Information Center

Moore, Sharon

This document is intended to assist new and experienced vocational education teachers in the United Kingdom who are delivering General National Vocational Qualifications (GNVQs) and vocational A-levels. The following are among the topics discussed in the guide's four sections: (1) developing an approach to vocational learning (establishing links…

Project Inspire: Vocational Guidance Institute.

ERIC Educational Resources Information Center

National Alliance of Businessmen, Washington, DC.

Two introductory speeches suggest the general social and interracial climate in the United States. It is against this backdrop that Project Inspire is described. Its purpose is the development of a vocational guidance component within the broader school curriculum. Its major objective is elevating the awareness level of students to the work world…

China: A Resource and Curriculum Guide.

ERIC Educational Resources Information Center

Posner, Arlene, Ed.; de Keijzer, Arne J., Ed.

This publication is intended to help secondary and college level teachers locate textbooks, curriculum units, audiovisuals, and other resources on China. The guide's contents include the following: (1) Teaching Materials on Contemporary China: A Critical Evaluation; (2) Adapting Scholarly Work to the Needs of Educators; (3) Teaching about China in…

Roadmap for Growth

ERIC Educational Resources Information Center

Business Roundtable, 2010

2010-01-01

The United States is at a critical juncture. The deep recession and weak economic recovery have left one in 10 American workers without a job, and the federal budget is driving the country's debt to unprecedented levels. Business Roundtable believes that the nation's business community, the White House and Congress must work together to encourage…

Some Determinants of Employee Turnover in a Psychiatric Facility.

ERIC Educational Resources Information Center

Zautra, Alex J.; And Others

1987-01-01

Used research from illness-prevention and job-enrichment approaches to enhancing quality of work environments to create instruments assessing number of job stressors and level of task interest on psychiatric hospital units. Instruments successfully predicted employee turnover during one year. Job stress and interaction between job stress and task…

Grade 8 Spanish Math Skills Sharpeners and La Calculadora. Hojas de ejercicios (Calculator Unit. Exercise Sheets.)

ERIC Educational Resources Information Center

Milwaukee Public Schools, WI.

This workbook contains "skill sharpening" math problems presented in Spanish. These problems have been designed as supplementary work for students at the eighth grade level. Functions and topics such as addition, subtraction, division, multiplication, decimals, scientific notation (exponents), fractions, symmetry, angles, the metric…

Improving Productivity via QWL Centers.

ERIC Educational Resources Information Center

Bentley, Marion T.; Hansen, Gary B.

1980-01-01

Gives a brief history of productivity improvement legislation in the United States and of the development and demise of the National Center for Productivity and Quality of Working Life (QWL). Describes existing productivity and QWL centers, including their locations, scope, services, and activities, and urges greater support at the federal level.…

The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

PubMed

Baernholdt, Marianne; Mark, Barbara A

2009-12-01

The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.

Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitals.

PubMed

Chaboyer, W; Najman, J; Dunn, S

2001-08-01

This study examines the extent to which hospital nurses view their working environment in a positive sense, working as a cohesive group. Despite the fact that nursing in Australia is now considered a profession, it has been claimed that nurses are an oppressed group who use horizontal violence, bullying and aggression in their interactions with one and other. After ethical approval, a random sample of 666 nurses working directly with patients and all 333 critical care nurses employed in three large tertiary Australian hospitals were invited to participate in the study in the late 1990s. A mailed survey examined the perceptions of interaction nurses had with each other. The hypothesis, that level of employment (either Level I bedside nurses or Level II/III clinical leaders) and area of work (either critical care or noncritical care) would influence perceptions of cohesion, as measured by the cohesion amongst nurses scale (CANS) was tested. In total 555 (56%) surveys were returned. Of these, 413 were returned by Level I and 142 by Level II/III nurses. Of this sample, 189 were critical care and 355 noncritical care nurses. There was no difference between Level I and II/III nurses in mean CANS scores. It is interesting to note that the item rated most positively was "nurses on the units worked well together", however, the item rated least positive was "staff can be really bitchy towards each other" for both Level I and II/III nurses. There was no difference in CANS scores between critical care and noncritical care nurses. Nurses working in Australian hospitals perceived themselves to be moderately cohesive but, as would be expected in other work settings, some negative perceptions existed.

Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis

PubMed Central

Planer, Katarina; Hagel, Anja

2018-01-01

A validity test was conducted to determine how care level–based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level–based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance. We used observer-based measurement of assignable direct and indirect care time in 68 nursing units for 2028 residents across 2 working days. Organizational data were collected at the end of the quarter in which the observation was made. Data were collected from January to March, 2012. We used a null multilevel model with random intercepts and multilevel models with fixed and random slopes to analyze data at both the organization and resident levels. A total of 14% of the variance in total care time per day was explained by membership in nursing units. The impact of care levels on care time differed significantly between nursing units. Forty percent of residents at the lowest care level received less than the standard minimum registered nursing time per day. For facilities that have been significantly disadvantaged in the current staffing system, a higher minimum standard will function more effectively than a complex classification system without scientific controls. PMID:29442533

Job satisfaction and importance for intensive care unit research coordinators: results from binational survey.

PubMed

Rickard, Claire M; Roberts, Brigit L; Foote, Jonathon; McGrail, Matthew R

2007-09-01

To measure Intensive Care Unit Research coordinator job satisfaction and importance and to identify priorities for role development. Research coordinator numbers are growing internationally in response to increasing clinical research activity. In Australia, 1% of registered nurses work principally in research, many as Research coordinators. Internationally, the Association of Clinical Research Professionals currently has 6536 certified Research coordinators in 13 countries, with likely additional large numbers practicing without the voluntary certification. Research coordinators are almost always nurses, but little is know about this emerging specialty. Design. Cross-sectional study using anonymous self-report questionnaire. After ethics approval, the McCloskey-Mueller Satisfaction Scale and McCloskey-Mueller Importance Scale were administered via the Internet. The sample was 49 (response rate 71%) Research coordinators from the Australia and New Zealand Intensive Care Unit Research coordinators' Interest Group. Research coordinators were satisfied with structural aspects of the position working business hours; flexibility of working hours; high levels of responsibility and control over their work. Dissatisfaction was expressed regarding: remuneration and recognition; compensation for weekend work; salary package; career advancement opportunities; and childcare facilities. High priorities for role development are those rated highly important but with much lower satisfaction. These are: compensation for weekend call-out work; salary and remuneration package; recognition by management and clinicians; career advancement opportunities; departmental research processes; encouragement and feedback; and number of working hours. Increasing numbers of nurses have been attracted to this clinically based research position. These data contribute to the understanding and development of the role.

National Water-Quality Assessment Program; the Allegheny-Monongahela River Basin

USGS Publications Warehouse

McAuley, Steven D.

1995-01-01

In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The three major objectives of the NAWQA program are to provide a consistent description of current water-quality conditions for a large part of the Nation's water resources, define long-term trends in water quality, and identify, describe, and explain the major factors that affect water-quality conditions and trends. The program produces water-quality information that is useful to policy makers and managers at the National, State, and local levels.The program will be implemented through 60 separate investigations of river basins and aquifer systems called study units. These study-unit investigations will be conducted at the State and local level and will form the foundation on which national- and regional-level assessments are based. The 60 study units are hydrologic systems that include parts of most major river basins and aquifer systems. The study-unit areas range from 1,000 to more than 60,000 square miles and include about 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty studyunit investigations were started in 1991, 20 started in 1994, and 20 more are planned to start in 1997. The Allegheny-Monongahela River Basin was selected to begin assessment activities as a NAWQA study unit in 1994. The study team will work from the office of the USGS in Pittsburgh, Pa.

Knowledge regarding noncytotoxic medication extravasation among registered nurses working in western Saudi Arabia.

PubMed

Sisan, Mo'men; Rayan, Ahmad; Elmorsy, Soha; Elyan, Hamza; Salahat, Mosab

2018-03-01

Extravasation and infiltration are among the most common intravenous therapy complications. For noncytotoxic agents, the incidence of extravasation remains unknown. There has been little research into extravasation due to ethical considerations limiting controlled research; most evidences are based on small, uncontrolled trials or case reports. The purpose of this study was to assess the knowledge level regarding noncytotoxic medications extravasation and its associated factors among staff nurses.A descriptive correlational design using self-administered questionnaire was employed. A convenience sample of 387 nurses completed a questionnaire about noncytotoxic medication extravasation. Statistical Package for Social Sciences version 21 was used to analyze data by applying the chi-square test, t test, and the Mann-Whitney test to assess the knowledge difference between open and closed units' nurses.The results indicate that only 19.6% of nurses have a good knowledge about noncytotoxic medications extravasation. There was consistently poor staff knowledge regarding noncytotoxic medications extravasation. Although the closed units' nurses reported relatively higher level of knowledge than open units' nurses, their level of knowledge still inadequate. Health care organizations must consider developing specific policies regarding extravasation. Closed and open units' nurses should be enrolled in special education programs to improve their level of knowledge regarding noncytotoxic medication extravasation. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

Effect of electron withdrawing unit for dye-sensitized solar cell based on D-A-π-A organic dyes

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

Kwon, Dong Yuel; Chang, Dong Min; Kim, Young Sik, E-mail: youngkim@hongik.ac.kr

2014-10-15

Highlights: • To gain the red-shifted absorption spectra, withdrawing unit was substituted in dye. • By the introduction of additional withdrawing unit, LUMOs level of dye are decreased. • Decreasing LUMOs level of dye caused the red-shifted absorption spectra of dye. • Novel acceptor, DCRD, showed better photovoltaic properties than cyanoacetic acid. - Abstract: In this work, two novel D-A-π-A dye sensitizers with triarylamine as an electron donor, isoindigo and cyano group as electron withdrawing units and cyanoacetic acid and 2-(1,1-dicyanomethylene) rhodanine as an electron acceptor for an anchoring group (TICC, TICR) were designed and investigated with the ID6 dyemore » as the reference. The difference in HOMO and LUMO levels were compared according to the presence or absence of isoindigo in ID6 (TC and ID6). To gain insight into the factors responsible for photovoltaic performance, we used density functional theory (DFT) and time-dependent density functional theory (TDDFT) calculations. Owing to different LUMO levels for each acceptor, the absorption band and molar extinction coefficient of each dye was different. Among the dyes, TICR showed more red-shifted and broader absorption spectra than other dyes and had a higher molar extinction coefficient than the reference. It is expected that TICR would show better photovoltaic properties than the other dyes, including the reference dye.« less

An Expert System Solution for the Quantitative Condition Assessment of Electrical Distribution Systems in the United States Air Force

DTIC Science & Technology

1991-09-01

Distribution system ... ......... 4 2. Architechture of an Expert system .. .............. 66 vi List of Tables Table Page 1. Prototype Component Model...expert system to properly process work requests Ln civil engineering (8:23). Electric Power Research Institute (EPRI). EPRI is a private organization ...used (51) Training Level. The level of training shop technicians receive, and the resulting proficiency, are important in all organizations . Experts 1

Report on the Comprehensive Survey of the Water Resources of the Delaware River Basin. Volume IX. Appendix P. Gross and Net Water Needs. Appendix Q. Formation of the Plan of Development. Appendix R. Water Control at Intermediate Upstream Levels. Appendix S. Salt Water Barrier.

DTIC Science & Technology

1960-12-01

such as the Journal of the American Water Works Association, Public Works Magazine, Transactions of the American Society of Civil Engineers, reports of...American Water Works Associa- tion, August 1951. . .P-3 t I Picton 6/ related water use to population growth by application of trends in per capita...Committees on Public Works of the United States Senate and House of Representatives. Of the seven resolutions 1/ pertaining to this survey, five of them

Nursing unit managers, staff retention and the work environment.

PubMed

Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen

2011-01-01

This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to ensure that nurse leaders receive adequate organisational support from nursing executives. © 2010 Blackwell Publishing Ltd.

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion

PubMed Central

Lee, Sabrina S. M.; de Boef Miara, Maria; Arnold, Allison S.; Biewener, Andrew A.; Wakeling, James M.

2013-01-01

SUMMARY Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation–deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks. PMID:22972893

Recruitment of faster motor units is associated with greater rates of fascicle strain and rapid changes in muscle force during locomotion.

PubMed

Lee, Sabrina S M; de Boef Miara, Maria; Arnold, Allison S; Biewener, Andrew A; Wakeling, James M

2013-01-15

Animals modulate the power output needed for different locomotor tasks by changing muscle forces and fascicle strain rates. To generate the necessary forces, appropriate motor units must be recruited. Faster motor units have faster activation-deactivation rates than slower motor units, and they contract at higher strain rates; therefore, recruitment of faster motor units may be advantageous for tasks that involve rapid movements or high rates of work. This study identified motor unit recruitment patterns in the gastrocnemii muscles of goats and examined whether faster motor units are recruited when locomotor speed is increased. The study also examined whether locomotor tasks that elicit faster (or slower) motor units are associated with increased (or decreased) in vivo tendon forces, force rise and relaxation rates, fascicle strains and/or strain rates. Electromyography (EMG), sonomicrometry and muscle-tendon force data were collected from the lateral and medial gastrocnemius muscles of goats during level walking, trotting and galloping and during inclined walking and trotting. EMG signals were analyzed using wavelet and principal component analyses to quantify changes in the EMG frequency spectra across the different locomotor conditions. Fascicle strain and strain rate were calculated from the sonomicrometric data, and force rise and relaxation rates were determined from the tendon force data. The results of this study showed that faster motor units were recruited as goats increased their locomotor speeds from level walking to galloping. Slow inclined walking elicited EMG intensities similar to those of fast level galloping but different EMG frequency spectra, indicating that recruitment of the different motor unit types depended, in part, on characteristics of the task. For the locomotor tasks and muscles analyzed here, recruitment patterns were generally associated with in vivo fascicle strain rates, EMG intensity and tendon force. Together, these data provide new evidence that changes in motor unit recruitment have an underlying mechanical basis, at least for certain locomotor tasks.

Towards the formal specification of the requirements and design of a processor interface unit

NASA Technical Reports Server (NTRS)

Fura, David A.; Windley, Phillip J.; Cohen, Gerald C.

1993-01-01

Work to formally specify the requirements and design of a Processor Interface Unit (PIU), a single-chip subsystem providing memory interface, bus interface, and additional support services for a commercial microprocessor within a fault-tolerant computer system, is described. This system, the Fault-Tolerant Embedded Processor (FTEP), is targeted towards applications in avionics and space requiring extremely high levels of mission reliability, extended maintenance free operation, or both. The approaches that were developed for modeling the PIU requirements and for composition of the PIU subcomponents at high levels of abstraction are described. These approaches were used to specify and verify a nontrivial subset of the PIU behavior. The PIU specification in Higher Order Logic (HOL) is documented in a companion NASA contractor report entitled 'Towards the Formal Specification of the Requirements and Design of a Processor Interfacs Unit - HOL Listings.' The subsequent verification approach and HOL listings are documented in NASA contractor report entitled 'Towards the Formal Verification of the Requirements and Design of a Processor Interface Unit' and NASA contractor report entitled 'Towards the Formal Verification of the Requirements and Design of a Processor Interface Unit - HOL Listings.'

[Stress level assessment of the nursing staff in the Intensive Care Unit of a university hospital].

PubMed

Carrillo-García, C; Ríos-Rísquez, M I; Martínez-Hurtado, R; Noguera-Villaescusa, P

2016-01-01

The objective was to determine the work stress level among nursing staff in the Intensive Care Unit of a university hospital and to analyse its relationship with the various sociodemographic and working variables of the studied sample. A study was designed using a quantitative, descriptive and cross-sectional approach. The target population of the study was the nursing staff selected by non-random sampling. The instrument used was the Job Content Questionnaire. Data analysis was performed using SPSS 20. The mean, ranges and standard deviation for each of the variables were calculated. A bivariate analysis was also performed on the social and occupational variables of the sample. The participation rate was 80.90% (N=89). The mean of the Social support dimension was 3.13±0.397, for the Psychological demands at work dimension it was 3.10±0.384, with a mean of 2.96±0.436 being obtained for the Control over the work dimension. In the analysis of sociodemographic and work variables of the sample, only the professional category was significant, with nurses recording higher values in perception of job demands and control over their work compared to nursing assistants. In conclusion, there is a moderate perception of work stress in the analysed group of professionals. Among the sources of stress in the workplace was the low control in decision-making by practitioners, as well as the need to continually learn new things. On the other hand, the support received from colleagues is valued positively by the sample. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Review of noise in neonatal intensive care units regional analysis

NASA Astrophysics Data System (ADS)

Alvarez Abril, A.; Terrón, A.; Boschi, C.; Gómez, M.

2007-11-01

This work is about the problem of noise in neonatal incubators and in the environment in the neonatal intensive care units. Its main objective is to analyse the impact of noise in hospitals of Mendoza and La Rioja. Methodology: The measures were taken in different moments in front of higher or lower severity level in the working environment. It is shown that noise produces severe damages and changes in the behaviour and the psychological status of the new born babies. Results: The noise recorded inside the incubators and the neonatal intensive care units together have many components but the noise of motors, opening and closing of access gates have been considered the most important ones. Values above 60 db and and up to 120 db in some cases were recorded, so the need to train the health staff in order to manage the new born babies, the equipment and the instruments associated with them very carefully is revealed.

New 'patent accelerated care environment' aims to facilitate work flow, free up ED for acute care needs.

PubMed

2012-02-01

Faced with rising acuity levels and surging demand, Virginia Mason Medical Center modified the Clinical Decision Unit concept used in many EDs, and developed a new Patient Accelerated Care Environment (PACE) to care for observation patients, process patients for discharge, and to prepare patients for admission.The approach is designed to utilize ED beds for initial processing of patients, allowing resuscitative care if needed, and treating and releasing the patients with quick care needs. Using the Virginia Mason Production System, a methodology that is modeled after Toyota production techniques, developers designed an optimal work flow pattern and then built infrastructure to facilitate that process. All patients who present to the ED for care are seen by the ED team through a "team greet" approach. Approximately 35% to 40% of patients who come to the ED for care are transferred to the PACE unit. Patients assigned to the PACE unit typically remain there for 4 to 48 hours, depending on their care needs.

[Health and working conditions of high school and university teachers in Mendoza: between commitment and emotional distress].

PubMed

Collado, Patricia Alejandra; Soria, Cecilia Beatriz; Canafoglia, Eliana; Collado, Sandra Alicia

2016-01-01

With the objective of analyzing aspects related to the perception of working conditions and their impact on health in the teachers and professors who work for the Universidad Nacional de Cuyo (UNCuyo) in Mendoza, Argentina, this work analyzes the results of the Primer Censo de Condiciones y Salud Laboral [First Census on Health and Working Conditions]. The census was conducted in late 2013 in two academic units (one at the high school level and the other at the university level), including 193 educators. The exploration set out to characterize the teaching staff and the conditions affecting their health, primarily with respect to psycho-social health. In order to do, so a self-administered questionnaire was applied, the dimensions of which were discussed in sensitivity workshops with educators who helped to formulate the data collection instrument. Among the primary results emerge the physical and emotional burnout of these highly skilled workers, owing to the combined effect of their committed response to the demands of their work and the deterioration (both material and symbolic) of the conditions in which they carry out that work.

Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study

PubMed Central

2013-01-01

Background The provision of Intensive Care (IC) can lead to a health care provider’s physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. Methods A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Results Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. Conclusions A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account. PMID:24172172

Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study.

PubMed

Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António Manuel; Carvalho, Ana Sofia

2013-10-31

The provision of Intensive Care (IC) can lead to a health care provider's physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account.

Newman Unit 1 advanced solar repowering advanced conceptual design. Final report

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

None

1982-04-01

The Newman Unit 1 solar repowering design is a water/steam central receiver concept supplying superheated steam. The work reported is to develop a refined baseline conceptual design that has potential for construction and operation by 1986, makes use of existing solar thermal technology, and provides the best economics for this application. Trade studies performed in the design effort are described, both for the conceptual design of the overall system and for the subsystem conceptual design. System-level functional requirements, design, operation, performance, cost, safety, environmental, institutional, and regulatory considerations are described. Subsystems described include the collector, receiver, fossil energy, electrical powermore » generating, and master control subsystems, site and site facilities. The conceptual design, cost, and performance of each subsystem is discussed at length. A detailed economic analysis of the repowered unit is made to realistically assess the economics of the first repowered unit using present cost data for a limited production level for solar hardware. Finally, a development plan is given, including the design, procurement, construction, checkout, startup, performance validation, and commercial operation. (LEW)« less

Population patterns in World’s administrative units

PubMed Central

Miramontes, Pedro; Cocho, Germinal

2017-01-01

Whereas there has been an extended discussion concerning city population distribution, little has been said about that of administrative divisions. In this work, we investigate the population distribution of second-level administrative units of 150 countries and territories and propose the discrete generalized beta distribution (DGBD) rank-size function to describe the data. After testing the balance between the goodness of fit and number of parameters of this function compared with a power law, which is the most common model for city population, the DGBD is a good statistical model for 96% of our datasets and preferred over a power law in almost every case. Moreover, the DGBD is preferred over a power law for fitting country population data, which can be seen as the zeroth-level administrative unit. We present a computational toy model to simulate the formation of administrative divisions in one dimension and give numerical evidence that the DGBD arises from a particular case of this model. This model, along with the fitting of the DGBD, proves adequate in reproducing and describing local unit evolution and its effect on the population distribution. PMID:28791153

Nurses' views of shared leadership in ICU: a case study.

PubMed

Rosengren, Kristina; Bondas, Terese; Nordholm, Lena; Nordström, Gun

2010-08-01

New management models develop; one of them is shared leadership where two nurse managers share tasks and responsibility for a unit. The overall aim of this study was to describe the view of the staff about shared leadership at an ICU in Sweden and to study if there were any differences in perceptions between staff groups. This unit had changed the management organisation from single leadership (one nurse manager) to shared leadership (two nurse managers). Sixty-four (79%) registered nurses and assistant nurses responded to a 72 item questionnaire measuring social and organisational factors at work, especially leadership and shared leadership. The results showed that staff reported positive views in relation to the dimensions 'Organisational culture', 'Social interactions', 'Work satisfaction', 'Leadership', 'Shared leadership' and 'Work motives'. Registered nurses reported more positive views than assistant nurses in relation to the dimensions: 'Organisational culture', 'Social interactions', 'Work satisfaction' and 'Leadership'. Further, females had more positive views than males on the dimension 'Social interactions'. Staff described that shared leadership positively influenced the work in terms of confidence. In conclusion, staff reported positive views of work and the model shared leadership in the investigated ICU. One implication is that nurse managers have to be conscious of different health professionals in the unit and it is important to offer a good working environment for all staff. However, more research is needed within the area of shared leadership. A future research project could be to add a qualitative research question about how work and shared leadership affects different health professionals in the day to day practice both at the managerial as well as the team level to improve health care. Copyright 2010 Elsevier Ltd. All rights reserved.

A survey of computational aerodynamics in the United States

NASA Technical Reports Server (NTRS)

Gessow, A.; Morris, D. J.

1977-01-01

Programs in theoretical and computational aerodynamics in the United States are described. Those aspects of programs that relate to aeronautics are detailed. The role of analysis at various levels of sophistication is discussed as well as the inverse solution techniques that are of primary importance in design methodology. The research is divided into the broad categories of application for boundary layer flow, Navier-Stokes turbulence modeling, internal flows, two-dimensional configurations, subsonic and supersonic aircraft, transonic aircraft, and the space shuttle. A survey of representative work in each area is presented.

INSTALLATION OF A POST-ACCIDENT CONFINEMENT HIGH-LEVEL RADIATION MONITORING SYSTEM IN THE KOLA NUCLEAR POWER STATION (UNIT 2) IN RUSSIA

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

GREENE,G.A.; GUPPY,J.G.

1998-09-01

This is the final report on the INSP project entitled, ``Post-Accident Confinement High-Level Radiation Monitoring System'' conducted by BNL under the authorization of Project Work Plan WBS 1.2.2.6 (Attachment 1). This project was initiated in February 1993 to assist the Russians in reducing risks associated with the continued operation of older Soviet-designed nuclear power plants, specifically the Kola VVER-440/230 Unit 2, through improved accident detection capability, specifically by the installation of a dual train high-level radiation detection system in the confinement of Unit 2 of the Kola NPP. The major technical objective of this project was to provide, install andmore » make operational the necessary hardware inside the confinement of the Kola NPP Unit 2 to provide early and reliable warning of the release of radionuclides from the reactor into the confinement air space as an indication of the occurrence of a severe accident at the plant. In addition, it was intended to provide hands-on experience and training to the Russian plant workers in the installation, operation, calibration and maintenance of the equipment in order that they may use the equipment without continued US assistance as an effective measure to improve reactor safety at the plant.« less

The influence of organizational context on the use of research by nurses in Canadian pediatric hospitals

PubMed Central

2013-01-01

Background Organizational context is recognized as an important influence on the successful implementation of research by healthcare professionals. However, there is relatively little empirical evidence to support this widely held view. Methods The objective of this study was to identify dimensions of organizational context and individual (nurse) characteristics that influence pediatric nurses’ self-reported use of research. Data on research use, individual, and contextual variables were collected from registered nurses (N = 735) working on 32 medical, surgical and critical care units in eight Canadian pediatric hospitals using an online survey. We used Generalized Estimating Equation modeling to account for the correlated structure of the data and to identify which contextual dimensions and individual characteristics predict two kinds of self-reported research use: instrumental (direct) and conceptual (indirect). Results Significant predictors of instrumental research use included: at the individual level; belief suspension-implement, research use in the past, and at the hospital unit (context) level; culture, and the proportion on nurses possessing a baccalaureate degree or higher. Significant predictors of conceptual research use included: at the individual nurse level; belief suspension-implement, problem solving ability, use of research in the past, and at the hospital unit (context) level; leadership, culture, evaluation, formal interactions, informal interactions, organizational slack-space, and unit specialty. Conclusions Hospitals, by focusing attention on modifiable elements of unit context may positively influence nurses’ reported use of research. This influence of context may extend to the adoption of best practices in general and other innovative or quality interventions. PMID:24034149

Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.

PubMed

Mason, Virginia M; Leslie, Gail; Clark, Kathleen; Lyons, Pat; Walke, Erica; Butler, Christina; Griffin, Martha

2014-01-01

Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. Nurses' experience of moral distress has been measured in medical intensive care units but not in surgical trauma care units, where nurses are exposed to patients and families faced with sudden life-threatening, life-changing patient consequences.This pilot study is a nonexperimental, descriptive, correlational design to examine the effect of compassion satisfaction, compassion fatigue, moral distress, and level of nursing education on critical care nurses' work engagement. This is a partial replication of Lawrence's dissertation. The study also asked nurses to describe sources of moral distress and self-care strategies for coping with stress. This was used to identify qualitative themes about the nurse experiences. Jean Watson's theory of human caring serves as a framework to bring meaning and focus to the nursing-patient caring relationship.A convenience sample of 26 of 34 eligible experienced surgical intensive care unit trauma nurses responded to this survey, indicating a 77% response rate. Twenty-seven percent of the nurses scored high, and 73% scored average on compassion satisfaction. On compassion fatigue, 58% scored average on burnout and 42% scored low. On the secondary traumatic stress subscale, 38% scored average, and 62% scored low. The mean moral distress situations subscale score was 3.4, which is elevated. The mean 9-item Utrecht Work Engagement Scale total score, measuring work engagement, was 3.8, which is considered low.Content analysis was used to identify themes of Role Conflict With Management/Rules, Death and Suffering, Dealing With Violence in the Intensive Care Unit, Dealing With Family, Powerlessness, Physical Distress, and Medical Versus Nursing Values. Additional themes identified were caring, helping families, long-time interdependent relationships of colleagues, and satisfaction in trauma nursing.As work engagement increased, compassion satisfaction significantly increased, and burnout significantly decreased. Results of this study support moral distress as a clinically meaningful issue for surgical intensive care unit nurses. Moral distress scales were elevated, whereas work engagement scales were low. This finding was congruent with Lawrence's study and may reflect ongoing need for greater supports for experienced intensive care unit nurses, from both education and management. Future recommendations for research include examining the interaction of these variables in larger samples to examine additional explanatory factors as well as strategies for self-care, motivation, and behavior change.

Speed, Acceleration, and Velocity: Level II, Unit 9, Lesson 1; Force, Mass, and Distance: Lesson 2; Types of Motion and Rest: Lesson 3; Electricity and Magnetism: Lesson 4; Electrical, Magnetic, and Gravitational Fields: Lesson 5; The Conservation and Conversion of Matter and Energy: Lesson 6; Simple Machines and Work: Lesson 7; Gas Laws: Lesson 8; Principles of Heat Engines: Lesson 9; Sound and Sound Waves: Lesson 10; Light Waves and Particles: Lesson 11; Program. A High.....

ERIC Educational Resources Information Center

Manpower Administration (DOL), Washington, DC. Job Corps.

This self-study program for high-school level contains lessons on: Speed, Acceleration, and Velocity; Force, Mass, and Distance; Types of Motion and Rest; Electricity and Magnetism; Electrical, Magnetic, and Gravitational Fields; The Conservation and Conversion of Matter and Energy; Simple Machines and Work; Gas Laws; Principles of Heat Engines;…

Post-Treatment-Free Solution-Processed Reduced Phosphomolybdic Acid Containing Molybdenum Oxide Units for Efficient Hole-Injection Layers in Organic Light-Emitting Devices.

PubMed

Ohisa, Satoru; Endo, Kohei; Kasuga, Kosuke; Suzuki, Michinori; Chiba, Takayuki; Pu, Yong-Jin; Kido, Junji

2018-02-19

We report the development of solution-processed reduced phosphomolybdic acid (rPMA) containing molybdenum oxide units for post-treatment-free hole-injection layers (HILs) in organic light-emitting devices (OLEDs). The physical and chemical properties of rPMA, including its structure, solubility in several solvents, film surface roughness, work function, and valence states, were investigated. The formation of gap states just below the Fermi level of rPMA was observed. Without any post-treatment after the formation of rPMA films, OLEDs employing rPMA as an HIL exhibited a very low driving voltage and a high luminous efficiency. The low driving voltage was attributed to the energy level alignment between the gap states formed by reduction and the HOMO level of the hole-transport layer material N,N'-bis(1-naphthyl)-N,N'-diphenyl-(1,1'-biphenyl)-4,4'-diamine.

Methodological advances in unit cost calculation of psychiatric residential care in Spain.

PubMed

Moreno, Karen; Sanchez, Eduardo; Salvador-Carulla, Luis

2008-06-01

The care of the severe mentally ill who need intensive support for their daily living (dependent persons), accounts for an increasingly large proportion of public expenditure in many European countries. The main aim of this study was the design and implementation of solid methodology to calculate unit costs of different types of care. To date, methodologies used in Spain have produced inaccurate figures, suggesting few variations in patient consumption of the same service. An adaptation of the Activity-Based-Costing methodology was applied in Navarre, a region in the North of Spain, as a pilot project for the public mental health services. A unit cost per care process was obtained for all levels of care considered in each service during 2005. The European Service Mapping Schedule (ESMS) codes were used to classify the services for later comparisons. Finally, in order to avoid problems of asymmetric cost distribution, a simple Bayesian model was used. As an illustration, we report the results obtained for long-term residential care and note that there are important variations between unit costs when considering different levels of care. Considering three levels of care (Level 1-low, Level 2-medium and Level 3-intensive), the cost per bed in Level 3 was 10% higher than that of Level 2. The results obtained using the cost methodology described provide more useful information than those using conventional methods, although its implementation requires much time to compile the necessary information during the initial stages and the collaboration of staff and managers working in the services. However, in some services, if no important variations exist in patient care, another method would be advisable, although our system provides very useful information about patterns of care from a clinical point of view. Detailed work is required at the beginning of the implementation in order to avoid the calculation of distorted figures and to improve the levels of decision making within the Health Care Service. IMPLICATIONS FOR HEALTH CARE POLICY AND FORMULATIONS: As other European countries, Spain has adopted a new care system for the dependent population. To finance this new system, reliable figures must be calculated for each type of user in order to establish tariffs or public prices. This study provides a useful management tool to assist in decision making. The methodology should be implemented in other regions of Spain and even in other countries in order to compare our results and validate the cost system designed.

Gazing into the Future: A Synopsis of Unanswered Questions

ERIC Educational Resources Information Center

Felsher, Rivka Aliza; Garza Mitchell, Regina L.

2015-01-01

More than two dozen authors contributed to this special issue from 14 different think tanks, regional collaborative organizations, and institution-based policy centers and institutes to share the work being done to promote the community college agenda at state, regional, and national levels in the United States. This article synthesizes the still…

Working with Young Adults. NIACE Lifelines in Adult Learning.

ERIC Educational Resources Information Center

Jackson, Carol

This document explains how adult educators and others in the United Kingdom can increase levels of participation and achievement in learning for young adults by providing informal learning opportunities for those young people who are least inclined to participate in formal education and training programs. The guide outlines a step-by-step approach…

Examination of Pre-Service Teacher's Training through Tutoring Approach

ERIC Educational Resources Information Center

Wu, Hsiao-ping; Guerra, Myriam Jimena

2017-01-01

Pre-service teacher preparation in the United States is becoming progressively more challenging with respect to the demands on teachers. This study examined the impact of tutoring approach on pre-service teachers? skills to work with English language learners through a qualitative research design. Content analysis was used at the thematic level on…

Social Integration, Work-Family Conflict and Facilitation, and Job and Marital Quality

ERIC Educational Resources Information Center

Voydanoff, Patricia

2005-01-01

This paper examines relationships between 2 dimensions of social integration (community participation and affective community resources) and job and marital quality. Data from the 1995 National Survey of Midlife Development in the United States (n= 1,816) indicate that the level of community participation is unrelated or negatively related to job…

Pennsylvania School Improvement Program. Linkage Case Study. Intermediate Unit A.

ERIC Educational Resources Information Center

Barnette, J. Jackson

The Pennsylvania School Improvement Program (PSIP) was created to assist local schools and school districts in the development of curriculum improvement strategies. The process involves the use of "linkers," curriculum specialists who work with teams from the local level to ascertain needs, then connect the local teams with the research…

49 CFR Appendix C to Part 553 - Statement of Policy: Implementation of the United Nations/Economic Commission for Europe (UN/ECE...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Agreement Continuously improve safety and seek high levels of safety, particularly by developing and... and regions, thereby providing greater safety protection with available government resources. II... a working party of experts recommends a harmonized or new global technical regulation, it sends a...

National Survey of Professional Administrative, Technical, and Clerical Pay, March 1983. Bulletin 2181.

ERIC Educational Resources Information Center

Bureau of Labor Statistics (DOL), Washington, DC.

This survey, 24th in an annual series, provides nationwide salary data for 24 occupations spanning 101 work level categories. This information was collected from establishments in all areas of the United States except Alaska and Hawaii. The following major industrial groups were surveyed: mining; construction; manufacturing; transportation;…

Social Work Education: Achieving Transformative Learning through a Cultural Competence Model for Transformative Education

ERIC Educational Resources Information Center

Blunt, Kesha

2007-01-01

Migration across national borders has resulted in demographic changes in the United States, causing the country to become more multi-ethnic. This presents considerable challenges for graduate level educators who need to be responsive to the unique academic needs of diverse populations by considering students' previous experiences, values, and…

Green Time for Screenagers

ERIC Educational Resources Information Center

Dillon, Robert

2011-01-01

For the past decade, schools throughout the United States have been working diligently to hit the targets set by national and state guidelines for academic achievement. Those targets have helped direct attention on the need to get all students achieving at a high level, but the laserlike focus on the target numbers have led many middle schools to…

Geographic Variations in Public Schools' Costs. Working Paper Series.

ERIC Educational Resources Information Center

Chambers, Jay G.

This report addresses the following question: How much more or less does it cost to provide the same levels of educational resources across different geographic locations in the United States? To answer this question, the report develops a comprehensive geographic cost-of-education index (GCEI) that focuses on the prices of inputs (personnel and…

Assessment Portfolios as Opportunities for Teacher Learning. CRESST Report 736

ERIC Educational Resources Information Center

Gearhart, Maryl; Osmundson, Ellen

2008-01-01

This report is an analysis of the role of assessment portfolios in teacher learning. Over 18 months, 19 experienced science teachers worked in grade-level teams to design, implement, and evaluate assessments to track student learning throughout a curriculum unit, supported by semi-structured tasks and resources in assessment portfolios.…

The Cost to Industry. Basic Skills and the UK Workforce.

ERIC Educational Resources Information Center

Adult Literacy and Basic Skills Unit, London (England).

In Fall 1992, 400 telephone interviews established levels of basic skills difficulties among the work force as encountered or perceived by employers in the United Kingdom. Costs to employers of poor basic skills and the effect of these on their operation were quantified and described. Respondents were mainly personnel/training managers or…

33 CFR 207.440 - St. Marys Falls Canal and Locks, Mich.; use, administration, and navigation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... United States part and other lands, piers, buildings, water level regulation works, hydroelectric power plant, and other appurtenances acquired or constructed for the channel improvement and use of the...) Manning requirements. On all vessels of 400 gross tons or over navigating the canal under their own power...

33 CFR 207.440 - St. Marys Falls Canal and Locks, Mich.; use, administration, and navigation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... United States part and other lands, piers, buildings, water level regulation works, hydroelectric power plant, and other appurtenances acquired or constructed for the channel improvement and use of the...) Manning requirements. On all vessels of 400 gross tons or over navigating the canal under their own power...

Aquatic Habitats, Level 4-9.

ERIC Educational Resources Information Center

Weigel, Margaret

Designed to acquaint students in grades 4-9 with aquatic plants and animals, this guide provides materials which can be used in preparation for field trips or laboratory work, for individual projects, as supplemental activities for a unit, or for learning center projects. Teacher background notes and an answer key for the student activites are…

"Hiding in Plain Sight": An Interview with Cara Hoffman

ERIC Educational Resources Information Center

Hosey, Sara

2014-01-01

Cara Hoffman's work enacts George Orwell's imperative to "pay attention to the obvious" (an idea that several sympathetic characters repeat in her 2011 novel "So Much Pretty"), probing aspects of twenty-first century life in the United States that have become so accepted as to be unremarkable, such as epidemic levels of…

Science Education and Education for Sustainable Development--Justifications, Models, Practices and Perspectives

ERIC Educational Resources Information Center

Eilks, Ingo

2015-01-01

The year 2014 marks the end of the United Nations Decade of Education for Sustainable Development (ESD). All educational domains and levels, including primary and secondary science education, have been working to contribute to education enabling younger generations to become responsible citizens and promote sustainable development in our world.…

Le Francais Courant (Contemporary French), Part II.

ERIC Educational Resources Information Center

Dade County Public Schools, Miami, FL.

This course has been developed basically within the limits of Units 4-6 of "A-LM French: Level 1", second edition. The primary objectives are to develop French vocabulary relative to the family, home, transportation, and foods by continuing to work with short dialogues based on everyday, teenage experiences. While reviewing previously studied…

MACHINE TOOL OPERATOR--GENERAL, ENTRY, SUGGESTED GUIDE FOR A TRAINING COURSE.

ERIC Educational Resources Information Center

RONEY, MAURICE W.; AND OTHERS

THE PURPOSE OF THIS CURRICULUM GUIDE IS TO ASSIST THE ADMINISTRATOR AND INSTRUCTOR IN PLANNING AND DEVELOPING MANPOWER DEVELOPMENT AND TRAINING PROGRAMS TO PREPARE MACHINE TOOL OPERATORS FOR ENTRY-LEVEL POSITIONS. THE COURSE OUTLINE PROVIDES UNITS IN -- (1) ORIENTATION, (2) BENCH WORK, (3) SHOP MATHEMATICS, (4) BLUEPRINT READING AND SKETCHING, (5)…

Working with Navajo Special Education Students on the Reservation: Cultural Implications.

ERIC Educational Resources Information Center

Watt, Carolyn; Sorgnit, Heather; Medina, Catherine; Jennings, Marianne; Heimbecker, Connie; Gonnie, Pat; Dugi, Audrelia; Bowsley, Virginia; Prater, Greg

A study in the Kayenta Unified School District (Arizona) on the Navajo Nation--the largest reservation in the United States--examined cultural and language barriers in teaching Navajo special education students. Questionnaires were returned from 26 teachers at all grade levels, and interviews were conducted with 5 teachers and the district…

Secondary German Guidelines: Levels I, II, III.

ERIC Educational Resources Information Center

Klipple, Sitha; And Others

This manual is designed to assist schools in developing their German curriculum and to assist teachers in planning courses, units of work, and daily classroom activities. These guidelines for the teaching of German in secondary schools are based on the premises that language is communication and that language and culture are interrelated. The…

Compassion Satisfaction and Compassion Fatigue Among Critical Care Nurses.

PubMed

Sacco, Tara L; Ciurzynski, Susan M; Harvey, Megan Elizabeth; Ingersoll, Gail L

2015-08-01

Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. ©2015 American Association of Critical-Care Nurses.

Who gives? Multilevel effects of gender and ethnicity on workplace charitable giving.

PubMed

Leslie, Lisa M; Snyder, Mark; Glomb, Theresa M

2013-01-01

Research on diversity in organizations has largely focused on the implications of gender and ethnic differences for performance, to the exclusion of other outcomes. We propose that gender and ethnic differences also have implications for workplace charitable giving, an important aspect of corporate social responsibility. Drawing from social role theory, we hypothesize and find that gender has consistent effects across levels of analysis; women donate more money to workplace charity than do men, and the percentage of women in a work unit is positively related to workplace charity, at least among men. Alternatively and consistent with social exchange theory, we hypothesize and find that ethnicity has opposing effects across levels of analysis; ethnic minorities donate less money to workplace charity than do Whites, but the percentage of minorities in a work unit is positively related to workplace charity, particularly among minorities. The findings provide a novel perspective on the consequences of gender and ethnic diversity in organizations and highlight synergies between organizational efforts to increase diversity and to build a reputation for corporate social responsibility. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Radon Testing for Safe Schools Act. Report (To Accompany S. 1697) from the Committee on Environment and Public Works, United States Senate, One Hundred First Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Environment and Public Works.

This report was written to accompany the Radon Testing for Safe Schools Act (S.1697), a bill that provides for radon testing of schools located in high risk radon areas and provides limited financial assistance to schools for mitigation of high levels of radon. A description of radon, its harmful effects, and the radon levels detected in schools…

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life

PubMed Central

Holden, Richard J.; Scanlon, Matthew C.; Patel, Neal R.; Kaushal, Rainu; Escoto, Kamisha Hamilton; Brown, Roger L.; Alper, Samuel J.; Arnold, Judi M.; Shalaby, Theresa M.; Murkowski, Kathleen; Karsh, Ben-Tzion

2010-01-01

Backgrounds Nursing workload is increasingly thought to contribute to both nurses’ quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualizing and measuring the effects of workload in health care. In contrast, we conceptualized a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. Methods To test this model, we analyzed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care pediatric hospitals. Results Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading = .31) and burnout (path loading = .45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading = .25) and medication error likelihood (path loading = 1.04). Job-level workload was not uniquely and significantly associated with any outcomes. Discussion The human factors engineering model of nursing workload was supported by data from two pediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions. PMID:21228071

A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working life.

PubMed

Holden, Richard J; Scanlon, Matthew C; Patel, Neal R; Kaushal, Rainu; Escoto, Kamisha Hamilton; Brown, Roger L; Alper, Samuel J; Arnold, Judi M; Shalaby, Theresa M; Murkowski, Kathleen; Karsh, Ben-Tzion

2011-01-01

Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, we conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes. To test this model, we analysed results from a cross-sectional survey of a volunteer sample of nurses in six units of two academic tertiary care paediatric hospitals. Workload measures were generally correlated with outcomes of interest. A multivariate structural model revealed that: the unit-level measure of staffing adequacy was significantly related to job dissatisfaction (path loading=0.31) and burnout (path loading=0.45); the task-level measure of mental workload related to interruptions, divided attention, and being rushed was associated with burnout (path loading=0.25) and medication error likelihood (path loading=1.04). Job-level workload was not uniquely and significantly associated with any outcomes. The human factors engineering model of nursing workload was supported by data from two paediatric hospitals. The findings provided a novel insight into specific ways that different types of workload could affect nurse and patient outcomes. These findings suggest further research and yield a number of human factors design suggestions.

[The working environment control of anhydride hardeners from an epoxy resin system].

PubMed

Matsumoto, Naomi; Yokota, Kozo; Johyama, Yasushi; Takakura, Toshiyuki

2003-07-01

Epoxy resins are widely used in adhesives, coatings, materials for molds and composites, and encapsulation. Acid anhydrides such as methyltetrahydrophthalic anhydride are being used as curing agents for epoxy resins. The anhydride hardeners are well-known industrial inhalant allergens, inducing predominantly type I allergies. In the electronic components industry, these substances have been consumed in large quantities. Therefore, safe use in the industry demands control of the levels of exposure causing allergic diseases in the workshop. We conducted a prospective survey of two electronics plants to clarify how to control the atmospheric level of the anhydrides in the work environment. Measurements of the levels of the anhydrides in air started according to the Working Environment Measurement Standards (Ministry of Labour Notification No. 46, 1976) in April 2000, along with improvements in the work environment. A value of 40 micrograms/m3 was adopted as the administrative control level to judge the propriety of the working environment control. A total of 2 unit work areas in both plants belonged to Control Class III. The exposure originated from manual loading, casting, uncured hot resins, and leaks in an impregnating-machine or curing ovens. In order to achieve the working environment control, complete enclosure of the source, installation of local exhaust ventilation, and improvement or maintenance of the local exhaust ventilation system were performed on the basis of the results of the working environment measurement, with the result that the work environment was improved (Control Class I). It became evident that these measures were effective just like other noxious substances.

Microbial diversity in dental unit waterlines.

PubMed

Lisboa, Guacyra M; Lisboa, Yves R M; Pinheiro, Telma M L; Stegun, Roberto C; da Silva-Filho, Eurípedes A

2014-01-01

Dental health care providers and patients are exposed during ongoing work to contamination by the water used in the dental units, due to accidental swallowing or aspiration of the sprays generated by the high-speed handpiece and the threeway syringe. This study evaluated the quality of water in dental units in the public dental care system of Maceio, Alagoas, Brazil, by conducting analyses of contamination by total coliforms, E.Coli, heterotrophic bacteria and filamentous fungi. We collected 200 mL of water at 5 sites in 6 dental offices of the Department of Health located in different parts of the city. A total 212 isolates and 16 genera of filamentous fungi were identified in the water collected from the dental units. Total coliforms indicated that the water used in dental units was not appropriate for human consumption. The high levels of contamination found in this study showed that water was a potential source of cross-infection.

Missed nursing care: the impact on intention to leave and turnover.

PubMed

Tschannen, Dana; Kalisch, Beatrice J; Lee, Kyung Hee

2010-12-01

The purpose of the study was to examine the relationship between missed nursing care, nurse turnover, and intention to leave. A cross-sectional study using the MISSCARE Survey was conducted. The sample comprised 110 patient-care units in 10 acute-care hospitals. Staffing data, turnover rates, and unit-level Case Mix Index were collected from the participating hospitals. Higher percentages of females on the unit were associated with lower turnover rates (beta = -.235, p = .010). Units with higher rates of missed care (beta = .302, p < .0001) and absenteeism (beta = .247, p = .034) had more staff with intention to leave. Units with nursing staffwho worked overtime (beta = -.283, p = .001) and who were over 35 years of age (beta = -.270, p = .050) were less likely to have staff with intention to leave. By minimizing missed nursing care, organizations may be able to improve satisfaction and reduce intention to leave (and subsequent turnover).

Newborn screening policy in the United Kingdom & the United States: two different communities of practice.

PubMed

Patch, Christine

2006-01-01

Newborn screening is a rapidly developing area driven by both technological advances and public pressure. If they are not yet, all nurses working with mothers and children will soon be involved with implementing newborn-screening programs, and it is therefore important that they appreciate both the benefits and potential harms of such programs. In the United Kingdom, policy regarding the implementation of newborn-screening programs is developed at national level, and consideration of the introduction of new tests is subject to a formalized evaluation framework. In the United States, by contrast, each state develops its own screening program. Knowledge of developments in newborn screening in different countries that have diverse types of healthcare systems helps to inform nurses about the totality of healthcare for newborns, and assists them in becoming more knowledgeable about how international standards differ from those in the United States.

A multilevel analysis of the effects of the Practice Environment Scale of the Nursing Work Index on nurse outcomes.

PubMed

Gabriel, Allison S; Erickson, Rebecca J; Moran, Christina M; Diefendorff, James M; Bromley, Gail E

2013-12-01

Few researchers have examined how the components of the Practice Environment Scale of the Nursing Work Index (PES-NWI) relate to nurses' well-being at multiple organizational levels. The objective of the study was to perform a multilevel assessment of the relationships of the PES-NWI subscales with three nurse outcomes: job satisfaction, emotional exhaustion, and turnover intentions. Additionally, we tested the multilevel factor structure of the PES-NWI. In a sample of 699 full-time registered nurses in 79 units and 9 branches of a hospital system, relationships of the NWI with nurse outcomes were fairly consistent across levels of analysis. However, subscales contributed differently to the three outcomes, demonstrating the complexity of environmental influences on nurses' work experience. © 2013 Wiley Periodicals, Inc.

Neural mechanisms of mental schema: a triplet of delta, low beta/spindle and ripple oscillations.

PubMed

Ohki, Takefumi; Takei, Yuichi

2018-02-06

Schemas are higher-level knowledge structures that integrate and organise lower-level representations. As internal templates, schemas are formed according to how events are perceived, interpreted and remembered. Although these higher-level units are assumed to play a fundamental role in our daily life from an early age, the neuronal basis and mechanisms of schema formation and use remain largely unknown. It is important to elucidate how the brain constructs and maintains these higher-level units. In order to examine the possible neural underpinnings of schema, we recapitulate previous work and discuss their findings related to schemas as the brain template. We specifically focused on low beta/spindle oscillations, which are assumed to be the key components of schemas, and propose that the brain template is implemented with a triplet of neural oscillations, that is delta, low beta/spindle and ripple oscillations. © 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

The lived experiences of autonomous Angolan midwives working in midwifery-led, maternity units.

PubMed

Pettersson, K O; Svensson, M L; Christensson, K

2001-06-01

to describe the lived experiences of autonomous midwives working in Angolan midwifery-led maternity units. a qualitative approach using semi-structured, audiotaped interviews, in Portugese. Data were analysed in a six-step process. three midwifery-led maternity units in the most densely populated suburbs in the capital of Angola, Luanda. The average number of deliveries per unit was 2500 per year. 11 midwives from the three maternity units. four main areas emerged: society/culture, significant others, personal self and professional self. Sub-areas, concepts and supporting statements were defined in each area. the midwives served within a population living in rough circumstances but which maintained strong traditional roots. The midwives did not support homebirths, but did assist when needed. The midwives described their professional role as a 'calling', which was very independent. Cure, was considered more important than care, and strong emotions were expressed when discussing cases of failure. The partograph was viewed as an important instrument and continuous learning as crucial in their role as autonomous midwives. the model of a midwifery-led delivery unit described in this study may be used in other countries facing the same problems as Angola. Difficulties concerning transfer should be seriously considered as well as adequate education for the midwives. A pre-requisite in order for peripheral maternity units to have any impact on maternal morbidity and mortality, is a well-organised first-referral level. Copyright 2001 Harcourt Publishers Ltd.

Patient Safety Culture in Intensive Care Units from the Perspective of Nurses: A Cross-Sectional Study.

PubMed

Farzi, Sedigheh; Moladoost, Azam; Bahrami, Masoud; Farzi, Saba; Etminani, Reza

2017-01-01

One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation). Among the 12 dimensions of safety culture, the nurses assigned the highest score to "team work within units" (97.3%) and "Organizational learning-continuous improvement" (84%). They assigned the least score to "handoffs and transitions"(21.1%), "non-punitive response to errors" (24.7%), "Staffing" (35.6%), "Communication openness" (47.5%), and "Teamwork across units" (49.4%). The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error.

The physical environment and patients' activities and care: A comparative case study at three newly built stroke units.

PubMed

Anåker, Anna; von Koch, Lena; Sjöstrand, Christina; Heylighen, Ann; Elf, Marie

2018-04-20

To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units. Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce. This work is a comparative descriptive case study. Patients (N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 - December 2015. The units differed in the patients' levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single-room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients' activities and care. Patients' activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Level III Ecoregions of Kentucky

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Michigan

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Idaho

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Arkansas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Mississippi

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Ohio

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Connecticut

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Georgia

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Colorado

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Wisconsin

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Oregon

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Texas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Arkansas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Florida

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Idaho

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Nevada

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Texas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Virginia

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Illinois

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Virginia

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Delaware

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Wyoming

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Alabama

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Maine

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Alabama

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Nebraska

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Delaware

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Maine

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Kansas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Louisiana

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Michigan

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Arizona

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Georgia

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Utah

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Montana

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Iowa

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Nebraska

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Vermont

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Wisconsin

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Kansas

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Tennessee

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level IV Ecoregions of Nevada

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

Level III Ecoregions of Colorado

EPA Pesticide Factsheets

Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco