Jajosky, Ryan Philip; Jajosky, Audrey N; Kleven, Daniel T; Singh, Gurmukh
Some pathologists have observed that fewer trainees from US medical schools are entering pathology residency. This trend was measured and further explored using Main Residency Match (MRM) data from 2008 to 2017, obtained from the National Resident Matching Program (NRMP). Over the past decade, there was an increase of 93 (508 in 2008 versus 601 in 2017, an 18.3% increase) pathology positions offered in the MRM. However, the proportion of pathology residency positions filled in the MRM which were taken by trainees from US medical schools decreased from 77.7% to 50.1% over this timespan. This was primarily due to fewer seniors from US allopathic medical schools filling pathology positions in the MRM (298 in 2008 versus 216 in 2017, a 27.5% decrease). Compared to 14 other medical specialties, pathology had the largest decline in the proportion of residency positions filled in the MRM which were taken by seniors from US allopathic medical schools (63.8% in 2008 versus 39.6% in 2017). Furthermore, pathology now has the lowest percentage of residency positions filled in the MRM, which were taken by seniors from US allopathic medical schools. The primary reason for this decline was because fewer seniors from US allopathic medical schools participated in the MRM for pathology positions (326 in 2008 versus 232 in 2017, a 28.8% decrease); however, the underlying reasons for this decline are unknown. In conclusion, over the past decade, substantially fewer seniors from US allopathic medical schools sought/filled pathology residency positions in the MRM. These findings are relevant for pathology residency recruitment, especially in the context of a projected decline in US pathologist workforce. Copyright © 2017 Elsevier Inc. All rights reserved.
Schmiedt, Dean; Ellingson, Jody
To determine if pharmacist involvement within a senior dining program benefits diners by addressing their medication-related questions, using educational sessions, and providing individual consultations. Catholic Charities Senior Dining sites in central Minnesota. Pharmacists went to three senior dining sites, providing educational sessions and individual consultations to independently living senior diners. Pharmacists developed a program, in a nontraditional setting, that used educational sessions and individual consultations to assist seniors with their medication-related questions. The number of diner questions, significant issues raised, issues addressed, and level of diner satisfaction. Pharmacists made 36 visits from January to December 2009. During those visits they presented educational talks to 3,089 diners, and 12.4% of all diners spoke individually with pharmacists. Pharmacists addressed 581 questions or concerns from 384 diners. Significant issues were noted in 25.8% of individual consultations (144 questions). The most common significant issues included: adverse drug reactions (59), indications without treatment (27), and drug interactions (23). Nonopioid analgesics, antilipemics, and antihypertensive medications were most commonly involved in significant issues. Satisfaction surveys were strongly positive, with 97% indicating pharmacists had addressed their medication-related concern; only 3% did not reply. Almost half (42.7%) of satisfaction surveys indicated the diner would change something as a result of meeting with the pharmacist. Pharmacist availability in a nontraditional setting can assist seniors with addressing potentially significant medication-related issues. Independently living seniors will seek out information from a pharmacist in a convenient setting.
Full Text Available Abstract Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia. Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24% were female and 57 (76% were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%, 41–55 years = 46 participants (61.3% and >55 years = 13 participants (17.3%. Most participants (n = 48, 64% were staff specialists and 27 (36% were visiting medical officers. Half of the participants were internists (n = 39, 52%, 12 (16% were surgeons, and 24 (32% were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce.
Corwin, Sara J; Frahm, Kathryn; Ochs, Leslie A; Rheaume, Carol E; Roberts, Ellen; Eleazer, G Paul
In 2000, the Senior Mentor Program was implemented as an innovative, instructional method in the University of South Carolina's medical school curriculum designed to enhance and strengthen student training in geriatrics. This study qualitatively analyzed second- year medical students' and senior participants' perceptions of and attitudes towards the Senior Mentor Program as an effective learning modality. A total of 36 second-year students from two consecutive classes (2002-2003) and 42 senior mentors at USC's School of Medicine participated in five and seven separate focus group interviews, respectively. The group discussions were transcribed and a content analysis performed using NVivo. The coding scheme and analyses were driven by the data collected and recurrent themes were examined across all focus groups. Overall, student and senior mentor participants viewed the program positively. Thematic comparisons by participant type indicate a shared view that the mentoring relationship has a far-reaching, educational, professional, and personal impact. Both students and seniors agreed that myths and stereotypes about aging were dispelled and students indicated that a close, caring relationship with an older person will change they way they practice. A longitudinal mentoring program that pairs students with community-dwelling seniors can be a valuable addition to traditional geriatric curricular activities designed to increase students' skills and compassion for caring for older adults.
This survey study has five parts. In the first part two conceptual approaches to humor are characterized. One considers "the comic" to be an umbrella concept, and humor is only one of its rather positive forms. The other comes out from the umbrella concept "humor", and distinguishes between various forms of humor including the negative ones. Three main theories of humor are presented: theory of superiority, theory of incongruity, and a relief theory. The second part introduces humor in the elderly and draws the attention to the fact that we know relatively little about humor in old age because most research has been carried out in children, adolescents or adults in productive age. The third part of the study describes the process of diagnostics of humor in the elderly. For example, within the qualitative methods, in-depth interviews with seniors or analyses of their diary entries are used. Within quantitative methods, questionnaires are used, and this study presents the survey of seven most frequent ones applied in the studies of humor in the elderly. In the context of mixed methods, understanding of humor in young and seniors, or understanding of humor in relatively healthy seniors and seniors after stroke are compared. The fourth part of the study presents the Gelkopfs model on relationship between humor, treatment and cure of patients. The fifth part of the study demonstrates the options how to use humor to improve the mental state of the elderly (by means of individual or group interventions).
Jacobs, Jesse C; Guralnick, Michael L; Sandlow, Jay I; Langenstroer, Peter; Begun, Frank P; See, William A; O'Connor, Robert Corey
Applicant interviews for urology residency positions are a stressful and costly process for students, faculty, and staff. We conducted a prospective survey to better determine what urology applicants perceive as an ideal interview process to gain sufficient knowledge about a training program. A questionnaire was anonymously completed by all urology residency applicants interviewing at the Medical College of Wisconsin from 2007 to 2013. Questionnaire subject headings included "ideal interview format," "factors contributing to understanding the residency program," and "factors contributing to final rank list order." Questionnaires were distributed to and completed by 221 senior medical students applying for a urology residency position. Most respondents (>80%) reported they would prefer to partake in 5 to 7 faculty interviews in an office setting with the total interview process spanning half to three-fourths of the workday. Spending time with current residents was considered the most valuable tool to acquire knowledge about a residency program. The most important criteria when ranking a program were resident satisfaction, resident operative experience, and perceived strength of faculty. Academic urology programs may wish to consider applicant ideals when organizing residency interviews. Interaction with current residents appears to be the most valuable resource allowing applicants to garner knowledge about a urology training program. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Fetterolf, Donald E
Many physicians find hospital or health plan boards of directors to be intimidating arenas for medical quality presentations. This essay presents a number of "pearls" gleaned from successful senior clinician managers who have learned to relate to senior management and advance in their careers. This commentary was developed from research and a presentation of the same title delivered at the American College of Medical Quality Annual Meeting held in Las Vegas in October, 2001. It is important that medical directors who work with financial managers convert quality concepts into "business value" concepts. Talking in the language of business, rather than the language of doctors, makes it much easier to communicate with management (although some translation is often in order). As a clinician presenting to financial managers, you should become familiar with financial terms and how they are used. Indeed, the development of a financial model representing clinical activity results in the highest level of success. There are a number of methods for estimating impact that have been found within general business and health services research areas that are acceptable. Successful presenters of information approach their task effectively. Reports are in a more readable format and convey information for action by the corporation rather than as a scholarly treatise. Approaching senior management, one must consider the psychology of individuals in senior positions. Senior medical executives who are successful report similar approaches to their tasks, and offer helpful insight into career advancement.
... 3206-AL88 Pay for Senior-Level and Scientific or Professional Positions AGENCY: U.S. Office of... to amend rules for setting and adjusting pay of senior-level (SL) and scientific or professional (ST) employees. The Senior Professional Performance Act of 2008 changes pay for these employees by providing for...
Full Text Available Abstract Background Clinical experience has traditionally been highly valued in medical education and clinical healthcare. On account of its multi-faceted nature, clinical experience is mostly difficult to articulate, and is mainly expressed in clinical situations as professional approaches. Due to retirement, hospitals in Scandinavia will soon face a substantial decrease in the number of senior specialist doctors, and it has been discussed whether healthcare will suffer an immense loss of experienced-based knowledge when this senior group leaves the organization. Both senior specialists and junior colleagues are often involved in clinical education, but the way in which these two groups vary in professional approaches and contributions to clinical education has not been so well described. Cognitive psychology has contributed to the understanding of how experience may influence professional approaches, but such studies have not included the effect of differences in position and responsibilities that junior and senior doctors hold in clinical healthcare. In the light of the discussion above, it is essential to describe the professional approaches of senior doctors in relation to those of their junior colleagues. This study therefore aims to describe and compare the professional approaches of junior and senior doctors when making clinical judgements. Methods Critical incident technique was used in interviews with nine senior doctors and nine junior doctors in internal medicine. The interviews were subjected to qualitative content analysis. Result Senior and junior doctors expressed a variety of professional approaches in clinical judgement as follows: use of theoretical knowledge, use of prior experience of cases and courses of events, use of ethical and moral values, meeting and communicating with the patient, focusing on available information, relying on their own ability, getting support and guidance from others and being directed by the
... Regulations; Exempted Senior Employee Positions AGENCY: Office of Government Ethics (OGE). ACTION: Final rule... notice of the revocation of certain regulatory exemptions of senior employee positions at the Securities... employee'' for a period of one year from knowingly making, with the intent to influence, any communication...
To date western feminist scholarship on gender and work has primarily focused on women providing valuable information as to their discrimination and invisibility, especially in the echelons of power and in senior decision-making positions. Feminist scholars have needed to explore women's under representation in senior leadership positions because…
Hoff, Timothy; DePuccio, Matthew
The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.
Full Text Available Background and Objectives: Burnout is caused by high-stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so that this condition causes poor relationship with the patient. This study aimed at investigating burnout in senior medical students of Kashan University of Medical Sciences.Methods: This research was a cross sectional study carried out on all senior medical students (N=56 in 2008. Data were obtained by two questionnaires including demographic questionnaire and Maslach burnout Inventory. They were then analyzed using SPSS software and Chi square Test. Results: The findings showed that the majority of medical students (91.1% had burnout and only 8.9% of them had not burnout. Severe burnout was in 16% of students. There was not any significant relationship between burnout and sex, age, smoking, duration of education, interest in medical course and marital status P<0.05.Conclusion: The results of the study showed that burnout is common problem in senior medical students and need special consideration. Therefore medical students should be encouraged to seek help and adequate facilities by holding workshops of life-skill training and coping with stress. However, burnout should be paid special attention in medical students by counseling centers of University for prevention of consequences.
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Background and Objectives: Burnout is caused by high-stress jobs and could induce somatic, psychological disorders and negative attitude to professional actives so that this condition causes poor relationship with the patient. This study aimed at investigating burnout in senior medical students of Kashan University of Medical Sciences. Methods: This research was a cross sectional study carried out on all senior medical students (N=56 in 2008. Data were obtained by two questionnaires including demographic questionnaire and Maslach burnout Inventory. They were then analyzed using SPSS software and Chi square Test. Results: The findings showed that the majority of medical students (91.1% had burnout and only 8.9% of them had not burnout. Severe burnout was in 16% of students. There was not any significant relationship between burnout and sex, age, smoking, duration of education, interest in medical course and marital status P<0.05. Conclusion: The results of the study showed that burnout is common problem in senior medical students and need special consideration. Therefore medical students should be encouraged to seek help and adequate facilities by holding workshops of life-skill training and coping with stress. However, burnout should be paid special attention in medical students by counseling centers of University for prevention of consequences.
Voaklander, D C; Rowe, B H; Dryden, D M; Pahal, J; Saar, P; Kelly, K D
Suicide among seniors is a significant health problem in north America, particularly for men in whom the rates rise steadily after 50 years of age. The goal of this study was to examine elder suicides identified from a large population-based database using case-control methods to determine disease and medication factors related to suicide. A population-based 1 : 5 case-control study was conducted comparing seniors aged 66 years and older who had died by suicide with age and sex-matched controls. Case data were obtained through British Columbia (BC) Vital Statistics, whereas controls were randomly selected from the BC Health Insurance Registry. Cases and controls were linked to the provincial PharmaCare database to determine medication use and the provincial Physician Claims and Inpatient Hospitalization databases to determine co-morbidity. Between 1993 and 2002 a total of 602 seniors died by suicide in BC giving an annual rate of 13.2 per 100,000. Firearms were the most common mechanism (28%), followed by hanging/suffocation (25%), self-poisoning (21%), and jumping from height (7%). In the adjusted logistic model, variables related to suicide included: lower socioeconomic status, depression/psychosis, neurosis, stroke, cancer, liver disease, parasuicide, benzodiazepine use, narcotic pain killer use and diuretic use. There was an elevated risk for those prescribed inappropriate benzodiazepines and for those using strong narcotic pain killers. This study is consistent with previous studies that have identified a relationship between medical or psychiatric co-morbidity and suicide in seniors. In addition, new and potentially useful information confirms that certain types and dosages of benzodiazepines are harmful to seniors and their use should be avoided.
Dasgupta, Dipanwita; Johnson, Reid A; Chaudhry, Beenish; Reeves, Kimberly G; Willaert, Patty; Chawla, Nitesh V
Medication non-adherence is a pressing concern among seniors, leading to a lower quality of life and higher healthcare costs. While mobile applications provide a viable medium for medication management, their utility can be limited without tackling the specific needs of seniors and facilitating the active involvement of care providers. To address these limitations, we are developing a tablet-based application designed specifically for seniors to track their medications and a web portal for their care providers to track medication adherence. In collaboration with a local Aging in Place program, we conducted a three-month study with sixteen participants from an independent living facility. Our study found that the application helped participants to effectively track their medications and improved their sense of wellbeing. Our findings highlight the importance of catering to the needs of seniors and of involving care providers in this process, with specific recommendations for the development of future medication management applications.
Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.
Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…
Mendoza De La Garza, Maria; Tieu, Christina; Schroeder, Darrell; Lowe, Kathleen; Tung, Ericka
Medical schools throughout the country struggle with how best to train students to provide quality, patient-centered care to the burgeoning population of older adults. The Senior Sages Program (SSP) is a longitudinal Senior Mentor Program (SMP) that offers students the opportunity to learn about the aging process and core geriatric medicine concepts through the eyes of an aging expert: their Senior Sage. The SSP marries a robust electronic curriculum with an SMP and online discussion board. The aim of this program evaluation was to measure the impact on students' geriatric knowledge and attitudes toward older adults. This asynchronously facilitated course improved students' geriatric knowledge and facilitated stability of positive attitudes toward older adults. The majority of students felt that their SSP interactions were meaningful and valuable to their clinical development. The combination of SMP and electronic curricula offer a feasible, practical way to bridge the geriatric training chasm.
N. (Nicky H.D. Terblanche
Full Text Available Orientation: Coaching is sometimes used in organisations to assist and support people when they are promoted into senior leadership positions. These coaching interventions are not optimally designed. Research purpose: The objective of this research was to investigate how a transition coaching intervention should be designed to cater specifically for people promoted into senior leadership positions. Motivation for the study: Leaders face daunting challenges when promoted into a senior position. Coaching could offer powerful support, but very little research exists on how to design a transition coaching intervention specifically aimed at supporting recently promoted senior leaders. Research design, approach and method: A constructivist, grounded theory approach using purposeful, theoretical sampling was used to identify 16 participants (recently promoted senior leaders, coaches, Human Resource [HR] partners and a line manager from various organisations with whom open-ended interviews were conducted on their experiences of coaching during a transition. Main findings: Transition coaching is used reactively, started too late and was not continued for long enough. Transition coaching design should take cognisance of coach–coachee matching; goal setting that includes the organisation’s goals; location of coaching session (away from the office; should include reflection and active experimentation; and use assessments and involving the line manager, mentors and the new leader’s team in the process. Practical and managerial implications: The findings of this research provide practical recommendations for applying coaching during transitions into senior leadership positions and may be useful to human resource practitioners when designing leadership support and succession planning interventions. Contribution and value added: To address the serious and real possibility of failure once leaders are promoted, and to optimise the time and money spent on
Vigh-Larsen, Jeppe F; Dalgas, Ulrik; Andersen, Thomas B
Vigh-Larsen, JF, Dalgas, U, and Andersen, TB. Position-specific acceleration and deceleration profiles in elite youth and senior soccer players. J Strength Cond Res 32(4): 1114-1122, 2018-The purpose of the study was to characterize and compare the position-specific activity profiles of young and senior elite soccer players with special emphasis put on accelerations and decelerations. Eight professional senior matches were tracked using the ZXY tracking system and analyzed for the number of accelerations and decelerations and running distances within different speed zones. Likewise, 4 U19 and 5 U17 matches were analyzed for comparison between youth and senior players. In senior players, the total distance (TD) was 10,776 ± 107 m with 668 ± 28 and 143 ± 10 m being high-intensity running (HIR) and sprinting, respectively. Number of accelerations and decelerations were 81 ± 2 and 84 ± 3, respectively, with central defenders performing the lowest and wide players the highest number. Declines were found between first and second halves for accelerations and decelerations (11 ± 3%), HIR (6 ± 4%), and TD (5 ± 1%), whereas sprinting distance did not differ. U19 players performed a higher number of accelerations, decelerations, and TD compared with senior players. In conclusion, differences in the number and distribution of accelerations and decelerations appeared between player positions, which is of importance when monitoring training and match loads and when prescribing specific training exercises. Furthermore, youth players performed as much high-intensity activities as senior players, indicating that this is not a discriminating physiological parameter between these players.
Nyoni, Watende Pius; He, Chen; Yusuph, Mashala Lameck
Despite the international campaigns for gender equality and equity in Higher Education Institutions, studies conducted in several countries continue to show that women are underrepresented in senior leadership positions in universities. Women leaders in higher education subsector in Tanzania are very few. Of all the 60 and above universities and…
Rademakers, J.; Rooy, N. de; Cate, O.T.J. ten
CONTEXT: In 2003 the Dutch Central College of Medical Specialties presented guidelines for the modernisation of all medical specialty training programmes in the Netherlands. These guidelines are based to a large extent on the CanMEDS (Canadian Medical Education Directives for Specialists) 2000
McCabe, Sean Esteban; West, Brady T.; Teter, Christian J.; Boyd, Carol J.
Objective To determine the prevalence of medical and nonmedical use of prescription opioids among high school seniors in the United States, and to assess substance use behaviors based on medical and nonmedical use of prescription opioids. Design Nationally representative samples of high school seniors (modal age 18) were surveyed during the spring of their senior year via self-administered questionnaires. Setting Data were collected in public and private high schools. Participants The sample consisted of 7,374 students from three independent cohorts (2007-09). Main Outcome Measures Self-reports of medical and nonmedical use of prescription opioids and other substance use. Results An estimated 17.6% of high school seniors reported lifetime medical use of prescription opioids, while 12.9% reported nonmedical use of prescription opioids. Gender differences in the medical and nonmedical use were minimal, while racial/ethnic differences were extensive. Over 37% of nonmedical users reported intranasal administration of prescription opioids. An estimated 80% of nonmedical users with an earlier history of medical use had obtained prescription opioids from a prescription they had previously. The odds of substance use behaviors were greater among individuals who reported any history of nonmedical use of prescription opioids relative to those who reported medical use only. Conclusions Nearly one in every four high school seniors in the United States has ever had some exposure to prescription opioids either medically or nonmedically. The quantity of prescription opioids and number of refills prescribed to adolescents should be carefully considered and closely monitored to reduce subsequent nonmedical use of leftover medication. PMID:22566521
Chomicki, O. A.
Here is a story told by Maria Sklodowska-Curie at the meeting of the International Committee of Intellectual Cooperation in 1921: 'In a free literary competition on the role and importance of elephants the Englishman's story was 'My adventures while shooting elephants in South Africa', the Frenchman was more concerned with 'The sexual and erotic life of elephants', while the Polish approach was invariably 'The elephant versus Poland's national independence', which seemed quite understandable in the light of over 120 years when Poland was partitioned and lost its independence. Since then this saying has become proverbial and came to express the unmistakably Polish tendency to see everything in terms of Polish interests. In my remarks and reminiscences on the history of the Polish Society of Medical Physics you will quickly recognize the same tendency. First, I will, among other things, try to open some old cupboards to 'produce good [things] from the store of good' (Matthew 12:35), especially concerning the first few years of the activity in medical physics in Poland, and second, I will draw some conclusions and/or offer suggestions based on what a senior medical physicist has seen for more than 50 years of his activity in this field. (author)
Corwin, Sara J.; Bates, Tovah; Cohan, Mary; Bragg, Dawn S.; Roberts, Ellen
This paper compares two models of undergraduate geriatric medical education utilizing senior mentoring programs. Descriptive, comparative multiple-case study was employed analyzing program documents, archival records, and focus group data. Themes were compared for similarities and differences between the two program models. Findings indicate that…
Johns, Merida L
The business case for gender diversity in senior and executive positions is compelling. Studies show that companies that have the best records for promoting women outstrip their competition on every measure of profitability. Yet women disproportionately are failing to attain high-level positions. Reviewing current data on women in the workplace, findings of studies on the relationship between gender diversity in senior management and company performance, and the literature on gender behavioral differences and the workplace, this article explores the possible reasons for the persistent wage and gender gap between women and men in senior leadership positions and discusses possible remedies.
Kröger, Edeltraut; Tatar, Ovidiu; Vedel, Isabelle; Giguère, Anik M C; Voyer, Philippe; Guillaumie, Laurence; Grégoire, Jean-Pierre; Guénette, Line
Background Medication non-adherence may lead to poor therapeutic outcomes. Cognitive functions deteriorate with age, contributing to decreased adherence. Interventions have been tested to improve adherence in seniors with cognitive impairment or Alzheimer disease (AD), but high-quality systematic reviews are lacking. It remains unclear which interventions are promising. Objectives We conducted a systematic review to identify, describe, and evaluate interventions aimed at improving medication adherence among seniors with any type of cognitive impairment. Methods Following NICE guidance, databases and websites were searched using combinations of controlled and free vocabulary. All adherence-enhancing interventions and study designs were considered. Studies had to include community dwelling seniors, aged 65 years or older, with cognitive impairment, receiving at least one medication for a chronic condition, and an adherence measure. Study characteristics and methodological quality were assessed. Results We identified 13 interventions, including six RCTs. Two studies were of poor, nine of low/medium and two of high quality. Seven studies had sample sizes below 50 and six interventions focused on adherence to AD medication. Six interventions tested a behavioral, four a medication oriented, two an educational and one a multi-faceted approach. Studies rarely assessed therapeutic outcomes. All but one intervention showed improved adherence. Conclusion Three medium quality studies showed better adherence with patches than with pills for AD treatment. Promising interventions used educational or reminding strategies, including one high quality RCT. Nine studies were of low/moderate quality. High quality RCTs using a theoretical framework for intervention selection are needed to identify strategies for improved adherence in these seniors.
Johns, Merida L.
The business case for gender diversity in senior and executive positions is compelling. Studies show that companies that have the best records for promoting women outstrip their competition on every measure of profitability. Yet women disproportionately are failing to attain high-level positions. Reviewing current data on women in the workplace, findings of studies on the relationship between gender diversity in senior management and company performance, and the literature on gender behaviora...
Desouzart, Gustavo; Matos, Rui; Melo, Filipe; Filgueiras, Ernesto
The increase in life expectancy of elderly population has aroused the interest of different knowledge areas in understanding the variables that are involved in the aging process, linking them to other concepts such as active aging, healthy aging and the bio-psycho-social changes. This paper presents the results of the first controlled, experimental pilot study that aimed to analyze the relationship between the perception of back pain and the sleeping position adopted by physically active female seniors. Twenty female seniors (mean age 62.70 ± 3.827) participated in this study. The individuals were separated in 2 groups (Experimental and Control Group). For the carrying out of this study, the Visual Analogue Scale (VAS) was used to measure the intensity of back pain in the spine before and after four consecutive weeks an Intervention program. Individuals in the Experimental Group were instructed regarding the recommended way to sleep position (Intervention program) according to the pathological problems or the amount of pain reported. The Experimental Group (N = 10) presented significantly (p = 0.009) fewer complaints of back pain after an Intervention program in comparison to individuals who did not receive this type of information (Control Group).
Analyzing the Relationship of Geographic Mobility and Institutional Prestige to Career Advancement of Women in Academic Medicine Pursuing Midcareer-, Senior-, or Executive-Level Administrative Positions: Implications for Career Advancement Strategies
McLean, Marsha Renee
The purpose of this study was to explore the relationship of geographic mobility and institutional prestige to career advancement defined as administrative promotions of women seeking midcareer-, senior-, or executive-level positions at academic health centers (AHCs) and their medical schools or in non-AHC related medical schools in the United…
Full Text Available This article argues that Higher Education Institutions should adopt positive action in recruitment and promotion to tackle women’s under-representation in senior leadership roles. In a tie-break situation where two candidates are “as qualified as each other”, section 159 of the UK Equality Act 2010 allows employers to give preference to a candidate from an under-represented group. The use of this measure, however, is often contested on the grounds that it is a form of reverse discrimination, it is tokenistic and that it can undermine meritocracy. This article seeks to challenge these objections and suggests that, far from undermining meritocracy, the use of positive action in recruitment and promotion could prove a useful tool to tackle gender bias, unpack stereotypes and re-appraise how merit is defined and assessed.
LaPaglia, Donna; Robiner, William N; Yozwiak, John A; Brosig, Cheryl; Cubic, Barbara; Leventhal, Gerald
Physician shortages in the US are expected to intensify with the implementation of the Patient Protection and Affordable Care Act. These shortages may negatively impact access to care, quality of care, and confidence in the system's ability to adequately provide for health needs in the US. Concerns regarding physician demand underscore how critical Graduate Medical Education funding is to preparing the physician workforce. In 2014 5.6 % of US medical school seniors did not match into residency. Psychology has faced longstanding training imbalance issues with a misalignment between the number of internship positions and the number of applicants. The authors summon attention to the damaging effects a training imbalance poses to a health care profession, its trainees, and ultimately the public it serves.
Talbott, Vanessa A; Marks, Joshua A; Bodzin, Adam S; Comeau, Jason A; Maxwell, Pinckney J; Isenberg, Gerald A; Martin, Niels D
To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE). Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student. The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA. Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt. Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p Assertiveness scores from the "scavenger hunt" did not correlate with final OSCE scores (r = -0.328, p = 0.25), and were negatively correlated with the change between pre- and post-OSCE scores (r = -0.573, p assertiveness scores were determined by the number of tasks completed over the course of the rotation. As surgical education becomes more streamlined with evolving work hour restrictions, medical school education is playing an increasingly pivotal role in preparing students for internship. In our study, individual assertiveness in completing structured self-directed learning tasks did not directly predict the acquisition of proficiency in technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further studies are required to delineate these
Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon
Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home
Bakker, M.M.; Jacobs, M.H.
Underrepresentation of women in senior positions is a persistent problem in universities worldwide, and a wide range of strategies to combat this situation is currently being contemplated. One such strategy is the introduction of a tenure track system, in which decisions to promote scientific staff
Blackstone, Tondelaya K.
The focus of this study was how knowledge of the barriers to advancement for African American women (AAW) and key career support factors (KCSFs) influence the career advancement of African American women (AAW) to senior-level positions in higher education. The research method for this study consisted of the triangulation of evidence from multiple…
Chang, Anna; Chou, Calvin L; Teherani, Arianne; Hauer, Karen E
Lifelong learning is essential for doctors to maintain competence in clinical skills. With performance feedback, learners should be able to formulate specific and achievable learning goals in areas of need. We aimed to determine: (i) the type and specificity of medical student learning goals after a required clinical performance examination; (ii) differences in goal setting among low, average and high performers, and (iii) whether low performers articulate learning goals that are concordant with their learning needs. We conducted a single-site, multi-year, descriptive comparison study. Senior medical students were given performance benchmarks, individual feedback and guidelines on learning goals; each student was subsequently instructed to write two clinical skills learning goals. Investigators coded the learning goals for specificity, categorised the goals, and performed statistical analyses to determine their concordance with student performance level (low, average or high) in data gathering (history taking and physical examination) or communication skills. All 208 students each wrote two learning goals and most (n=200, 96%) wrote two specific learning goals. Nearly two-thirds of low performers in data gathering wrote at least one learning goal that referred to history taking or physical examination; one-third wrote learning goals pertaining to the organisation of the encounter. High performers in data gathering wrote significantly more patient education goals and significantly fewer history-taking goals than average or low performers. Only 50% of low performers in communication wrote learning goals related to communication skills. Low performers in communication were significantly more likely than average or high performers to identify learning goals related to improving performance in future examinations. The provision of performance benchmarking, individual feedback and brief written guidelines helped most senior medical students in our study to write specific
H. Jay Biem
Full Text Available Continuity of care, defined as the patient experiencing coherent care over time and place, is challenged when a rural senior with multiple medical problems is transferred to a regional hospital for acute care. From an illustrative case of an older patient with pneumonia and atrial fibrillation, we catalogue potential breaks in continuity of care. Optimal continuity of care is characterised not only by regular contact with the providers who establish collaboration with patients and their caregivers, but also by communication, co-ordination, contingency, convenience, and consistency. Because it is not possible to have the same providers continuously available (relational continuity, for continuity of care, there is a need for integrative system approaches, such as: (1 policy and standards, disease management programs, integrated clinical pathways (management continuity, (2 electronic health information systems and telecommunications technology (communication continuity. The evaluation of these approaches requires measures that account for the multi-faceted nature of continuity of care.
Full Text Available Background: The accurate knowledge of generic medicine issues among future prescribers will enhance the prescribing of cost-effective medicines. This study aimed to explore the knowledge and perception of senior medical students about the generic medicines. Methodology: A cross-sectional study was conducted among 237 senior medical students (final year students and interns using a validated self-administered questionnaire. The collected data were analyzed using Statistical Package for the Social Sciences version 20 for windows and comparison of difference was done using linear by linear association. A p value of less than 0.05 was taken as statistically significant. Results: The average age (standard deviation of the respondents was 23.54 (1.39 years. Almost 5% of respondents correctly answered the question regarding the regulatory limits for bioequivalence. Almost two-thirds of respondents correctly agreed that generic medicine is bioequivalent to a brand-name medicine, and 79.3% and 72.5% of respondents correctly agreed that the medicine should be present in the same dosage form and same dose, respectively, as the brand-name medicines. However, almost half of the respondents had impression that brand-name medicines are required to meet higher safety standard than generic medicines. Almost 90% of respondents felt that advertisement by the drug companies would influence the use of brand-name medicine and they need more information about generic medicine. Conclusion: This study highlights the negative perception and knowledge deficit among the respondents. The students’ responses to almost all the statements were almost similar to the respondents’ academic year (final year students and interns, gender and nationality.
Full Text Available Becher Al-Halabi,1 Yousef Marwan,2 Mohammad Hasan,3 Sulaiman Alkhadhari41Department of Surgery, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait; 2Department of Orthopaedic Surgery, Al-Razi Hospital, Al-Sabah Medical Area, Ministry of Health, Kuwait; 3Department of Radiation Oncology, Kuwait Cancer Control Center, Al-Sabah Medical Area, Ministry of Health, Kuwait; 4Department of Psychiatry, Faculty of Medicine, Health Sciences Center, Kuwait University, KuwaitBackground: Research is the foundation of scientific advancement and improvement in quality of health care, which ensures the good health of the community. The aim of this study is to explore experiences, attitudes, and barriers of medical students in Kuwait University (KU in regards to extracurricular research.Methods: A questionnaire about extracurricular research activities (ie, any research activity that is not part of the required undergraduate curriculum, such as publishing a paper, research elective, etc was distributed to 175 senior medical students (years 6 and 7. Descriptive and chi-square analyses were used to analyze the responses, considering a P-value of <0.05 as the cut-off level for significance. The main outcome was defined as taking part in any of the extracurricular research activities.Results: Of the 150 participants (response rate = 85.7%, 26 (17.3%, 68 (45.3%, 52 (34.7%, and 17 (11.3% had published their required medical school research, presented abstracts in conferences, conducted extracurricular research, and completed a research elective/course, respectively; 99 (66.0% took part in any of these activities. Participants who read medical journals regularly (81; 54% reported higher participation in extracurricular research activities than those who did not read journals (P=0.003. Improving the availability of mentors for students' extracurricular research was ranked by the participants as the most important factor to improve their participation in
Cannon, Jeremy W; Fischer, Josef E
In World War II, Edward D. Churchill volunteered as a combat consultant. In this role, he mentored many junior surgeons and challenged the Army leadership to treat hemorrhagic shock with blood rather than plasma. These lessons have continued relevance for today's Senior Visiting Surgeons and our military medical corps.
Kearsley, John H; Lobb, Elizabeth A
We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h workshops designed around the core themes of 'physician know thyself' (Workshop 1) and 'confronting suffering' (Workshop 2). Of the 56 students who initially enrolled, 48 students completed both workshops and provided a written open-ended reflection of their learning experience. The study, undertaken over a consecutive 5-year period (2008-2012), employed an emergent, qualitative design using thematic analysis of the reflective comments. We found that the design and content of both workshops promoted transformative learning for these final year medical students. Students identified the following benefits: (1) the opportunity to reaffirm their commitment to their chosen career path; (2) the value of listening to other students share their stories; (3) the importance of the timing of the workshops to occur after exams; (4) the use of various mediums such as art, poetry, music and contemporary/classic literature to present concepts of suffering and healing; and (5) the creation of a safe and confidential space. Students reported that these innovative workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of medicine (healing) not covered in the traditional medical curriculum. Workshops in Healing helped them to rediscover a deeper meaning to medicine and their roles as future healthcare professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Scali, Elena; Mayo, John; Nicolaou, Savvas; Kozoriz, Michael; Chang, Silvia
Senior medical students represent future physicians who commonly refer patients for diagnostic imaging studies that may involve ionizing radiation. The radiology curriculum at the University of British Columbia provides students with broad-based knowledge about common imaging examinations. The purpose of this study was to investigate students' awareness of radiation exposures and risks. An anonymous multiple-choice cross-sectional questionnaire was distributed to final year medical students to assess knowledge of radiation from common diagnostic examinations and radiation-related risks following completion of the longitudinal radiology curriculum, carried out over the four years of medical training. Sixty-three of 192 eligible students participated (33% response rate). The majority felt that knowledge of radiation doses of common imaging examinations is somewhat or very important; however, only 12% (N = 8) routinely discuss radiation-related risks with patients. While all respondents recognized children as most sensitive to the effects of radiation, only 24% (N = 15) correctly identified gonads as the most radiation-sensitive tissue. Almost all respondents recognized ultrasound and MRI as radiation free modalities. Respondents who correctly identified the relative dose of common imaging examinations in chest x-ray equivalents varied from 3-77% (N = 2 - 49); the remaining responses were largely underestimates. Finally, 44% (N = 28) correctly identified the excess risk of a fatal cancer from an abdominal CT in an adult, while the remainder underestimated this risk. Medical students acknowledge the importance of radiation-related issues to patient care. While almost all students are familiar with radiation-free modalities, many are not familiar with, and commonly underestimate, the relative doses and risks of common imaging studies. This may expose patients to increasing imaging investigations and exposure to radiation hazards.
Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program GovDelivery Skip Navigation Links Health and Social Services > Public Assistance > Senior Benefits Page Content Senior Benefits Senior Benefits Logo Senior Benefits Fact Sheet - June, 2016 Reduction Information
Williams, Robert L; Romney, Crystal; Kano, Miria; Wright, Randy; Skipper, Betty; Getrich, Christina M; Sussman, Andrew L; Zyzanski, Stephen J
Research suggests stereotyping by clinicians as one contributor to racial and gender-based health disparities. It is necessary to understand the origins of such biases before interventions can be developed to eliminate them. As a first step toward this understanding, we tested for the presence of bias in senior medical students. The purpose of the study was to determine whether bias based on race, gender, or socioeconomic status influenced clinical decision-making among medical students. We surveyed seniors at 84 medical schools, who were required to choose between two clinically equivalent management options for a set of cardiac patient vignettes. We examined variations in student recommendations based on patient race, gender, and socioeconomic status. The study included senior medical students. We investigated the percentage of students selecting cardiac procedural options for vignette patients, analyzed by patient race, gender, and socioeconomic status. Among 4,603 returned surveys, we found no evidence in the overall sample supporting racial or gender bias in student clinical decision-making. Students were slightly more likely to recommend cardiac procedural options for black (43.9 %) vs. white (42 %, p = .03) patients; there was no difference by patient gender. Patient socioeconomic status was the strongest predictor of student recommendations, with patients described as having the highest socioeconomic status most likely to receive procedural care recommendations (50.3 % vs. 43.2 % for those in the lowest socioeconomic status group, p socioeconomic status, geographic variations, and the influence of interactions between patient race and gender on student recommendations.
Full Text Available Jaroslav Kacetl,1 Petra Maresova2 1Department of Applied Linguistics, 2Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic Introduction: The majority of developed countries are currently experiencing demographic aging. The most frequently expressed concerns related to the changing age structure are the increased costs of social and medical care, a lack of labor force in the job market, and financial sustainability of the pension system. These concerns are often based on the pessimistic view of population aging. This view understands aging as a prolonged period of illness and suffering. On the other hand, optimists believe that a longer life span is a result of increased quality of life and better health care. The quality of life may be improved not only by medicaments, but also by rapidly developing area of medical devices, which allow better care for seniors in many areas.Aim: This contribution aims to assess the legislative environment and ethical questions related to the use of medical devices, especially medical devices, in medical care for senior citizens.Methods: The methods used in this study are literature reviews of legislative and ethical environment in the European Union (EU and the US.Results: Main findings of this study result from assessing the state of medical device regulations in Europe and the US. Namely, the US regulation seems to be better arranged, which is probably due to the fact that there is only one responsible body – the US Food and Drug Administration, which is responsible for all medical device regulations. On the other hand, in the EU, talks about new legislation are led by ministers from all the EU member states and it may take a long time before all the EU countries come to an agreement. Keywords: senior citizen, medical devices, legislation, ethical aspects
Meitar, Dafna; Karnieli-Miller, Orit; Eidelman, Shmuel
To evaluate the possible influence of personal difficulties and barriers that are within the news bearer and his or her self-awareness (SA) of them, on the patterns of communication during encounters involving breaking bad news (BBN). Following an intensive BBN course in 2004, 103 senior medical students at the Sackler School of Medicine, Tel Aviv University, were evaluated for BBN competencies by the analysis of their written descriptions of how they visualized their manner of delivering bad news to a patient described in a challenging vignette. The students were further asked to reflect on their own difficulties and barriers that surfaced in response to reading the narrative presented in the vignette and in delivering the bad news. Using an immersion crystallization narrative analysis method, the authors analyzed the relationship between the students' BBN strategies and their self-perceived barriers and difficulties. Four types of communicators were identified and related to 45 different personal and professional barriers that the students, through self-reflection, found in themselves. These perceived barriers as well as the ability to self-reflect on them influenced their patterns of communication in their envisioned and written-down encounters, including the level of emotional connectedness, information provided, and the chosen focus-of-care paradigm (physician-centered, patient-centered, or relationship-centered). These findings empirically demonstrate that intrapersonal difficulties within the communicator and his or her level of SA about them influenced the manner and content of the communication during the encounter. This finding suggests that enhancing SA and addressing personal and professional difficulties could help physicians' capability to cope with challenging communication tasks. The authors propose a working tool (the Preparatory SPIKES) to facilitate the integration of self-reflection (by identifying personal difficulties) into day-by-day planning
Orfanou, Christina; Tsiamis, Costas; Karamagioli, Evika; Pikouli, Anastasia; Terzidis, Agis; Pikoulis, Emmanuel
Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees' and migrants' inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests.In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.
David Eduardo López González
Full Text Available Abstract Objective. To classify the perfomance of world class women wrestlers as the frequency and characteristics of their Technical-Tactical Combinations (TTC with effectiveness in the standing position during the most important competition on the international calendar 2009.Methods. In the TTC were characterized all standing position effectives by a sample of 70 wrestlers, occupants of the top 10 in each of the 7 weight categories convened. Descriptive variables were used 5 of effectiveness, technical group, and characteristics of its phases. Variables were obtained determining the effectiveness, measured the "success rate" achieved by each fighter, all through factor analysis. Later wrestlers were classified by cluster analysis by Ward's method.Results. The most important factor related to get a medal was the execution of legs attacks of with several possible endings started with almost no contact with the opponent, followed by the use of low-risk attacks launched from a firm grip. The wrestlers opted mostly for defense and counter low risk. Most of the competitors who had good results using several and alternative projections also managed to end their attacks.Conclusions. Characterization Model used and the factors of effectiveness in the fight standing obtained provided detailed explanations of the performance characteristics of the best wrestlers in the Senior World Championships 2009. The design of this research can be applied year after year in both freestyle and women's.Key words: Technical - Tactical Combinations, Rules, Fighting Women, Factor Analysis and Effectiveness
David Eduardo López González
Full Text Available Abstract Objective. To classify the perfomance of world class women wrestlers as the frequency and characteristics of their Technical-Tactical Combinations (TTC with effectiveness in the standing position during the most important competition on the international calendar 2009. Methods. In the TTC were characterized all standing position effectives by a sample of 70 wrestlers, occupants of the top 10 in each of the 7 weight categories convened. Descriptive variables were used 5 of effectiveness, technical group, and characteristics of its phases. Variables were obtained determining the effectiveness, measured the "success rate" achieved by each fighter, all through factor analysis. Later wrestlers were classified by cluster analysis by Ward's method. Results. The most important factor related to get a medal was the execution of legs attacks of with several possible endings started with almost no contact with the opponent, followed by the use of low-risk attacks launched from a firm grip. The wrestlers opted mostly for defense and counter low risk. Most of the competitors who had good results using several and alternative projections also managed to end their attacks. Conclusions. Characterization Model used and the factors of effectiveness in the fight standing obtained provided detailed explanations of the performance characteristics of the best wrestlers in the Senior World Championships 2009. The design of this research can be applied year after year in both freestyle and women's. Key words: Technical - Tactical Combinations, Rules, Fighting Women, Factor Analysis and Effectiveness
Frampton, Christopher M A; Barclay, Murray; McKee, Martin
Objectives To explore the prevalence of, and associated factors contributing to burnout among senior doctors and dentists working in the New Zealand's public health system. Design Cross-sectional, mixed methods study. Setting New Zealand's 20 district health boards (DHBs). Participants A total of 1487 of 3740 senior doctors and dentists who are members of the Association of Salaried Medical Specialists working in DHBs were recruited (response rate 40%). Primary and secondary outcome measures Gender, age, self-rated health status, vocation and hours of work per week were obtained from an electronic questionnaire. Burnout was measured using the Copenhagen Burnout Inventory. Qualitative data taken from an open-ended comments section was coded using grounded theory and used for contextual data. Results The overall prevalence of high personal burnout was 50%. Women aged burnout. Prevalence of high work-related burnout and patient-related burnout was 42% and 16%, respectively. Those working in emergency medicine and psychiatry had significantly higher mean work-related burnout than other specialties (pburnout. Personal burnout rates decreased with age (age 30–39 OR 2.86, 95% CI 1.78 to 4.59, age 40–49 OR 2.45, 95% CI 1.70 to 3.55, age 50–59 OR 1.70, 95% CI 1.17 to 2.46, compared with age>60). Qualitative data emphasised intense and unrelenting workloads, under-staffing, onerous on-call duties and frustrations with management as factors contributing to burnout. Conclusions High burnout appears prevalent in New Zealand's senior doctors and dentists. Many attribute their feelings of burnout to work conditions. These findings may assist with understanding contributors to burnout and with developing strategies to ameliorate the high burnout found across this cohort. PMID:27881531
Bledowski, Piotr; Mossakowska, Malgorzata; Chudek, Jerzy; Grodzicki, Tomasz; Milewicz, Andrzej; Szybalska, Aleksandra; Wieczorowska-Tobis, Katarzyna; Wiecek, Andrzej; Bartoszek, Adam; Dabrowski, Andrzej; Zdrojewski, Tomasz
Both descriptive and longitudinal studies of aging are nowadays a subject of growing interest in different countries worldwide. However, in Poland and other Central-Eastern European countries, such comprehensive, nationally representative, multidimensional studies were never performed in the past in elderly population. The present paper describes the PolSenior project including its objectives, sample selection and structure, methods, fieldwork procedures and study flow. The aim of the project was to examine medical, psychological and socioeconomic aspects of aging in Poland. The research sample included 5695 respondents (2899 males and 2796 females) split into six equally sized age groups of elderly individuals (65-69 years, 70-74 years, 75-79 years, 80-84 years, 85-89 years, 90+years) and one group of subjects just about to enter old age (55-59 years). Subjects were recruited using three stage stratified, proportional draw. The response rate was 42% and ranged from 32% to 61% between provinces. The study consisted of three visits performed by trained nurses including questionnaire survey, comprehensive geriatric assessment and blood and urine sampling. The questionnaire consisted of medical and specific socioeconomic questions. The comprehensive geriatric assessment included blood pressure and anthropometric measurements, as well as selected scales and tests routinely used in the examination of elderly subjects. Blood and urine samples were collected from 4737 and 4526 individuals, respectively. More than 50 biochemical parameters were measured, and DNA was isolated and banked. In a selected group of 1018 subjects, a medical examination by a physician was performed. The self-rated health was lower in females than in males in age groups 70-84, but similar in individuals of both sexes aged 65-69 and 85 years. Besides providing data on health and functioning of elderly population, the PolSenior project aims to analyze interrelationships between different elements of
chair N, length = 48 cm, wide = 43 cm, cushion base’s height from floor surfaces = 47 cm, bag keeper’s height from floor surfaces =3cm, bag keeper’s wide= 43 cm, bag keeper’s length = 47 cm, cushion’s wide = 41 cm, cushion’s length = 46cm, handrest’s height = 22 cm, handrest’s length = 30 cm, backrest’s height = 38 cm, backrest’s wide = 43 cm, cushion’s foam thickness = 4 cm, backrest’s foam thickness = 4 cm; 2 Prototype desk N, length = 50 cm, wide = 66 cm, back section’s height = 85 cm, front section’s height = 75 cm, footrest from fl oor surfaces = 10 cm, drawer’s height = 10cm, front bamper’s height = 40 cm, and table’s angle = 10o. Discussion: An ergonomic desks and chairs are very important for students at school, it will help teaching learning process run well and comfortable. The measurement of desk and chair must be reviewed after fi ve years, because of student’s anthropometric development. So then students will feel no fatigue. Keywords: ergonomy, senior high school student’s seating position
Alagiakrishnan, Kannayiram; Wilson, Patricia; Sadowski, Cheryl A; Rolfson, Darryl; Ballermann, Mark; Ausford, Allen; Vermeer, Karla; Mohindra, Kunal; Romney, Jacques; Hayward, Robert S
Background Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. Methods Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR). The “Seniors Medication Alert and Review Technologies” (SMART) intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages) and active (order-entry alerts) prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed. Results Analysis of subjective data revealed that most clinicians agreed that CDS appeared at appropriate times during patient care. Although managing alerts incurred a modest time burden, most also agreed that workflow was not disrupted. Prevalent concerns related to clinician accountability and potential liability. Approximately 36% of eligible encounters triggered at least one SMART alert, with GFR alert, and most frequent medication warnings were with hypnotics and anticholinergics. Approximately 25% of alerts were overridden and ~15% elicited an evidence check. Conclusion While most SMART alerts validated clinician choices, they were received as valuable reminders for evidence-informed care and education. Data from this study may aid other attempts to implement Beers’ Criteria in
Šedová, Lenka; Doskočil, Ondřej; Brabcová, Iva; Hajduchová, Hana; Bártlová, Sylva
This study aimed to map the selected indicators of health literacy in the senior population via a qualitative survey that focused specifically on its relationship with autonomy in the context of health literacy among seniors. A qualitative survey focused on the selected indicators of health literacy of seniors living in the South Bohemian Region of the Czech Republic (R1-19). The snowball sampling method was intentionally selected. Completed interviews were transcribed and data was reduced, analyzed, and categorized. The identified categories were 1) information comprehension, 2) decision-making in healthcare, and 3) compliance with nonpharmacologic treatment. The 'information comprehension' category clearly shows that the seniors involved in this study rated the comprehensibility of information provided by medical professionals as being good. An especially positive finding was that seniors do seek information through the internet, print sources, or other media, even though, as one senior (80-year-old woman) said, comprehension of medical information is becoming "more and more complex". The 'decision-making in healthcare' category touched upon opinions regarding informed consent and opinions regarding seniors' own involvement in healthcare. Results from this category suggest that seniors accept informed consent as a routine necessity. Inhibition regarding personal involvement in healthcare was also apparent: "... I come from a family accustomed to not bothering the doctor unnecessarily, so I just stick out my arm..." The last category of 'compliance with nonpharmacologic treatment' clearly shows that respondents are informed regarding lifestyle modifications that would benefit their treatment, although, few respondents had achieved the desired lifestyle changes. Results of this qualitative research show clear health literacy limits among seniors. As shown in this study, age itself could also be a limiting factor of health literacy.
T R Nizovtseva
Full Text Available The present study analyses the qualitative characteristics of the attitude of the Russian and international medical students to the patient. The peculiarities of the perception of the patient and the contact with him/her are revealed through interviewing students.
Chester, Aaron N.; Walthert, Susan E.; Gallagher, Stephen J.; Anderson, Lynley C.; Stitely, Michael L.
Background Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling (PTG), which involves a healthcare professional using a social networking site (SNS) or publicly available search engine to find patient information online. The study’s aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. Metho...
Full Text Available Background: Hand hygiene (HH is the most important element of infection prevention. The aim of the study was to analyze the level of HH knowledge among medical students of Jagiellonian University Medical College in correlation with their clinical experience and the presence and extent of trainings in hospital hygiene prior to internships, as well as with HH practice among medical staff perceived by students. Material and Methods: The study was carried out in a group of 414 students from October to December, 2014. The questionnaire built of 14 questions was used as a study tool. Results: Absolutely correct answers to questions about HH were given by 52.9%, and about HH technique by 6.5% of respondents. The degree of accuracy of answers to questions concerning HH did not correlate with the gender of the respondents or with the fact that work placement had been preceded by training in the field of HH or with its scope. A statistically significant correlation was found between the year, the field, and the type of the study. Students with greater professional practice, significantly less often claimed that medical workers comply with HH. Professional practice of 22.9% of students was not preceded by any training in the field of hospital hygiene and in 28% of cases training did not cover HH. Nearly half of the respondents declared that pre-internship training had not addressed the problem of occupational exposure to biological agents. Conclusions: The results of the study shows that knowledge gained by students participating in the study was not satisfactory. Moreover, there is a need for improving the educational scheme in the discussed subject at all levels of basic and clinical subjects as well as during internships. Med Pr 2016;67(5:623–633
Różańska, Anna; Wójkowska-Mach, Jadwiga; Bulanda, Małgorzata
Hand hygiene (HH) is the most important element of infection prevention. The aim of the study was to analyze the level of HH knowledge among medical students of Jagiellonian University Medical College in correlation with their clinical experience and the presence and extent of trainings in hospital hygiene prior to internships, as well as with HH practice among medical staff perceived by students. The study was carried out in a group of 414 students from October to December, 2014. The questionnaire built of 14 questions was used as a study tool. Absolutely correct answers to questions about HH were given by 52.9%, and about HH technique by 6.5% of respondents. The degree of accuracy of answers to questions concerning HH did not correlate with the gender of the respondents or with the fact that work placement had been preceded by training in the field of HH or with its scope. A statistically significant correlation was found between the year, the field, and the type of the study. Students with greater professional practice, significantly less often claimed that medical workers comply with HH. Professional practice of 22.9% of students was not preceded by any training in the field of hospital hygiene and in 28% of cases training did not cover HH. Nearly half of the respondents declared that pre-internship training had not addressed the problem of occupational exposure to biological agents. The results of the study shows that knowledge gained by students participating in the study was not satisfactory. Moreover, there is a need for improving the educational scheme in the discussed subject at all levels of basic and clinical subjects as well as during internships. Med Pr 2016;67(5):623-633. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Full Text Available Kannayiram Alagiakrishnan,1 Patricia Wilson,2 Cheryl A Sadowski,3 Darryl Rolfson,1 Mark Ballermann,4,5 Allen Ausford,6,7 Karla Vermeer,7 Kunal Mohindra,8 Jacques Romney,9 Robert S Hayward10 1Department of Medicine, Division of Geriatric Medicine, 2Department of Medicine, 3Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 4Chief Medical Information Office, Alberta Health Services, 5Division of Critical Care, Department of Medicine, University of Alberta, 6Department of Family Medicine, University of Alberta, 7Lynwood Family Physician, 8eClinician EMR, Alberta Health Services-Information Systems, 9Department of Medicine, Division of Endocrinology, 10Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada Background: Elderly people (aged 65 years or more are at increased risk of polypharmacy (five or more medications, inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS within an electronic medical record (EMR could improve medication safety.Methods: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR. The “Seniors Medication Alert and Review Technologies” (SMART intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages and active (order-entry alerts prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed.Results: Analysis of
Chester, Aaron N; Walthert, Susan E; Gallagher, Stephen J; Anderson, Lynley C; Stitely, Michael L
Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling (PTG), which involves a healthcare professional using a social networking site (SNS) or publicly available search engine to find patient information online. The study's aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. The authors surveyed final year medical students at the Otago Medical School, University of Otago in January 2016. A subset completed focus groups that were analysed using thematic analysis to identify key themes relating to students' attitudes towards PTG, and reasons why they might engage in PTG. Fifty-four students completed the survey (response rate = 65.1%), which showed that PTG was uncommon (n = 9, 16.7%). Attitudes were varied and context dependent. Most participants saw problems with PTG and favoured more explicit guidance on the issue (n = 29, 53.7%). SNS usage was high (n = 51, 94.4%); participants were concerned by the content of their SNS profiles and who they were connecting with online. Participants showing high SNS use were 1.83 times more likely to have conducted PTG than lower use groups. The diverse attitudes uncovered in this study indicated that teaching or guidelines could be useful to healthcare professionals considering PTG. Though ethically problematic, PTG may be important to patient care and safety. The decision to conduct PTG should be made with consideration of ethical principles and the intended use of the information.
Full Text Available Susanne Gustafsson,1,2 Helene Berglund,1,3 Joel Faronbi,1,4 Emmelie Barenfeld,1,2,5 Isabelle Ottenvall Hammar1,2 1Frail Elderly Research Support Group (FRESH, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, 2Gothenburg University Centre for Ageing and Health (AgeCap, 3Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; 4Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria; 5Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden Objective: The aim of this study was to evaluate the 1-year effect of the health-promoting intervention “senior meetings” for older community-dwelling persons regarding loneliness, social network, and social support.Methods: Secondary analysis of data was carried out from two randomized controlled studies: Elderly Persons in the Risk Zone and Promoting Aging Migrants’ Capabilities. Data from 416 participants who attended the senior meetings and the control group at baseline and the 1-year follow-up in the respective studies were included. Data were aggregated and analyzed with chi-square test and odds ratio (OR to determine the intervention effect.Results: The senior meetings had a positive effect on social support regarding someone to turn to when in need of advice and backing (OR 1.72, p=0.01. No positive intervention effect could be identified for loneliness, social network, or other aspects of social support.Conclusion: Health-promoting senior meetings for older community-dwelling persons have a minor positive effect on social support. The senior meetings might benefit from a revision to reinforce content focused on loneliness, social network, and social support. However, the modest effect could also depend on the lack of accessible social resources to meet participants’ identified needs, a possible hindrance for a
This is a theoretical work. It deals with the topics of senior citizens and the aging process in an abbreviated conception, periodization of old age, and active life of seniors. It describes forms of social work with seniors in medical facilities, home environments and communities, and in old people's homes. Further, it describes memory: its definition, types of memory, memory loss, reasons why people forget, work with memory and advice on memory improvement from the medical point of view. Th...
Fam Med). Senior Lecturer, Department of Family Medicine ... Keywords: Medical Professionalism, Patient welfare, Autonomy, Social justice, .... unenviable position of having to balance professionalism and ... Physicians should work actively.
Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke
Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.
Kitching, Fiona; Winbolt, Margaret; MacPhail, Aleece; Ibrahim, Joseph E
Participatory web-based platforms, including social media, have been recognised as valuable learning tools in healthcare education for over a decade. Use of these platforms is now widespread in tertiary education. It is less widely accepted as a tool for continuing professional education and development at the industry level. This study explores perspectives of senior stakeholders in the nursing home sector to explore perceived benefits, barriers and risks for use in professional education. Qualitative data were collected through semi-structured interviews of 'high level' clinical and executive staff from a cross section of nursing home stakeholder organisations. Established printed educational material (PEM) was used as a case study for adaptation to web-based social applications. Questions were designed to gather information about the interviewee's views on the potential to apply PEM to programs such as blogs, Twitter and YouTube to deliver education and aid communication in the sector. Twelve participants from eleven stakeholder organisations took part in the study. Most participants were cautious about the use of social media programs in continuing professional education. Participants described the benefits (contemporary information, delivered rapidly, varying formats) and barriers (credibility of information, potential misinterpretation, sector demographics, time constraints) to uptake of these programs. The majority of participants preferred formal e-learning programs to web-based social media applications. Reservations expressed about the use of social media, such as accuracy, legal and privacy risks to the organisation reflected those previously expressed by the broader medical community. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lei, Yiling; Xi, Chuhao; Li, Pengsheng; Luo, Min; Wang, Wanxin; Pan, Siyuan; Gao, Xue; Xu, Yan; Huang, Guoliang; Deng, Xueqing; Guo, Lan; Lu, Ciyong
Non-medical prescription opioid use (NMPOU) and childhood maltreatment are currently serious problems among adolescents worldwide, and childhood maltreatment may be associated with the increased rates of NMPOU. This study examined the specific associations between particular types of childhood maltreatment and lifetime NMPOU and assessed whether gender has a moderating effect on these associations. A 3-stage, stratified cluster, randomized sampling method was used to collect data from 11,194 high school students in Chongqing. The prevalence of the lifetime NMPOU among senior high school students in Chongqing was 7.7%. Physical abuse (AOR = 1.11, 95% CI = 1.07-1.14), emotional abuse (AOR = 1.05, 95% CI = 1.03-1.08), sexual abuse (AOR = 1.04, 95% CI = 1.01-1.07), physical neglect (AOR = 1.06, 95% CI = 1.04-1.09), and emotional neglect (AOR = 1.03, 95% CI = 1.02-1.04) were all positively associated with lifetime NMPOU. The moderating effects of gender on emotional abuse (P = 0.004) and sexual abuse (P = 0.019) were statistically significant in the adjusted model of lifetime NMPOU. According to the stratification analyses in which the male and female students were analyzed separately, female students who previously experienced emotional/sexual abuse had a higher prevalence of lifetime NMPOU. The study sample only contained school students and cross-sectional design limited our ability to make causal inferences. Childhood maltreatment was positively associated with lifetime NMPOU, and gender had a moderating effect on the associations between childhood maltreatment and lifetime NMPOU. Early identification of and intervention for childhood maltreatment victims, particularly female victims, may help reduce the lifetime risk of NMPOU. Copyright © 2018 Elsevier B.V. All rights reserved.
Bronikowski, Michał; Bronikowska, Małgorzata; Pluta, Beata; Maciaszek, Janusz; Tomczak, Maciej; Glapa, Agata
The promotion of physical activity (PA) in children and their parents requires effective planning and sometimes even interventions. This study shows the effect of PA during a 15-week intervention program "Junior for Seniors" by applying a socioecological model to the interpretation of the data. This comprehensive approach emphasizes the fact that health promotion should focus not only on intrapersonal factors but also on the multilevel factors that might be determinants and modulators of increased PA. In 2015, 24 children ("juniors," 14 girls and 10 boys, aged M = 7.96 ± 0.69) and 22 parents ("seniors," 14 mothers aged M = 38.86 ± 2.96 and 8 fathers aged M = 37.38 ± 2.97) were voluntarily enrolled in a study spread across three primary schools in the city of Poznań, Poland. The effectiveness of the intervention was determined according to postintervention behavioural changes in PA in comparison to preintervention levels, as reported by the parents and children. Overall, the study found increases in PA levels and reductions in sedentary time. Although the changes are modest, there are some unrecognized benefits of the intervention which may have occurred, such as improved sport and motor skills, more frequent family social behaviours (walks, meals, and visiting relatives), or simply improved quality of "do-together" leisure time PA.
Frampton, Christopher M A; McKee, Martin; Barclay, Murray
Objectives To estimate prevalence of and factors contributing to bullying among senior doctors and dentists in New Zealand’s public health system, to ascertain rates of reporting bullying behaviour, perceived barriers to reporting and the effects of bullying professionally and personally. Design Cross-sectional, mixed methods study. Setting New Zealand. Participants Members of the Association of Salaried Medical Specialists (40.8% response rate). Main outcome measures Prevalence of bullying was measured using the Negative Acts Questionnaire (revised) (NAQ-r). Workplace demands and level of peer and managerial support were measured with the Health and Safety Executive Management Standards Analysis tool. Categories of perpetrators for self-reported and witnessed bullying and barriers to reporting bullying were obtained and qualitative data detailing the consequence of bullying were analysed thematically. Results The overall prevalence of bullying, measured by the NAQ-r, was 38% (at least one negative act on a weekly or daily basis), 37.2% self-reported and 67.5% witnessed. There were significant differences in rates of bullying by specialty (P=0.001) with emergency medicine reporting the highest bullying prevalence (47.9%). The most commonly cited perpetrators were other senior medical or dental specialists. 69.6% declined to report their bullying. Bullying across all measures was significantly associated with increasing work demands and lower peer and managerial support (P=0.001). Consequences of bullying were wide ranging, affecting workplace environments, personal well-being and subjective quality of patient care. Conclusions Bullying is prevalent in New Zealand’s senior medical workforce and is associated with high workloads and low peer and managerial support. These findings help identify conditions and pressures that may encourage bullying and highlight the significant risk of bullying for individuals and their patients. PMID:29555792
Chambers, Charlotte N L; Frampton, Christopher M A; McKee, Martin; Barclay, Murray
To estimate prevalence of and factors contributing to bullying among senior doctors and dentists in New Zealand's public health system, to ascertain rates of reporting bullying behaviour, perceived barriers to reporting and the effects of bullying professionally and personally. Cross-sectional, mixed methods study. New Zealand. Members of the Association of Salaried Medical Specialists (40.8% response rate). Prevalence of bullying was measured using the Negative Acts Questionnaire (revised) (NAQ-r). Workplace demands and level of peer and managerial support were measured with the Health and Safety Executive Management Standards Analysis tool. Categories of perpetrators for self-reported and witnessed bullying and barriers to reporting bullying were obtained and qualitative data detailing the consequence of bullying were analysed thematically. The overall prevalence of bullying, measured by the NAQ-r, was 38% (at least one negative act on a weekly or daily basis), 37.2% self-reported and 67.5% witnessed. There were significant differences in rates of bullying by specialty (P=0.001) with emergency medicine reporting the highest bullying prevalence (47.9%). The most commonly cited perpetrators were other senior medical or dental specialists. 69.6% declined to report their bullying. Bullying across all measures was significantly associated with increasing work demands and lower peer and managerial support (P=0.001). Consequences of bullying were wide ranging, affecting workplace environments, personal well-being and subjective quality of patient care. Bullying is prevalent in New Zealand's senior medical workforce and is associated with high workloads and low peer and managerial support. These findings help identify conditions and pressures that may encourage bullying and highlight the significant risk of bullying for individuals and their patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved
Alabousi, Abdullah; Patlas, Michael N; Meshki, Malek; Monteiro, Sandra; Katz, Douglas S
The purpose of our study was to retrospectively evaluate the prevalence and clinical relevance of positive abdominal and pelvic CT findings for patients 65 years of age and older, when compared with all other scanned adult Emergency Department (ED) patients, at a single tertiary care hospital. Our hypothesis was that there is an increased prevalence and clinical relevance of positive abdominal/pelvic CT findings in senior patients. A research ethics board-approved retrospective review of all adult patients who underwent an emergency CT of the abdomen and pelvis for acute nontraumatic abdominal and/or pelvic signs and symptoms was performed. Two thousand one hundred two patients between October 1, 2011, and September 30, 2013, were reviewed. Six hundred thirty-one patients were included in the 65 group (209 men and 253 women; mean age 77.6, age range 65-99). Overall, there were more positive CT findings for patients 65 group (257 positive cases, 55.6 %), which was a statistically significant difference (p 65 group, there were no statistically significant differences in the clinical/surgical relevance of the positive CT findings between the two groups. The findings of our retrospective study therefore refute our hypothesis that there is an increased prevalence of positive abdominal CT findings in patients >65. This may be related to ED physicians at our institution being more hesitant to order CT examinations for the younger population, presumably due to radiation concerns. However, older patients in our series were more likely to present with complicated appendicitis, and a lower threshold for ordering CT examinations of the abdomen and pelvis in this patient population should therefore be considered.
Aldring og seksualitet er begreber, der sjældent optræder i samme sætning. Det skyldes, at ældre menneskers seksuelle aktivitet længe har et tabuiseret felt. Nyere forskning dokumenterer imidlertid, at der er god grund til at se nærmere på de sexede seniorer, for ældre mennesker giver i stigende...
This review examines the application of positive psychology concepts in physical health care contexts. Positive psychology aims to promote well-being in the general population. Studies identifying character strengths associated with well-being in healthy populations are numerous. Such strengths have been classified and Positive Psychology Interventions (PPIs) created to develop these strengths further in individuals. Positive psychology research is increasingly being undertaken in health care...
Motoki, Marcelo Shigueo Yosikawa; Cabar, Fabio Roberto; Francisco, Rossana Pulcineli Vieira
OBJECTIVES: To compare the views of freshman students with senior students of the Faculty of Medicine- University of São Paulo concerning the respect for the mother’s freedom of choice, the need to protect the unborn child, the proportionality between the mother’s freedom of choice and the protection of the unborn child, and issues related to legal abortion. To determine whether the medical knowledge acquired throughout the academic years can influence the views of medical students on these issues. METHODS: First- and sixth-year students of the Faculty of Medicine – University of São Paulo answered a questionnaire; the inclusion criteria were as follows: a first- or sixth-year student of the medical school and a signature on the free informed consent form. To compare the proportions, a chi-square or Fisher’s exact test was used. The significance level was set to 5%. RESULTS: Regarding the mother’s freedom of choice, in the case when a pregnant woman undergoes a cesarean section by means of a court order despite her intention to not have a cesarean, 55.7% of the first-year students have answered that the mother’s choice should be respected. Among the sixth-year students, only 28.9% believe that the mother’s intention should be considered (p<0.0001). With reference to the mother’s choice in connection with antiretroviral medication, 38.1% of the first-year students agreed that the mother’s intention should be respected, whereas 33% of sixth-year students believed that the mother’s intention should be respected (p=0.453). CONCLUSION: There was a tendency to consider the unborn child’s rights over the mother’s choice as students spent more time in medical school. PMID:27759844
Buhai, Ioan Sebastian; Portela, Miguel; Teulings, Coen
This study documents two empirical regularities, using data for Denmark and Portugal. First, workers who are hired last, are the first to leave the firm (Last In, First Out; LIFO). Second, workers' wages rise with seniority (= a Worker's tenure relative to the tenure of her colleagues). We seek...... at the moment of separation). The LIFO rule provides a stronger bargaining position for senior workers, leading to a return to seniority in wages. Efficiency in hiring requires the workers' .bargaining power to be in line with their share in the cost of specific investment. Then, the LIFO rule is a way...
Sedighe Sadat Hashemikamangar
Full Text Available The efficacy of methods like e-learning as a supplement to traditional face-to-face instruction needs to be evaluated in dental courses. This study aimed to assess the efficacy of posting case presentations on one of the educational websites of the virtual school of Tehran University of Medical Sciences called “SARMAD” to enhance the ability of senior dental students to diagnose tooth discolorations and offer treatment plans. This experimental study had a pre-test/post-test control group design and was conducted on 63 senior dental students. After filling out the primary questionnaire and obtaining a written informed consent, students participated in a pre-test and were then randomly divided into two groups of intervention and control. Fifteen case presentations were posted on the university website (SARMAD during 6 weeks and discussed. Then, students participated in a post-test. Students’ perspectives and their satisfaction with the website were assessed by a questionnaire. For ethical purposes, the same program was also offered to the controls. The post-test score was significantly higher than the pre-test score in the intervention group (P<0.001; but in the control group, the post-test score was only slightly higher than the pre-test score (P=0.128. In the intervention group, 70% stated that they would suggest this method as an efficient educational modality; 93.3% stated that this method would be beneficial as a supplement to conventional education; 16.7% ranked the SARMAD website excellent, 30% ranked it good, 33.3% acceptable, 16.7% moderate and 3.3 poor. It appears that this instructional modality may be efficiently used as a supplement to traditional instruction in undergraduate dental curricula.
Hashemikamangar, Sedighe Sadat; Yazdanpanah, Farnoosh; Mirzaii, Mansoore; Yazdani, Reza; Karazifard, Mohammad Javad; Yasini, Esmaeil
The efficacy of methods like e-learning as a supplement to traditional face-to-face instruction needs to be evaluated in dental courses. This study aimed to assess the efficacy of posting case presentations on one of the educational websites of the virtual school of Tehran University of Medical Sciences called "SARMAD" to enhance the ability of senior dental students to diagnose tooth discolorations and offer treatment plans. This experimental study had a pre-test/post-test control group design and was conducted on 63 senior dental students. After filling out the primary questionnaire and obtaining a written informed consent, students participated in a pre-test and were then randomly divided into two groups of intervention and control. Fifteen case presentations were posted on the university website (SARMAD) during 6 weeks and discussed. Then, students participated in a post-test. Students' perspectives and their satisfaction with the website were assessed by a questionnaire. For ethical purposes, the same program was also offered to the controls. The post-test score was significantly higher than the pre-test score in the intervention group (P<0.001); but in the control group, the post-test score was only slightly higher than the pre-test score (P=0.128). In the intervention group, 70% stated that they would suggest this method as an efficient educational modality; 93.3% stated that this method would be beneficial as a supplement to conventional education; 16.7% ranked the SARMAD website excellent, 30% ranked it good, 33.3% acceptable, 16.7% moderate and 3.3 poor. It appears that this instructional modality may be efficiently used as a supplement to traditional instruction in undergraduate dental curricula.
Amini, Homayoun; Moghaddam, Yasaman; Nejatisafa, Ali-Akbar; Esmaeili, Sara; Kaviani, Hosein; Shoar, Saeed; Shabani, Amir; Samimi-Ardestani, Mehdi; Akhlaghi, Amir Abbas Keshavarz; Noroozi, Alireza; Mafi, Mostafa
Objectives: The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to…
Sambunjak, Dario; Marušić, Matko
Young scientists rarely have extensive international connections that could facilitate their mobility. They often rely on their doctoral supervisors and other senior academics, who use their networks to generate opportunities for young scientists to gain international experience and provide the initial trigger for an outward move. To explore the process of informal recommending of young physicians from a small country for postdoctoral research positions in foreign countries, we conducted in-depth interviews with eight senior academics who acted as recommenders and eight physicians who, based on the recommendations of senior academics, spent at least a year working in a laboratory abroad. Interviews were transcribed and analyzed by using the framework approach. The findings showed that recommending can take four distinct forms: 1) forwarding information, 2) passive recommending, 3) active recommending, and 4) mentor recommending. These forms differ in their level of commitment and mutual trust among actors, and possible control over the success of the process. Two groups of recommendees--'naive' and 'experienced'--can be distinguished based on their previous scientific experience and research collaboration with the recommender. Crucial for the success of the process is an adequate preparation of recommendees' stay abroad, as well as their return and reintegration. The benefits of recommending extend beyond the individual participants to the scientific community and broader society of the sending country. With a sufficient level of commitment by the actors, informal recommending can be a part of or grow into an all-encompassing developmental relationship equal to mentoring. The importance of senior academics' informal contacts and recommendations in promoting junior scientists' mobility should be acknowledged and encouraged by the research institutions and universities, particularly in developing countries.
Full Text Available Abstract Background Young scientists rarely have extensive international connections that could facilitate their mobility. They often rely on their doctoral supervisors and other senior academics, who use their networks to generate opportunities for young scientists to gain international experience and provide the initial trigger for an outward move. Methods To explore the process of informal recommending of young physicians from a small country for postdoctoral research positions in foreign countries, we conducted in-depth interviews with eight senior academics who acted as recommenders and eight physicians who, based on the recommendations of senior academics, spent at least a year working in a laboratory abroad. Interviews were transcribed and analyzed by using the framework approach. Results The findings showed that recommending can take four distinct forms: 1 forwarding information, 2 passive recommending, 3 active recommending, and 4 mentor recommending. These forms differ in their level of commitment and mutual trust among actors, and possible control over the success of the process. Two groups of recommendees - 'naive' and 'experienced' - can be distinguished based on their previous scientific experience and research collaboration with the recommender. Crucial for the success of the process is an adequate preparation of recommendees' stay abroad, as well as their return and reintegration. The benefits of recommending extend beyond the individual participants to the scientific community and broader society of the sending country. Conclusions With a sufficient level of commitment by the actors, informal recommending can be a part of or grow into an all-encompassing developmental relationship equal to mentoring. The importance of senior academics' informal contacts and recommendations in promoting junior scientists' mobility should be acknowledged and encouraged by the research institutions and universities, particularly in developing
... GO MEDICAL ENCYCLOPEDIA Exercise and age Related Health Topics Exercise and Physical Fitness Seniors' Health Sports Fitness National Institutes of Health The primary NIH organization for research on Exercise for Seniors is the National Institute ...
Varma, Anshu; Marott, Jacob Louis; Stoltenberg, Christian Ditlev Gabriel; Wieclaw, Joanna; Kolstad, Henrik Albert; Bonde, Jens Peter Ellekilde
The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship. A nationwide prospective cohort study of 2790 Danish senior medical consultants was conducted (61.7% response rate). With the consent of Danish Data Protection Agency, data from a questionnaire survey was linked with data from a Medical Products Agency Register. Long work hours were defined based on a self-reported average of weekly work hours >40, while redemption of anti-depressive (AD) drug prescriptions defined depression. Proportional hazards Cox regression analyses were conducted adjusting for gender, age, marital status, medical specialty, decision authority at work, work social support, quantitative work demands, and AD drugs prescribed before baseline. Long weekly work hours did not increase the risk of redeeming AD drug prescriptions at all times during follow-up compared to the reference of 37-40 work hours [41-44 hours: hazard ratio (HR) 0.95, 95% confidence interval (95% CI) 0.5-1.8; 45-49 hours: HR 0.88, 95% CI 0.4-1.8; 50-54 hours: HR 0.83, 95% CI 0.3-2.1; 55-59 hours: HR 0.67, 95% CI 0.2-2.9; ≥ 60 hours: HR 0.48, 95% CI 0.1-3.7]. The same result emerged when work hours was applied in a continuous form (from 25-36 hours to 37-40 hours to 41-44 hours and so on) (HR 0.93, 95% CI 0.76-1.13) and when robust analyses were conducted (data not shown). This study does not support the anticipation that long work hours increase the risk of depression. If anything, long work hours vaguely appear to decrease the risk of redeeming AD drug prescriptions.
As digital technologies are integrated into medical environments, they continue to transform the experience of contemporary health care. Importantly, medicine is increasingly visual. In the history of sonography, visibility has played an important role in accessing fetal bodies for diagnostic and entertainment purposes. With the advent of three-dimensional (3D) rendering, sonography presents the fetus visually as already a child. The aesthetics of this process and the resulting imagery, made possible in digital networks, discloses important changes in the relationship between technology and biology, reproductive health and political debates, and biotechnology and culture.
UCLA's program in strategic management for European corporate communication professionals provides participants with a concentrated, yet selective, immersion in those management disciplines taught at U.S. business schools, topics that are essential to their work as senior advisors to CEOs and as leaders in the field. The choice of topics…
Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C
To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed
Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".
more chronic health problems, is becoming an increasing problem internationally, particularly amongst the elderly. Evidence-based psychological treatments exist for late-life depression and these have been shown to be effective for participants with individual health problems and depression. However, there are no studies that have compared the two leading psychotherapies shown to be effective in the treatment of late-life depression. In addition, many trials of psychotherapy with older adults exclude those with multi-morbidity. Hence, this trial will confirm whether CBT and PST are efficacious in the treatment of depression in the context of complex medical needs and determine which of these two interventions is most efficacious. Trial registration ACTRN12612000854831
Full Text Available BACKGROUND: Given that the population all over the world is aging, it is necessary to fi nd ways to help maintain or improve the quality of life of seniors. The main goal of this paper is to show how appropriate physical activity programs contribute to the improvement of the functionality and psychosocial wellbeing of seniors. We are particularly interested in the possibilities of preserving self-suffi ciency and self-service, independence and the ability to perform everyday activities. One of the most eff ective forms of physical activity is psychomotr activity.OBJECTIVE: The aim of our paper is to present basic information concerning the meaning and the application of the psychomotr activities in intervention movement programmes in order to improve seniors’ life quality.METHODS: We defi ne the term psychomotr activities according to Adamírová (1995 and Novotná (2010. In this paper we present some results of research that stress the positive eff ect of psychomotor exercises and games on the life satisfaction of the elderly (Stará 2011; Stará & Kopřivová, 2011.DESCRIPTION: According to the results of our research and practical experience gained from working with the elderly it is strongly recommended to include suitable psychomotor exercises and games focusing on the development of manual dexterity in training programs in order to improve the balance abilities and the psychosocial area. In terms of prevention, because of the growing number of neurological disorders at an old age it is appropriate to include psychomotor exercises that encourage the development of cognitive functions in the physical interventions.CONCLUSION: We were able to positively infl uence the emotional aspect from performing physical activities, to enhance self-esteem of the exercising subjects and to create new social relationships. Motion programs, which also included psychomotor exercises and games, had a positive eff ect on the physical assessment of the
Mandrusiak, Allison M; Isles, Rosemary; Chang, Angela T; Choy, Nancy L Low; Toppenberg, Rowena; McCook, Donna; Smith, Michelle D; O'Leary, Karina; Brauer, Sandra G
Standardised patients are used in medical education to expose students to clinical contexts and facilitate transition to clinical practice, and this approach is gaining momentum in physiotherapy programs. Expense and availability of trained standardised patients are factors limiting widespread adoption, and accessing clinical visits with real patients can be challenging. This study addressed these issues by engaging senior students as standardised patients for junior students. It evaluated how this approach impacted self-reported constructs of both the junior and senior students. Learning activities for undergraduate physiotherapy students were developed in five courses (Neurology, Cardiorespiratory and three Musculoskeletal courses) so that junior students (Year 2 and 3) could develop skills and confidence in patient interview, physical examination and patient management through their interaction with standardised patients played by senior students (Year 4). Surveys were administered before and after the interactions to record junior students' self-reported confidence, communication, preparedness for clinic, and insight into their abilities; and senior students' confidence and insight into what it is like to be a patient. Satisfaction regarding this learning approach was surveyed in both the junior and senior students. A total of 253 students completed the surveys (mean 92.5% response rate). Across all courses, junior students reported a significant (all P Senior students demonstrated a significant improvement in their confidence in providing feedback and insight into their own learning (P senior students as standardised patients resulted in positive experiences for both junior and senior students across a variety of physiotherapy areas, activities, and stages within a physiotherapy program. These findings support the engagement of senior students as standardised patients to enhance learning within physiotherapy programs, and may have application across other
Gajewski, Patrick D; Falkenstein, Michael; Hengstler, Jan G; Golka, Klaus
Almost 30% of humans present a Toxoplasma gondii positive antibody status and its prevalence increases with age. The central nervous system is the main target. However, little is known about the influence of asymptomatic i.e. latent Toxoplasmosis on cognitive functions in humans. To investigate neurocognitive dysfunctions in asymptomatic older adults with T. gondii positive antibody status a double-blinded neuropsychological study was conducted. The participants were classified from a population-based sample (N=131) of healthy participants with an age of 65 years and older into two groups with 42 individuals each: Toxoplasmosis positive (T-pos; IgG>50 IU/ml) and Toxoplasmosis negative (T-neg; IgG=0 IU/ml). The outcome measures were a computer-based working-memory test (2-back) and several standardized psychometric tests of memory and executive cognitive functions. T-pos seniors showed an impairment of different aspects of memory. The rate of correctly detected target symbols in a 2-back task was decreased by nearly 9% (P=0.020), corresponding to a performance reduction of about 35% in working memory relative to the T-neg group. Moreover, T-pos seniors had a lower performance in a verbal memory test, both regarding immediate recall (10% reduction; P=0.022), delayed recognition (6%; P=0.037) and recall from long-term memory assessed by the word fluency tests (12%; P=0.029). In contrast, executive functions were not affected. The effects remained mostly unchanged after controlling for medication. The impairment of memory functions in T-pos seniors was accompanied by a decreased self-reported quality of life. Because of the high prevalence of asymptomatic Toxoplasmosis and an increasing population of older adults this finding is of high relevance for public health. Copyright © 2013 Elsevier Inc. All rights reserved.
Gabbay, R.A.; Friedberg, M.W.; Miller-Day, M.; Cronholm, P.F.; Adelman, A.; Schneider, E.C.
PURPOSE The medical home has gained national attention as a model to reorganize primary care to improve health outcomes. Pennsylvania has undertaken one of the largest state-based, multipayer medical home pilot projects. We used a positive deviance approach to identify and compare factors driving
Day, David S.; And Others
This article examines the retirement plans and personal characteristics of 273 senior law school faculty, focusing on health status, income, job satisfaction, and preferred age of retirement. The study suggests that early retirement incentives and a "senior faculty" alternative to full retirement are positive institutional options. (DB)
Schneider, Antonius; Karsch-Völk, Marlies; Rupp, Alica; Fischer, Martin R; Drexler, Hans; Schelling, Jörg; Berberat, Pascal
Germany is witnessing an increasing shortage of general practitioners (GPs). The aim was to determine predictors of the job-related motivation of medical students of three medical faculties with different institutionalisation of general practice as an academic discipline. Medical students were surveyed with a standardised questionnaire about their attitudes towards general practice and their motivation to work as a GP in different working conditions. Predictors for positive attitudes and motivation were calculated using logistic regression models. 940 (15.2%) out of 6182 medical students from three Bavarian medical faculties participated in an online survey. 585 (62.7%) were female, and the average age was 25.0 (standard deviation 3.7). The average grade of a university-entrance diploma was 1.6 (standard deviation 0.5). 718 (76.4%) could imagine working as a GP. However, they favoured being employed within another organisation and not having their own private practice (65.5% vs. 35.1%). "Presence of a professorship of general practice" was associated with a positive attitude towards general practice (OR 1.57; 95%CI 1.13-2.417). Motivation for working as a GP was associated with "being female" (OR 2.56; 95%CI 1.80-3.56) and "presence of a professorship of general practice" (OR 1.68; 95%CI 1.14-2.46). Having a lower grade for one's university-entrance diploma was associated with a higher preference to work in one's own practice (OR 1.39; 95%CI 1.02-1.90). A high amount of medical students were open-minded towards general practice. However, they favoured employment within an organization over working in their own practice. Institutionalisation of general practice as an academic discipline might be of importance to gain positive attitudes towards general practice and motivate medical students to work as a GP.
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Full Text Available Medical implants based on wireless communication will play crucial role in healthcare systems. Some applications need to know the exact position of each implant. RF positioning seems to be an effective approach for implant localization. The two most common positioning data typically used for RF positioning are received signal strength and time of flight of a radio signal between transmitter and receivers (medical implant and network of reference devices with known position. This leads to positioning methods: received signal strength (RSS and time of arrival (ToA. Both methods are based on trilateration. Used positioning data are very important, but the positioning algorithm which estimates the implant position is important as well. In this paper, the proposal of novel algorithm for trilateration is presented. The proposed algorithm improves the quality of basic trilateration algorithms with the same quality of measured positioning data. It is called Enhanced Positioning Trilateration Algorithm (EPTA. The proposed algorithm can be divided into two phases. The first phase is focused on the selection of the most suitable sensors for position estimation. The goal of the second one lies in the positioning accuracy improving by adaptive algorithm. Finally, we provide performance analysis of the proposed algorithm by computer simulations.
Full Text Available Defined effective technology stages of forming a positive attitude towards physical education of students in special medical groups, stimulate motivation, epistemologically, informative, content-procedural, analytical and adjustment. For each stage technology offered special tools: lectures, seminars, analysis articles, mini conference on improving technique, racing games, mini-competitions, diagnostic interviews, questionnaires, analysis of log data on attendance. Selected criteria forming positive attitudes towards physical education: theoretical and practical, formed groups for research: experimental and control, analyzed results introduction of technology, efficiency of the proposed technology and means forming a positive attitude towards physical education students in special medical groups.
Jung, Minsoo; Hong, Myung-Sun
In today's medical market, marketing philosophy is being rapidly transformed from customer searching to patient satisfaction and service improvement. The principal objective of this study was to contribute to the establishment of a desirable medical marketing strategy, through the factors of customer satisfaction and the positioning of patients' perceptions by marketing institutions. The data were collected from 282 students of the College of Public Health and Medicine in Seoul. The survey tools were developed using the SERVQUAL scale. Analysis in this study involved both statistical and network analysis. The former was used to verify the determinants of service satisfaction as perceived by respondents, via factor analysis and multiple regression analysis. The latter was obtained using a positioning map and 2-mode network analysis with the matrix data converted from raw data. The determining factors for patient satisfaction were identified as facilities, accessibility, process, physicians, and medical staff. The regression equation was significant (R = 0.606), and the most influential variable was the service quality of physicians (β = .569). According to multidimensional scaling, the positioning of medical institutions indicated that patients' perceptions were affected by hospital size and specialization. By recognizing and managing patient satisfaction, medical institutions are able to foster customer loyalty and, in turn, to enhance service quality. It is necessary to develop an adequate marketing mix to provide better medical services and to overcome medical competition among institutions.
Full Text Available The article deals about the possibilities of using the internet for seniors. Authors suggest using www pages as alternative of retrospective therapy. Authors describe barriers of internet access for seniors. The authors of the article consider about utilization of internet for the reminiscent therapy of seniors. The target group of this article are the workers of the information centres, gerontopeds and the other persons working as the pedagogues. The objective of this article is to summarize ways of using internet for helping seniors to better life. The authors describe terms e-senior. The authors suggest methodological approach to exercising user’s skills.
David, Dagmar M; Euteneier, Alexander; Fischer, Martin R; Hahn, Eckhart G; Johannink, Jonas; Kulike, Katharina; Lauch, Robert; Lindhorst, Elmar; Noll-Hussong, Michael; Pinilla, Severin; Weih, Markus; Wennekes, Vanessa
The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung), other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education. With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA) would like to point out some central questions for this process and support the current discourse. As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy. In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.
Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke
To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.
Herrmann-Lingen, Christoph; Brunner, Edgar; Hildenbrand, Sibylle; Loew, Thomas H; Raupach, Tobias; Spies, Claudia; Treede, Rolf-Detlef; Vahl, Christian-Friedrich; Wenz, Hans-Jürgen
The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists' careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here. The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific "impact" rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the promotion of junior scientists. With the
Reason, Ben; Terner, Michael; Moses McKeag, Ali; Tipper, Brenda; Webster, Greg
Prescription medication use increases with age. Seniors face an increased risk of adverse drug reactions from medications, partly because the kidneys and liver can lose functional ability with increasing age, resulting in the need for changes in dosage. To use population survey data to understand the extent and impact of multiple medication use and adverse drug events among Canadian seniors. This study consists of analysis of data from the Canadian Survey of Experiences with Primary Health Care, which was conducted through telephone by Statistics Canada in 2008. These analyses focussed on the 3132 respondents who were ≥ 65 years of age. Twenty-seven per cent of seniors reported taking five or more medications on a regular basis. Within the past year, 12% of seniors taking five or more medications experienced a side effect that required medical attention compared with 5% of seniors taking only one or two medications. Even when controlling for age and number of chronic conditions, the number of prescription medications was associated with the rate of emergency department use. Less than half of all seniors reported having received medication reviews and having the possible side effects of their prescription medications explained to them by their physician. Many Canadian seniors have an elevated risk of adverse events due to taking a high number of prescription medications and not having the potential side effects and drug interactions explained to them. There are interventions that can potentially reduce polypharmacy and adverse events, including routine medication reviews.
Cardiovascular evaluation of middle-aged/ senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation.
Borjesson, Mats; Urhausen, Alex; Kouidi, Evangelia; Dugmore, Dorian; Sharma, Sanjay; Halle, Martin; Heidbüchel, Hein; Björnstad, Hans Halvor; Gielen, Stephan; Mezzani, Alessandro; Corrado, Domenico; Pelliccia, Antonio; Vanhees, Luc
Regular aerobic exercise at moderate intensities and an increased physical fitness are associated with a reduced risk of fatal and nonfatal coronary events in middle-aged individuals. In contrast, moderate and vigorous physical exertion is associated with an increased risk for cardiac events, including sudden cardiac death in individuals harbouring cardiovascular disease. The risk-benefit ratio may differ in relation to the individual’s age, fitness level, and presence of cardiovascular disease; sedentary individuals with underlying coronary artery disease are at greatest risk. The intention of the present position stand of the European Association of Cardiovascular Prevention and Rehabilitation is to encourage individuals to participate in regular physical activity and derive the benefits of physical exercise while minimizing the risk of cardiovascular adverse events. Therefore, the aim is to establish the most practical method of cardiovascular evaluation in middle-age/senior individuals, who are contemplating exercise or who are already engaged in nonprofessional competitive or recreational leisure sporting activity. These recommendations rely on existing scientific evidence, and in the absence of such, on expert consensus. The methodology of how middle-aged and older individuals should be evaluated appropriately before engaging in regular physical activity is both complex and controversial. On practical grounds the consensus panel recommend that such evaluation should vary according to the individual’s cardiac risk profile and the intended level of physical activity. Self assessment of the habitual physical activity level and of the risk factors, are recommended for screening of large populations. Individuals deemed to be at risk require further evaluation by a qualified physician. In senior/adult individuals with an increased risk for coronary events, maximal exercise testing (and possibly further evaluations) is advocated. Hopefully, the recommendations
Michalec, Barret; Veloski, J Jon; Hojat, Mohammadreza; Tykocinski, Mark L
Abstract Background: Previous research has paid little to no attention towards exploring methods of identifying existing medical student leaders. Aim: Focusing on the role of influence and employing the tenets of the engaging leadership model, this study examines demographic and academic performance-related differences of positive influencers and if students who have been peer-identified as positive influencers also demonstrate high levels of genuine concern for others. Methods: Three separate fourth-year classes were asked to designate classmates that had significant positive influences on their professional and personal development. The top 10% of those students receiving positive influence nominations were compared with the other students on demographics, academic performance, and genuine concern for others. Results: Besides age, no demographic differences were found between positive influencers and other students. High positive influencers were not found to have higher standardized exam scores but did receive significantly higher clinical clerkship ratings. High positive influencers were found to possess a higher degree of genuine concern for others. Conclusion: The findings lend support to (a) utilizing the engaging model to explore leaders and leadership within medical education, (b) this particular method of identifying existing medical student leaders, and (c) return the focus of leadership research to the power of influence.
Kruse, Clemens Scott; Beane, Amanda
Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames. ©Clemens Scott Kruse, Amanda Beane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.02.2018.
My bachelor thesis is called "The Effective Communication With Seniors". The aim of this thesis is to describe communication, its various kinds and the basic principles of the effective communication. I will also describe the communication with seniors suffering from dementia. Another aim of this thesis is to find out whether workers in the senior houses know and use the principles of the effective communication.
Rain, Tomáš; Ivana Švarcová
The article deals about the possibilities of using the internet for seniors. Authors suggest using www pages as alternative of retrospective therapy. Authors describe barriers of internet access for seniors. The authors of the article consider about utilization of internet for the reminiscent therapy of seniors. The target group of this article are the workers of the information centres, gerontopeds and the other persons working as the pedagogues. The objective of this article is to summarize...
Morris, D E
Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.
Gazibara, Tatjana; Kovacevic, Nikolina; Maric, Gorica; Kurtagic, Ilma; Nurkovic, Selmina; Kisic-Tepavcevic, Darija; Pekmezovic, Tatjana
The aim of this study was to assess attitudes and practice of blood donation among medical students. Medical students were recruited at Medical Faculty, University of Belgrade, Serbia. Of 973 students, 38.4% of freshmen and 41.4% of final year students have donated blood (χ(2) = 0.918, p = 0.186). Blood donors had significantly more positive attitude towards some aspects of blood donation. Being female, residing in a city other than the capital and previous blood donation experience were independent predictors of positive attitude towards being a blood donor to an unknown person. Efforts are required to augment blood donor pool among future physicians. Copyright © 2015 Elsevier Ltd. All rights reserved.
Moireau, Philippe; Chapelle, Dominique; Tallec, Patrick Le
We propose an effective filtering methodology designed to perform estimation in a distributed mechanical system using position measurements. As in a previously introduced method, the filter is inspired by robust control feedback, but here we take full advantage of the estimation specificity to choose a feedback law that can act on displacements instead of velocities and still retain the same kind of dissipativity property which guarantees robustness. This is very valuable in many applications for which positions are more readily available than velocities, as in medical imaging. We provide an in-depth analysis of the proposed procedure, as well as detailed numerical assessments using a test problem inspired by cardiac biomechanics, as medical diagnosis assistance is an important perspective for this approach. The method is formulated first for measurements based on Lagrangian displacements, but we then derive a nonlinear extension allowing us to instead consider segmented images, which of course is even more relevant in medical applications
Crane, Monique F; Brouwers, Sue; Forrest, Kirsty; Tan, Suyin; Loveday, Thomas; Wiggins, Mark W; Munday, Chris; David, Leila
This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation. The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation. Twelve practicing anesthetists (4 females; M age = 39 years; SD = 6.71) were involved in a medical simulation. Prior to the simulation, practitioners rated the frequency they had experienced various positive and negative emotions in the previous three days. During the simulation, the patient deteriorated rapidly, and anesthetists were observed for their degree of fixation. After the simulation, practitioners indicated the frequency of these same emotions during the simulation. Nonparametric correlations were used to explore the independent relationships between positive and negative affect and the behavioral measures. Only positive affect impacted the likelihood of fixation. Anesthetists who reported more frequent recent positive affect in the three days prior to the simulation and during the simulation tended to be less fixated as judged by independent raters, identified a decline in patient oxygen saturation more quickly, and more rapidly implemented the necessary intervention (surgical cricothyroidotomy). These findings have some real-world implications for positive affect in patient safety. This research has broad implications for professions where fixation may impair practice. This research suggests that professional training should teach practitioners to identify their emotions and understand the role of these emotions in fixation.
Moss, Arthur J; Greenberg, Henry; Dwyer, Edward M; Klein, Helmut; Ryan, Daniel; Francis, Charles; Marcus, Frank; Eberly, Shirley; Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Gillespie, John; Goldstein, Robert; Haigney, Mark; Krone, Ronald; Lichstein, Edgar; Locati, Emanuela; Oakes, David; Thomsen, Poul Erik Bloch; Zareba, Wojciech
An increasing number of academic senior physicians are approaching their potential retirement in good health with accumulated clinical and research experience that can be a valuable asset to an academic institution. Considering the need to let the next generation ascend to leadership roles, when and how should a medical career be brought to a close? We explore the roles for academic medical faculty as they move into their senior years and approach various retirement options. The individual and institutional considerations require a frank dialogue among the interested parties to optimize the benefits while minimizing the risks for both. In the United States there is no fixed age for retirement as there is in Europe, but European physicians are initiating changes. What is certain is that careful planning, innovative thinking, and the incorporation of new patterns of medical practice are all part of this complex transition and timing of senior academic physicians into retirement. Copyright © 2013 Elsevier Inc. All rights reserved.
Dolan, Susan A; Arias, Kathleen Meehan; Felizardo, Gwen; Barnes, Sue; Kraska, Susan; Patrick, Marcia; Bumsted, Amelia
The transmission of bloodborne viruses and other microbial pathogens to patients during routine health care procedures continues to occur because of the use of improper injection, infusion, medication vial, and point-of-care testing practices by health care personnel. These unsafe practices occur in various clinical settings and result in unacceptable and devastating events for patients. This document updates the Association for Professionals in Infection Control and Epidemiology 2010 position paper on safe injection, infusion, and medication vial practices in health care. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Mars, Nina; Kalske, Jaakko; Halttunen-Nieminen, Mervi; Pitkäranta, Anne
At the University of Helsinki, the licentiate degree in medicine involves internships that can be conducted as a medical intern or locum doctor. The students and their supervisors fill out a feedback form, which helps in assessing the students' improvement in various areas. Based on the feedback form between 2008 and 2013, students having worked as locum doctor rated better improvement in their diagnostic skills, writing medical records, interacting with the patient, and operating in the work community. Supervisor evaluations did not show a similar clear difference between the job positions.
The new learning opportunities that feed mind, body and soul helps the senior students develop the resiliency and intellectual qualities they need to make a healthy transition to post-high school life. The Monsignor Donovan High School in Toms River, New Jersey, has provided creative learning opportunities to seniors, which has planted in them the…
Cam Tavan Sendromu ve Kadınların Üst Düzey Yönetici Pozisyonuna Yükselmelerindeki Engeller: Balıkesir İli Örneği(Glass Ceiling Syndrome and the Obstacles Facing Women’s Advancement to Senior Management Positions: Evidence From Balikesir
Full Text Available Examining the reasons why women’s presentation in senior management levels and strategically important positions is lower compared to men constitutes the aim of this study. Conducting a literature survey, the concept of “Glass Ceiling” has been explained and the obstacles confronting women in preferment to senior management positions have been presented depending on the related studies held in Turkey and other countries. In the application part of the study, under the light of the findings from the literature, a survey covering 200 employees, of whom 103 male and 97 female, has been conducted in order to find out about the opinions of employees in Balıkesir on the obstacles in question. The findings have revealed that the limited horizon of leadership and managerial capability, excessive familial responsibilities, and the “queen bee” syndrome are the main obstacles that hamper women in the progress towards senior level managerial positions.
Wang, Hua; Wen, Yingyou; Zhao, Dazhe
Medical applications have begun to benefit from Internet of Things (IoT) technology through the introduction of wearable devices. Several medical applications require accurate patient location as various changes affect pressure parameters inside the body. This study aims to develop a system to measure indoor altitude for IoT medical applications. We propose a differential barometric-based positioning system to estimate the altitude between a reference sensor and a localizing sensor connected to the human body. The differential barometric altimetry model is introduced to estimate indoor elevations and eliminate environmental artifacts. In addition, a Gaussian filter processing is adopted to remove noise from the elevation measurements. The proposed system is then investigated through extensive experiments, using various evaluation criteria. The results indicate that the proposed system yielded good accuracy with reduced implementation complexity and fewer costs. The proposed system is resilient compared to other indoor localization approaches, even when numerous environmental artifacts in indoor environments are present.
Full Text Available This work contains research of the position of ethnic minorities in two important existential areas such are medical care and social security. The author puts under a critical analyze not only semantics of the ideas and phrases of medical care and, especially, social security themselves, believing that their inaccurate meaning and usage hide more than they expose facts and relations according to which it is possible to detect and describe a real position of ethnic minorities in the post-dayton society of Bosnia and Herzegovina, but also the experience of implementation of rules from those areas, which should enable them to use the rights defined. Of course, his attention is specially focused on members of Roma ethnic minority, for which he claims to be the most sensible, and that their members, unlike members of all the other ethnic minorities in BiH, are most, or more precisely, only discriminated a-pro-pos the protection of their rights in the areas of medical care and social security, which is not only a responsibility of institutions that provide services in the mentioned areas of life. By using a method of analysis of contents of legal (constitutions, laws, conventions, charters, resolutions, sublegal acts and political (reports, evaluations, analyses, strategies, action plans etc. documents, and by analyzing real life features, processes, relations and events in contemporary BiH society, the author came to sociologically relevant insights of real social and legally-political positions of ethnic minorities in BiH, a state and courses in the areas of medical care and social security and clearly formulated a conclusion that members of ethnic minority determined collectivities, apart from Roma, are in no way ancillary positioned compared to members of constitutional people of post-dayton BiH.
Kalolella, Admirabilis Beno
A 49 years old man, known case of bronchial asthma for 43 years, with history of frequent asthmatic attacks, usually responding to double dose of intravenous Aminophylline and double dose of Hydrocortisone was received at medical emergency care unit at midnight with night-time asthma attack. The attack did not settle with Aminophylline single Intravenous injection. He was then admitted and put in supine sleep position for re-evaluation while his asthma symptoms were monitored while waiting for the medical officer's evaluation of his asthma status. After 3 hours of observation, asthma symptoms were relieved, and patient was discharged home and advised to sleep in supine position throughout every night to prevent asthma symptoms. The patient was followed up through nighttime sleep diary for one month. After one month period of monitoring, the patient had significance reduction in asthma symptoms and reduced night time medication, reduced episodes of night awakening due to asthma symptoms, and improved capability for normal works. This case report describes a novel approach of management and prophylaxis of asthmatic episodes through sleeping position that reduces and control asthma symptoms resulting in reduced drug consumption.
Elkington, Lisa J; Hughes, David C
Sport-related concussion is a growing health concern in Australia. Public concern is focused on the incidence and potential long term consequences of concussion. Children may be more prone to concussion and take longer to recover. The Australian Institute of Sport and the Australian Medical Association have collaborated to present the most contemporary evidence-based information in a format appropriate for all stakeholders. This position statement aims to ensure that participant safety and welfare is paramount when dealing with concussion in sport.First aid principles apply in the management of the athlete with suspected concussion, including protection of the cervical spine. Tools exist for use by members of the community, allowing identification of key symptoms and signs that raise the suspicion of concussion. Medical professionals should use the Sport Concussion Assessment Tool 3, in conjunction with clinical assessment for the diagnosis of concussion. Clinical assessment includes mechanism of injury, symptoms and signs, cognitive functioning, and neurological assessment including balance testing. In any situation where concussion is suspected, the athlete must be immediately removed from sport and not be allowed to return to activity until they have been assessed by a medical practitioner. "If in doubt, sit them out."A diagnosis of concussion requires immediate physical and cognitive rest, followed by a structured, graduated return to physical activity. Children require a longer period of recovery from concussion. Algorithms are provided for use by medical and non-medically trained stakeholders in the recognition and management of concussion.
Van Isacker, P
Seniority isomers are nuclear states with an electromagnetic decay that is hindered by selection rules related to the seniority quantum number. A simple analysis is presented of their possible formation with reference to the nickel isotopes 70–76 Ni and the N = 50 isotones from molybdenum to cadmium. It is shown that the existence of seniority isomers in a j = 9/2 shell is predominantly governed by the quadrupole pairing matrix element of the nucleon-nucleon interaction. The analysis is generalized to shells with larger j.
Full Text Available In the article materials of the three-year looking are utillized after the state of positive health of group of women in age 50-80 years. The method of statistical ground of adequate control indexes is shown for the estimation of bodily condition of inspected. The use of high-quality criteria is offered for the estimation of efficiency of physical exercises on the Norwegian method of walking with sticks.
Mohr, Christine; Schofield, Kerry; Leonards, Ute; Wilson, Marc S; Grimshaw, Gina M
When testing risk for psychosis, we regularly rely on self-report questionnaires. Yet, the more that people know about this condition, the more they might respond defensively, in particular with regard to the more salient positive symptom dimension. In two studies, we investigated whether framing provided by questionnaire instructions might modulate responses on self-reported positive and negative schizotypy. The O-LIFE (UK study) or SPQ (New Zealand study) questionnaire was framed in either a "psychiatric", "creativity", or "personality" (NZ only) context. We tested psychology students (without taught knowledge about psychosis) and medical students (with taught knowledge about psychosis; UK only). We observed framing effects in psychology students in both studies: positive schizotypy scores were lower after the psychiatric compared to the creativity instruction. However, schizotypy scores did not differ between the creativity and personality framing conditions, suggesting that the low scores with psychiatric framing reflect defensive responding. The same framing effect was also observed in medical students, despite their lower positive schizotypy scores overall. Negative schizotypy scores were not affected by framing in either study. These results highlight the need to reduce response biases when studying schizotypy, because these might blur schizotypy-behaviour relationships. Copyright © 2018 Elsevier B.V. All rights reserved.
... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...
.... Leadership at senior levels involves a different type of work than at lower organizational levels and this requires leaders to possess a different set of skills, knowledge, and attributes in order to be successful...
Dal-Ré, R; Carné, X
Should medical journals publish editorials and educational articles written by authors who have financial conflicts of interest with pharmaceutical and biotechnology industries on whose products (or their competitors) they discuss? In the last 18 months, a controversy was sparked between The New England Journal of Medicine and BMJ, who took 2 opposite positions: the former stated that the negative bias against authors with conflicts of interest with industry is excessive and therefore accept articles from any expert, ensuring that they have the minimum possible bias. BMJ, in contrast, prohibits the publication of these types of article by authors who have financial conflicts of interest with industry. This article discusses the approaches of the 2 journals (and those of others) and reflects on this type of conflict in the medical profession. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
Spencer, Abby L; Brosenitsch, Teresa; Levine, Arthur S; Kanter, Steven L
Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the "preclinical curriculum." However, students' retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students' understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.
Radysh, Ia F; Tsema, Ie V; Mehed', V P
The basic theoretical and practical aspects of problem of malpractice in the system of health protection Ukraine are presented in the article. On specific examples the essence of the term "malpractice" is expounded. It was considered types of malpractice, conditions of beginning and kinds of responsibility to assumption of malpractice. The special attention to the legal and mental and ethical questions of problem from positions of protection of rights for a patient and medical worker is spared. The necessity of qualification malpractices on intentional and unintentional, possible and impermissible is grounded.
D. V. Аlkаz
Full Text Available The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Senior Executive Service, Defense Intelligence Senior Executive Service, and Senior Cryptologic Executive Service. 842.211 Section 842.211... EMPLOYEES RETIREMENT SYSTEM-BASIC ANNUITY Eligibility § 842.211 Senior Executive Service, Defense...
Delord, Vincent; Khirani, Sonia; Ramirez, Adriana; Joseph, Erick Louis; Gambier, Clotilde; Belson, Maryse; Gajan, Francis; Fauroux, Brigitte
Patient cooperation is crucial for the success of noninvasive positive pressure ventilation (NPPV). This study evaluated the efficacy of medical hypnosis to reduce anticipatory anxiety and acclimatization time in children who are candidates for long-term NPPV. Medical hypnosis was performed by a trained nurse. The acclimatization time and long-term compliance with NPPV were evaluated. Hypnosis was performed in nine children aged 2 to 15 years. Seven children had a high level of anticipatory anxiety because of a tracheotomy since birth (n=2), a history of maxillofacial surgery (n=2), severe dyspnea because of lung disease (n=2), and morbid obesity and depression (n=1), and two children with obstructive sleep apnea failed standard NPPV initiation. The hypnosis techniques were based on distraction in the youngest patient and indirect or direct hypnotic suggestions in the older children to obtain a progressive psychocorporal relaxation. All patients accepted the interface and the NPPV after the first hypnosis session. A median of three sessions was needed for overnight (>6 h) NPPV acceptance. The 6-month compliance with NPPV was excellent, with a median use of 7.5 h per night. Medical hypnosis is an effective, safe, noninvasive, and inexpensive tool for reducing the anticipatory distress and acclimatization time for NPPV. This therapy is particularly useful in children with traumatic experiences, such as a tracheotomy or facial surgical procedures.
The purpose of the research was to investigate the role of personal resources, such as optimism and sense of selfefficacy in both negative (posttraumatic stress disorder (PTSD) symptoms) and positive (posttraumatic growth - PTG) effects of experienced trauma in a group of emergency service representatives. Data of 100 medical rescue workers, mostly men (59%) who have experienced traumatic events in their worksite were analyzed. The age of the participants ranged from 24 to 60 years (mean = 37.43; standard deviation = 8.73). Polish versions of the Impact of Event Scale - Revised and the Posttraumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Optimism was assessed by the Life Orientation Test and sense of self-efficacy by the Generalized Self-Efficacy Scale. The obtained results revealed that optimism is negatively associated with symptoms of PTSD in men, and sense of self-efficacy - positively with the severity of growth after trauma in women. The analyzed personal resources play a diverse role in the emergence of negative and positive effects of experienced traumatic events, depending on the gender of the respondents. Med Pr 2016;67(5):635-644. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Full Text Available Background: The purpose of the research was to investigate the role of personal resources, such as optimism and sense of selfefficacy in both negative (posttraumatic stress disorder (PTSD symptoms and positive (posttraumatic growth – PTG effects of experienced trauma in a group of emergency service representatives. Material and Methods: Data of 100 medical rescue workers, mostly men (59% who have experienced traumatic events in their worksite were analyzed. The age of the participants ranged from 24 to 60 years (mean = 37.43; standard deviation = 8.73. Polish versions of the Impact of Event Scale – Revised and the Posttraumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Optimism was assessed by the Life Orientation Test and sense of self-efficacy by the Generalized Self-Efficacy Scale. Results: The obtained results revealed that optimism is negatively associated with symptoms of PTSD in men, and sense of self-efficacy – positively with the severity of growth after trauma in women. Conclusions: The analyzed personal resources play a diverse role in the emergence of negative and positive effects of experienced traumatic events, depending on the gender of the respondents. Med Pr 2016;67(5:635–644
Blaakilde, Anne Leonora
Radiobroadcasting and the hardware materialization of radio have during the 20th century changed significantly, which means that senior radio listeners have travelled along with this evolution from large, impressive radio furnitures to DAB and small, wireless, mobile devices, and from grave...... and solemn radio voices to lightharted, laughing and chatting speakers. Senior radio listerners have experienced the development and refinements of technique, content and genres. It is now expected of all media users that they are capable of crossing media, combining, juggling and jumping between various...... media platforms, not the least when listening to radio. The elder generation is no exception from this. Recently, for instance, the Danish public broadcast DR has carried out an exodus of programmes targeted for the senior segment. These programmes are removed from regular FM and sent to DAB receivers...
Bartsch, David A; Rodgers, Vicki K; Strong, Don
Outcomes of older adults referred for care management and mental health services through the senior reach gatekeeper model of case finding were examined in this study and compared with the Spokane gatekeeper model Colorado Senior Reach and the Mid-Kansas Senior Outreach (MKSO) programs are the two Senior Reach Gatekeeper programs modeled after the Spokane program, employing the same community education and gatekeeper model and with mental health treatment for elderly adults in need of support. The three mature programs were compared on seniors served isolation, and depression ratings. Nontraditional community gatekeepers were trained and referred seniors in need. Findings indicate that individuals served by the two Senior Reach Gatekeeper programs demonstrated significant improvements. Isolation indicators such as social isolation decreased and depression symptoms and suicide ideation also decreased. These findings for two Senior Reach Gatekeeper programs demonstrate that the gatekeeper approach to training community partners worked in referring at-risk seniors in need in meeting their needs, and in having a positive impact on their lives.
This bachelor thesis deals with the use of music therapy in the lives of seniors. The target of this thesis is to map the possibilities of using music therapy ways with seniors and to recommend a suitable music therapy resources on the basis of the research and evaluation of obtained dates. The theoretical part describes the term "the music therapy", e.g. concept, definition, types and forms, the development of music therapy, the history, methods and techniques. This age group is defined in t...
Step-by-step instructions for seniors to get up and running on a home PC Answering the call for an up-to-date, straightforward computer guide targeted specifically for seniors, this helpful book includes easy-to-follow tutorials that escort you through the basics and shows you how to get the most out of your PC. Boasting an elegant, full-color interior with a clean, sophisticated look and feel, the layout makes it easy for you to find the information you need quickly. Author Linda Clark has earned her highly respected reputation through years of teaching computers at both the beginnin
Curtis, Anthony; Eley, Lizzie; Gray, Selena; Irish, Bill
This qualitative study sought to elicit the views, experiences, career journeys and aspirations of women in senior post-graduate medical education roles to identify steps needed to help support career progression. In-depth semi-structured telephone interviews. UK. Purposive sample of 12 women in a variety of senior leadership roles in post-graduate medical education in the UK. Self reported motivating influences, factors that helped and hindered progress, key branch points, and key educational factors and social support impacting on participants' career in postgraduate medicine. Respondents often reported that career journeys were serendipitous, rather than planned, formal or well structured. Senior women leaders reported having a high internal locus of control, with very high levels of commitment to the NHS. All reported significant levels of drive, although the majority indicated that they were not ambitious in the sense of a strong drive for money, prestige, recognition or power. They perceived that there was an under-representation of women in senior leadership positions and that high-quality female mentorship was particularly important in redressing this imbalance. Social support, such a spouse or other significant family member, was particularly valued as reaffirming and supporting women's chosen career ambition. Factors that were considered to have hindered career progression included low self-confidence and self-efficacy, the so-called glass ceiling and perceived self-limiting cultural influences. Factors indirectly linked to gender such as part-time versus working full time were reportedly influential in being overlooked for senior leadership roles. Implications of these findings are discussed in the paper. Social support, mentorship and role modelling are all perceived as highly important in redressing perceived gender imbalances in careers in post-graduate medical education.
Duffy, S Q; Farley, D E
In this study, the effects of hospital, staff, and patient characteristics on the rates of use and abandonment of an outmoded medical technology, intermittent positive pressure breathing (IPPB) are analyzed. The study focuses specifically on the use of IPPB to treat inpatients with chronic obstructive pulmonary disease in a national sample of more than 500 community hospitals from 1980 to 1987. Cross-sectionally, hospitals with shorter case-mix-adjusted lengths of stay, private nonprofit or investor-owned hospitals, and hospitals located outside of the north central United States were more likely to abandon IPPB by 1980. Teaching status, location, ownership, volume, and source of payment all appeared to affect rates of IPPB use in 1980. The longitudinal analysis examines both the probability a hospital abandoned IPPB and declines in rates of IPPB use over the study period, conditioned on the availability of IPPB in 1980. The results show that changes in the characteristics of hospitals, patients, and physicians all help to explain variations in the abandonment of IPPB. These findings contrast with previous studies of technological change, which find hospital size to be the most important variable. Size is important in explaining the rate of use in 1980, but it has no effect on the rate of decline in use or abandonment after 1980. In general, the analysis demonstrates that a combination of factors, economic incentives as well as information, contribute to the abandonment of outmoded medical technologies. Given the surprisingly long time periods required for this process to occur, the analysis underscores the need to strengthen financial incentives that encourage appropriate medical decisions and to disseminate information about the efficacy of specific procedures more widely and effectively.
Bohnert, Kipling M; Perron, Brian E; Ashrafioun, Lisham; Kleinberg, Felicia; Jannausch, Mary; Ilgen, Mark A
Twenty-one states and the District of Columbia have passed legislation allowing for the use of medical cannabis for those individuals with qualifying medical conditions, which include posttraumatic stress disorder (PTSD) for a growing number of states. Little information is available regarding PTSD among medical cannabis patients. This study seeks to provide initial data on this topic by examining the prevalence and correlates of positive PTSD screens among a sample of patients seeking medical cannabis certification for the first time (n=186). Twenty-three percent (42/186; 95% confidence interval [CI] =17%-29%) of the patients in the study sample screened positive for PTSD. Moreover, the group that screened positive for PTSD had higher percentages of lifetime prescription opioid, cocaine, prescription sedative, and street opioid use, as well as a higher percentage of recent prescription sedative use, than the group that screened negative for PTSD. These findings highlight the relatively common use of other substances among medical cannabis patients with significant PTSD symptoms, even when compared with other patients seeking medical cannabis for the first time. As a growing number of states include PTSD among the list of qualifying medical conditions for medical cannabis, additional research is needed to better characterize the longitudinal relationship between medical cannabis use and PTSD symptoms. Published by Elsevier Ltd.
Janero, David R
The significant contribution of substance-use disorders (SUDs) to the global-disease burden and associated unmet medical needs has not engendered a commensurate level of pharma-industry research and development (R&D) for novel SUD therapeutics invention. Analysis of contextual factors shaping this position suggests potential routes toward incentivizing R&D commitment for that purpose. This article considers multiple primary factors that have consorted to disincentivize pharma industry's operating in the SUD space: ill-understood pathology; variegated treatments and patient profiles; involved clinical trials; and - with particular reference to SUDs-negative cultural/business stigmas and shallow commercial precedent. Industry incentivization for SUD drug innovation requires progress on several fronts, including: translational experimental data and systems; personalized, holistic SUD treatment approaches; interactions among pharma, nonindustry constituencies, and the medical profession with vested interests in countering negative stereotypes and expanding SUD treatment options; and public-private alliances focused on improving SUD pharmacotherapy. Given the well-entrenched business stance whereby the prospect of future profits in major markets largely determines drug-company R&D investment trajectory, strategic initiatives offering substantial reductions in the risks and opportunity (i.e., time and money) costs associated with SUD drug discovery are likely to be the most potent drivers for encouraging mainstream industry positioning in this therapeutic area. Such initiatives could originate from front-loaded R&D operational and back-loaded patent, regulatory, marketing and health-care policy reforms. These may be too involved and protracted for the turbulent pharmaceutical industry to entertain amid its recent retrenchment from psychiatric/CNS diseases and intense pressures to increase productivity and shareholder value.
The Seniors' Residential Retrofitting Project was Yukon's most ambitious CREDA, funded demonstration with a total cost of $460,000. The project undertook to demonstrate energy-efficient retrofitting techniques in 38 homes and two apartment complexes for senior citizens. At the same time, the project strove to train Yukon tradesmen in retrofitting techniques, thus creating a local industry and employment within this industry. To this end, two training courses were given for local tradesmen and contractors, the first of their kind in Canada. The training part of the project was given equal importance as the actual demonstration part. Three levels of retrofit work were done on the homes of senior citizens. Level one included caulking, weatherstripping, furnace servicing, and installation of water flow restrictors, water heater blankets and timers. The level two retrofit included the treatment in level one, plus upgrading windows and the insulation levels in walls and ceilings. A level three retrofit involved a total rewrap of the building shell with some of the features in levels one and two incorporated. The demonstration program included the following steps: initial contact with senior citizens; energy audit on each house; determination of level of retrofit work based on individual audit results; contract packages drawn up and put to tender; monitoring of fuel records and air-tightness tests both before and after retrofit; and tabulation of data and information transfer. 10 figs., 4 tabs.
Danner, Omar K; Lokko, Carl; Mobley, Felicia; Dansby, Montreka; Maze, Michael; Bradley, Brene'; Williams, Elizabeth; Matthews, Leslie Ray; Harrington, Emma; Mack, Lisa; Clark, Clarence; Wilson, Ken; Beech, Derrick; Heron, Sheryl; Childs, Ed
According to the National Center for Educational Statistics, underrepresented minorities (URMs) are more likely to leave science, technology, engineering and mathematics (STEM) fields at higher rates than their peers during undergraduate studies. Many institutions of higher learning have implemented pipeline programs aimed at preparing and inspiring high school and college aged students in select careers in health sciences with varying levels of success. Research has shown that a health care workforce that mirrors the community they serve is more effective in reducing health disparities and increasing positive health outcomes. We hypothesize that a hospital-based, multidisciplinary youth mentoring and medical exposure program will enhance the decision of URM high school students to choose healthcare careers. A retrospective analysis of the Reach One Each One Program (ROEO) was performed. ROEO is a hospital based, 11-week multidisciplinary youth mentoring and medical exposure program for inner-city high school students. The analysis was based on a phone survey of the twenty-six (26) seniors who completed the program and subsequently graduated from high school between May 2013 and May 2015 to assess the following: 1) College enrollment/attendance, 2) Health profession majors, and 3) Pre-med status. The study was approved by the Morehouse School of Medicine Institutional Review Board. Of the twenty-six students, 23 were female and 3 were male; 25 (96%) of the students were African American and one student was a Caucasian female. Twenty-four (92.3%) of the students were enrolled in college and 2 (7.7%) were scheduled to begin in the spring semester of 2016. Twenty-one of the 24 attending college at the time of the survey (87.5%) were enrolled in a health science degree program and 16 (66.7%) confirmed that they were enrolled in pre-medical (Pre-med) curriculum. Hospital-based, multidisciplinary medical mentoring programs can have a positive impact on the lives and
can cause harm) to the physical well-being of or jeopardize the security of the employee , co-workers, customers or the general public through a lapse...DEPARTMENT OF THE ARMY US ARMY PUBLIC HEALTH CENTER 5158 BLACKHAWK ROAD ABERDEEN PROVING GROUND MARYLAND 21010-5403 Directorate of Clinical... Employees in Critical Safety or Security Positions and Positions with Safety Sensitive Duties. 1. REFERENCES. A. Army Regulation 40-5, Preventive
Egan, Mary Y; Laliberte Rudman, Debbie; Ceci, Christine; Kessler, Dorothy; McGrath, Colleen; Gardner, Paula; King, Judy; Lanoix, Monique; Malhotra, Ravi
Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations. Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life. Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary. This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an
Popescu, R A; Schäfer, R; Califano, R; Eckert, R; Coleman, R; Douillard, J-Y; Cervantes, A; Casali, P G; Sessa, C; Van Cutsem, E; de Vries, E; Pavlidis, N; Fumasoli, K; Wörmann, B; Samonigg, H; Cascinu, S; Cruz Hernández, J J; Howard, A J; Ciardiello, F; Stahel, R A; Piccart, M
The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.
The diploma thesis deals with the theme of volunteering of seniors in the community. The work focuses on the specifics of volunteering of seniors, emphasizing the benefits of volunteering for participating seniors and how to identify them with other groups of people. Using a qualitative research work, it examines on a sample of eight respondents how these senior volunteers perceive the benefits of volunteering, how they relate to the geographical location in which they work, and what communit...
Muessig, Kathryn E; LeGrand, Sara; Horvath, Keith J; Bauermeister, José A; Hightow-Weidman, Lisa B
We describe recent mobile health (mHealth) interventions supporting antiretroviral therapy (ART) medication adherence among HIV-positive MSM. Keyword searches (1 January 2016-13 May 2017) identified 721 citations. Seven publications reporting on six studies met inclusion criteria. Five studies focused on MSM. Interventions primarily employed text messaging (n = 4), whereas two focused on smartphone apps and one on social media. Three studies measured intervention impact on adherence and found increased ART use intentions (n = 1), self-reported adherence (n = 1), and viral suppression (n = 1, no control group). Other mHealth interventions for HIV-positive MSM focused on status disclosure and reducing sexual risk. mHealth interventions to support ART adherence among MSM show acceptability, feasibility, and preliminary efficacy. No recent mHealth interventions for MSM measured impact on viral suppression compared with a control condition despite earlier (pre-2015) evidence for efficacy. Studies are underway that include multiple features designed to improve adherence within complex smartphone or internet-based platforms. Areas for future growth include overcoming measurement and engagement challenges, developing tools for coordinating patient and provider adherence data, testing combination interventions, and adapting efficacious interventions for new languages and geographic settings.
Previous research found that "fun on line" is the most dominant content in seniors' online communities. The present study aimed to further explore the fun culture in these communities and to discover its unique qualities. The study applied an online ethnography (netnography) approach, utilizing a full year's data from 6 leading seniors' online communities. The final database included about 50,000 posts. The majority of posts were part of online social games, including cognitive, associative, and creative games. The main subjects in all contents were sex, gender differences, aging, grandparenting, politics, faith, and alcohol. Main participatory behaviors were selective timing, using expressive style, and personalization of the online character. Although most participants were "lurkers," the active participants nurtured community norms and relationships, as reflected in the written dialogues. In a reality of limited alternatives for digital games that meet older adults' needs and interests, seniors found an independent system to satisfy their need for play. Seniors' online communities provided a unique form of casual leisure, whose nature varied among different groups of participants. The fun culture seemed to offer participants many desired benefits, including meaningful play, liminality and communitas, opportunity to practice and demonstrate their abilities, and means for coping with aging. Therefore, it may have positive impact on seniors' well-being and successful aging.
O'Connor, Shawn; Carlson, Elizabeth
This report describes how staff-designed behavior changes among senior leaders can have a positive impact on clinical nursing staff and enhance the culture of safety in a community hospital. A positive culture of safety in a hospital improves outcomes for patients and staff. Senior leaders are accountable for developing an environment that supports a culture of safety. At 1 community hospital, surveys demonstrated that staff members did not view senior leaders as supportive of or competent in creating a culture of safety. After approval from the hospital's institutional review board was obtained, clinical nurses generated and selected ideas for senior leader behavior change. The new behaviors were assessed by a convenience sample survey of clinical nurses. In addition, culture of safety survey results were compared. Risk reports and harm events were also measured before and after behavior changes. The volume of risk and near-miss reports increased, showing that clinical staff were more inclined to report events after senior leader communication, access, and visibility increased. Harm events went down. The culture of safety survey demonstrated an improvement in the senior leadership domain in 4 of 6 units. The anonymous convenience survey demonstrated that staff members recognized changes that senior leaders had made and felt that these changes positively impacted the culture of safety. By developing skills in communication, advocacy, visibility, and access, senior leaders can enhance a hospital's culture of safety and create stronger ties with clinical staff.
Krauss, K; Smith, J
Academic medical centers (i.e., medical schools and their principal hospitals) are following very similar strategies in attempts to secure their futures. It is likely that these undifferentiated strategies will fail, since most of them have been copied from the lower-cost, geographically better-positioned hospitals and health systems. Despite a wealth of innovative, entrepreneurial talent and the potential to reshape the world that AMCs live in, most AMCs are in reactive modes. Future directions and strategies are almost always shaped, forced, and justified by external pressures. The major problem with the strategic plans of most AMCs is that they are based on conventional industry wisdom. Strategic plans tend not to be analytically driven. The insight and understanding of those factors that drive the demand for AMCs' services and determine the performances of AMCs are lacking. The authors note some questions that are critical to the formulation of strategies for AMCs. For example, how can the research mission be changed from a cost-based to a value-based endeavor? Most AMCs cannot answer these questions, and if they do address them in the planning process, they do so superficially. Several examples of the factors that need to be understood are also given, such as patients' purposes and needs in seeking specialty care. Alternative strategies are listed, such as maintaining and exploiting the economic irrationality of the market rather than acting as if it were economically rational or forcing it to become so. Last, the authors outline the scope of the changes that are required and urge AMCs to reject conventional wisdom, determine their own unique situations, and work from there.
Smart home technology with situation-awareness is important for seniors to improve safety and security. With the development of context-aware computing, wearable sensor technology, and ubiquitous computing, it is easier for seniors to manage their health problem in smart home environment. For monitoring senior activity in smart home, wearable, and motion sensors-such as respiration rate (RR), electrocardiography (ECG), body temperature, and blood pressure (BP)-were used for monitoring movements of seniors. For context-awareness, environmental sensors-such as gas, fire, smoke, dust, temperature, and light sensors-were used for senior location data collection. Based on senior activity, senior health status can be classified into positive and negative. Based on senior location and time, senior safety is classified into safe and emergency. In this paper, we propose a hybrid inspection service middleware for monitoring elderly health risk based on senior activity and location. This hybrid-aware model for the detection of abnormal status of seniors has four steps as follows: (1) data collection from biosensors and environmental sensors; (2) monitoring senior location and time of stay in each location using environmental sensors; (3) monitoring senior activity using biometric data; finally, (4) expectation-maximization based decision-making step recommending proper treatment based on a senior health risk ratio.
This diploma thesis explores the area of sexuality of older people, summarizes previously published theoretical knowledge in this area and is complemented by empirical research. It deals with aging and outlines the changes that may occur in humans during this process, especially in terms of development and transformation of sexuality. This thesis also pursues the perception of senior sexuality by his surroundings and the general public. This thesis also partially covers the issue of instituti...
Aarhus, Rikke; Ballegaard, Stinne Aaløkke; Grönvall, Erik; Larsen, Simon Bo
In this paper we adopt the position that design of social media for the elderly and virtual senior communities may be informed by studying ‘real’ senior communities. Since current research efforts target the role of social media and virtual communities for supporting seniors ageing in place, i.e. in their homes, housing communities seem a natural place to begin this enquiry. We conducted observations and informal interviews in six different senior dwellings. In this paper we present the key f...
Savarino, Edoardo; de Bortoli, Nicola; Bellini, Massimo; Galeazzi, Francesca; Ribolsi, Mentore; Salvador, Renato; Savarino, Vincenzo; Penagini, Roberto
Patients with esophageal symptoms potentially associated to esophageal motor disorders such as dysphagia, chest pain, heartburn and regurgitation, represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal manometry in clinical practice is: (1) to accurately define esophageal motor function, (2) to identify abnormal motor function, and (3) to establish a treatment plan based on motor abnormalities. With this in mind, in the last decade, investigations and technical advances, with the introduction of high-resolution esophageal manometry, have enhanced our understanding and management of esophageal motility disorders. The following recommendations were developed to assist physicians in the appropriate use of esophageal manometry in modern patient care. They were discussed and approved after a comprehensive review of the medical literature pertaining to manometric techniques and their recent application. This position statement created under the auspices of the Gruppo Italiano di Studio per la Motilità dell'Apparato Digerente (GISMAD), Società Italiana di Gastroenterologia ed Endoscopia Digestiva (SIGE) and Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri (AIGO) is intended to help clinicians in applying manometric studies in the most fruitful manner within the context of their patients with esophageal symptoms. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
This paper examined through research, whether any evidence exists which indicates that, army women are confronted with inherent obstacles as they try to advance through the ranks to senior level positions...
Duke, Jan; Connor, Margaret
Like the general population, nurses become patients within the health care services available to them. They write anecdotal accounts of their experience and research the experience of their colleagues. This paper reports a small descriptive study of how the positions of senior nurses who experienced a life threatening condition influenced their illness trajectories. Eleven nurses in both New Zealand and Australia told stories of their experiences which focussed on intercessions/intervention by themselves, their family and the health care team. Themes identified were: looking after our own, the gaze of family and friends in advocacy and intercession, stereotypes of nurses as patients, senior nurses as vulnerable patients - existential healing through the small things, and senior nurses as knowledgeable people. Within these themes were narratives of special and meagre care. The authors conclude that all senior nurses should receive care that is regardful of who they are as senior nurses and vulnerable patients.
Garrett-Howard, Camille Elaine
The problem researched in this study was the limited number of women in senior leadership positions in the aerospace industry. The purpose of this qualitative phenomenological research study was to interview women senior leaders in the aerospace industry to explore the factors they perceived as beneficial to their advancement to senior leadership positions in the aerospace industry. The research study was guided by a central research question relating to what professional and personal factors might have led to promotional opportunities into senior leadership roles. Transformational leadership was the conceptual framework used to inform the study. The qualitative, phenomenological approach was selected to gain insights of the lived experiences and perceptions relating to career advancement of women to senior leadership positions in the aerospace industry. Data were collected using a modified Van Kaam method, coded, and analyzed to discern themes or patterns. Findings were that the attributes participants contributed to their success, included a focus on leadership, personal development, and the importance of mentoring relationships. This study presented a positive direction in addressing the gaps in the body of knowledge related to women and leadership development by exploring the experiences of women in senior leadership positions in the aerospace industry. Implications for social change include informing organizations and women about specific leadership development practices as one way to promote more women into leadership positions thus reducing the gap between the number of men and women leaders.
Osborne, M A
The histories of medical entomology and parasitology are entwined. Raphaël Blanchard (1857-1919), Chair of Medical Natural History and Parasitology at the Faculty of Medicine in Paris, organized the teaching of medical entomology and civilian colonial medicine. He also founded and edited the journal Archives de Parasitologie and started the Institute de Médecine Coloniale where he mentored many foreign students and researchers. Additionally, Blanchard is important for his scientific internationalism and medical historical work on the cultural location of parasitology and for training the future professors of parasitology Jules Guiart, Emile Brumpt, and Charles Joyeux.
Woolley, Torres; Cristobal, Fortunato; Siega-Sur, Jusie; Ross, Simone; Neusy, Andre-Jacques; Halili, Servando; Reeve, Carole
Hundreds of millions of people worldwide lack access to quality health services, largely because of geographic and socioeconomic maldistribution of qualified practitioners. This study describes differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education (SAHPE) schools and the practice locations of graduates from two 'conventionally trained' medical schools located in the same respective geographic regions. Licensed medical graduates were currently practising in the Philippines and had been practising for at least 6 months. Graduates were from two Philippines SAHPE schools (Ateneo de Zamboanga University-School of Medicine (ADZU-SOM) on the Zamboanga Peninsula (n=212) and the University of the Philippines Manila-School of Health Sciences (SHS-Palo) in Eastern Visayas (n=71), and from two 'conventional' medical schools Methods: Current graduate practice locations in municipalities or cities were linked with their respective population size and socioeconomic income class, and geocoded using Geographical Information System software onto a geospatial map of the Philippines. Bivariate analysis compared the population size and socioeconomic class of communities where the SAHPE medical graduates practised to communities where 'conventional' medical school graduates practised. Thirty-one percent of ADZU-SOM medical graduates practised in communities play a significant role in graduates choosing to practice in rural and/or economically disadvantaged communities. Governments experiencing medical workforce maldistributions similar to those in the Philippines should consider SAHPE as a potentially cost-effective strategy in recruiting and retaining health graduates to underserved areas.
Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.
Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…
Sherer, Renslow; Wan, Yu; Dong, Hongmei; Cooper, Brian; Morgan, Ivy; Peng, Biwen; Liu, Jun; Wang, Lin; Xu, David
To modernize its stagnant, traditional curriculum and pedagogy, the Medical School of Wuhan University in China adopted (with modifications) the University of Chicago's medical curriculum model. The reform effort in basic sciences was integrating histology and physiology into one course, increasing the two subjects' connection to clinical…
Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.
Full Text Available Tourism products are systemic products which offer multiple value to tourists in multiple aspects to satisfy their needs, however, tourists' preferences vary in terms of travelers' characteristics. The current study attempts to analyse senior and non-senior package holiday travelers' preferences with respect to tourism product attributes. The surveyed sample of 463 tourists spent their holiday on the coach tours in Poland in 2013. The main implication of this research for tourism product managers is that they have to focus on providing tourists with well suited packages and position appropriately by selecting suitable communication strategies for selected target segments.
Substantial evidence exists to demonstrate that the NSF ADVANCE Inititiative has made a positive impact upon institutions. Since it began in 2001, ADVANCE has changed the conversation, policies, and practices in ways to remove obstacles and systemic barriers preventing success for academic women scientists and engineers. Results from ADVANCE projects on campuses have facilitated consensus nationally about policies and practices that institutions may implement to help to alleviate issues, particularly for junior women scientists.Although getting women into senior and leadership positions in STEM constituted an initial impetus for ADVANCE, less emphasis was placed upon the needs of senior women scientists. Surveys of academic women scientists indicate that the issues faced by junior and senior women scientists differ significantly. The focus of ADVANCE on junior women in many ways seemed appropriate--the senior cohort of women scinetists is fed by the junior cohort of scientists; senior women serve as mentors, role models, and leaders for the junior colleagues, while continuing to struggle to achieve full status in the profession. This presentation will center on the differences in issues faced by senior compared to junior women scientists to explore whether a next step for ADVANCE should be to address needs of senior academic women scientists.
Galvan, Frank H; Bogart, Laura M; Wagner, Glenn J; Klein, David J; Chen, Ying-Tung
HIV-positive Latino men have been found to have poorer medication adherence compared to Whites. This study sought to identify how cultural conceptualisations of masculinity are associated with self-reported medication adherence among Latino men. A total of 208 HIV-positive men reported the number of doses of antiretroviral medication missed in the previous seven days (dichotomised at 100% adherence versus less). Conceptualisations of masculinity consisted of traditional machismo (e.g., power and aggressive attitudes, which are normally associated with negative stereotypes of machismo) and caballerismo (e.g., fairness, respect for elders and the importance of family). Multivariate logistic regression was used to identify factors associated with adherence. The mean adherence was 97% (SD = 6.5%; range = 57-100%). In all, 77% of the participants reported 100% adherence in the previous seven days. Caballerismo was associated with a greater likelihood (OR = 1.77; 95% CI: 1.08-2.92; p = 0.03) and machismo with a lower likelihood (OR = 0.60; 95% CI: 0.38-0.95; p = 0.03) of medication adherence. In addition, higher medication side-effects were found to be associated with a lower likelihood (OR = 0.59; 95% CI: 0.43-0.81; p = 0.001) of medication adherence. These findings reinforce the importance of identifying cultural factors that may affect medication adherence among HIV-positive Latino men resident in the USA.
Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C
To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.
Bach, Henning Bjerregaard; Mehlsen, Line; Høgelund, Jan
evidens for, at samtaler har en positiv effekt for ledige seniorers overgang til beskæftigelse - indikation for, at tidlige indsatser har en positiv effekt for ledige seniorers overgang til beskæftigelse - stærk evidens for tilstedeværelsen af positive motivationseffekter, som fremkommer ved en generel...... forpligtigelse for ledige seniorer til at deltage i den almindelige aktiveringsindsats for ledige eller dokumenteret jobsøgning. Denne oversigt er en i rækken af litteraturoversigter, som Styrelsen for Arbejdsmarked og Rekruttering har taget initiativ til....
Kruse, Clemens Scott; Beane, Amanda
Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is...
It is shown that the concept of seniority can be introduced in projection operator formalism through the use of the operator Q, which has been defined by de-Shalit and Talmi. The usefulness of seniority concept in projection operator formalism is discussed. An example of four nucleons in j=3/2 configuration is given for illustrative purposes
Prud'homme, Robert K.
Reviews a senior undergraduate research program in chemical engineering at Princeton University. Includes strengths and requirements for a successful program. Senior thesis research provides creative problem solving experiences for students and is congruent with departmental research objectives. Selected student comments are included. (SK)
Mochizuki, Takashi; Tsuboi, Ryoji; Sei, Yoshihiro; Hiruma, Masataro; Watanabe, Shinichi; Makimura, Koichi
To improve the ability of dermatologists to diagnose cutaneous mycoses, we have proposed a list of the minimum mycological knowledge and skills required by senior residents of dermatology. The list includes ability to select the most appropriate sampling method, knowledge of the basic method of potassium hydroxide (KOH) examination and skill in performing fungal cultures and identifying the most prevalent fungal species isolated from skin lesions. It is not possible for the Japanese Society of Medical Mycology to train every senior resident directly, and it is difficult for them to acquire sufficient expertise independently. Consequently, training and advice given by instructors in residents' home institutes is essential. A project of an advanced course for instructors, who are in charge of educating senior residents in their own institute, may be possible. Therefore, we have proposed here a list for instructors of the knowledge and skills required to educate senior residents. Employing this list should realize improved skill in dermatologists.
Full Text Available The etiology of ESRD under the age of 20 almost is the inherited kidney disease or congenital disorders of urinary tract. NPHP/ medullary cystic disease includes a group of tubulo- genetic kidney disorders. NPHP is the cause of 15-20% ESRD in children and adolescents. The extra renal manifestations include: oculomotor Apraxia(Cogan syndrome, mental retardation, retinitis pigmentosa, (Senior- Loken syndrome liver fibrosis and skeletal disorders. Recently, on the basis of genetics and type of the protein product of these mutations, NPHP is divided to 6 types. The presented case is a 17 year old boy with end stage renal disease that he has been managed with hemodialysis. As the patient has polyuria and disturbance in vision from childhood and on physical examination he had retinitis pigmentosa and horizontal nystagmus with a history of chronic kidney disease in his 12 years old sister, and familial marriage between his parents, we suggest NPHP4 for the patient.
Zarzecka, Olga; Villeseche, Florence
While the importance or even necessity to build and maintain resourceful social networks appears as a forthright fact, there is still a lack of certainty as to who benefits from the resources that can be accessed through senior managers’ networks, and under what conditions. In this paper, we...... contribute to answering this puzzle with a sample constituted of senior managers from Denmark and their network ties, and investigate both economic and sociological conditions of senior managers’ tie use. Our results show that the greater the distance between aspiration level and actual firm performance......, the more likely it is that senior managers will use their network ties to access resources that benefit chiefly the individual rather than the organization. In addition, we demonstrate that this rapport is moderated by senior managers’ social identity as a member of the corporate elite, so that a strong...
Sivamalai, Sundram; Murthy, Shashidhar Venkatesh; Gupta, Tarun Sen; Woolley, Torres
Technology has revolutionised teaching. Teaching pathology via digital microscopy (DM) is needed to overcome increasing student numbers, a shortage of pathology academics in regional medical schools, and difficulties with teaching students on rural clinical placement. To identify whether an online DM approach, combining digital pathology software, Web-based slides and classroom management software, delivers effective, practical pathology teaching sessions to medical students located both on campus and on rural placement. An online survey collected feedback from fourth and fifth year undergraduate James Cook University medical students on the importance of 16 listed benefits and challenges of using online DM to teach pathology, via a structured five-point Likert survey. Fifty-three students returned the survey (response rate = 33%). Benefits of online DM to teach pathology rated as 'very important' or 'extremely important' by over 50% of students included: higher quality images; faster learning; more convenient; better technology; everyone sees the same image; greater accessibility; helpful annotations on slides; cost savings; and more opportunity for self-paced learning out-of-hours and for collaborative learning in class. Challenges of online DM rated as 'very important' or 'extremely important' by over 50% of students included: Internet availability in more remote locations and potential problems using online technology during class. Nearly all medical students welcomed learning pathology via online digital technology. DM should improve the quantity, quality, cost and accessibility of pathology teaching by regional medical schools, and has significant implications for the growing emphasis in Australia for decentralised medical education and rural clinical placements. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Teister, Corina J; Chocano-Bedoya, Patricia O; Orav, Endel J; Dawson-Hughes, Bess; Meyer, Ursina; Meyer, Otto W; Freystaetter, Gregor; Gagesch, Michael; Rizzoli, Rene; Egli, Andreas; Theiler, Robert; Kanis, John A; Bischoff-Ferrari, Heike A
There is no consensus on most reliable falls ascertainment method. Therefore, we investigated which method captures most falls among pre-frail and frail seniors from two randomized controlled trials conducted in Zurich, Switzerland, a 18-month trial (2009-2010) including 200 community-dwelling pre-frail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both included the same fall ascertainment methods: monthly active-asking, daily self-report diary, and a call-in hotline. We compared number of falls reported and estimated overall and positive percent agreement between methods. Pre-frail seniors reported 499 falls (rate = 2.5/year) and frail seniors reported 205 falls (rate = 1.4/year). Most falls were reported by active-asking: 81% of falls in pre-frail, and 78% in frail seniors. Among pre-frail seniors, diaries captured additional 19% falls, while hotline added none. Among frail seniors, hotline added 16% falls, while diaries added 6%. The positive percent agreement between active-asking and diary was 100% among pre-frail and 88% among frail seniors. While monthly active-asking captures most falls in both groups, this method alone missed 19% of falls in pre-frail and 22% in frail seniors. Thus, a combination of active-asking and diaries for pre-frail, and active-asking and the hotline for frail seniors is warranted.
Phronesis has become a buzzword in contemporary medical ethics. Yet, the use of this single term conceals a number of significant conceptual controversies based on divergent philosophical assumptions. This paper explores three of them: on phronesis as universalist or relativist, generalist or particularist, and natural/painless or painful/ambivalent. It also reveals tensions between Alasdair MacIntyre's take on phronesis, typically drawn upon in professional ethics discourses, and Aristotle's original concept. The paper offers these four binaries as a possible analytical framework for classifying and evaluating accounts of phronesis in the medical ethics literature. It argues that to make sense of phronesis as a putative ideal in professional medical ethics--for example, with the further aim of crafting interventions to cultivate phronesis in medical ethics education--the preliminary question of which conception of phronesis is most serviceable for the aim in question needs to be answered. The paper identifies considerable lack of clarity in the current discursive field on phronesis and suggests how that shortcoming can be ameliorated.
Nahar, Papreen; Kannuri, Nanda Kishore; Mikkilineni, Sitamma; Murthy, G V S; Phillimore, Peter
This analysis challenges a tendency in public health and the social sciences to associate India's medical pluralism with a distinction between biomedicine, as a homogeneous entity, and its non-biomedical 'others'. We argue that this overdrawn dichotomy obscures the important part played by 'informal' biomedical practice, an issue with salience well beyond India. Based on a qualitative study in rural Andhra Pradesh, South India, we focus on a figure little discussed in the academic literature - the Registered Medical Practitioner (RMP) - who occupies a niche in the medical market-place as an informal exponent of biomedical treatment. We explore the significance of these practitioners by tracking diagnosis and treatment of one increasingly prominent medical 'condition', namely diabetes. The RMP, who despite the title is rarely registered, sheds light on the supposed formal-informal sector divide in India's healthcare system, and its permeability in practice. We develop our analysis by contrasting two distinctive conceptualisations of 'informality' in relation to the state in India - one Sarah Pinto's, the other Ananya Roy's. © 2016 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.
Cheng, Xin; Ka Ho Lee, Kenneth; Chang, Eric Y.; Yang, Xuesong
Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of…
Lambert, Trevor W; Smith, Fay; Goldacre, Michael J
We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.
Duperly, John; Lobelo, Felipe; Segura, Carolina; Sarmiento, Francisco; Herrera, Deisy; Sarmiento, Olga L; Frank, Erica
Background Physician-delivered preventive counseling is important for the prevention and management of chronic diseases. Data from the U.S. indicates that medical students with healthy personal habits have a better attitude towards preventive counseling. However, this association and its correlates have not been addressed in rapidly urbanized settings where chronic disease prevention strategies constitute a top public health priority. This study examines the association between personal health practices and attitudes toward preventive counseling among first and fifth-year students from 8 medical schools in Bogotá, Colombia. Methods During 2006, a total of 661 first- and fifth-year medical students completed a culturally adapted Spanish version of the "Healthy Doctor = Healthy Patient" survey (response rate = 78%). Logistic regression analyses were used to assess the association between overall personal practices on physical activity, nutrition, weight control, smoking, alcohol use (main exposure variable) and student attitudes toward preventive counseling on these issues (main outcome variable), stratified by year of training and adjusting by gender and medical training-related factors (basic knowledge, perceived adequacy of training and perception of the school's promotion on each healthy habit). Results The median age and percentage of females for the first- and fifth-year students were 21 years and 59.5% and 25 years and 65%, respectively. After controlling for gender and medical training-related factors, consumption of ≥ 5 daily servings of fruits and/or vegetables, not being a smoker or binge drinker were associated with a positive attitude toward counseling on nutrition (OR = 4.71; CI = 1.6–14.1; p = 0.006 smoking (OR = 2.62; CI = 1.1–5.9; p = 0.022), and alcohol consumption (OR = 2.61; CI = 1.3–5.4; p = 0.009), respectively. Conclusion As for U.S. physician and medical students, a positive association was found between the personal health habits of
Sherer, Renslow; Wan, Yu; Dong, Hongmei; Cooper, Brian; Morgan, Ivy; Peng, Biwen; Liu, Jun; Wang, Lin; Xu, David
To modernize its stagnant, traditional curriculum and pedagogy, the Medical School of Wuhan University in China adopted (with modifications) the University of Chicago's medical curriculum model. The reform effort in basic sciences was integrating histology and physiology into one course, increasing the two subjects' connection to clinical medicine, and applying new pedagogies and assessment methods. This study assessed the results of the reform by comparing the attitudes and academic achievements of students in the reform curriculum (n = 41) and their traditional curriculum peers (n = 182). An attitude survey was conducted to obtain students' views of their respective histology and physiology instruction. Survey items covered lectures, laboratory teaching, case analyses and small-group case discussions, assessment of students, and overall quality of the courses and instruction. A knowledge test consisting of questions from three sources was given to measure students' mastery of topics that they had learned. Results showed that reform curriculum students were rather satisfied with their course and new teaching methods in most cases. When these students' attitudes were compared with those of their traditional curriculum peers, several significant differences favoring the reform were identified regarding physiology teaching. No other significant difference was found for physiology or histology teaching. Reform curriculum students outperformed their peers on four of five subcategories of the knowledge test questions. These findings support the benefits of integration and state-of-the-art teaching methods. Our study may offer lessons to medical schools in China and other countries whose medical education is in need of change. Copyright © 2014 The American Physiological Society.
Ladas, P; Giatagatzidis, P; Anogianakis, G; Maglavera, S
Telemedicine dates to the days of "wireless telegraphy". As an "extraordinary" arrangement for medical services delivered at time of need, telemedicine has thus far escaped the developments that have taken place over the last 50 years in the areas of medical liability, safety and confidentiality. Today, however, telemedicine is also used to increase quality and cost effectiveness of healthcare provision. This trend is set by the U.S. where the U.S. federal government funds telemedicine at an annual rate of more than $100 million i.e., at a rate 30 times or more than what the EU does while state and local agency support and private business investment in telemedicine is 3 to 4 times larger than that of the U.S. federal government. In this respect it must be stressed that technology tends to satisfy the relevant demand for telecommunications. Telemedicine is used in diverse areas such as pathology, surgery, physical therapy, and psychiatry. It is expected to revolutionise health care in the coming decade and, therefore, it will certainly take into account requirements for medical liability, safety and confidentiality in the same way as traditional "establishment" medicine does.
Ray, Robin A; Woolley, Torres; Sen Gupta, Tarun
The regionally based James Cook University (JCU) College of Medicine and Dentistry aims to meet its mission to address the health needs of the region by using a selection policy favouring rural origin applicants and providing students with early and repeated exposure to rural experiences during training. This study seeks to determine if the JCU medical school's policy of preferentially selecting rural and remote background students is associated with differing patterns of undergraduate performance or graduate practice location. Data at application to medical school and during the undergraduate years was retrieved from administrative databases held by the university and the medical school. Postgraduate location data were obtained either from personal contact via email, telephone or Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (ASGC-RA) categories, with 1 being a major city and 5 being a very remote location. The 856 Australian-based students accepted into the JCU medical program between 2000 and 2008 came from all geographical regions across Australia: 20% metropolitan (ASGC-RA 1), 20% inner regional (ASGC-RA 2), 56% outer regional (ASGC-RA 3), and 5% from remote or very remote locations (ASGC-RA 4 and 5). Having a rural or remote hometown at application (ASGC-RA 3-5) was significantly associated with a lower tertiary entrance score (pacademic achievement across years 1 to 3 (p=0.002, p=0.005 and p=0.025, respectively). Graduates having either a rural or a remote home town at application were more likely to practise in rural (RA 3-5) towns than graduates from metropolitan/inner regional centre across all postgraduate years. For example, the prevalence odds ratios (POR) for graduates practising in a rural town at postgraduate year 1 (PGY 1) having either a rural or remote hometown were 2.6 and 1.8, respectively
Harmon, Kimberly G; Drezner, Jonathan A; Gammons, Matthew; Guskiewicz, Kevin M; Halstead, Mark; Herring, Stanley A; Kutcher, Jeffrey S; Pana, Andrea; Putukian, Margot; Roberts, William O
, rugby, soccer and basketball. RISK FACTORS FOR SPORT-RELATED CONCUSSION: ▸ A history of concussion is associated with a higher risk of sustaining another concussion. ▸ A greater number, severity and duration of symptoms after a concussion are predictors of a prolonged recovery. ▸ In sports with similar playing rules, the reported incidence of concussion is higher in female athletes than in male athletes. ▸ Certain sports, positions and individual playing styles have a greater risk of concussion. ▸ Youth athletes may have a more prolonged recovery and are more susceptible to a concussion accompanied by a catastrophic injury. ▸ Preinjury mood disorders, learning disorders, attention-deficit disorders (ADD/ADHD) and migraine headaches complicate diagnosis and management of a concussion. ▸ Concussion remains a clinical diagnosis ideally made by a healthcare provider familiar with the athlete and knowledgeable in the recognition and evaluation of concussion. ▸ Graded symptom checklists provide an objective tool for assessing a variety of symptoms related to concussions, while also tracking the severity of those symptoms over serial evaluations. ▸ Standardised assessment tools provide a helpful structure for the evaluation of concussion, although limited validation of these assessment tools is available. ▸ Any athlete suspected of having a concussion should be stopped from playing and assessed by a licenced healthcare provider trained in the evaluation and management of concussions. ▸ Recognition and initial assessment of a concussion should be guided by a symptoms checklist, cognitive evaluation (including orientation, past and immediate memory, new learning and concentration), balance tests and further neurological physical examination. ▸ While standardised sideline tests are a useful framework for examination, the sensitivity, specificity, validity and reliability of these tests among different age groups, cultural groups and settings is largely
.... The data analysis yielded eight themes related to the Senior Enlisted Leader Program. Six of these themes present positive aspects of the program, and two of these themes address areas for improvement. Overall, the data suggest that the Senior Enlisted Leader Program has had a significant positive impact on the leadership development of midshipmen and the Naval Academy as a whole.
Esposito, Susanna; Franco, Elisabetta; Gavazzi, Gaetan; de Miguel, Angel Gil; Hardt, Roland; Kassianos, George; Bertrand, Isabelle; Levant, Marie-Cécile; Soubeyrand, Benoit; López Trigo, Jose Antonio
Longer life expectancy and decreasing fertility rates mean that the proportion of older people is continually increasing worldwide, and particularly in Europe. Ageing is associated with an increase in the risk and severity of infectious diseases. These diseases are also more difficult to diagnose and manage in seniors who often have at least one comorbid condition (60% of seniors have two or more conditions). Infectious diseases increase the risk of hospitalization, loss of autonomy and death in seniors. Effective vaccines are available in Europe for infectious diseases such as influenza, pneumococcal diseases, herpes zoster, diphtheria, tetanus and pertussis. Their effectiveness has been demonstrated in terms of reducing the rates of hospitalization, disability, dependency and death. The prevention of diseases in seniors also results in savings in healthcare and societal costs each year in Europe. Despite the availability of vaccines, vaccine-preventable diseases affect millions of European citizens annually, with the greatest burden of disease occurring in seniors, and the medical and economic benefits associated with are not being achieved. Vaccination coverage rates must be improved to achieve the full benefits of vaccination of seniors in Europe. Copyright © 2018 Elsevier Ltd. All rights reserved.
Hojat, Mohammadreza; Michalec, Barret; Veloski, J Jon; Tykocinski, Mark L
To test the hypotheses that medical students recognized by peers as the most positive social influencers would score (1) high on measures of engaging personality attributes that are conducive to relationship building (empathy, sociability, activity, self-esteem), and (2) low on disengaging personality attributes that are detrimental to interpersonal relationships (loneliness, neuroticism, aggression-hostility, impulsive sensation seeking). The study included 666 Jefferson Medical College students who graduated in 2011-2013. Students used a peer nomination instrument to identify classmates who had a positive influence on their professional and personal development. At matriculation, these students had completed a survey that included the Jefferson Scale of Empathy and Zuckerman-Kuhlman Personality Questionnaire short form and abridged versions of the Rosenberg Self-Esteem Scale and UCLA Loneliness Scale. In multivariate analyses of variance, the method of contrasted groups was used to compare the personality attributes of students nominated most frequently by their peers as positive influencers (top influencers [top 25% in their class distribution], n = 176) with those of students nominated least frequently (bottom influencers [bottom 25%], n = 171). The top influencers scored significantly higher on empathy, sociability, and activity and significantly lower on loneliness compared with the bottom influencers. However, the effect size estimates of the differences were moderate at best. The research hypotheses were partially confirmed. Positive social influencers appear to possess personality attributes conducive to relationship building, which is an important feature of effective leadership. The findings have implications for identifying and training potential leaders in medicine.
Boscardin, Christy K; Grbic, Douglas; Grumbach, Kevin; O'Sullivan, Patricia
The projected U.S. physician shortage will disproportionately affect underserved areas. This study examined the impact of medical school educational experiences on positive changes in and reaffirmation of students' intention to practice in underserved areas (practice intention). Medical students (n = 7,361) from 113 U.S. MD-granting medical schools who graduated in 2009-2010 and responded to both the Association of American Medical Colleges' 2006 Matriculating Student Questionnaire and 2010 Graduation Questionnaire were included. Multilevel logistic regression analyses were conducted to determine factors associated with change in and reaffirmation of practice intention. After controlling for individual characteristics, community health field experience (adjusted odds ratio [OR]: 1.36; 95% CI: 1.18, 1.57), learning another language (OR: 1.41; 95% CI: 1.22, 1.63), cultural competence/awareness experience (OR: 1.38; 95% CI: 1.21, 1.58), becoming more aware of perspectives of individuals from different backgrounds (OR: 1.24; 95% CI: 1.04, 1.48), and attending schools with higher social mission scores (OR: 1.66; 95% CI: 1.28, 2.16) were all significantly associated with positive changes in practice intention from matriculation to graduation. Field experience in community health (OR: 1.24; 95% CI: 0.99, 1.53), learning another language (OR: 1.29; 95% CI: 1.01, 1.65), and attending schools with higher social mission scores (OR: 1.62; 95% CI: 1.09, 2.43) were all significantly associated with reaffirmation of practice intention at graduation. Multifaceted factors are associated with practice intention. This study suggests medical schools can play active roles in alleviating the physician shortage in underserved areas through targeted curricular interventions and recruitment.
Full Text Available ObjectivesTo conduct a systematic review of published evidence around seafood, health and seniors.MethodData sources reviewing included: Proquest; PubMed; Science Direct; Taylor and Francis; Cochran Collaboration; Web of Knowledge and Web of Science. Key search terms included seniors, ageing, fish, seafood, protein, health and various lifestyle conditions Results A diet high in marine source Omega-3 poly unsaturated fatty acids affords particular benefits for seniors in a reduced risk of all cause mortality, with the strongest evidence around coronary heart disease and ischemic stroke. Other benefits include reduced inflammation associated with arthritis and delay to onset and slowed progression of dementia and Alzheimer’s disease. Conclusion There is increasing evidence to support the regular seafood consumption (particularly oily fish as being protective against a number of aged-related health conditions. Seniors should be encouraged to consume 3500mg- 4000mg of marine source Omega-3 PUFAs each week.
”I believe that all people need to move about. Actually, some have difficulties in doing so. They stay in their home neighbourhoods where they’ve grown up and feel safe. I can understand that, but my wife and I, we didn’t want that. We are more open to new ideas.” This anthology is about seniors...... on the move. In seven chapters, Nordic researchers from various disciplines, by means of ethnographic methods, attempt to comprehend the phenomenon of Nordic seniors who move to leisure areas in their own or in other countries. The number of people involved in this kind of migratory movement has grown...... above gives voice to one of these seniors, stressing the necessity of moving. The anthology contributes to the international body of literature about later life migration, specifically representing experiences made by Nordic seniors. As shown here, mobility and migration in later life have implications...
Enns, Sylvia Claassen; Perotta, Bruno; Paro, Helena B; Gannam, Silmar; Peleias, Munique; Mayer, Fernanda Brenneisen; Santos, Itamar Souza; Menezes, Marta; Senger, Maria Helena; Barelli, Cristiane; Silveira, Paulo S P; Martins, Milton A; Zen Tempski, Patricia
To assess perceptions of educational environment of students from 22 Brazilian medical schools and to study the association between these perceptions and quality of life (QoL) measures. The authors performed a multicenter study (August 2011 to August 2012), examining students' views both of (1) educational environment using the Dundee Ready Education Environment Measure (DREEM) and (2) QoL using the World Health Organization Quality of Life Assessment, abbreviated version (WHOQOL-BREF). They also examined students' self-assessment of their overall QoL and medical-school-related QoL (MSQoL). The authors classified participants' perceptions into four quartiles according to DREEM total score, overall QoL, and MSQoL. Of 1,650 randomly selected students, 1,350 (81.8%) completed the study. The mean total DREEM score was 119.4 (standard deviation = 27.1). Higher total DREEM scores were associated with higher overall QoL and MSQoL scores (P student QoL.
Jafar Asgari Arani
Full Text Available ABSTRACT- This study uses Depth Interview as a research instrument to study users' perceptions and acceptance of the potential use of mobile phones in a prospective design for learning Medical English, a mandatory course in medicine. Almost all the respondents (93% across graduates and students were unanimous about the need to learn English through M-Learning. When respondents were asked to suggest ideas on how medical English can be taught through mobiles (unaided question, 49% suggested SMS and 27% suggested SMS & Live Calls. The survey indicates that there is a unanimous demand to learn English amongst students and graduates of medicine in a new e-education setting called M-learning. Constraints imposed by one’s occupation and available resources expose the limitations of traditional learning and opens up a huge opportunity for M-English learning. Irrespective of differences, potential learners accepted the credibility of M-learning and displayed willingness to be an active user of an M-learning module. Diversity of responses on potential frequency of usage for SMSs, preferences regarding listening to IVR, speaking to Live Callers, traditional classroom learning, M-learning and testing options will establish at a primary level that the means of ‘engagement’, ‘presence’ and ‘flexibility’ can be significantly different ‘between’ and ‘within’ different educational groups.
This thesis aims to examine how senior employees experience that their psychological work environment affects their decision to stay on the labour market despite their possibility to retire. I have conducted interviews with 6 senior employees and 2 supervisors in the consulting group COWI. I have analysed the interviews by using a well-known work environment model, the Job-Demand-Control model presented by Karasek and the cognitive coping theory presented by Lazarus. The assumption in the Job...
Composition and mandateThe Senior Staff Advancement Committee is composed of members nominated ad persona by the Director-General.The Committee examines proposals from Divisions concerning promotions to grade 13 in Career Path IX, changes of career path to Career Path IX and advancements to the exceptional grade in Career path VIII.The Director-General may consult the Committee on any matter related to senior staff careers.The Committee makes its recommendations to the Director-General.
Full Text Available Background and Aim: The utilization of information and communication technologies in medical librarianship would put librarians in new created conditions. Therefore, the aim of this study was to evaluate the effects of external factors on medical librarians' attitudes toward their future professional situation.Materials and Methods: This was a cross-sectional study. All libraries and affiliated with ministry of health, and medical education were included in the study. The research consisted of all medical librarians working in the mentioned centers. Data was collected through questionnaires including two major parts and an additional section pertaining to personal information. From total of 1368 cases, 1001 answered to the questions. Statistical measurements consisted of frequency distribution, mean, percentage, measures of dispersion, correlation coefficient, and two tailed tests analyzed by SPSS software. P<0.05 was considered as the limit of significance.Results: The results showed that the mean score of external factors and attitude, were 3.25 and 4.18 respectively, at the scale of 5. There was a positive and significant relationship between external factors and attitude. Medical librarians did not consider the presence informaticians as a threat to their job security, and they have been able to adapt themselves to modern situations. Also, they were aware of the fact that if they can not succeed to match themselves with technological revolution, they will loose their jobs.Conclusion: Structural changes in staff and educational establishments are necessary to satisfy future needs and is a priority to improve the influence of external factors on medical librarians' attitude toward the future of their profession.
Improving the application of the justification principle in medical imaging is the responsibility of many stakeholders. This document is intended to provide clarity on the regulator's approach to the roles and responsibilities of the undertaking as well as a range of professionals involved in medical exposures. In doing so it considers the requirements of the new European Basic Safety Standards (BSS) Directive 2013/59/Euratom and discusses a number of emerging challenges associated with efficient, effective and rapidly changing health care systems. In summary, - the justification process should be completed prior to the exposure taking place and include consideration of the following: - adequate information regarding the clinical condition(s) of the patient, relevant to the imaging request -this must be available including known possible contraindications (e.g. pregnancy, breast feeding) - the diagnostic question(s) to be addressed - where practicable, information, with regard to possible previous/concurrent examinations - the decision on the appropriate imaging procedure including the option of one that does not involve ionising radiation - traceability of the above to the referrer and practitioner, - the role of the regulator is to provide, through regulations and associated guidance, a clear and unambiguous regulatory framework including requirements for the justification process and accountability within local procedures - these will be subject to inspection, - the role of the undertaking and the professionals involved is to demonstrate compliance with regulations through procedures and documentation associated with each individual exposure, showing beyond reasonable doubt that the elements of the justification process have been completed, and by whom, in accordance with the responsibilities laid down in procedures
Ladd, S.C.; Krause, U.; Ladd, M.E.
The legal and medical basis for chest radiographs as part of pre-employment examinations (PEE) at a University Hospital is evaluated. The radiographs are primarily performed to exclude infectious lung disease. A total of 1760 consecutive chest radiographs performed as a routine part of PEEs were reviewed retrospectively. Pathologic findings were categorized as ''nonrelevant'' or ''relevant.'' No positive finding with respect to tuberculosis or any other infectious disease was found; 94.8% of the chest radiographs were completely normal. Only five findings were regarded as ''relevant'' for the individual. No employment-relevant diagnosis occurred. The performance of chest radiography as part of a PEE is most often not justified. The practice is expensive, can violate national and European law, and lacks medical justification. (orig.) [de
Randhawa, Avleen; Wakeling, James M
Changes in muscle structure due to aging occur in a process known as sarcopenia. These changes can alter muscle mechanics during contraction that may limit mobility in seniors. The purpose of this study was to investigate the effect of sarcopenia on muscle fascicle length, pennation and belly thickness in a contracting muscle during isokinetic movements. Fascicles within a pennate muscle shorten at a slower velocity than that of the muscle belly, in a process called belly gearing. Belly gearing may be affected by atrophy and so was also tested in these seniors. The gastrocnemii were tested using ultrasound from 10 young adults (20-40 years) and 9 seniors (70-85 years). The muscle structure was imaged during standing and maximal plantarflexion at four constant velocities on a dynamometer and torque, position and time were recorded during contractions. The muscle belly thickness and pennation in seniors were significantly lower than young adults during standing. Belly thickness, changes in pennation, the belly gearing, ankle torque and power output were all significantly lower in seniors during plantarflexion contractions of the medial gastrocnemius (MG) and lateral gastrocnemius (LG). The higher pennation observed in young adults is commonly associated with increased fascicle rotations during contraction causing an increased belly gearing. The decreased fascicle rotations in seniors resulted in reduced belly gearing but the size of this effect did not match the loss in strength or power from the muscles. Copyright © 2013 Elsevier Ltd. All rights reserved.
Sepponen, K; Kokki, H; Ahonen, R
The aim of this study was to describe how parents manage their child's postoperative pain at home following day-case surgery. The incidence of pain, different analgesics used and problems related to administering medications were the main interests of the study. A postal questionnaire was sent to the parents of 275 children who were under 8 years of age and had undergone an ear, nose and throat (ENT) day-case operation. The questionnaire was sent to the parents a week after discharge from hospital. Altogether, the parents of 227 children answered the questionnaire (response rate 83%). The study was divided into two phases (preintervention and postintervention), and incorporated a training program for doctors and nurses between these two phases. The training program aimed to improve the treatment practices of postoperative pain in children. Seventy-eight per cent of the children in the preintervention study and 75% in the postintervention study experienced at least mild pain after discharge. The training program for doctors and nurses affected the home treatment practices of postoperative pain. The proportion of parents treating their children increased from 68% to 80% after the training program (p = 0.028). Many parents faced problems while treating their children; for example, 19% (n = 30) of the children refused to take their medicine, and suppositories were regarded to be an especially unpleasant dosage form. However, no serious adverse effects were reported. We conclude that due to the pain experienced at home by the great majority of children following day-case ENT operations, parents need information on how to manage their child's pain. A training program for doctors and nurses can improve the treatment of children's pain even at home. Since some children dislike suppositories, it would be worth considering the use of small tablets or mixtures instead.
Rationale and methods of a multicentre randomised controlled trial of the effectiveness of a Community Health Assessment Programme with Emergency Medical Services (CHAP-EMS) implemented on residents aged 55 years and older in subsidised seniors' housing buildings in Ontario, Canada.
Agarwal, Gina; McDonough, Beatrice; Angeles, Ricardo; Pirrie, Melissa; Marzanek, Francine; McLeod, Brent; Dolovich, Lisa
Chronic diseases and falls substantially contribute to morbidity/mortality among seniors, causing this population to frequently seek emergency medical care. Research suggests the paramedic role can be successfully expanded to include community-based health promotion and prevention. This study implements a community paramedicine programme targeting seniors in subsidised housing, a high-risk population and frequent users of emergency medical services (EMS). The aims are to reduce EMS calls, improve health outcomes and healthcare utilisation. This is a pragmatic clustered randomised control trial in four communities across Ontario, Canada. Within each, four to eight seniors' apartment buildings will be paired and within each pair one building will be randomly assigned to receive the Community Health Assessment Programme through EMS (CHAP-EMS) intervention, while the other building receives no intervention. During the 1-year intervention, paramedics will run weekly sessions in a common area of the building, assessing risk factors for cardiovascular disease, diabetes and falls; providing health education and referrals to community programmes; and communicating results to the participant's primary physician. The primary outcomes are rate of emergency calls per 100 residents, change in blood pressure and change in Canadian Diabetes Risk (CANRISK) score, as collected by the local EMS and study databases. The secondary outcomes are change in health behaviours, measured using a preintervention and postintervention survey and healthcare utilisation, available through administrative databases. Analysis will mainly consist of descriptive statistics and generalised estimating equations, including subgroup cluster analysis. This study is approved by the Hamilton Integrated Research Ethics Board and will follow the Tri-Council Policy Statement. Findings will be disseminated through reports to local stakeholders, publication in peer-reviewed journals and conference presentations
Hsiue, H-C; Wu, T-H; Chang, T-C; Hsiue, Y-C; Huang, Y-T; Lee, P-I; Hsueh, P-R
We reviewed 776 patients who were culture positive for Aspergillus species at the hospital from 2000 to 2009. The isolates were collected for species identification by oligonucleotide hybridization and sequence analysis. A total of 96 cases of proven or probable IA were identified according to published criteria. The incidence of IA has increased significantly during the study period. Aspergillus fumigatus and A. flavus (41.7% each) were equally prevalent causative species. IA due to unusual species including A. nidulans (n=2), A. versicolor (n=2), and A. tubingensis (n=1) were also found. Among patients with IA, 55.2% had hematological disorder, 19.8% had underlying lung disorder, and 10.4% had autoimmune disease. The isolates species (Pculture with invasive disease. The overall mortality at three months was 62.5%, which remained stable throughout the study period. Multivariate analysis identified prior steroid use (P=0.007) as a significant risk factor for death, while surgery (P=0.030) and voriconazole (P=0.012) had protective effects. In conclusion, autoimmune disorders and underlying pulmonary diseases should also be considered as important predisposing factors of IA. Further emphasis on surgery and voriconazole in the management of IA might be beneficial.
The requirement of associating in the boson space seniority with twice the number of non-s bosons defines a similarity transformation which re-expresses the Dyson pair boson images in terms of seniority bosons. In particular the fermion S-pair creation operator is mapped onto an operator which, unlike the pair boson image, does not change the number of non-s bosons. The original results of Otsuka, Arima and Iachello are recovered by this procedure while at the same time they are generalized to include g-bosons or even bosons with J>4 as well as any higher order boson terms. Furthermore the seniority boson images are valid for an arbitrary number of d- or g-bosons - a result which is not readily obtainable within the framework of the usual Marumori- or OAI-method
Full Text Available Abstract Background Senior veterans living in government sponsored, long-term care (LTC facilities, known as veterans' homes (VHs, are a special minority group in Taiwan. These seniors came from different provinces of mainland China during their teenage years at the end of civil wars in 1945. The situation of institutionalized senior veterans shares many characteristics with the concept of "total institution". Very little quality of life (QOL research has involved senior veterans. This study aimed to explore the QOL and related factors of VH-dwelling senior veterans in Taiwan. Methods Chronic conditions and socio-demographic characteristics of 260 male VH residents were recorded. The Brief Form of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version; Short-Form 36; Inventory of Socially Supportive Behavior questionnaire; Geriatric Depression Scale-short form; Barthel Index; and instrumental activities of daily living were used. Data analyses including descriptive and inferred statistics were performed using SPSS, version 17. Results WHOQOL-BREF showed acceptable reliability in this study. Compared to Taiwanese male norms, WHOQOL-BREF physical, psychological, and social relationship domain scores were around the 25th percentile, and the environment domain was about the 75th percentile. Our participants scored low in all concepts of SF-36. Although these residents rated the social support of their children, relatives, friends, social and medical staff as low, they gave high satisfaction ratings to their social supports. On multiple stepwise linear regression analysis, depressive symptoms, number of chronic conditions, retired military rank, and relatives' support correlated with QOL in both the physical and psychological domains. Friends' support and depressive symptoms correlated with the social relationships domain. Friends' support and instrumental activities of daily living correlated with the
Griebel, Juergen; Ebdon-Jackson, Steve
Over the course of several meetings the HERCA-Working Group (WG) 'Medical Applications' has discussed the exposure of asymptomatic individuals in health care. In particular, the discussions focused on the issue of the early detection of severe diseases, by use of X-rays, for those who do not present with symptoms. An important and established example is the use of X-ray mammography to detect early breast cancer and this has traditionally been referred to as screening. An emerging application is the use of computed tomography in a range of circumstances, some of which may be better described as a separate category of medical exposure as they are neither diagnostic nor screening in the accepted sense. The discussions have indicated that it is pivotal to clearly define the relevant terms generally applied and to clearly differentiate these terms from diagnostic examinations used in health care. In this context, it is important to note, that the revision of the Euratom Basic Safety Standards (Euratom BSS) Directive is under way and addresses in particular medical radiological procedures on asymptomatic individuals, intended to be performed for early detection of disease (Draft Proposal 29 September 2011 Article 54). Hereby, two types of examinations of asymptomatic individuals, (that in some cases have both been referred to as screening) are addressed: (1) exposures as part of screening programmes and (2) exposures associated with individual health assessment. On adoption, this directive will have significant implications for and a substantial impact on the work of the radiation protection authorities in Europe. In this position paper the WG 'Medical Applications' proposes a clear distinction between screening and radiological procedures as part of an individual health assessment and highlights special requirements for the latter. Finally, the impact on the work of radiation protection authorities in Europe is addressed
Full Text Available The purpose of this study was to identify the differences in the motives between senior and non-senior sport consumers who attend sport events and to compare the effect of spectator motivation on sport consumption behaviors between senior and non-senior consumers. Multiple regression analyses were conducted to examine the relationship between motivation factors and sport consumption variables for senior and non- senior spectator groups. The results showed that both senior and non-senior spectators were commonly motivated by the following specific motives of escape, social interaction, physical skill and drama for attending a MLB game.
Many school leaders seek new strategies from their colleagues and education literature on how to develop and sustain a positive school culture where students feel safe and are able to reach their greatest potential in academic achievement. Leadership books focus on strategies of building professional learning communities and developing capacity…
Denne undersøgelse har til formål at afdække holdninger, praksis, barrierer og muligheder i forhold til rekruttering og fastholdelse af seniorer. Undersøgelsen er baseret på 19 kvalitative interviews med henholdsvis tillidsrepræsentanter og personaleledere på 13 forskellige arbejdspladser. De...... udvalgte arbejdspladser repræsenterer såvel den offentlige som den private sektor samt større (mindst 50 ansatte) og mindre (under 50 ansatte) arbejdspladser. Vi har endvidere besøgt virksomheder, der henholdsvis har og ikke har seniorer ansat, for at indsamle information om holdninger og praksis fra flere...
other burgeoning global issues mandate the existence of capable senior civilian leaders who can effectively participate within the whole-of-government...experience that provides the opportunity to discuss and debate current global issues with the members of the world’s finest military. Civilians not only
Loorbach, N.R.; Karreman, Joyce; Steehouder, M.F.
Purpose: Research shows that confidence-increasing elements in user instructions positively influence senior users' task performance and motivation. We added verification steps and personal stories to user instructions for a cell phone, to find out how seniors (between 60 and 70 years) perceive
Hamluk, Brian Frederick
In comparison to other backgrounds of college and university presidents (e.g., chief academic officers, finance, institutional advancement, etc.) few presidents in American higher education achieve the presidency from a senior-level position within student affairs, and mentoring of senior student affairs officers may play a role in assisting them…
Jarnagin, Whitney L.; Woodside, Marianne
The concept of wellness provides a positive view of life development that can support psychological support and counseling. There is little in the literature about wellness and seniors, especially women. This study describes one senior woman's wellness across the life span by addressing two research questions: (a) What are the experiences of one…
Proulx, Jeff; Hunt, Jordan
Seniors take more drugs than younger Canadians because, on average, they have a higher number of chronic conditions. Although taking multiple medications may be necessary to manage these conditions, it is important to consider the benefits and risks of each medication and the therapeutic goals of the patient. This article provides an in-depth look at the number and types of drugs used by seniors using drug claims data from the CIHI's National Prescription Drug Utilization Information System Database, representing approximately 70% of seniors in Canada. In 2012, almost two-thirds (65.9%) of seniors on public drug programs had claims for five or more drug classes, while 27.2% had claims for 10 or more, and 8.6% had claims for 15 or more. The most commonly used drug class was statins, used by nearly half (46.6%) of seniors. Nearly two-thirds (60.9%) of seniors living in long-term care (LTC) facilities had claims for 10 or more drug classes. Proton pump inhibitors were the most commonly used drug class among seniors living in LTC facilities (used by 37.0% of seniors in LTC facilities), while statins ranked seventh (29.8%).
A social studies course for high school seniors combines a problems of democracy content with options emphasizing long-term accountability. Each student has a faculty adviser who encourages the student to pursue a specialized social studies topic. (Author/DB)
Sharpe, Charles C
This book facilitates and expands Internet access and usage by seniors, assists them in finding the information they want and need, and contributes to their knowledge of the aging process and the challenges it presents by providing a list of online resources of particular interest to them.
Taylor, Harry Owen; Wang, Yi; Morrow-Howell, Nancy
There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual's loneliness and mental health.
van den Berg, J. W.; Verberg, C. P. M.; Berkhout, J. J.; Lombarts, M. J. M. H.; Scherpbier, A. J. J. A.; Jaarsma, A. D. C.
Attention for the well-being of medical school faculty is not only important for the prevention of attrition and burnout, but may also boost performance in their tasks in medical education. Positive well-being can be conceptualized as work engagement and this is associated with increased
van den Berg, J W; Verberg, C P M; Berkhout, J J; Lombarts, M J M H; Scherpbier, A J J A; Jaarsma, A. D. C.
BACKGROUND: Attention for the well-being of medical school faculty is not only important for the prevention of attrition and burnout, but may also boost performance in their tasks in medical education. Positive well-being can be conceptualized as work engagement and this is associated with increased
POCK, JOHN C.
HIGH SCHOOL STUDENTS WERE MEASURED ON THE DEGREE TO WHICH THEY HOLD VIEWS WHICH FAVOR A CIVIL LIBERTARIAN POSITION, AND THE EXTENT TO WHICH THESE VIEWS APPEARED TO BE INFLUENCED BY THE SOCIAL ATTRIBUTES OF THE PEOPLE INVOLVED. FROM NINE SCHOOLS IN THE PORTLAND METROPOLITAN AREA, 3,066 SENIORS RESPONDED TO A SELF-ADMINISTERED QUESTIONNAIRE. THE…
... and Drugs" Home | Contact Us Special Concerns for Seniors Clostridium difficile - an introduction Clostridium difficile (“C. diff”) ... see APUA’s contribution to CDC’s Vital Signs campaign . Seniors are especially at risk People over the age ...
Titov Evgeny V.
Full Text Available The current state of environment demands from senior pupils to occupy a correct position in problem ecological situations. An effective means of forming senior pupils’ own position is activity in a field of ecology. Through a variety of activities in the field of ecology (learning, playing, research, environmental protection, and others. senior pupils are involved in situations requiring self-determination. Self-determined senior pupils overcome a conflict, a contradiction between an individual’’s position and a social role caused by a situation arising in activity.
Hansen, Søren Tranberg; Krogsager, Anders; Fredslund, Jakob
This paper describes the initial findings of a multimodal game which has been implemented on a humanoid robot platform and tested with seniors suffering from dementia. Physical and cognitive activities can improve the overall wellbeing of seniors, but it is often difficult to motivate seniors...... feedback and includes animated gestures and sounds. The game has been tested in a nursing home with four seniors suffering from moderate to severe dementia....
Rios-Gutierrez, Fernando; Alba-Flores, Rocio
This work describes the educational experiences gained teaching the Senior Design I & II courses, a senior level, two-semester sequence in the Electrical Engineering (EE) program at Georgia Southern University (GSU). In particular, the authors present their experiences in using robotics as the main area to develop the capstone senior design,…
Full Text Available In the Mauricie and Centre-du-Qu_bec region of the province of Quebec, Canada, an integrated services network has been implemented for frail seniors. It combines three of the best practices in the field of integrated services, namely: single-entry point, case management and personalised care plan. A shared interdisciplinary electronic health record (EHR system was set up in 1998. A consensus on the relevance of using EHRs is growing in Quebec, in Canada and around the world. However, technology has outpaced interest in the notions of confidentiality, informed consent and the impact perceived by the clientele. This study specifically examines how frail seniors perceive these issues related to an EHR. The conceptual framework is inspired by the DeLone and McLean model whose main attributes are: system quality, information quality, utilisation modes and the impact on organisations and individuals. This last attribute is the focus of this study, which is a descriptive with quantitative and qualitative component. Thirty seniors were surveyed. Positive information they provided falls under three headings: (i being better informed; (ii trust and consideration for professionals; and (iii appreciation of innovation. The opinions of the seniors are generally favourable regarding the use of computers and the EHR in their presence. Improvements in EHR systems for seniors can be encouraged.
Nazzi, Elena; Sokoler, Tomas
Novel technological possibilities emerge when tangible and social computing come together. This paper explores the potential of such technology when designing for seniors and their social interaction. Our research is guided by the concept of twitterIDo, which is to make seniors’ everyday activities...... and displays designed to start a dialogue with the seniors on how twitterIDo-technology may fit into their everyday situations. Our findings point out how augmented everyday artefacts can make a positive difference when designing technology in a domain such the one of seniors’ and their social interaction...... more visible by augmenting everyday artefacts to communicate the ongoing activity they are used for. We engaged a local community of seniors in a living lab to explore the possibilities of twitterIDo in real life situations. This paper presents a series of interactive prototypes of everyday artefacts...
Longest, B B
The advent of integrated delivery systems (IDSs) in the healthcare industry has changed much about the work involved in running many healthcare organizations. As a result of these changes, senior healthcare managers in IDSs need different skills and knowledge (competencies) than managers of other healthcare systems. The work of managers is changed by the shift to more organizational integration in the healthcare industry because they become responsible for coordinated continuation of services, accountable for the overall health status of the populations they serve, and involved in more complex organizational structures. The article identifies six distinct managerial competencies--conceptual, technical managerial/clinical, interpersonal/collaborative, political, commercial, and governance--and describes how they relate to an IDS senior manager's successful work performance. The implications of these competencies are considered for practicing senior managers in IDSs, as well as those who aspire to such positions, and those who help educate them.
Gratwick, Steve; Jihanian, Lila J; Holloway, Ian W; Sanchez, Marisol; Sullivan, Kathleen
The Los Angeles Gay & Lesbian Center began providing services to LGBT seniors in 2008. Since then, the Center's seniors program has grown to over 3,300 clients. It provides a variety of enrichment and support services with the overarching goal of empowering seniors to successfully age in place. This article outlines the service delivery program of the Center's Seniors Services Department and describes its successes and challenges in meeting the needs of diverse LGBT seniors. It offers future directions for social work practice, policy, and research with LGBT older adults.
Miller, Christopher W T; Himelhoch, Seth
Mobile phone technology is increasingly used to overcome traditional barriers limiting access to care. The goal of this study was to evaluate access and willingness to use smart and mobile phone technology for promoting adherence among people attending an urban HIV clinic. One hundred consecutive HIV-positive patients attending an urban HIV outpatient clinic were surveyed. The questionnaire evaluated access to and utilization of mobile phones and willingness to use them to enhance adherence to HIV medication. The survey also included the CASE adherence index as a measure of adherence. The average age was 46.4 (SD = 9.2). The majority of participants were males (63%), black (93%), and Hispanic (11.4%) and reported earning less than $10,000 per year (67.3%). Most identified themselves as being current smokers (57%). The vast majority reported currently taking HAART (83.5%). Approximately half of the participants reported some difficulty with adherence (CASE mobile phone. Among owners of mobile phones 47.4% reported currently owning more than one device. Over a quarter reported owning a smartphone. About 60% used their phones for texting and 1/3 used their phone to search the Internet. Nearly 70% reported that they would use a mobile device to help with HIV adherence. Those who reported being very likely or likely to use a mobile device to improve adherence were significantly more likely to use their phone daily (P = 0.03) and use their phone for text messages (P = 0.002). The vast majority of patients in an urban HIV clinic own mobile phones and would use them to enhance adherence interventions to HIV medication.
Golightly, Melissa; Kennett, Natalie; Stout, Jacqueline A
Traditional senior practicum experiences (SPEs) are microsystem based-they allow senior nursing students the opportunity to build professional nursing competencies as they transition into practice. As health care transformation continues unabated, there is a need to work toward closing the gap between nursing academia and nursing practice. A cardiovascular service line created an innovative SPE to better prepare senior nursing students for working as professional nurses in a service line model. The Senior Practicum Immersion Experience (SPIE) proved to be beneficial to senior practicum students and offered firsthand experience of the role professional nurses play in a service line model. This model increased the number of senior practicum students accepted into the cardiac service line by 50%. The SPIE creates an innovative solution to increasing the number of senior practicum students while allowing students the ability to learn and practice in a service line model. [J Nurs Educ. 2017;56(12):745-747.]. Copyright 2017, SLACK Incorporated.
Muhammad Arifin Tanjung
Full Text Available State Senior Islamic School 2 Model Medan oh of famous Islamic schools in North Sumatera. The issues in this writing are what are the formulation, organization, application, and evaluation of headmaster Policy of Senior Islamic School to Increase Teacher Professionalism at State Senior Islamic School 2 Model Medan. To explain the main issue in this writings, I have to observe and interview the Moslem population. Data has been collected will be explained detailly and analyzed by Islamic education management. Based on research, formulation of headmaster Policy of Senior Islamic School to Increase Teacher Professionalism at State Senior Islamic School 2 Model Medan is bottom up which ideas from teachers, beginning from teachers meeting in one subject, teachers meeting in one program, annual meeting in a month and annual meeting in a year, and finally in teamwork, for example, anual teachers meeting, seminar, workshop, coffee morning, study comparison to university and another school. It will motivate teacher in teaching, activity, and anything. Besides it, headmaster facilitates everything whatever teacher need it, for example, infocus, laptop, and everything. And the organization of headmaster Policy of Senior Islamic School to Increase Teacher Professionalism at State Senior Islamic School 2 Model Medan is cooperation with the school community and he helped by vices and head program and teachers and chairman of the student. The special of school organization is evaluation of teachers activity and relation to abroad. Headmaster states his position as a teacher who teaches students, a leader who leads teachers, a manager who manages, a motivator who motivate, a supervisor who supervise teachers activity, and facilitator for teachers. And finally evaluation of headmaster Policy of Senior Islamic School to Increase the Teacher Professionalism at State Senior Islamic School 2 Model Medan each level, beginning from teachers meeting in one subject
Khosravi, Pouria; Ghapanchi, Amir Hossein
Recently, a number of Information and Communication Technologies have emerged with the aim to provide innovative and efficient ways to help seniors in their daily life and to reduce the cost of healthcare. Studies have been conducted to introduce an assistive technology to support seniors and to investigate the acceptance of these assistive technologies; however, research illustrating the effectiveness of assistive technologies is scant. This study undertakes a systematic literature review of ScienceDirect, PubMed, ProQuest and IEEE Explore databases to investigate current empirical studies on the assistive technologies applied in aged care. Our systematic review of an initial set of 2035 studies published from 2000 to 2014 examines the role of assistive technologies in seniors' daily lives, from enhancements in their mobility to improvements in the social connectedness and decreases in readmission to hospitals. This study found eight key issues in aged care that have been targeted by researchers from different disciplines (e.g., ICT, health and social science), namely, dependent living, fall risk, chronic disease, dementia, social isolation, depression, poor well-being, and poor medication management. This paper also identified the assistive technologies that have been proposed to overcome those problems, and we categorised these assistive technologies into six clusters, namely, general ICT, robotics, telemedicine, sensor technology, medication management applications, and video games. In addition, we analyzed the effectiveness of the identified technologies and noted that some technologies can change and enhance seniors' daily lives and relieve their problems. Our analysis showed a significant growth in the number of publications in this area in the past few years. It also showed that most of the studies in this area have been conducted in North America. Assistive technologies are a reality and can be applied to improve quality of life, especially among older age
Van Isacker, P.; Heinze, S.
We point out the possibility of the partial conservation of the seniority quantum number when most eigenstates are mixed in seniority but some remain pure. This situation occurs in nuclei for the g 9/2 and h 9/2 shells where it is at the origin of the existence of seniority isomers in the ruthenium and palladium isotopes. It also occurs for f bosons
The focus of the presented diploma thesis is to evaluate the knowledge of seniors in the field of healthy nutrition. It is furthermore important to find out, whether the seniors have enough relevant information about rational nutrition and which sources they would like to use to gather information about healthy nutrition. Socio-economic aspects, which lead to senior nutrition, are also monitored. A quantitative research strategy and an in-depth interview were used to fulfil the aim of the the...
expectation other than rudimentary dialogues on career paths. Some senior leaders are superb mentors , but this appears to be a result of the personality... mentoring discussions, as well as resources and senior -level attention to these expectations, could complement individual development plans and structured...including senior leaders. This extends to the reserve components (RC) and their “critical bridge to the civilian population, infusing the Joint
Liang, Mei; Curtin, Laurie S; Signer, Mona M; Savoia, Maria C
The application and interview behaviors of unmatched U.S. allopathic medical school senior students (U.S. seniors) participating in the 2015 National Resident Matching Program (NRMP) Main Residency Match were studied in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and ranking preferences to understand their effects on Match outcome. USMLE Step 1 score and preferred specialty information were reviewed for U.S. seniors who responded to the 2015 NRMP Applicant Survey. Unmatched U.S. seniors were categorized as "strong," "solid," "marginal," or "weak" based on the perceived competitiveness of their Step 1 scores compared with U.S. seniors who matched in the same preferred specialty. The numbers of applications sent, interviews obtained, and programs ranked also were examined by Match outcome. Strong unmatched U.S. seniors submitted significantly more applications to achieve and attend approximately the same number of interviews as strong matched U.S. seniors. Strong unmatched seniors ranked fewer programs than their matched counterparts. As a group, unmatched U.S. seniors were less likely than their matched counterparts to rank a mix of competitive and less competitive programs and more likely to rank programs based on their perceived likelihood of matching. A small number of unmatched U.S. seniors would have matched if they had ranked programs that ranked them. U.S. seniors' Match outcomes may be affected by applicant characteristics that negatively influence their selection for interviews, and their difficulties may be exacerbated by disadvantageous ranking behaviors.
Full Text Available Digital divide owing to age has become a major concern around the world, even in developed country, Japan. To combat the digital divide, a project named “e-namokun” aiming to help senior citizens use the Internet was started in Nagoya, Japan, which was a national first joint project run through government, universities, and NPO cooperation. In the project, nearly 2000 senior citizens have taken course of the software we developed. In relation with this project, we have been developing useful tools to support senior IT beginners. In the paper, we introduce the outline of the project and explain developed tools for senior citizens.
Hellberg, Ingela; Augustsson, Veronica; Hellström Muhli, Ulla
This article presents a hermeneutic phenomenological analysis of interview material in which 12 seniors living in Special Housing Accommodation (SHA) facilities reflect on the experience of living in such facilities. Of particular interest in the analysis is living in a SHA as a phenomenon. The finding shows that the phenomenon of lived experience in a SHA seems to be a state of ambiguity regarding one's existence, which is made up of several constituents (elements of meaning). The analysis contributes to the understanding of how the phenomenon of SHA living is coming into existence as a need, due to an individual's failing health; however, the SHA is not considered to be a true home. Accordingly, this has consequences to the subject position for the seniors in that they have to navigate between existing and not existing. The seniors learn to cope with living in the SHA by lowering their expectations of life and existence while the SHA provides the prerequisites for their existence. An implication for promoting care is to support the seniors to enable a full existence of life within SHA living. PMID:21412446
Grewe, Lynne; Magaña-Zook, Steven
Senior Collapse Detection (SCD) is a system that uses cyber-physical techniques to create a "smart home" system to predict and detect the falling of senior/geriatric participants in home environments. This software application addresses the needs of millions of senior citizens who live at home by themselves and can find themselves in situations where they have fallen and need assistance. We discuss how SCD uses imagery, depth and audio to fuse and interact in a system that does not require the senior to wear any devices allowing them to be more autonomous. The Microsoft Kinect Sensor is used to collect imagery, depth and audio. We will begin by discussing the physical attributes of the "collapse detection problem". Next, we will discuss the task of feature extraction resulting in skeleton and joint tracking. Improvements in error detection of joint tracking will be highlighted. Next, we discuss the main module of "fall detection" using our mid-level skeleton features. Attributes including acceleration, position and room environment factor into the SCD fall detection decision. Finally, how a detected fall and the resultant emergency response are handled will be presented. Results in a home environment will be given.
Full Text Available The purpose of this study was to know the relationship between the variables (social support, autonomy, mental health, and physical recreational activity included in the subjective perspective of the quality of life of Costa Rican senior citizens related to gender. Another objective was to know the main reason for the subjects to practice physical activity and the benefits perceived by them, according to their gender. A total of 152 subjects (92 women and 60 men ranging between 60 and 75 years of age from 21 senior centers participated in this study. Two instruments were applied to the subjects: a questionnaire on quality of life (INISA, 1994 and a survey on physical recreational activity. Results showed a significant relationship between the variables autonomy and social support, autonomy and mental health, autonomy and frequency of activity, and autonomy and duration. Regarding gender, geriatric depression was more frequent in women (F=5.86. Health was the main motivation to do physical activity and the major benefits for both genders were feeling more revitalized, happier, energized, and pain relief. In conclusion, quality of life (social support, autonomy, mental health as perceived by senior citizens shows no differences as far as gender or reasons to exercise or benefits received, except for depression, which is more frequent in women. It is proven that the more times and the longer physical recreational activities are practiced by senior citizens per week the more positive results are received.
Gregersen, U B
During the last 18 years, senior citizens in Viborg, Denmark, have participated in study circles based on the theory of impression pedagogy and socially relevant activities. They arrange excursions at home and abroad and make films about the trips. They teach schoolchildren, students at folk high schools, and nurses, as well as occupational therapists and physiotherapists. They publish poems and books, write role plays, stage musicals, sing in choirs, and function as tour guides in town. They set up educational color slide programmes on preventing bone fractures, dealing with the problem of reduced hearing, and the importance of healthy food and exercise. They travel abroad and talk about Denmark and the conditions for senior citizens in our country. With the support of the Danish Ministry for Social Affairs, they produce videos about their activities as a source of inspiration to others. The use of drugs by the participants in the study circles has declined, while the level of activities has increased, and none of the participants has ever had to enter residential care.
Beijers, Lian; Jeronimus, Bertus F; Turner, Erick H; de Jonge, Peter; Roest, Annelieke M
Objectives: This study aimed to determine the presence of spin in papers on positive randomised clinical trials (RCTs) of antidepressant medication for anxiety disorders by comparing concerns expressed in the Food and Drug Administration (FDA) reviews with those expressed in the published paper.
Background: Previous research addressing physical activity among senior citizens tend to focus on the actual benefits of being active hence approaching the topic from a physiological and medical perspective. Addressing a gap in interdisciplinary research combining the physiological with the built...... will be focusing on intervention design in everyday life activities, social community and local urban spaces. Aims: The research seeks to investigate and explore issues linked to health promotion; e.g. how architecture and design can influence and enhance new body cultures and public health among senior citizens...... – both mentally, socially and physically. Theoretical approach: Hypothesizing that in order to address these issues and sustain the solutions local stakeholders and end-users must be engaged in all phases of the process – from identifying and defining the problem, through developing the design...
... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Senior Executive Service Performance... announces the appointment of the members of the Senior Executive Service Performance Review Boards for the... appropriate personnel actions for incumbents of Senior Executive Service, Senior Level and Senior Professional...
... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Senior Executive Service Performance... notice announces the appointment of the members of the Senior Executive Service Performance Review Boards... other appropriate personnel actions for incumbents of Senior Executive Service, Senior Level and Senior...
Women are underrepresented in senior-level leadership positions in higher education institutions, and their experiences are underrepresented in research about leadership and power in higher education. This qualitative study engaged women senior administrators at liberal arts colleges in the Upper Midwestern United States to better understand how…
Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn
This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
The double charge exchange transition matrix elements from an even-even target to the double isobaric analog state and the ground state are derived in the generalized seniority model as a function of the number of valence nucleons. Crucial differences with the seniority model are found and their consequences are discussed. (orig.)
... AmeriCorps State/National, Senior Companions, Foster Grandparents, and Retired and Senior Volunteer...) on Senior Companions, Foster Grandparents, Retired Senior Volunteer Program grant-funded staff, Learn... X ....... X X ....... Senior Companions Yes X ....... ....... X X ....... X X ....... X X X No...
McPhaul, Jr, John H
Army transformation efforts are focusing on developing an Army capable of responding to a wide range of contingency operations given the unpredictable and complex security environment demands of the world...
... Service. Officer. Administrator, Operations and Management. Director, Human Resources. Deputy... Resources Management. Director for Human Resources Management. Director for Director for Financial Financial.... Defense Human Chief Actuary. Resources Activity. Director, Civilian Personnel Management Service. Deputy...
Hamal Mishra, Binisha
Smart home can be of significant importance for positive ageing allowing elderly to maintain independence, functionality, well-being and higher quality of life. Aim: The aim of this thesis is to study attitude of senior citizens towards smart home technologies. Understanding senior citizen's attitude towards current smart home technol-ogies is an important aspect in optimization of the existing technologies as well as in the design of new technologies. The review will aim to find the answe...
Satiani, Bhagwan; Vaccaro, Patrick S; Go, Michael R
To determine diversity in the membership and analyze representation of private practitioners and ethnic and racial minorities/women in senior leadership roles in a regional vascular society. The program book distributed at the 2008 annual meeting was used to compile information on membership categories, academic status, gender, and ethnic origin of members. Excluded from further analysis were all but active and senior members (n = 386). Officers for President and current President-Elect (P, n = 31), Secretary (S, n = 10), Treasurer (T, n = 11), and Councilor (C, n = 33) over a 30-year period were scrutinized for similar information. Members were considered to be "academic" if they worked full time at an academic medical center or as faculty at a teaching hospital with a vascular fellowship and national recognition. Private practice (PP) or academic practice (AP) was determined by personal knowledge, mailing address, e-mail address, and search engines. Ethnic and racial origin was determined by name, personal knowledge, or a web search. Of the 386 active and senior members in the society, 86% were white, 13.7% were of various ethnic/racial groups, and 5.7% were women. Sixty-eight percent of members were in PP. Female members were more likely to be in AP compared with male members (68.1% vs 29.6%, P academics (WMAs) (23.7% of membership) occupied 86% of all senior leadership and 57% of C positions compared with 13% and 42%, respectively, for the rest of the membership (P academics are under represented in senior leadership positions. With changing demographics, a predicted shortage of vascular surgeons, the need for role models in leadership positions and a push to culturally competent care, regional and national societies must change course and promote a more diverse membership and representative senior leadership. Published by Mosby, Inc.
... OFFICE OF PERSONNEL MANAGEMENT Senior Executive Service Performance Review Board AGENCY: Office of... of a senior executive's performance by the supervisor, and considers recommendations to the appointing authority regarding the performance of the senior executive. Office of Personnel Management. John...
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
... NATIONAL CAPITAL PLANNING COMMISSION Senior Executive Service; Performance Review Board; Members AGENCY: National Capital Planning Commission. ACTION: Notice of Members of Senior Executive Service... Senior Executive Service. The PRB established for the National Capital Planning Commission also makes...
... DEPARTMENT OF TRANSPORTATION Surface Transportation Board Senior Executive Service Performance... Transportation Board (STB) publishes the names of the Persons selected to serve on its Senior Executive Service... performance appraisal system making senior executives accountable for organizational and individual goal...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Senior Executive Service Performance Review Board AGENCY... the Defense Nuclear Facilities Safety Board (DNFSB) Senior Executive Service (SES) Performance Review.... The PRB shall review and evaluate the initial summary rating of the senior executive's performance...
... AGENCY FOR INTERNATIONAL DEVELOPMENT Senior Executive Service Performance Review Board: Update... Development, Office of Inspector General's Senior Executive Service Performance Review Board. DATES: September... reference-- USAID OIG Senior Executive Service (SES) Performance Review Board). SUPPLEMENTARY INFORMATION: 5...
... DEFENSE NUCLEAR FACILITIES SAFETY BOARD Senior Executive Service Performance Review Board... the membership of the Defense Nuclear Facilities Safety Board (DNFSB) Senior Executive Service (SES... rating of a senior executive's performance, the executive's response, and the higher level official's...
Role ambiguity is a lack of clarity or uncertainty related to one's position or role. Role ambiguity has been documented in the literature in relationship to athletics, industry, business, education, and nursing. However, a concept analysis has not been performed. Therefore, the process of concept analysis outlined by Walker and Avant is now used to look at the concept of role ambiguity and its relevance to senior nursing students' socialization and education into the profession of nursing. Attributes, antecedents, consequences, and empiric referents are discussed and theories commonly associated with role ambiguity are presented. At the end of the analysis, an operational definition is provided for use in exploring the concept of role ambiguity as it relates to senior nursing students' articulation of the role of the professional nurse. © 2017 Wiley Periodicals, Inc.
Senior centers in the United States play a vital role in the aging continuum of care as the focal points of a community-based system of services targeting independent older adults to promote their social integration and civically engagement. Although several studies have evaluated the diversity of senior center programs, demographic characteristics of participants, and benefits of participation, very few have explored motivations to volunteer among participants. Many senior centers rely on a cadre of participants who volunteer there to assist with programs and meal services. However, a systematic examination of volunteering interests and the rationale for volunteering among senior center participants has been missing from the literature. This mixed-methods study, conducted at a large suburban senior center, explores the interests and motivations of volunteerism among the participants. The study found that there was limited interest in volunteering among senior center participants. Those who were motivated to volunteer wanted to do so in order to stay connected with their community. There was strong interest in volunteering for single events or projects rather than a long-term commitment. Implications for senior centers are discussed.
Mangione, Salvatore; Chakraborti, Chayan; Staltari, Giuseppe; Harrison, Rebecca; Tunkel, Allan R; Liou, Kevin T; Cerceo, Elizabeth; Voeller, Megan; Bedwell, Wendy L; Fletcher, Keaton; Kahn, Marc J
Literature, music, theater, and visual arts play an uncertain and limited role in medical education. One of the arguments often advanced in favor of teaching the humanities refers to their capacity to foster traits that not only improve practice, but might also reduce physician burnout-an increasing scourge in today's medicine. Yet, research remains limited. To test the hypothesis that medical students with higher exposure to the humanities would report higher levels of positive physician qualities (e.g., wisdom, empathy, self-efficacy, emotional appraisal, spatial skills), while reporting lower levels of negative qualities that are detrimental to physician well-being (e.g., intolerance of ambiguity, physical fatigue, emotional exhaustion, and cognitive weariness). An online survey. All students enrolled at five U.S. medical schools during the 2014-2015 academic year were invited by email to take part in our online survey. Students reported their exposure to the humanities (e.g., music, literature, theater, visual arts) and completed rating scales measuring selected personal qualities. In all, 739/3107 medical students completed the survey (23.8%). Regression analyses revealed that exposure to the humanities was significantly correlated with positive personal qualities, including empathy (p humanities and both a higher level of students' positive qualities and a lower level of adverse traits. These findings may carry implications for medical school recruitment and curriculum design. "[Science and humanities are] twin berries on one stem, grievous damage has been done to both in regarding [them]... in any other light than complemental." (William Osler, Br Med J. 1919;2:1-7).
Inge van Dijk
Full Text Available Abstract Background Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called ‘positive mental health’. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores possible predictors in a Dutch sample of clinical clerkship students. Methods Fourth-year medical students in their first year of clinical clerkships were invited to complete an online questionnaire assessing demographics, psychological distress (Brief Symptom Inventory, positive mental health (Mental Health Continuum- SF, dysfunctional cognitions (Irrational Beliefs Inventory and dispositional mindfulness skills (Five Facet Mindfulness Questionnaire. Multiple linear regression analysis was used to explore relationships between psychological distress, positive mental health (dependent variables and demographics, dysfunctional cognitions and dispositional mindfulness skills (predictors. Results Of 454 eligible students, 406 (89% completed the assessment of whom 21% scored in the clinical range of psychological distress and 41% reported a flourishing mental health. These proportions partially overlap each other. Female students reported a significantly higher mean level of psychological distress than males. In the regression analysis the strongest predictors of psychological distress were ‘acting with awareness’ (negative and ‘worrying’ (positive. Strongest predictors of positive mental health were ‘problem avoidance’ (negative and ‘emotional irresponsibility’ (negative. Conclusions The prevalence of psychopathology in our sample of Dutch clinical clerkship students is slightly higher than in the general population. Our results support
van Dijk, Inge; Lucassen, Peter L B J; van Weel, Chris; Speckens, Anne E M
Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called 'positive mental health'. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores possible predictors in a Dutch sample of clinical clerkship students. Fourth-year medical students in their first year of clinical clerkships were invited to complete an online questionnaire assessing demographics, psychological distress (Brief Symptom Inventory), positive mental health (Mental Health Continuum- SF), dysfunctional cognitions (Irrational Beliefs Inventory) and dispositional mindfulness skills (Five Facet Mindfulness Questionnaire). Multiple linear regression analysis was used to explore relationships between psychological distress, positive mental health (dependent variables) and demographics, dysfunctional cognitions and dispositional mindfulness skills (predictors). Of 454 eligible students, 406 (89%) completed the assessment of whom 21% scored in the clinical range of psychological distress and 41% reported a flourishing mental health. These proportions partially overlap each other. Female students reported a significantly higher mean level of psychological distress than males. In the regression analysis the strongest predictors of psychological distress were 'acting with awareness' (negative) and 'worrying' (positive). Strongest predictors of positive mental health were 'problem avoidance' (negative) and 'emotional irresponsibility' (negative). The prevalence of psychopathology in our sample of Dutch clinical clerkship students is slightly higher than in the general population. Our results support conclusions of previous research that psychological distress and positive mental
Sherin Susan Paul
Full Text Available Aim: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model “senior citizens' recreation centers” that can be replicated in the other parts of the country. Materials and Methods: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED and quality of life at the beginning of enrolment using body mass index (BMI and WHO-BREF scale. Results: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05. There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05. Conclusion: Care of underprivileged senior citizens is a growing need in the rural areas and the “Recreation centers” proved to be a beneficial model that can be easily replicated.
Van Isacker, P.
The use of the seniority quantum number in many-body systems is reviewed. A brief summary is given of its introduction by Racah in the context of atomic spectroscopy. Several extensions of Racah's original idea are discussed: seniority for identical nucleons in a single-j shell, its extension to the case of many, non-degenerate j shells and to systems with neutrons and protons. To illustrate its usefulness to this day, a recent application of seniority is presented in Bose-Einstein condensates of atoms with spin.
Clear, easy-to-understand instructions for seniors who want to get the most out of Microsoft Office 2010. Seniors are buying computers—both desktops and laptops—in record numbers to stay in touch with family and friends, connect with peers, research areas of interest, make purchases online, or learn a new skill. Assuming no prior knowledge of Microsoft Office, this book is aimed at seniors who are interested in maximizing the capabilities of Microsoft Word, Excel, PowerPoint, and Outlook. Written in large typeface and featuring enlarged figures and drawings to make the book easier to read, thi
Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L
Purpose and scope The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it...
Shirai, Masato; Tsujimura, Akira; Hisasue, Shin-Ichi; Abdelhamed, Amr; Horie, Shiego
Objective The purpose of the present study was to investigate the current state of sexuality education in Japanese medical schools and the association of the position title of Japanese Society for Sexual Medicine (JSSM). Methods We surveyed the four factors, the number of lecture components, the time of curriculum hours, the degree of sufficiency level of the components, and the degree of sufficiency level of the curriculum hours in medical schools in Japan. Also, we have investigated the four factors difference among three groups, Directors, Council, and Non-member of JSSM. Results Of the 80 medical schools, the faculties of the Urological department of 69 medical schools (86%) responded. The mean number of lecture components was 7.8. The number of lecture components of Directors (10.2) had significantly higher than Council (4.7) and Non-member (7.3). There is no significant difference the number of lecture components between Council and Non-member. The mean curriculum hour was 113 minutes. The curriculum hour of Directors (152.6) was significantly longer than Non-member (95.9). There is no significant difference the curriculum hour between Council (106.7) and Non-member. The satisfactory degree of the components was very satisfied (1.5%), satisfied (26.5%), not satisfied (55.9%), and dissatisfied (16.5%) for the faculties. The satisfactory degree of the curriculum hours was very long (0%), long (0%), moderate (50%), short (45.6%), and very short (4.4%) for the faculties. There is no significant difference the satisfactory degree of the components and the curriculum hours among three groups. Conclusions The Directors of JSSM have a positive attitude for sexuality education in Japanese medical schools. While curriculum hour is insufficient for the faculties in half of medical schools, over 70% medical schools answered that the lecture components are insufficient, too. Now we should make every effort to achieve sufficient components for sexuality education. We need
Stilma, J S
Every year people sustain serious injuries when they let off fireworks on New Year's Eve. Public education and protective eye wear do not solve this problem. Experience from other countries shows that the number of injuries decreases dramatically when fireworks are handled only by experienced specialists. Medical scientific associations are invited to promote a ban on ordinary citizens letting off fireworks and for fireworks to be reserved for firework specialists only.
Luzny, Jan; Jurickova, Lubica
Elder abuse and neglect (EAN) comprises emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. Elder abuse and neglect in seniors with psychiatric morbidity was not monitored in the Czech Republic at all, despite the literature shows mental morbidity as one of the important risk factor for developing elder abuse and neglect. We designed comparative cross sectional study comprising 305 seniors hospitalized in Mental Hospital Kromeriz in June 2011 - group of 202 seniors hospitalized due to mental disorder in psychogeriatric ward and group of 103 seniors hospitalized due to somatic disorder in internal ward. Content analysis of medical records was done in both groups of seniors, with regards to symptoms of elder abuse. Then, we discussed the topic of elder abuse with 30 nurses of psychogeriatric ward in focus group interview. Between two compared groups of seniors we detected statistically higher prevalence of elder abuse in seniors with psychiatric morbidity (48 cases, 23.8% prevalence of EAN), compared to somatically ill seniors (3 cases, 2.9%). As for nursing staff, 5 from 30 nurses (16.7%) have never heard about symptoms of elder abuse and neglect, 10 from 30 nurses (33.3%) had just a partial knowledge about elder abuse and neglect and its symptoms, the rest of nurses (15 from 30 nurses, 50.0%) had good knowledge about elder abuse and neglect and its symptoms. Elder abuse and neglect seems to be a relevant problem in senior population with mental disorders. Development of educational programs for nursing and medical staff about Elder abuse and neglect (symptoms of EAN, early detection of EAN, knowledge how to report cases of EAN) could improve the situation and help mentally ill seniors to better quality of life.
Santana, Maria da Silva; Chaves Maia, Eulália M
This work analysed senior citizens' perception of needs and social values involved in taking physical activity for their own benefit. This study's main aim was to investigate social representations of 3rd age physical activity. This was a cross-sectional, interdisciplinary qualitative study, underpinned by theoretical-methodological social representation theory. A convenience, non-probabilistic, census-dependent method was used for obtaining the sam-ple of 62 people aged 50 to 78 from north-eastern Brazil. The data were collected by using the free word association technique and analysed by EVOC/2000 software. Analysing the replies led to three types of elements being identified which were related to the social representation of physical activity as attributed by the elderly: a psychological dimension (represented by happiness, well-being), a social dimension (dancing) and a biophysical dimension (gymnastics, water-gymnastics and health). The term 'happiness' stood out most in the word recall tests. When relating old age to the sample's social representation of physical activity, the study showed that physical activity assumed a preponderant role in the life of the elderly through cyclical appreciation-depreciation, social representation simultaneously and gradually acquiring 'life having more health and quality' from social representation. The subjects reported a positive association between physical activity, social interaction and well-being. The elderly also believed in physical activity's effects on physical-motor aspects and health. The social representation of physical activity by the group being studied was close to the physical activity's biopsychosocial dimension.
There are different types of information on men's health in older age. High morbidity burden is offset by subjective assessments of "very good" and "good" health by 52% of men over 65 years. The aim of this study is to assess the health situation of seniors from official publications and public health reports. How can the quality of life in our male population be positively influenced so that they can actively participate in society in old age. Information on the health of seniors and burden of disease were taken from men's health reports and official publications from the Robert-Koch-Institute, the Federal Statistical Office, and the IHME Institute of the USA according to age groups and gender. Burden of disease in seniors is influenced by one's own health behavior and the social situation. The increase in life expectancy of seniors is characterized by longer life with chronic conditions. Official statistics indicate that about 50% of seniors are affected by disease or severe disability, while 50% assess their health status as "very good" or "good". Aging of the population requires diverse health promotion activities. Parallel with the inevitable increased multimorbidity in the elderly, maintaining and increase of physical fitness is required so that seniors have a positive "subjective health" or "wellbeing".
Sen Gupta, T; Woolley, T; Murray, R; Hays, R; McCloskey, T
The regionally-based James Cook University (JCU) School of Medicine aims to meet its mission to address the health needs of the region by combining selection and curriculum strategies shown to increase rural career recruitment outcomes. The School has graduated 536 students in its first seven cohorts from 2005 to 2011. This paper presents the early career practice locations and the specialty training undertaken by these cohorts, and describes the association between later practice location with both hometown at application and internship location. Hometown at application' data for JCU Bachelor of Medicine, Bachelor of Surgery (MBBS) graduates was retrieved from administrative databases held by the university, while postgraduate location and career data were obtained either from personal contact via email, telephone, Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (RA) categories. Data for the primary practice location of 536 JCU MBBS graduates across postgraduate years (PGY) 1 to 7 is 99% complete. A total of 65% of JCU graduates undertook their internship in non-metropolitan locations including 20% in RA 2 and 44% in RA 3-5, a pattern of practice different to that of other Australian clinicians. For the internship year, 'non-metropolitan-origin' JCU MBBS graduates predominantly worked in RA 2-5 locations, while 'metropolitan origin' graduates were more likely to work in major cities. However, by PGY 7, the distribution of 'rural' and 'metropolitan' origin JCU graduates across RA categories was similar. The RA category of internship location - either 'metropolitan (RA 1) or 'non-metropolitan' (RA 2-5) - was associated with the location of subsequent practice across PGY 2-7. This comprehensive data set provides the first real evidence from one of Australia's new medical schools on actual postgraduate practice
Briggs, Morgan; Morzinski, Jeffrey A; Ellis, Julie
Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency. The 100 Healthy, At-Risk Families study team implemented 8 monthly educational health sessions promoting self-care and social support. Community nurses led the 60- to 90-minute sessions at each of 10 churches. To collect study data, nurses interviewed enrolled seniors pre- and post-intervention. Descriptive and comparison statistics were analyzed in Excel and Statistical Package for Social Sciences. Senior data at baseline found high rates of polypharmacy and physical imbalance, and no significant depression or gaps in social support. There was not a statistically significant change pre- to post-program in fall frequency "in prior year." Study findings reveal insights about African American senior health and fall risks. Church settings may provide a protective, psychosocial buffer for seniors, while polypharmacy and mobility/balance concerns indicate need for continued attention to fall risks. No increase in pre- to post-program falls was encouraging.
Gomez, J.M.G.; Prieto, C.
A new self-consistent method is used to take into account the mean-field and the pairing correlations in nuclei at the same time. We call it the Hartree-Fock seniority approximation, because the long-range and short-range correlations are treated in the frameworks of Hartree-Fock theory and the seniority scheme. The method is developed in detail for a minimum-seniority variational wave function in the coordinate representation for an effective interaction of the Skyrme type. An advantage of the present approach over the Hartree-Fock-Bogoliubov theory is the exact conservation of angular momentum and particle number. Furthermore, the computational effort required in the Hartree-Fock seniority approximation is similar to that ofthe pure Hartree-Fock picture. Some numerical calculations for Ca isotopes are presented. (orig.)
The Senior Strategic Outreach and Engagement Officer provides strategic advice ... the third one in the area of knowledge management and the forth one in the area ... or the International Research Initiative on Adaptation to Climate Change.
... Subscribe July 2014 Print this issue Health Capsule Physical Activity Helps Seniors Stay Mobile En español Send us your comments A carefully structured, moderate physical activity program helped vulnerable older people maintain their mobility. ...
Tamura, T.; Li, C.; Pedrocchi, V.G.
A boson expansion formalism in the seniority scheme is presented and its relation with number-conserving quasiparticle calculations is elucidated. Accuracy and convergence are demonstrated numerically. A comparative discussion with other related approaches is given
Michelsen la Cour, Annette
Abstract Seniorer i bevægelse Projekt Seniorer i Bevægelse var et fireårigt projekt i Københavns Kommune målrettet ældre +60, der bevægede sig mindre end anbefalet af Sundhedsstyrelsen. I perioden 2010-2014 deltog 583 borgere i fysisk træning organiseret omkring sociale netværker, heraf ca. 25...
Michelsen la Cour, Annette
Abstract Seniorer i bevægelse Projekt Seniorer i Bevægelse var et fireårigt projekt i Københavns Kommune målrettet ældre +60, der bevægede sig mindre end anbefalet af Sundhedsstyrelsen. I perioden 2010-2014 deltog 583 borgere i fysisk træning organiseret omkring sociale netværker, heraf ca. 25...
Tanaka, Martin L; Fischer, Kenneth J
The design of products and processes is an important area in engineering. Students in engineering schools learn fundamental principles in their courses but often lack an opportunity to apply these methods to real-world problems until their senior year. This article describes important elements that should be incorporated into a senior capstone design course. It includes a description of the general principles used in engineering design and a discussion of why students often have difficulty with application and revert to trial and error methods. The structure of a properly designed capstone course is dissected and its individual components are evaluated. Major components include assessing resources, identifying projects, establishing teams, understanding requirements, developing conceptual designs, creating detailed designs, building prototypes, testing performance, and final presentations. In addition to the course design, team management and effective mentoring are critical to success. This article includes suggested guidelines and tips for effective design team leadership, attention to detail, investment of time, and managing project scope. Furthermore, the importance of understanding business culture, displaying professionalism, and considerations of different types of senior projects is discussed. Through a well-designed course and proper mentoring, students will learn to apply their engineering skills and gain basic business knowledge that will prepare them for entry-level positions in industry.
Ádám, Szilvia; Nistor, Anikó; Nistor, Katalin; Hazag, Anikó
Effective management and prevention of widespread burnout among medical students in Hungary require thorough understanding of its relations to coping strategies, which lacks sufficient data. To explore the prevalence of burnout and its relations to coping strategies among medical students. Cross-sectional study with 292 participants. Burnout was assessed by the Maslach Burnout Inventory-Student Survey. Coping strategies were evaluated by the Folkman-Lazarus Ways of Coping Questionnaire and questions about health-maintenance behaviours. Associations between burnout and coping strategies were explored with linear regression analyses. The prevalence of high-level burnout was 25-56%. Both problem-focused coping and support-seeking were protective factors of exhaustion and cynicism, however, they predicted reduced personal accomplishment. Emotion-focused coping predicted exhaustion and cynicism and correlated negatively with reduced personal accomplishment. Health-maintenance behaviours were protective factors for exhaustion and predicted reduced personal accomplishment. Deployment of coping strategies that target the most prevalent burnout dimension may improve effective management of burnout.
Lu, Chow-Chin; Sung, Chia-Chi
In this research, we cooperate with senior high school teachers to understand current nanotechnology model of senior high school nanotechnology curriculum in Taiwan. Then design senior high school nanotechnology (nano-tech) curriculum to teach 503 senior high school students. After teaching the nano-tech curriculum we use the "Nanotechnology…
Willems, A; Paepe, D; Marynissen, S; Smets, P; Van de Maele, I; Picavet, P; Duchateau, L; Daminet, S
There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited. To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy. Hundred client-owned dogs. Dogs were prospectively recruited. Owners completed a questionnaire. SBP measurement, physical, orthopedic and neurologic examination, direct fundoscopy and Schirmer tear test were performed. Complete blood count, serum biochemistry, and urinalysis were evaluated. Forty-one senior and 59 geriatric dogs were included. Mean SBP was 170 ± 38 mmHg, and 53 dogs had SBP > 160 mmHg. Thirty-nine animals were overweight. A heart murmur was detected in 22, severe calculus in 21 and 1 or more (sub)cutaneous masses in 56 dogs. Thirty-two dogs had increased serum creatinine, 29 hypophosphatemia, 27 increased ALP, 25 increased ALT, and 23 leukopenia. Crystalluria, mostly amorphous crystals, was commonly detected (62/96). Overt proteinuria and borderline proteinuria were detected in 13 and 18 of 97 dogs, respectively. Four dogs had a positive urine bacterial culture. Frequency of orthopedic problems, frequency of (sub)cutaneous masses, and platelet count were significantly higher in geriatric compared with senior dogs. Body temperature, hematocrit, serum albumin, and serum total thyroxine concentration were significantly lower in geriatric compared with senior dogs. Physical and laboratory abnormalities are common in apparently healthy elderly dogs. Veterinarians play a key role in implementing health screening and improving health care for elderly pets. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Lužný, Jan; Ivanová, Kateřina; Juríčková, Lubica
Non-adherence to treatment in seniors with dementia is a frequent and potentially dangerous phenomenon in routine clinical practice which might lead to the inappropriate treatment of a patient, including the risk of intoxication. There might be different causes of non-adherence in patients with dementia: memory impairment, sensory disturbances, limitations in mobility, economical reasons limiting access to health care and medication. Non-adherence leads to serious clinical consequences as well as being a challenge for public health. to estimate prevalence of non-adherence in seniors with dementia and to study correlation between cognitive decline and non-adherence. Prospective study, analyzing medical records of seniors with dementia admitted to the inpatient psychogeriatric ward in the Kromeriz mental hospital from January 2010 to January 2011. Cognitive decline measured by MMSE, prevalence of Non-adherence to treatment and reasons for patient Non-adherence were studied. Non-adherence to any treatment was detected in 31.3% of seniors; memory impairment was the most common cause of non-adherence to treatment. In conclusion, non-adherence to treatment in the studied group of seniors with dementia correlates with the severity of cognitive impairment - a higher cognitive decline correlates with a higher risk of non-adherence to treatment.
Full Text Available Background: Non-adherence to treatment in seniors with dementia is a frequent and potentially dangerous phenomenon in routine clinical practice which might lead to the inappropriate treatment of a patient, including the risk of intoxication. There might be different causes of non-adherence in patients with dementia: memory impairment, sensory disturbances, limitations in mobility, economical reasons limiting access to health care and medication. Non-adherence leads to serious clinical consequences as well as being a challenge for public health. Aim: to estimate prevalence of non-adherence in seniors with dementia and to study correlation between cognitive decline and non-adherence. Subjects and Methods: Prospective study, analyzing medical records of seniors with dementia admitted to the inpatient psychogeriatric ward in the Kromeriz mental hospital from January 2010 to January 2011. Cognitive decline measured by MMSE, prevalence of Non-adherence to treatment and reasons for patient Non-adherence were studied. Results: Non-adherence to any treatment was detected in 31.3% of seniors; memory impairment was the most common cause of non-adherence to treatment. Conclusion: In conclusion, non-adherence to treatment in the studied group of seniors with dementia correlates with the severity of cognitive impairment – a higher cognitive decline correlates with a higher risk of non-adherence to treatment.
Rosted, Elizabeth; Schultz, Martin; Dynesen, Helle
. Patients ≥ 65 years treated during a 14-day period were included. Their mean age was 78 years. Screening with the Identification of Seniors at Risk (ISAR) was performed (n = 198) by the Mobile Geriatric Team (MGT). The patients' medical journals were assessed retrospectively by the SG to determine any need...
Berkelmans, P.G.J.; Berendsen, A.J.; Verhaak, P.F.M.; Meer, K. van der
Background: In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is
Berkelmans, P. (Ine) G. J.; Berendsen, Annette J.; Verhaak, Peter F. M.; van der Meer, Klaas
Background: In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is
Neduzhko, Oleksandr; Postnov, Oleksandr; Perehinets, Ihor; DeHovitz, Jack; Joseph, Michael; Odegaard, David; Kaplan, Robert; Kiriazova, Tetiana
In Ukraine, about one-third of identified HIV-positive individuals are not connected to care. We conducted a cross-sectional survey (n = 200) among patients registered at Odessa AIDS centers in October to December 2011. Factors associated with delayed enrollment in HIV care (>3 months since positive HIV test) were evaluated using logistic regression. Among study participants (mean age 35 ± 8.2 years, 47.5% female, 42.5% reported history of injecting drugs), 55% delayed HIV care enrollment. Odds of delayed enrollment were higher for those with lower educational attainment (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [CI]: 1.04-6.76), not feeling ill (aOR: 2.98, 95% CI: 1.50-5.93), or not having time to go to the AIDS center (aOR: 3.89, 95% CI: 1.39-10.89); injection drug use was not associated with delayed enrollment. Programs linking HIV-positive individuals to specialized care should address enrollment barriers and include education on HIV care benefits and case management for direct linkage to care. HIV testing and treatment should be coupled to ensure a continuum of care.
Luan, Xiaorong; Wang, Ping; Hou, Wenxiu; Chen, Lili; Lou, Fenglan
Senior nurses can suffer from high job stress and burnout, which can lead to negative patient outcomes and higher turnover rates; however, few studies have examined this topic. We recruited 224 head and senior nurses from September to December 2015 using convenience and cluster sampling, to compare job stress and burnout levels between the two groups. The Nurse Job Stressors Inventory and Maslach Burnout Inventory scales were used to evaluate job stress and burnout, respectively. Results indicated that job stress scores significantly differed between head and senior nurses. The highest scoring subscales in both groups were time allocation and workload problems. Scores for the three burnout dimensions also significantly differed between the groups. Positive correlations between job stress and burnout were stronger among senior nurses than head nurses. Burnout may be higher among senior nurses given head nurses' potential for greater perceived job control. Our findings suggest that measures need to be taken to reduce burnout and turnover rates among senior nurses. © 2017 John Wiley & Sons Australia, Ltd.
Full Text Available Abstract Background Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Methods Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. Data The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists. Results Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be
Bervoets, K; Schlenzig, J S; Böhles, H
The fact that almost all neonates exhibit a "physiological" jaundice, prompts the question whether bilirubin, usually exclusively considered a potentially toxic endproduct of the metabolism of heme, might not also have a positive task in the first days of life. A recently discovered property of bilirubin under in vitro conditions is its ability to combine with free oxygen radicals such as are produced in the oxidative metabolic processes of the neonate immediately following birth. In the present article, the concept of the anti-oxidative effect of bilirubin, and its translation to the early neonatal period is presented and discussed on the basis of a number of examples.
Clement, James L.; Boyd, J. E.; Saylor, S.; Kanas, N.
NASA flight controllers have always worked in a very demanding environment, but the International Space Station (ISS) poses even more challenges than prior missions. A recent NASA/Ames survey by Parke and Orasanu of NASA/Johnson flight controllers uncovered concerns about communications problems between American personnel and their international counterparts. To better understand these problems, we interviewed 14 senior and 12 junior ISS flight controllers at NASA/Johnson about leadership and cultural challenges they face and strategies for addressing these challenges. The qualitative interview data were coded and tabulated. Here we present quantitative analyses testing for differences between junior and senior controllers. Based on nonparametric statistical tests comparing responses across groups, the senior controllers were significantly more aware of the impact of working in dispersed teams, the context of constant change, and the upcoming multilateral challenges, while junior controllers were more aware of language and cultural issues. We consider our findings in light of other studies of controllers and other known differences between senior and junior controllers. For example, the fact that senior controllers had their formative early experience controlling pre-ISS short-duration Shuttle missions seems to have both positive and negative aspects, which are supported by our data. Our findings may also reflect gender differences, but we cannot unconfound this effect in our data because all the senior respondents were males. Many of the junior-senior differences are not only due to elapsed time on the job, but also due to a cohort effect. The findings of this study should be used for training curricula tailored differently for junior and senior controllers.
Zecevic, Aleksandra A.; Salmoni, Alan W.; Lewko, John H.; Vandervoort, Anthony A.
An in-depth understanding of human factors and human error is lacking in current research on seniors' falls. Additional knowledge is needed to understand why seniors are falling. The purpose of this article is to describe the adapting of the Integrated Safety Investigation Methodology (ISIM) (used for investigating transportation and industrial…
Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D
Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P mental health persisted independent of burnout (all P mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.
Shields, Richard K; Pizzimenti, Marc A; Dudley-Javoroski, Shauna; Schwinn, Debra A
The purpose of this report is to describe student satisfaction with a near-peer interprofessional education (IPE) session for physical therapy and medical students. Ten senior physical therapy students worked in peer-groups to develop a musculoskeletal anatomy demonstration for first-semester medical students. Together with their classmates, they demonstrated observation, palpation, and musculoskeletal assessment of the shoulder and scapular-thoracic articulation to medical student dissection groups in the Gross Anatomy laboratory. The medical students were encouraged to consider the synergistic function of shoulder structures and the potential impact of a selected pathology: rotator cuff injury. The session provided the medical students with an opportunity to integrate their new anatomical knowledge into a framework for clinical musculoskeletal evaluation. The experience offered senior physical therapy students an opportunity to work in teams with their peers, internalize and adapt to constructive feedback, and seek common ground with members of another profession. Both student groups reported a high degree of satisfaction with the sessions and expressed a desire for further interaction. These positive perceptions by student stakeholders have prompted us to consider additional IPE exchanges for the anatomy course in the upcoming school year. Given the positive outcome of this descriptive study, we now plan to systematically test whether near-peer IPE interactions can enhance the degree that students learn key anatomical concepts. © 2014 American Association of Anatomists.
Ingvaldsen, Anne Kristin; Balandin, Susan
Background: Concepts of inclusion and participation are at the core of both international and Norwegian policy for people with intellectual disability. The aim of this study was to identify senior centre users' views of the barriers and solutions to the inclusion of seniors with intellectual disability in community senior centres. Method: Thirty…
Rodrigues, Ana M; Eusébio, Mónica; Santos, Maria José; Gouveia, Nélia; Tavares, Viviana; Coelho, Pedro S; Mendes, Jorge M; Branco, Jaime C; Canhão, Helena
Using a large population database, we showed that fragility fractures were highly prevalent in senior women and were associated with significant physical disability. However, treatment rates were low because osteoporosis treatment was not prescribed or not agreed to by the majority of women with prevalent fragility fractures. The purpose of the study is to estimate prevalence of fragility fractures (FF), risk factors, and treatment rates in senior women and to assess impact of FF on physical function and quality of life. Women aged 65 years and older from the EpiReumaPt study (2011-2013) were evaluated. Rheumatologists collected data regarding FF, clinical risk factors for fractures, and osteoporosis (OP) treatment. Health-related quality of life (EQ5D) and physical function (HAQ) were analyzed. Peripheral dual-energy X-ray absorptiometry was performed. FF was defined as any self-reported low-impact fracture that occurred after 40 years of age. Prevalence estimates of FF were calculated. Among 3877 subjects evaluated in EpiReumaPt, 884 were senior women. The estimated prevalence of FF was 20.7%. Lower leg was the most frequent fracture site reported (37.8%) followed by wrist (18.6%). Only 7.1% of the senior women reporting a prevalent FF were under treatment for OP, and 13.9% never had treatment. OP treatment was not prescribed in 47.7% of FF women, and 23.4% refused treatment. Age (OR = 2.46, 95% CI 1.11-5.47), obesity (OR = 2.05, 95% CI 1.14-3.70), and low wrist BMD (OR = 2.29; 95% CI 1.20, 4.35; p = 0.012) were positively associated with prevalent FF. A significantly higher proportion of women in the lowest quintile of wrist bone mineral density reported FF (OR = 2.29, 95% CI 1.20-4.35). FF were associated with greater physical disability (β = 0.33, 95% CI 0.13-0.51) independent of other comorbidities. FF was frequently reported among senior women as an important cause of physical disability. However, the prevalence of OP treatment was
Trabulsi, Nora; Riedel, Kristen; Winslade, Nancy; Gregoire, Jean-Pierre; Meterissian, Sarkis; Abrahamovicz, Michal; Tamblyn, Robyn; Mayo, Nancy; Meguerditchian, Ari
A third of breast cancers (BC) occur in women ≥65 years (seniors). Anti-estrogen therapy (AET) significantly reduces BC recurrence and death. This study characterizes determinants of adherence to AET in seniors with BC. Provincial cancer registry and administrative claims data were accessed for all non-metastatic BC diagnosed in Quebec (1998-2005) to identify seniors treated for 5 years with AET. Multivariate linear regression was used to assess the association with patient, disease, and physician characteristics and the 5-year medication possession ratio (MPR) for each patient. 4,715 women were included (mean age: 72.9). Mean MPR was 83.5%, 79% of patients reached a 5-year MPR of ≥80%, and 34% discontinued AET at some point during treatment. The cumulative probability of discontinuation was 33.8% (mean time to discontinuation 2.3 years). The MPR decreased with increasing age and non-BC related hospitalizations, p seniors with BC remained a challenge and medication discontinuation rates were high. Advanced age, increasing number of hospitalizations, in situ disease, baseline use of antidepressants, Tamoxifen (versus aromatase inhibitors), early switches of AET type, and newly added medications significantly reduced the MPR. © 2014 Wiley Periodicals, Inc.
Full Text Available In the last decade the provision of school breakfast has increased significantly in the UK. However, there is an absence of knowledge regarding senior stakeholder views on the processes and potential outcomes on different groups, within the communities served by school breakfast programs. The purpose of this study was to examine the views and experiences of senior level stakeholders and thereby provide an original qualitative contribution to the research. A sample of senior level stakeholders were recruited, including senior officers, directors and elected members, from within a Local Authority (LA involved in the leadership, implementation and delivery of a council-wide universal free school breakfast (USFB program, and from the senior staff body of mainstream primary and special schools, participating in the program. A grounded theory analysis of the data collected identified issues encountered in the implementation and delivery, and views on the funding and future of a USFB program, in addition to perceived outcomes of children, parents, families, schools and the wider community. The results refer to both positive and negative issues and implications associated with the program, according to the perspectives of senior level stakeholders. Perceived positive outcomes included benefits to children, families, schools and the community. For instance, alleviating hunger, improving health outcomes, and conferring financial benefits, with the potential to cumulate in overall improvements in educational, social and behavioral outcomes. Reported negative implications included the absence of an effective communication strategy in implementing the USFB program; in addition to concerns about the impacts of ‘double-breakfasting’ on obesity levels among children, particularly in less deprived communities. Findings were validated using theoretical sampling and saturation, triangulation methods, member checks, and inter-rater reliability measures. In
Halaschek-Wiener, Julius; Tindale, Lauren C; Collins, Jennifer A; Leach, Stephen; McManus, Bruce; Madden, Kenneth; Meneilly, Graydon; Le, Nhu D; Connors, Joseph M; Brooks-Wilson, Angela R
To understand why some people live to advanced age in good health and others do not, it is important to study not only disease, but also long-term good health. The Super-Seniors Study aims to identify factors associated with healthy aging. 480 healthy oldest-old 'Super-Seniors' aged 85 to 105 years and never diagnosed with cancer, cardiovascular disease, diabetes, dementia, or major pulmonary disease, were compared to 545 mid-life controls aged 41-54, who represent a group that is unselected for survival from late-life diseases. Health and lifestyle information, personal and family medical history, and blood samples were collected from all participants. Super-Seniors also underwent four geriatric tests. Super-Seniors showed high cognitive (Mini-Mental State Exam mean = 28.3) and functional capacity (Instrumental Activities of Daily Living Scale mean = 21.4), as well as high physical function (Timed Up and Go mean = 12.3 seconds) and low levels of depression (Geriatric Depression Scale mean = 1.5). Super-Seniors were less likely to be current smokers than controls, but the frequency of drinking alcohol was the same in both groups. Super-Seniors were more likely to have 4 or more offspring; controls were more likely to have no children. Female Super-Seniors had a mean age of last fertility 1.9 years older than controls, and were 2.3 times more likely to have had a child at ≥ 40 years. The parents of Super-Seniors had mean ages of deaths of 79.3 years for mothers, and 74.5 years for fathers, each exceeding the life expectancy for their era by a decade. Super-Seniors are cognitively and physically high functioning individuals who have evaded major age-related chronic diseases into old age, representing the approximately top 1% for healthspan. The familiality of long lifespan of the parents of Super-Seniors supports the hypothesis that heritable factors contribute to this desirable phenotype.
Chen, Zhenhua; Zhou, Chen; Wu, Wei
In this work, a hierarchy of valence bond (VB) methods based on the concept of seniority number, defined as the number of singly occupied orbitals in a determinant or an orbital configuration, is proposed and applied to the studies of the potential energy curves (PECs) of H8, N2, and C2 molecules. It is found that the seniority-based VB expansion converges more rapidly toward the full configuration interaction (FCI) or complete active space self-consistent field (CASSCF) limit and produces more accurate PECs with smaller nonparallelity errors than its molecular orbital (MO) theory-based analogue. Test results reveal that the nonorthogonal orbital-based VB theory provides a reverse but more efficient way to truncate the complete active Hilbert space by seniority numbers.
Generalized seniority gives good description of the lowest states of semimagic nuclei. Recently, a very large fraction of eigenstates obtained with random two-nucleon matrix elements were shown to have the structure prescribed by generalized seniority, also for lower values of isospin. To study such states, this concept is generalized to states of nuclei with valence protons and neutrons in the same major shell. States of generalized seniority are defined and constructed. Conditions are derived on charge-independent shell-model Hamiltonians which have such states as eigenstates. From these conditions follow directly the corresponding eigenvalues. Even without an underlying group structure, these eigenvalues have the same form as in the case of protons and neutrons in the same j-orbit
Michelli Luciana Massolini Laureano
Full Text Available Objective: to verify if functional fitness (FF is associated with the annual cost of medication consumption and mood states (MSt in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01. FF is also inversely associated with MSt (p < 0.05. Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01. Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt.
John H Rogers
Full Text Available While voluntary medical male circumcision (VMMC has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal.Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18-35 years (median 26, IQR 23-30 were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70-1.20. Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23-1.00.Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision.
Drawer, Scott; Pollard, Ben; Eager, Robin; Taylor, Neil; Cook, Christian J.
This study compared the movement demands of elite international Under-20 age grade (U20s) and senior international rugby union players during competitive tournament match play. Forty elite professional players from an U20 and 27 elite professional senior players from international performance squads were monitored using 10Hz global positioning systems (GPS) during 15 (U20s) and 8 (senior) international tournament matches during the 2014 and 2015 seasons. Data on distances, velocities, accelerations, decelerations, high metabolic load (HML) distance and efforts, and number of sprints were derived. Data files from players who played over 60 min (n = 258) were separated firstly into Forwards and Backs, and more specifically into six positional groups; FR–Front Row (prop & hooker), SR–Second Row, BR–Back Row (Flankers & No.8), HB–Half Backs (scrum half & outside half), MF–Midfield (centres), B3 –Back Three (wings & full back) for match analysis. Linear mixed models revealed significant differences between U20 and senior teams in both the forwards and backs. In the forwards the seniors covered greater HML distance (736.4 ± 280.3 vs 701.3 ± 198.7m, p = 0.01) and severe decelerations (2.38 ± 2.2 vs 2.28 ± 1.65, p = 0.05) compared to the U20s, but performed less relative HSR (3.1 ± 1.6 vs 3.2 ± 1.5, p rugby, however, the current study highlight for the first time that certain positional groups may require more time to be able to match the movement demands required at a higher playing level than others. Conditioning staff must also bear in mind that the U20s players whilst maintaining or improving match movement capabilities may require to gain substantial mass in some positions to match their senior counterparts. PMID:27824865
SeniorInteraktion er et bud på en ny strategisk tilgang til design for det gode ’ældreliv’. Kernen i dagordenen er et fokus på at designe for social interaktion, dvs. at designe for at bevare og styrke sociale relationer, at bevare eller genskabe følelsen af at blive set og høre til samt følelsen...... seniorer i levende (design) laboratorier hvor seniorernes hverdagsaktiviteter udfolder sig. Det ene fra et ældreboligkompleks i Valby. Det andet fra et motionsfællesskab i Valbyparken i København....
M.Ed. (Education Management) The aim of this research was to assess the management role of the senior housemaster/mistress in the school hostels of the Transvaal Education Department. In this regard, it was initially determined that to be able to manage, a person must also be able to lead, because management is the process of working through other people to attain departmental or organizational goals. As ''head'' of the school hostel, the senior housemaster will see that the policy, as lai...
A fun and easy social media guide for the over-55 set. People over 55 were the fastest-growing user group on Facebook in the first half of 2009, and they're flocking to Twitter at a faster rate than their under-20 grandchildren. From basic information about establishing an Internet connection to rediscovering old friends, sharing messages and photos, and keeping in touch instantly with Twitter, this book by online expert Marsha Collier helps seniors jump right into social media.: Seniors are recognizing the communication possibilities of Facebook and Twitter and are signing up in record number
Escuderos, A.; Zamick, L.
The g 9/2 shell of identical particles is the first one for which one can have seniority-mixing effects. We consider three interactions: A delta interaction that conserves seniority, a quadrupole-quadrupole (Q·Q) interaction that does not, and a third one consisting of two-body matrix elements taken from experiment ( 98 Cd) that also leads to some seniority mixing. We deal with proton holes relative to a Z=50,N=50 core. One surprising result is that, for a four-particle system with total angular momentum I=4, there is one state with seniority v=4 that is an eigenstate of any two-body interaction--seniority conserving or not. The other two states are mixtures of v=2 and v=4 for the seniority-mixing interactions. The same thing holds true for I=6. Another point of interest is that, in the single-j-shell approximation, the splittings ΔE=E(I max )-E(I min ) are the same for three and five particles with a seniority conserving interaction (a well-known result), but are equal and opposite for a Q·Q interaction. We also fit the spectra with a combination of the delta and Q·Q interactions. The Z=40,N=40 core plus g 9/2 neutrons (Zr isotopes) is also considered, although it is recognized that the core is deformed
Shams Vahdati, Samad; Sarkhosh Khiavi, Reza; Rajaei Ghafouri, Rouzbeh; Adimi, Ida
Lower back pain is one of the most common complaints among the general population and among health professionals. Multiple workplace-related risk factors may contribute to back pain among physicians. The aim of this study was to assess the prevalence of lower back pain among medical residents of different medical specialties and to evaluate the relevant risk factors. A Dutch Musculoskeletal Questionnaire (DMQ) was completed by 125 medical residents. Part I concerned general demographic information, part II evaluated workplace-specific factors, and part III assessed the individual characteristics of lower back pain. The overall prevalence of lower back pain among residents was 56.8%, with 45.1% of men and 76.5% of women reporting lower back pain. A total of 94.4% of affected individuals believed that their lower back pain was related to their current job, and 72.6% claimed that the onset of lower back pain occurred after beginning medical work. Statistical analysis revealed a significant correlation between lower back pain and certain risk factors, such as working in the same position for long periods, repetitive movement (bending, twisting) of the lumbar region, working in uncomfortable postures, stress, walking, and standing for long periods. However, no significant relationship was found between lower back pain and heavy lifting, smoking, or prolonged sitting. The role of exercise as a protective factor in reducing the incidence of lower back pain was supported by the statistical analysis. The prevalence of lower back pain among residents is high and is associated with a number of workplace-related risk factors.
Çalimli, Olgu; Türkeli, Serkan; Eken, Emir Gökberk; Gönen, Halil Emre
In literature of strategic management, there are three layers of control defined in organizational structures. These layers are strategic, tactical and operational, in which resides senior, medium level and low level managers respectively. In strategic level, institutional strategies are determined according to senior managers' perceived state of organization. In tactical level, this strategy is processed into methods and activities of a business management plan. Operational level embodies actions and functions to sustain specified business management plan. An acknowledged lead organization in Turkish medical area is examined using case study and data mining method in the scope of this paper. The level of decisions regarded in managerial purposes evaluated through chosen organization's business intelligence event logs report. Hence specification of management level importance of medical organizations is made. Case study, data mining and descriptive statistical method of taken case's reports present that positions of "Chief Executive Officer", "Outpatient Center Manager", "General Manager", monitored and analyzed functions of operational level management more frequently than strategic and tactical level. Absence of strategic management decision level research in medical area distinguishes this paper and consequently substantiates its significant contribution.
Kim, Yoon-Sook; Han, Seol-Heui; Hwang, Jeong-Hae; Park, Jae-Min; Lee, Jongmin; Choi, Jaekyung; Moon, Yeonsil; Kim, Hee Joung; Shin, Grace Jung Eun; Lee, Ji-Sun; Choi, Ye Ji; Uhm, Kyeong Eun; Kim, In Ae; Nam, Ji-Won
Aging is an inevitable part of life. One can maintain well-being and wellness even after discharge and/or transition if his or her functional decline is minimized, sudden decline is prevented, and functioning is promoted during hospitalization. Caring appropriately for elderly patients requires the systematic application of Senior-Friendly Hospital principles to all operating systems, including medical centres' organization and environment, as well as patient treatment processes. The Senior-Friendly Hospital framework is valid and important for patient safety and quality improvement. This study aimed to make recommendations regarding the development of the Korean Framework for Senior-Friendly Hospitals for older patients' care management, patient safety interventions, and health promotion, via a Delphi survey. Two rounds of Delphi surveying were conducted with 15 participants who had at least 3 years' experience in accreditation surveying and medical accreditation standards, survey methods, and accreditation investigator education. In each round, we calculated statistics describing each standard's validity and feasibility. The Korean Framework for Senior-Friendly Hospitals included 4 Chapters, 11 categories, and 67 standards through consensus of the Senior-Friendly Hospitals task force and experts' peer review. After the two rounds of Delphi surveying, validity evaluation led to no changes in standards of the Senior-Friendly Hospitals; however, the number of standards showing adequate validity decreased from 67 to 58. Regarding feasibility, no changes were necessary in the standards; however, the number of categories showing adequate feasibility decreased from 11 to 8 and from 67 to 30, respectively. The excluded categories were 3.2, 4.2, and 4.3 (service, transportation, and signage and identification). The highest feasibility values were given to standards 2.1.1, 4.1.4, and 4.1.6. The highest feasibility score was given to standard 2.4.2. The Korean Framework for
Golenko, Xanthe; Pager, Susan; Holden, Libby
Evidence-based practice aims to achieve better health outcomes in the community. It relies on high quality research to inform policy and practice; however research in primary health care continues to lag behind that of other medical professions. The literature suggests that research capacity building (RCB) functions across four levels; individual, team, organisation and external environment. Many RCB interventions are aimed at an individual or team level, yet evidence indicates that many barriers to RCB occur at an organisational or external environment level. This study asks senior managers from a large healthcare organisation to identify the barriers and enablers to RCB. The paper then describes strategies for building allied health (AH) research capacity at an organisational level from a senior managers' perspective. This qualitative study is part of a larger collaborative RCB project. Semi-structured in-depth interviews were conducted with nine allied health senior managers. Recorded interviews were transcribed and NVivo was used to analyse findings and emergent themes were defined. The dominant themes indicate that the organisation plays an integral role in building AH research capacity and is the critical link in creating synergy across the four levels of RCB. The organisation can achieve this by incorporating research into its core business with a whole of organisation approach including its mission, vision and strategic planning. Critical success factors include: developing a co-ordinated and multidisciplinary approach to attain critical mass of research-active AH and enhance learning and development; support from senior managers demonstrated through structures, processes and systems designed to facilitate research; forming partnerships to increase collaboration and sharing of resources and knowledge; and establishing in internal framework to promote recognition for research and career path opportunities. This study identifies four key themes: whole of
Lee, Su Jin; Sanford, Jon; Calkins, Margaret; Melgen, Sarah; Endicott, Sarah; Phillips, Anjanette
To identify the optimal spatial and dimensional requirements of grab bars that support independent and assisted transfers by older adults and their care providers. Although research has demonstrated that toilet grab bars based on the Americans with Disabilities Act (ADA) Accessibility Standards do not meet the needs of older adults, the specific dimensional requirements for alternative configurations are unknown. A two-phased study with older adults and care providers in residential facilities was conducted to determine the optimal requirements for grab bars. Seniors and caregivers in skilled nursing facilities performed transfers using a mock-up toilet. In Phase 1, participants evaluated three grab bar configurations to identify optimal characteristics for safety, ease of use, comfort, and helpfulness. These characteristics were then validated for using ability-matched samples in Phase 2. The optimal configuration derived in Phase 1 included fold-down grab bars on both sides of the toilet (14" from centerline [CL] of toilet, 32" above the floor, and extended a minimum of 6" in front of the toilet) with one side open and a sidewall 24" from CL of toilet on the other. Phase 2 feedback was significantly positive for independent and one-person transfers and somewhat lower, albeit still positive, for two-person transfers. The study provides substantial evidence that bilateral grab bars are significantly more effective than those that comply with current ADA Accessibility Standards. Findings provide specific spatial and dimensional attributes for grab bar configurations that would be most effective in senior facilities.
This study investigated whether a senior teacher with many years of teaching experience, despite lacking adequate technology skills or contending with other barriers, can sufficiently implement technology integration in the classroom. The research was conducted between October 2013 and January 2014 and was focused on a junior high school biology…
Loos, Eugène; Zonneveld, Annemiek
This exploratory qualitative study provides insight into the role that exergames play for seniors. 15 participants (aged 53–78) engaged in playing Your Shape Fitness Evolved 2 on the Xbox 360 Kinect, after which we conducted a semi-structured interview with each participant. We found that in all
Relationship between Senior School Physics Students' Perceptions of ... Teacher's management abilities prevent disturbances by encouraging cooperation .... Dealing with pupils with such individual differences in the classroom is a great task for every ... The merits of such workshops cannot be over stressed and money.
In the Netherlands, many schools for senior secondary vocational education are implementing competence-based curricula. These curricula start from a constructivist approach and are based on the idea that young people should learn to reflect on their personal ambitions and motives, and to undertake
Turnover is a problem within the senior administrative and professional staff category of the University of Cape Coast. Information gathered from the University's Personnel Section indicates that, over the decade 1987-1996, the University recorded an annual turnover rate of 8.9%. This study was therefore carried out to find ...
Bern, Stine Hvid; Brauer, Charlotte; Møller, Karina Lauenborg
Heavy lifting is associated with musculoskeletal disorders but it is unclear whether it is related to acute reversible effects or to chronic effects from cumulated exposure. The aim of this study was to examine whether musculoskeletal symptoms in Danish airport baggage handlers were associated wi...... with their seniority as baggage handler, indicating chronic effects from cumulated workload....
Heo, Jimmoo; King, Carina
Stebbins (1992) defined serious leisure as the systematic pursuit of amateur, hobbyist, or volunteer activity that is substantial and interesting for the participants involved. This study investigated associations between serious leisure and sport tourism using Indiana Senior Games participants. This study used a self-report questionnaire to…
Benoliel, Pascale; Somech, Anit
Purpose: There has been an increasing trend toward the creation of senior management teams (SMTs) which are characterized by a high degree of functional heterogeneity. Although such teams may create better linkages to information, along with the benefits of functional heterogeneity comes the potential for conflicts that stem from the value…
Wood, M R; Palm, L J
The State-Trait Anxiety Inventory was administered on Weeks 8, 12, and 15 of a semester to 16 students enrolled in a senior thesis course. State anxiety scores were elevated when oral presentations began and declined following the presentations. Trait anxiety scores remained constant across test administrations. The influence of situational variables on students' anxiety was discussed.
Heinemann, Robert L.
This paper examines a basic philosophical issue involved with the purpose of a senior capstone communication course required of all majors. The issue involves two opposites: closure, represented by the dome, and further exploration, represented by the spire. Both approaches have legitimate claims for a capstone course. There is definitely a need…
Loos, E.; Zonneveld, A.; Zhou, J.; Salvendy, G.
This exploratory qualitative study provides insight into the role that exergames play for seniors. 15 participants (aged 53-78) engaged in playing Your Shape Fitness Evolved 2 on the Xbox 360 Kinect, after which we conducted a semi-structured interview with each participant. We found that in all
Trosset, Carol; Weisler, Steven
Kuh (2008) describes the capstone as a "culminating experience" students undertake close to graduation often involving "a project of some sort that integrates and applies what they've learned" (p. 11). The senior thesis is one form of the capstone in which students write an analytic paper under faculty supervision, typically as…
Hunter, Mary Stuart, Ed.; Keup, Jennifer R., Ed.; Kinzie, Jillian, Ed.; Maietta, Heather, Ed.
Increasing pressures on colleges and universities to ensure degree completion and job placement as measures of success make it imperative that the path to graduation is clear and that seniors receive the support needed to earn a degree and make a successful transition to life beyond college. This new edited collection describes today's college…
In April 2004, the members of the management board of KLM waived bonuses offered to them in the run-up to the Dutch airline's merger with Air France, under pressure from trade unions and the government. During the current agreed national wage freeze, increases in senior management remuneration are
Fedorenko, Marina V.; Bykova, Svetlana S.
The relevance of the topic is due to the need of self-correction of senior preschoolers. Adequate self-esteem of preschoolers will give us an opportunity to prepare them for school more effectively, as well as to create some positive character traits. The preschool age is the initial period of development of a child's self-esteem. This is the most…
Sisk, Dorothy A.
Sixty middle and senior managers were interviewed to determine characteristics of creative leadership. Four strategies emerged that enhance creative leadership: (1) focusing, (2) empowering, (3) transforming and (4) facilitating. Implications for educational leaders concern revitalizing the workplace and providing positive reinforcement. (Contains…
Eboiyehi, Christiana O.; Fayomi, Ike; Eboiyehi, Friday A.
The study examined factors encouraging gender inequality in university management in three selected universities in Southwestern Nigeria. This was with a view to assessing women's participation in the senior management positions in the region. Data were obtained from primary and secondary sources. A questionnaire was administered to senior…
This article highlights the multifaceted character of the Swedish higher education sector and investigates senior academic management positions from a gender perspective using theories about an academic prestige economy and academic capitalism. The focus is on an aspect often overseen in research on Swedish academia: the distinction between…
... Z Study Quantifies Physical Demands of Yoga in Seniors Share: A recent NCCAM-funded study measured the ... performance of seven standing poses commonly taught in senior yoga classes: Chair, Wall Plank, Tree, Warrior II, ...
Students' perceptions of difficult concepts in biology in senior secondary schools in ... that students in Senior Secondary School Two (SSII) have difficulties in learning, the ... However, teaching strategies, students' attitude, inadequate learning ...
... America) National Institute on Aging Also in Spanish Topic Image MedlinePlus Email Updates Get Nutrition for Seniors updates by email What's this? GO Related Health Topics Nutrition Seniors' Health National Institutes of Health The ...
Meyer, Erna Rosenlund
Samarbejde mellem fysioterapeutudddannelsen på UCN og Aalborg senior Sport er givende for alle parter, inklusiv studerende.......Samarbejde mellem fysioterapeutudddannelsen på UCN og Aalborg senior Sport er givende for alle parter, inklusiv studerende....
... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Senior Executive Service Performance Review; Correction AGENCY: Office of the Secretary, DHS. ACTION: Notice; correction. SUMMARY: The... the appointment of the members of the Senior Executive Performance Review Boards. This correction adds...
Full Text Available To attract and retain customers, an understanding of their motives and reasons for selecting particular food and grocery store is needed. This is of particular importance in the growing segment of seniors. The size of the senior's market demands a better understanding of the older consumer. The aim of our study is to identify psychographic characteristics of the elderly consumer, and to indicate the lifestyle groups and the relationship between these groups and retail store attributes. Differences in the motives for patronizing specific food stores are analyzed for lifestyle groups. We use the lifestyle as a segmentation variable in the diverse population of seniors for the reason, that the lifestyle of the elderly provides more valuable information than chronological age alone. This information can be used by retailers to improve marketing strategies in order to appeal to a target group of senior shoppers. Empirical research is based on a self-administrated questionnaire aimed on the identification of the lifestyle characteristics and retail store attributes of the consumers in 65+ age, used for the choice of food purchasing retail stores. Lifestyles characteristics were measured by the respondents activities, interests and opinions (AIO. The results of the research indicate that there are differences among the lifestyle groups with significant differences in attitudes towards quality of products or internal store environment. Our research demonstrates the value of psychographic information over age alone regarding the patronage factors in store selection. Our study is a part of the research project VEGA 1/0612/12 'Determinants of the size, structure and tendences in the individual consumption of seniors'.
Fietz, Jennifer; Stupp, Barbara
Traditional municipal services are not successful at reaching Turkish seniors. Compared to native Germans Turkish seniors have a lower social participation. Do native language groups hosted by a German organization promote the social participation of Turkish seniors? How does social participation take place in the ZWAR networks (between work and retirement; a project to strengthen social participation of seniors) and which factors promote or reduce social participation? Qualitative structuring content analysis of two group discussions, which were based on guided interviews. The social participation of Turkish-speaking seniors was strengthened on three levels: (1) through regular meetings of the Turkish ethnic group social relationships were promoted and German language skills and other skills were improved. Through mutual sharing and understanding of the stressors specific to migration, emotional support was provided. The sharing of mutual cultural and linguistic backgrounds created a sense of community and meetings were perceived as an antidote to migrants' exhausting lives in German society. (2) At the organizational level, participation was promoted through extensive group events. Regardless of their cultural background all participants identified as equal ZWAR members. The ZWAR project functioned as an umbrella organization for participation in the intercultural context. (3) Participation in community events created contacts with community stakeholders and fostered volunteer work. Hence, participants were able to use their skills, and therefore broaden their horizons. Turkish ZWAR networks promoted the social participation of members because integration with their ethnic group reduced access barriers, broadened members' scopes of action, and created new opportunities for participation.
Elen Ferraz Teston
Full Text Available The objective of the study was to compare the use of medical and dental services by seniors residing at a seniors-only living facility and in the general community. It was a quantitative study, among 50 residents of the living facility and 173 in the general community. The data were collected between November 2011 and February 2012 through a questionnaire, and subjected to statistical analysis. Performance of clinical exams and satisfaction with health services was greater among seniors living in the general community; however, physical therapy treatment was more common among those living in the facility. The use of medical and dental services showed a statistically significant difference. The seniors in both groups need oral health monitoring and those living in the facility also require coverage by the Family Health Strategy. The presence of professionals with the right profile to adequately serve residents and the network of available services are determining factors for the success of this new housing policy.
Lehr, Bosco; Ostermann, Herwig; Schubert, Harald
As a result of more economising in German hospitals, changes evolve in organising the deployment of senior medical staff. New demands are made of senior hospital management. Leadership competencies in the training and development of physicians are of prime importance to the successful perception of managerial responsibilities. The present study investigates the actual and targeted demands of leadership made of senior medical staff in terms of how these demands are perceived. To this end, the demands of leadership were surveyed using a competence-based questionnaire and investigated with a view to potentials in professional development by way of example of the senior management of psychiatric hospitals in Germany. In all, the results show high ratings in personal performance, the greatest significance being attributed to value-oriented competence in the actual assessment of demands on leadership. Besides gender-specific differences in the actual assessments of single fields of competence, the greatest differences between the targeted and the actual demands are, in all, shown to be in the competencies of self-management and communication. Competence-based core areas in leadership can be demonstrated for the professional development of physicians and an adaptive mode of procedure deduced. Copyright © 2010. Published by Elsevier GmbH.
Yamazaki, Ryuji; Nishio, Shuichi; Ishiguro, Hiroshi
isolation of senior citizens. It has become a major issue even in Denmark that is known as one of countries with advanced welfare systems. In this pilot study at Danish homes, we found that the elderly with or without dementia showed positive attitudes toward Telenoid and developed various dialogue...... strategies. Contrary to the issue of revulsion that can be caused by humanlike robots and the negative reactions by non-users in media reports, we discuss potentials and challenges of the android’s embodiment for social inclusion of senior citizens in telecommunications....
Xue, Yuan; Cheng, Teng; Xu, Xiaohai; Gao, Zeren; Li, Qianqian; Liu, Xiaojing; Wang, Xing; Song, Rui; Ju, Xiangyang; Zhang, Qingchuan
This paper presents a system for positioning markers and tracking the pose of a rigid object with 6 degrees of freedom in real-time using 3D digital image correlation, with two examples for medical imaging applications. Traditional DIC method was improved to meet the requirements of the real-time by simplifying the computations of integral pixel search. Experiments were carried out and the results indicated that the new method improved the computational efficiency by about 4-10 times in comparison with the traditional DIC method. The system was aimed for orthognathic surgery navigation in order to track the maxilla segment after LeFort I osteotomy. Experiments showed noise for the static point was at the level of 10-3 mm and the measurement accuracy was 0.009 mm. The system was demonstrated on skin surface shape evaluation of a hand for finger stretching exercises, which indicated a great potential on tracking muscle and skin movements.
Song, Misoon; Seo, Kyoungsan; Choi, Suyoung; Choi, Jeongshil; Ko, Hana; Lee, Soo Jin
Despite the great need for health interventions among seniors centre participants, this matter has received little attention. This systematic review aimed to identify what types of health interventions are effective and feasible for seniors centre participants. MEDLINE, Ovid, CINAHL, Google Scholar, EMBASE, and RISS were searched. We searched for health intervention studies conducted in seniors centres published in English and Korean between 1990 and 2014. Of 907 screened articles, 22 studies of all types of experimental designs were selected. Selected studies were grouped by intervention domain: health promotion (n = 8), safety (n = 5), chronic disease management (n = 6), and comprehensive wellness (n = 3). Overall, 59.1% of the interventions were provided by nurses. The health interventions resulted in positive effects on seniors centre participants' knowledge, health behaviours, clinical indices, and hospitalization rates. Few studies reported on feasibility outcomes such as satisfaction and cost-effectiveness. Considering the impact and ease of access to older people at seniors centres, health interventions and services within seniors centres should be strengthened. There is potential for nursing to spearhead seniors centre health intervention programmes to enhance active ageing for participants. © 2017 John Wiley & Sons Australia, Ltd.
Amanda Washington Lockett
Full Text Available While it is important for college and university senior administrators to embrace the traditional roles of their administrative positions, senior administrators’ interactions with students also shape institutional culture, students’ engagement, and ultimately play a role in students’ motivation to succeed. This engagement is especially evident in the Historically Black College and University (HBCU context as senior administrators’ engagement with students can directly or indirectly affect how students perceive themselves and their ability to succeed. This article aims to illuminate the role that HBCU senior level administrators play in students’ motivation toward success. We also highlight the notion that senior level administrators’ role in organizational culture ultimately led historically-disempowered Black women students toward success in even the most historically inaccessible pathways in the science, technology, engineering, and math (STEM fields. The study used semi-structured interviews with 71 Black women STEM students across 10 HBCUs and asked questions to better understand how events in their lives and on their campuses shaped their choice to pursue and persist through a STEM degree program. The study found that the women were highly motivated by their HBCUs’ family-like community of support. Integral to this article, this support was not confined to professors and peers, but extended to senior administrators. We conclude that Black women STEM students’ perception of their ability to succeed and their motivation is influenced by the institutions’ senior administration.
Bobo William V
Full Text Available Abstract Background Diabetic ketoacidosis (DKA is a potentially life-threatening complication of treatment with some atypical antipsychotic drugs in children and youth. Because drug-associated DKA is rare, large automated health outcomes databases may be a valuable data source for conducting pharmacoepidemiologic studies of DKA associated with exposure to individual antipsychotic drugs. However, no validated computer case definition of DKA exists. We sought to assess the positive predictive value (PPV of a computer case definition to detect incident cases of DKA, using automated records of Tennessee Medicaid as the data source and medical record confirmation as a "gold standard." Methods The computer case definition of DKA was developed from a retrospective cohort study of antipsychotic-related type 2 diabetes mellitus (1996-2007 in Tennessee Medicaid enrollees, aged 6-24 years. Thirty potential cases with any DKA diagnosis (ICD-9 250.1, ICD-10 E1x.1 were identified from inpatient encounter claims. Medical records were reviewed to determine if they met the clinical definition of DKA. Results Of 30 potential cases, 27 (90% were successfully abstracted and adjudicated. Of these, 24 cases were confirmed by medical record review (PPV 88.9%, 95% CI 71.9 to 96.1%. Three non-confirmed cases presented acutely with severe hyperglycemia, but had no evidence of acidosis. Conclusions Diabetic ketoacidosis in children and youth can be identified in a computerized Medicaid database using our case definition, which could be useful for automated database studies in which drug-associated DKA is the outcome of interest.
Caplan, Eleanor O; Kamble, Pravin S; Harvey, Raymond A; Smolarz, B Gabriel; Renda, Andrew; Bouchard, Jonathan R; Huang, Joanna C
To evaluate the positive predictive value of claims-based V85 codes for identifying individuals with varying degrees of BMI relative to their measured BMI obtained from medical record abstraction. This was a retrospective validation study utilizing administrative claims and medical chart data from 1 January 2009 to 31 August 2015. Randomly selected samples of patients enrolled in a Medicare Advantage Prescription Drug (MAPD) or commercial health plan and with a V85 claim were identified. The claims-based BMI category (underweight, normal weight, overweight, obese class I-III) was determined via corresponding V85 codes and compared to the BMI category derived from chart abstracted height, weight and/or BMI. The positive predictive values (PPVs) of the claims-based BMI categories were calculated with the corresponding 95% confidence intervals (CIs). The overall PPVs (95% CIs) in the MAPD and commercial samples were 90.3% (86.3%-94.4%) and 91.1% (87.3%-94.9%), respectively. In each BMI category, the PPVs (95% CIs) for the MAPD and commercial samples, respectively, were: underweight, 71.0% (55.0%-87.0%) and 75.9% (60.3%-91.4%); normal, 93.8% (85.4%-100%) and 87.8% (77.8%-97.8%); overweight, 97.4% (92.5%-100%) and 93.5% (84.9%-100%); obese class I, 96.9 (90.9%-100%) and 97.2% (91.9%-100%); obese class II, 97.0% (91.1%-100%) and 93.0% (85.4%-100%); and obese class III, 85.0% (73.3%-96.1%) and 97.1% (91.4%-100%). BMI categories derived from administrative claims, when available, can be used successfully particularly in the context of obesity research.
... CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD Senior Executive Service Performance Review Board... change in the membership of the Senior Executive Service Performance Review Board for the Chemical Safety... Senior Executive Service (SES) and makes recommendations as to final annual performance ratings for...
Warren-Peace, Paula; Parrish, Elaine; Peace, C. Brian; Xu, Jianzhong
In this article, we describe data from two case studies of seniors (one younger senior and one older senior) in learning to use computers. The study combined interviews, observations, and documents to take a close look at their experiences with computers, as well as the influences of aging and computer training on their experiences. The study…
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9227-3] Senior Executive Service Performance Review Board... review and evaluate the initial appraisal of a senior executive's performance by the supervisor, along with any recommendations to the appointment authority relative to the performance of the senior...
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... DEPARTMENT OF THE INTERIOR Council of the Inspectors General on Integrity and Efficiency Senior..., each agency is required to establish one or more Senior Executive Service (SES) performance review boards. The purpose of these boards is to review and evaluate the initial appraisal of a senior executive...
... OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION Senior Executive Service Performance Review Board Membership AGENCY: Occupational Safety and Health Review Commission. ACTION: Annual notice. SUMMARY: Notice... established a Senior Executive Service PRB. The PRB reviews and evaluates the initial appraisal of a senior...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9489-5] Senior Executive Service Performance Review Board... review and evaluate the initial appraisal of a senior executive's performance by the supervisor, along with any recommendations to the appointment authority relative to the performance of the senior...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9747-4] Senior Executive Service Performance Review Board... performance review boards. This board shall review and evaluate the initial appraisal of a senior executive's... performance of the senior executive. Members of the 2012 EPA Performance Review Board are: Benita Best-Wong...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9904-20-OARM] Senior Executive Service Performance Review... review boards. This board shall review and evaluate the initial appraisal of a senior executive's... performance of the senior executive. Members of the 2013 EPA Performance Review Board are: Benita Best-Wong...
ARNG Readiness Home : Leadership : SEA Senior Enlisted Advisor to the CNGB Command Sergeant Major Christopher Kepner Command Sergeant Major Christopher Kepner currently serves as the Senior Enlisted Advisor include the United States Army Sergeants Major Academy, Senior Enlisted Joint Professional Military
... FEDERAL RETIREMENT THRIFT INVESTMENT BOARD Senior Executive Service Performance Review Board... appointment of the members of the Senior Executive Service Performance Review Boards for the Federal... actions for members of the Senior Executive Service. DATES: This notice is effective November 5, 2013. FOR...
... FEDERAL LABOR RELATIONS AUTHORITY Senior Executive Service (SES) Performance Review Board AGENCY... Management, one or more PRBs. The PRB shall review and evaluate the initial appraisal of a senior executive's performance by the supervisor, along with any response by the senior executive, and make recommendations to...
... Part IV Department of Labor Employment and Training Administration 20 CFR Part 641 Senior... Administration 20 CFR Part 641 RIN 1205-AB48 and RIN 1205-AB47 Senior Community Service Employment Program; Final... implement changes in the Senior Community Service Employment Program (SCSEP) resulting from the 2006...
... CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD Senior Executive Service Performance Review Board... change in the membership of the Senior Executive Service Performance Review Board for the Chemical Safety... Senior Executive Service (SES) and makes recommendations as to final annual performance ratings for...
... FEDERAL RETIREMENT THRIFT INVESTMENT BOARD Senior Executive Service Performance Review Board... appointment of the members of the Senior Executive Service Performance Review Boards for the Federal... appropriate personnel actions for members of the Senior Executive Service. DATES: This notice is effective...
... CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD Senior Executive Service Performance Review Board... change in the membership of the Senior Executive Service Performance Review Board for the Chemical Safety... performance ratings of members of the Senior Executive Service (SES) and makes recommendations as to final...
... COUNCIL OF THE INSPECTORS GENERAL ON INTEGRITY AND EFFICIENCY Senior Executive Service Performance... required to establish one or more Senior Executive Service (SES) performance review boards. The purpose of these boards is to review and evaluate the initial appraisal of a senior executive's performance by the...
... FEDERAL RETIREMENT THRIFT INVESTMENT BOARD Senior Executive Service Performance Review Board... appointment of the members of the Senior Executive Service Performance Review Boards for the Federal... actions for members of the Senior Executive Service. DATES: This notice is effective November 27, 2012...
... OFFICE OF PERSONNEL MANAGEMENT Senior Executive Service--Performance Review Board AGENCY: Office... performance review boards. The board reviews and evaluates the initial appraisal of a senior executive's... performance of the senior executive. U.S. Office of Personnel Management. John Berry, Director. The following...
... COUNCIL OF THE INSPECTORS GENERAL ON INTEGRITY AND EFFICIENCY Senior Executive Service Performance... Management, each agency is required to establish one or more Senior Executive Service (SES) performance review boards. The purpose of these boards is to review and evaluate the initial appraisal of a senior...
... AND EFFICIENCY Senior Executive Service Performance Review Board Membership AGENCY: Council of the... of Personnel Management, each agency is required to establish one or more Senior Executive Service... appraisal of a senior executive's performance by the supervisor, along with any recommendations to the...
Balleyguier, Corinne; Kinkel, Karen; Fermanian, Jacques; Malan, Sebastien; Djen, Germaine; Taourel, Patrice; Helenon, Olivier
Objectives: To evaluate the impact of a computer-aided detection (CAD) system on the ability of a junior and senior radiologist to detect breast cancers on mammograms, and to determine the potential of CAD as a teaching tool in mammography. Methods: Hundred biopsy-proven cancers and 100 normal mammograms were randomly analyzed by a CAD system. The sensitivity (Se) and specificity (Sp) of the CAD system were calculated. In the second phase, to simulate daily practice, 110 mammograms (97 normal or with benign lesions, and 13 cancers) were examined independently by a junior and a senior radiologist, with and without CAD. Interpretations were standardized according to BI-RADS classification. Sensitivity, Specificity, positive and negative predictive values (PPV, NPV) were calculated for each session. Results: For the senior radiologist, Se slightly improved from 76.9 to 84.6% after CAD analysis (NS) (one case of clustered microcalcifications case overlooked by the senior radiologist was detected by CAD). Sp, PPV and PNV did not change significantly. For the junior radiologist, Se improved from 61.9 to 84.6% (significant change). Three cancers overlooked by the junior radiologist were detected by CAD. Sp was unchanged. Conclusion: CAD mammography proved more useful for the junior than for the senior radiologist, improving sensitivity. The CAD system may represent a useful educational tool for mammography
Ziółkowski, Artur; Błachnio, Aleksandra; Pąchalska, Maria
Modern medicine is still searching for the antecedents which will lead to successful aging. The article discusses the self-perception of life satisfaction and health of senior citizens. The aim of the study was to determine the relationship between self-evaluation of life satisfaction and health by senior citizens in comparison to different age groups. The study included 463 persons - 230 men and 233 women. The age of the participants was in the range 16 - 83 years. All participants were asked to fill the Life Satisfaction Questionnaire (Fragebogen zur Lebenszufriedenheit - FLZ). The FLZ questionnaire assesses the global life satisfaction of a person and health domain separately. The results show age-related differences in the evaluation of life satisfaction. Accordingly, there is a significant change in health evaluations in different age groups, but there are no significant gender differences in health self-report data. The senior citizens' assessment of general health, although the lowest among all the age-subgroups, showed significant difference only in relation to the people below 45 years of age. The significant differences in satisfaction from mental health occurred only for the elderly and participants aged 25-34 and 35-44. Life satisfaction is associated with subjective health evaluations. There are two domains (mental health and performance) that are positively evaluated by more than two-thirds of senior citizens. The observed differences challenge stereotypes and prejudices relating to negative aging process. Senior citizens can improve their control beliefs and develop self-regulation and coping skills.
Park, Jin Seong
This study examined whether seniors' exposure to direct-to-consumer advertising (DTCA) for Alzheimer's disease (AD) medicine contributes to his or her subjective and objective knowledge of AD. A self-administered survey was conducted with a sample of 626 US seniors who were registered for an online consumer research panel. The study found that (1) exposure to DTCA for AD medicine was positively related to seniors' subjective knowledge of AD, (2) DTCA exposure had no significant relationship with overall objective knowledge of AD, and (3) DTCA exposure might influence knowledge of specific features of AD. Although DTCA for AD medicine may induce people to "feel" knowledgeable about AD, it may not result in an equivalent increase in actual knowledge. Therefore, to enhance doctor-patient interactions, both patients and doctors should be aware that although DTCA delivers important and potentially useful health information, it does not necessarily enhance actual knowledge. © The Author(s) 2014.
... Person: Robert Horowits, Ph.D., Senior Investigator, National Institute of General Medical Sciences..., Pharmacology, Physiology, and Biological Chemistry Research; 93.862, Genetics and Developmental Biology...
Resident-as-teacher courses are pretty common in Western medical schools however they are a rarity in Asian and developing countries. The current report is a scholarly analysis of a three day orientation program for senior residents in order to improve their functioning by providing new template either for supplementing basic workshops for faculty or to advocate a change in system. The experience gained by Medical Education Unit of University College of Medical Sciences can be used to conduct training breeding grounds at national or regional levels. Resident as teachers educational interventions need to be designed taking into account their impact on education system.
Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L; Nelson, Tanya N; Richer, Julie; Sadikovic, Bekim; Skidmore, David L; Stockley, Tracy; Taylor, Sherry; van Karnebeek, Clara; Zawati, Ma'n H; Lauzon, Julie; Armour, Christine M
The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it does not address the clinical application of this technology in other fields such as molecular investigation of cancer or for population screening of healthy individuals. Two multidisciplinary groups consisting of medical geneticists, clinical laboratory geneticists, genetic counsellors, ethicists, lawyers and genetic researchers were assembled to review existing literature and guidelines on genome-wide sequencing for clinical genetic diagnosis in the context of monogenic diseases, and to make recommendations relevant to the Canadian context. The statement was circulated for comment to the Canadian College of Medical Geneticists (CCMG) membership-at-large and, following incorporation of feedback, approved by the CCMG Board of Directors. The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. Recommendations include (1) clinical genome-wide sequencing is an appropriate approach in the diagnostic assessment of a patient for whom there is suspicion of a significant monogenic disease that is associated with a high degree of genetic heterogeneity, or where specific genetic tests have failed to provide a diagnosis; (2) until the benefits of reporting incidental findings are established, we do not endorse the intentional clinical analysis of disease-associated genes other than those linked to the primary indication; and (3) clinicians should
Boycott, Kym; Hartley, Taila; Adam, Shelin; Bernier, Francois; Chong, Karen; Fernandez, Bridget A; Friedman, Jan M; Geraghty, Michael T; Hume, Stacey; Knoppers, Bartha M; Laberge, Anne-Marie; Majewski, Jacek; Mendoza-Londono, Roberto; Meyn, M Stephen; Michaud, Jacques L; Nelson, Tanya N; Richer, Julie; Sadikovic, Bekim; Skidmore, David L; Stockley, Tracy; Taylor, Sherry; van Karnebeek, Clara; Zawati, Ma'n H; Lauzon, Julie; Armour, Christine M
Purpose and scope The aim of this Position Statement is to provide recommendations for Canadian medical geneticists, clinical laboratory geneticists, genetic counsellors and other physicians regarding the use of genome-wide sequencing of germline DNA in the context of clinical genetic diagnosis. This statement has been developed to facilitate the clinical translation and development of best practices for clinical genome-wide sequencing for genetic diagnosis of monogenic diseases in Canada; it does not address the clinical application of this technology in other fields such as molecular investigation of cancer or for population screening of healthy individuals. Methods of statement development Two multidisciplinary groups consisting of medical geneticists, clinical laboratory geneticists, genetic counsellors, ethicists, lawyers and genetic researchers were assembled to review existing literature and guidelines on genome-wide sequencing for clinical genetic diagnosis in the context of monogenic diseases, and to make recommendations relevant to the Canadian context. The statement was circulated for comment to the Canadian College of Medical Geneticists (CCMG) membership-at-large and, following incorporation of feedback, approved by the CCMG Board of Directors. The CCMG is a Canadian organisation responsible for certifying medical geneticists and clinical laboratory geneticists, and for establishing professional and ethical standards for clinical genetics services in Canada. Results and conclusions Recommendations include (1) clinical genome-wide sequencing is an appropriate approach in the diagnostic assessment of a patient for whom there is suspicion of a significant monogenic disease that is associated with a high degree of genetic heterogeneity, or where specific genetic tests have failed to provide a diagnosis; (2) until the benefits of reporting incidental findings are established, we do not endorse the intentional clinical analysis of disease-associated genes
Full Text Available Research Question (RQ: Does the opinion of the medical and non - medical staff varies on (1 the level of stress depending on seniority, (2 the staircase of stress in relation to education, and (3 how motivation affects the level of stress. Purpose: The purpose of the study is to determine whether in health care and higher education contribute to increased job stress. Also, we wanted to know whether they are more motivated workers are less exposed to occupational stress and / or employees with higher seniority also more exposed to stress. Method: We did quantitative research in public health institute. Overview of theoretical principles based on domestic and foreign professional literature. Articles and expert input was obtained in electronic databases ProQuest Online Information Service, Ebsco and SpringerLink. Statistical part of the study, we calculated the statistical program where we used the Mann - Whitney U- statistics and Wilcox W-statistics. Results: The results indicate that there is a statistical difference in understanding the importance of seniority and education on occupational stress among medical and non - medical sector. Employees in the medical sector more statistically argue that education and working life affect the career stress. We rejected our second hypothesis, which says that there is a difference between the two sectors regarding the impact of motivation on occupational stress. Both sectors they consider to be less motivated workers exposed to occupational stress. Organization: The survey can further highlight the risks that may be possible due to congestion and occupational stress. Society: positive influence on the social understanding of diversity obtained service of a single profession and thus routing problem in a disproportionate burden of healthcare workers. Healthcare professionals who work under less stress effectively and positively affect the quality of services rendered. Originality: This kind of research by
Grace Haeson Park
Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.
Hampanda, Karen M
Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women's adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence. This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT. In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses. Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed. Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission of HIV. Copyright © 2016 Elsevier Ltd. All rights reserved.
Dempsey, Gary M; Gibson, Neil V; Sykes, Dave; Pryjmachuk, Bradley C; Turner, Anthony P
Dempsey, GM, Gibson, NV, Sykes, D, Pryjmachuk, BC, and Turner, AP. Match demands of senior and junior players during International Rugby League. J Strength Cond Res 32(6): 1678-1684, 2018-This study aims to quantify and compare the positional game demands of international junior and senior rugby league competition for the first time. Global positioning system (GPS) and video analysis were used to track 118 elite male rugby league players (57 seniors aged 28.7 ± 4.4 years; 61 juniors aged 17.2 ± 0.5 years) over 10 international matches (6 senior; 4 junior) characterized as either forwards (n = 67) or backs (n = 51). There were significant increases in the offensive carries (0.18 cf. 0.09 n·min; r = 0.56) and defensive tackles (0.36 cf. 0.23 n·min; r = 0.3) between senior and junior players, and forwards and backs (0.16 cf. 0.09; r = 0.34 and 0.41 cf. 0.14; r = 0.52), respectively. Running demands were significantly greater in backs than forwards (independent of playing level) for total distance (6,962 ± 1,263 m cf. 4,879 ± 1,824 m; r = 0.55), individualized high-speed distances (310 ± 158 m cf. 250 ± 171 m; r = 0.2), high-intensity accelerations (28.7 ± 12.1 m·s cf. 21.9 ± 11.7 m·s; r = 0.27), and decelerations (57.2 ± 18.3 m·s cf. 43.0 ± 17.8 m·s; r = 0.38). Positional differences were eliminated when reported relative to minutes played. From a practical perspective, although running demands relative to time on the pitch may prepare junior players for senior competition, it is not representative of the increased body mass and contact frequency within the senior game. Coaches should therefore reflect these differences within their physical preparation programs to prepare junior athletes accordingly for progression to the senior level.
McGovern, Justine; Brown, Dwayne; Gasparro, Vita
This article describes an interdisciplinary pilot study exploring the impact of LGBTQ senior centers on the lives of center members. Many LGBTQ adults face the future having experienced stigma and bias, restricted rights, and rejection from family of origin, and are now growing older without the support of a partner and adult children. As a result, older LGBTQ adults experience higher rates of depression, loneliness and isolation, and shortened life expectancy as compared to non-LGBTQ peers. Findings from focus group and key informant interviews highlight features of LGBTQ senior center experiences that can significantly improve members' quality of life. These include providing family, acceptance and a home, which can have an impact on outlook and outcomes. Moreover, findings suggest the need for re-thinking hetero-normative definitions of "community" in the context of LGBTQ aging. Beyond sharing findings from the study, suggesting a conceptual framework for deepening understanding about LGBTQ aging, and identifying lines of future inquiry, the article articulates implications for social work research, practice and education. Ultimately, the article argues that social work is well positioned to improve quality of life for this under-served population when it adopts a cultural humility stance in research, practice and education.
Full Text Available Susie Riva-Mossman, Thomas Kampel, Christine Cohen, Henk Verloo School of Nursing Sciences, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland Abstract: The Senior Living Lab (SLL is dedicated to the care of older adults and exemplifies how nursing leadership can influence clinical practice by designing research models capable of configuring interdisciplinary partnerships with the potential of generating innovative practices and better older patient outcomes. Demographic change resulting in growing numbers of older adults requires a societal approach, uniting stakeholders in social innovation processes. The LL approach is an innovative research method that values user perceptions and participation in the cocreation of new products and services. The SLL is crafting a platform responsive to change. It is a learning organization facilitating community-based participatory research methods in the field. Advanced nurse practitioners are well positioned to lead the way forward, fostering interdisciplinary academic collaborations dedicated to healthy aging at home. The SLL demonstrates how nursing science is taking the lead in the field of social innovation. Keywords: community-based participatory approach, Living Lab, nursing leadership, nursing practice, Senior Living Lab, social innovation
Kvaerner, K J; Aasland, O G; Botten, G S
To assess the relation between male and female medical leadership. Cross sectional study on predictive factors for female medical leadership with data on sex, age, specialty, and occupational status of Norwegian physicians. Oslo, Norway. 13 844 non-retired Norwegian physicians. Medical leaders, defined as physicians holding a leading position in hospital medicine, public health, academic medicine, or private health care. 14.6% (95% confidence interval 14.0% to 15.4%) of the men were leaders compared with 5.1% (4.4% to 5.9%) of the women. Adjusted for age men had a higher estimated probability of leadership in all categories of age and job, the highest being in academic medicine with 0.57 (0.42 to 0.72) for men aged over 54 years compared with 0.39 (0.21 to 0.63) for women in the same category. Among female hospital physicians there was a positive relation between the proportion of women in their specialty and the probability of leadership. Women do not reach senior positions as easily as men. Medical specialties with high proportions of women have more female leaders.
Benberin, V V; Akhetov, A A; Tanbaeva, G Z
The article discusses a new model for active ageing in Republic of Kazakhstan with participation the state, population and medical social services. Achieving active longevity will lead to positive trends in the development of human capital of the state, because it enables to use experience and knowledge of senior generation in enhancing the effectiveness of socio-economic transformation in health care. The study was carried out on the base of the Central clinical hospital of the President's affairs administration in Republic of Kazakhstan, with the participation of 147 admitted patients of elderly and senile age.
Gomes, Gonçalo; Duarte, Carlos; Coelho, José; Matos, Eduardo
The adoption of social networks by older adults has increased in recent years. However, many still cannot make use of social networks as these are simply not adapted to them. Through a series of direct observations, interviews, and focus groups, we identified recommendations for the design of social networks targeting seniors. Based on these, we developed a prototype for tablet devices, supporting sharing and viewing Facebook content. We then conducted a user study comparing our prototype with Facebook's native mobile application. We have found that Facebook's native application does not meet senior users concerns, like privacy and family focus, while our prototype, designed in accordance with the collected recommendations, supported relevant use cases in a usable and accessible manner.
Muir, Nancy C
The full-color guide to the exciting new iPad, written specifically with the needs of seniors in mind!. The iPad is the perfect device for the senior market, combining the Web, e-mail, photos, video, and book reading into an intuitive, portable device. Written by veteran Dummies author Nancy Muir, this fun and friendly guide shows you how to use the many features and capabilities of the iPad to make life easier! You'll learn how to use the multitouch screen to zoom in and out on Web pages and choose a font and size that makes reading comfortable so that you can get directions, plan vacations,
Full Text Available The adoption of social networks by older adults has increased in recent years. However, many still cannot make use of social networks as these are simply not adapted to them. Through a series of direct observations, interviews, and focus groups, we identified recommendations for the design of social networks targeting seniors. Based on these, we developed a prototype for tablet devices, supporting sharing and viewing Facebook content. We then conducted a user study comparing our prototype with Facebook's native mobile application. We have found that Facebook's native application does not meet senior users concerns, like privacy and family focus, while our prototype, designed in accordance with the collected recommendations, supported relevant use cases in a usable and accessible manner.
Michelsen la Cour, Annette
Projekt Seniorer i Bevægelse var et fireårigt projekt i Københavns Kommune målrettet ældre +60, der bevægede sig mindre end anbefalet af Sundhedsstyrelsen. I perioden 2010-2014 deltog 583 borgere i fysisk træning organiseret omkring sociale netværker, ca. 25% blev rekrutteret i et samarbejde med en...
also act as a “ think factory” for commanders and civilian leaders at the strategic level worldwide and routinely engage in discourse and debate...current and past senior leaders, helping them bet - ter appreciate the decisions and activities those lead- ers undertook so as to ease their own...to instill “requisite values, strategic, and critical thinking skills to keep pace with the [changing] strategic environment.”78 Six DLAs were
Brummitt, Charles D.; Kobayashi, Teruyoshi
The seniority of debt, which determines the order in which a bankrupt institution repays its debts, is an important and sometimes contentious feature of financial crises, yet its impact on systemwide stability is not well understood. We capture seniority of debt in a multiplex network, a graph of nodes connected by multiple types of edges. Here an edge between banks denotes a debt contract of a certain level of seniority. Next we study cascading default. There exist multiple kinds of bankruptcy, indexed by the highest level of seniority at which a bank cannot repay all its debts. Self-interested banks would prefer that all their loans be made at the most senior level. However, mixing debts of different seniority levels makes the system more stable in that it shrinks the set of network densities for which bankruptcies spread widely. We compute the optimal ratio of senior to junior debts, which we call the optimal seniority ratio, for two uncorrelated Erdős-Rényi networks. If institutions erode their buffer against insolvency, then this optimal seniority ratio rises; in other words, if default thresholds fall, then more loans should be senior. We generalize the analytical results to arbitrarily many levels of seniority and to heavy-tailed degree distributions.
Godbout, Elisabeth; Filiatrault, Johanne; Plante, Michelle
Volunteer work can be a very significant form of social participation for seniors. It can also provide seniors with important physical and psychological health benefits. This explains why occupational therapists and other health care professionals, as well as community workers who are concerned with healthy aging, appeal to seniors to volunteer in health promotion and community support However, the recruitment and ongoing involvement of seniors as volunteers is often challenging. A systematic review of the literature was undertaken to enlighten practitioners working in this domain. The objective was to identify factors that influence seniors' participation in volunteer work. Six bibliographic databases were searched using key words. A total of 27 relevant papers were retrieved and allowed an identification of a series of factors that could influence seniors' participation in volunteer work, namely personal factors, environmental factors, and occupational factors. This analysis leads to practical guidelines for facilitating the recruitment and maintenance of seniors' engagement in volunteer work.
Stein, Tamar; Henderson, Thomas M.; Scuseria, Gustavo E.
Coupled cluster theory with single and double excitations accurately describes weak electron correlation but is known to fail in cases of strong static correlation. Fascinatingly, however, pair coupled cluster doubles (p-CCD), a simplified version of the theory limited to pair excitations that preserve the seniority of the reference determinant (i.e., the number of unpaired electrons), has mean field computational cost and is an excellent approximation to the full configuration interaction (FCI) of the paired space provided that the orbital basis defining the pairing scheme is adequately optimized. In previous work, we have shown that optimization of the pairing scheme in the seniority zero FCI leads to a very accurate description of static correlation. The same conclusion extends to p-CCD if the orbitals are optimized to make the p-CCD energy stationary. We here demonstrate these results with numerous examples. We also explore the contributions of different seniority sectors to the coupled cluster doubles (CCD) correlation energy using different orbital bases. We consider both Hartree-Fock and Brueckner orbitals, and the role of orbital localization. We show how one can pair the orbitals so that the role of the Brueckner orbitals at the CCD level is retained at the p-CCD level. Moreover, we explore ways of extending CCD to accurately describe strongly correlated systems
Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia Pleotis
Abstract Background: Balancing career and family obligations poses challenges to medical school faculty and contributes to dissatisfaction and attrition from academics. We examined the relationship between family setting and responsibilities, rank, and career and work–life satisfaction for faculty in a large U.S. medical school. Methods: Baseline faculty surveys were analyzed from the first year of a 4-year National Institutes of Health–funded study to evaluate awareness, knowledge, attitudes, and use of family friendly policies and career satisfaction. The study focus was on the impact of family responsibilities and characteristics of the faculty position (rank, clinical vs. nonclinical, and academic series) in multivariate comparisons between primary predictors and outcomes of interest. Results: Both clinical and family responsibilities for children under 18 play a major and interacting role in satisfaction with career and work–life balance. Clinical faculty respondents without children at home reported significantly greater career satisfaction and better work–life balance than their nonclinical counterparts. Nonclinical faculty respondents with children reported greater satisfaction and better balance than counterparts without family responsibilities. However, the advantage in career satisfaction and work–life balance for clinical faculty respondents disappeared for those with responsibility for young children. No gender-based differences were noted in the results or across faculty rank for respondents; however, for women, reaching associate professor resulted in greater career satisfaction. Conclusion: This study suggests that both work-related factors and family responsibilities influence satisfaction with career and work–life balance, but the predictors appear to interact in complex and nuanced ways. Further research is needed to delineate more clearly these interactions and to explore other factors that may play important additional roles. PMID
Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia Pleotis; Villablanca, Amparo C
Balancing career and family obligations poses challenges to medical school faculty and contributes to dissatisfaction and attrition from academics. We examined the relationship between family setting and responsibilities, rank, and career and work-life satisfaction for faculty in a large U.S. medical school. Baseline faculty surveys were analyzed from the first year of a 4-year National Institutes of Health-funded study to evaluate awareness, knowledge, attitudes, and use of family friendly policies and career satisfaction. The study focus was on the impact of family responsibilities and characteristics of the faculty position (rank, clinical vs. nonclinical, and academic series) in multivariate comparisons between primary predictors and outcomes of interest. Both clinical and family responsibilities for children under 18 play a major and interacting role in satisfaction with career and work-life balance. Clinical faculty respondents without children at home reported significantly greater career satisfaction and better work-life balance than their nonclinical counterparts. Nonclinical faculty respondents with children reported greater satisfaction and better balance than counterparts without family responsibilities. However, the advantage in career satisfaction and work-life balance for clinical faculty respondents disappeared for those with responsibility for young children. No gender-based differences were noted in the results or across faculty rank for respondents; however, for women, reaching associate professor resulted in greater career satisfaction. This study suggests that both work-related factors and family responsibilities influence satisfaction with career and work-life balance, but the predictors appear to interact in complex and nuanced ways. Further research is needed to delineate more clearly these interactions and to explore other factors that may play important additional roles.
Saxena, Anurag; Desanghere, Loni; Stobart, Kent; Walker, Keith
With current emphasis on leadership in medicine, this study explores Goleman's leadership styles of medical education leaders at different hierarchical levels and gain insight into factors that contribute to the appropriateness of practices. Forty two leaders (28 first-level with limited formal authority, eight middle-level with wider program responsibility and six senior- level with higher organizational authority) rank ordered their preferred Goleman's styles and provided comments. Eight additional senior leaders were interviewed in-depth. Differences in ranked styles within groups were determined by Friedman tests and Wilcoxon tests. Based upon style descriptions, confirmatory template analysis was used to identify Goleman's styles for each interviewed participant. Content analysis was used to identify themes that affected leadership styles. There were differences in the repertoire and preferred styles at different leadership levels. As a group, first-level leaders preferred democratic, middle-level used coaching while the senior leaders did not have one preferred style and used multiple styles. Women and men preferred democratic and coaching styles respectively. The varied use of styles reflected leadership conceptualizations, leader accountabilities, contextual adaptations, the situation and its evolution, leaders' awareness of how they themselves were situated, and personal preferences and discomfort with styles. The not uncommon use of pace-setting and commanding styles by senior leaders, who were interviewed, was linked to working with physicians and delivering quickly on outcomes. Leaders at different levels in medical education draw from a repertoire of styles. Leadership development should incorporate learning of different leadership styles, especially at first- and mid-level positions.
Shaw, Marta; Rypien, Candace; Drummond, Neil; Harasym, Patricia; Nixon, Lara
Primary care initiatives face an imperative to not only reduce barriers to care for their patients but also to uniquely accommodate the complex needs of at-risk patient populations. Patient-centered multidisciplinary care team models for primary care, like the Alex Seniors Clinic, are one approach for providing comprehensive care for marginalized seniors. The purpose of this qualitative study was to explore patient perspectives on the responsiveness of the Alex Seniors Clinic to their stated health needs. Themes reflected participants' perspectives on factors impacting their health needs as vulnerable seniors as well as on the measures that the Alex Seniors Clinic has taken to meet those needs. Factors impacting health included: the nature of their relationships to the physical environment in which they lived, the nature of the relationships they had to others in that environment, and independence and autonomy. Participants identified accessibility, respect and support, and advocacy as the ways in which the clinic was working to address those health needs. While respect and support, as well as advocacy, effectively addressed some patient needs, participants felt that accessibility problems continue to be health-related barriers for clinic patients. This may be due to the fact that issues of accessibility reflect larger community and social problems. Nevertheless, it is only through engaging the patient community for input on clinic approaches that an understanding can be gained of how closely a clinic's care goals are currently aligning with patient perspectives of the care and services they receive.
Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...
Dapp, U; Anders, J; Meier-Baumgartner, H P; v Renteln-Kruse, W
Nearly all diseases in old age that are epidemiologically important can be reduced or prevented successfully through consequent changes in individual lifestyle, a systematic provision of measures in primary prevention (i.e. vaccination programmes) and the creation of health promoting settings. However, at the moment the amount of potential for preventative interventions is neither systematically nor sufficiently utilised in Germany. Two different preventative approaches: a) multidimensional advice session in small groups through an interdisciplinary team at a geriatric centre (seniors come to seek advice offered at a centre) or b) multidimensional advice at the seniors home through one member of the interdisciplinary team from the geriatric centre (expert takes advice to seniors home) were tested simultaneously with a well-described study sample of 804 independent community-dwelling senior citizens aged 60 years or over, without need of care and cognitive impairments recruited from general practices. Information about target group specific approaches in health promotion and prevention for senior citizens were retrieved from analyses of sociodemographic, medical, psychological and spacial characteristics of this study sample. The majority of the study sample (580 out of 804 or 72.1%) decided to participate: a) 86.7% (503 out of 580) attended at the geriatric centre and sought advice in group sessions and b) 13.3% (77 out of 580) decided to receive advice in a preventive home visit. A total of 224 seniors (224 out of 804 or 27.9%) refused to participate at all. These three target groups were characterised on the basis of their age, gender, education, social background, health status, health behaviour, use of preventive care, self perceived health, functional disabilities, social net and social participation and distance or accessibility of preventative approaches. The 503 senior citizens who participated in small group sessions at the geriatric centre were
Liao, Hui; Subramony, Mahesh
Pursuing a customer-focused strategy in manufacturing organizations requires employees across functions to embrace the importance of understanding customer needs and to align their everyday efforts with the goal of satisfying and retaining customers. Little prior research has examined what factors influence employee customer orientation in manufacturing settings. Drawing on the attraction-selection-attrition model, upper-echelons theory, and contingency theories of leadership, this study investigated the joint influences of functional roles' proximity to external customers and the senior leadership team's customer orientation on employee customer orientation. Hierarchical linear modeling results based on data obtained from 4,299 employees and 403 senior leaders from 42 facilities of a global manufacturer operating in 16 countries revealed that employees occupying customer-contact roles had the highest level of customer orientation, followed by employees occupying production roles, and then by those in support roles. In addition, there was a positive relationship between the senior leadership team's customer orientation and employee customer orientation for all 3 functional roles. The positive relationship between the senior leadership team and employee customer orientation was the strongest for employees in support roles, suggesting that lower levels of proximity to external customers may create a greater need for leadership in developing employees' customer-oriented attitudes. Copyright 2008 APA
Full Text Available The growth of the elderly and middle-aged population, and the life expectancy have changed the attitudes towards the seniors; Meanwhile, the importance of caring for the self-esteem among the seniors required to do this study in the field; which, its results can help to improve the seniors’ mental health. This study has been carried out aiming to measure the elderly’s self-esteem dwelling in Ahwaz Nursing Homes in 2014. This is a descriptive-comparative study carried out on 190 people of the seniors dwelling in Ahwaz nursing homes. For the eligible seniors, two questioners of Rosenberg’s Measuring Scale, and Cooper Smith’s Measuring Scale were filled out. The variables regression was determined by using SPSS statistical software, version 18. About 44% of participants in the study were aged from 60 to 65 years old. 68% were men, and 61% were married. Some 50% had 3 to 5 children. More than 43% received higher education. Some 53% were financially dependent. About 50% were self-employed. There was no significant difference between self-esteem among the male and female seniors. Also, there was no significant difference among the elderly’s self-esteem based on their marital status. But, there was a significant negative correlation between the total scores of self-esteem, and the marital status, the financial independence, and dwelling in the nursing homes. As, for the effect of the self-esteem on the elderly’s mental health, and their being highly affected by the life conditions, and with respect to the cultural, religious, and social position of Iran, as much as possible, the backgrounds should be provided for the seniors to dwell with their families; and, if dwelling in the nursing homes is the best choice, providing necessary services with high quality should be employed with grater attempts.
Ellis, Julie L; Morzinski, Jeffrey A
The purpose of this study was to determine the impact of a nurse-led, church-based educational support group for "at-risk," older African Americans on hospitalization and emergency department use. Study nurses enrolled 81 "at-risk" older adult members of ten churches. Participants completed a trifold pamphlet identifying personal health information and support, and they attended eight monthly educational/support group sessions in their church during the 10-month intervention. Study nurses completed a risk assessment interview with each senior both pre- and post-participation. The study nurse completed post-program assessments with 64 seniors, a 79% retention rate. At the program's conclusion researchers conducted a focus group with the study RNs and used an anonymous written survey to gather participant appraisals of program elements. Neither hospitalization nor emergency department/urgent care usage was significantly different from pre- to post-program. Session attendance was moderate to high and over half of the seniors brought a family member or friend to one or more sessions. The majority of seniors initiated positive health changes (e.g., smoking cessation, weight loss, or diet changes). Participants expressed high satisfaction and expressed satisfaction to perceive that they were supporting other seniors in their community. We conclude that this intervention was successful in engaging and motivating seniors to initiate health behavior change and contributed to a health-supportive church-based community. To demonstrate a statistically significant difference in hospital and ED usage, however, a stronger intervention or a larger sample size is needed.
The author is a nursing management practitioner, whose purpose in writing this paper is twofold: to examine the impact of corporate memory loss on a health care institution, caused by increasing retirement rates of senior executives; and to use this research as an opportunity for action learning where both the author and the institution can benefit from the learning outcomes. Using qualitative research methods based on ethnographic interviewing techniques and grounded theory, the author interviews 12 senior executives from four diverse health care facilities. The purpose is to determine the point at which corporate memory loss, in the form of tacit knowledge in the heads of departing executives, becomes a problem for the institution. The research determined that the requisite managerial competencies normally assumed for senior management positions are insufficient to minimize the negative impacts of corporate memory loss caused by departing senior executives. Effective knowledge management and knowledge transfer within the organization are fundamental for ongoing organizational effectiveness. The research is limited to 12 senior executives. The grounded theory nature of the research provides a framework for more research in other institutions to test and further explore some of the findings. One of the most significant threats facing the majority of health care organizations related to the aging workforce is the greater number of staff who are retiring from all levels within the organization. The development of techniques to reducing the impact of corporate memory loss on the culture of an organization will increase its effectiveness, help build continuity, and provide a more secure footing for the workforce of the future. The exit of knowledge workers is causing a major problem for Canada's health care organizations. This study throws more light on to this problem from the point of view of senior executives who have been specifically impacted by the problem of
McKenna, Alexandra C; Kloseck, Marita; Crilly, Richard; Polgar, Jan
As the demographic of older people continues to grow, health services that support independence among community-dwelling seniors have become increasingly important. Personal Emergency Response Systems (PERS) are medical alert systems, designed to serve as a safety net for seniors living alone. Health care professionals often recommend that seniors in danger of falls or other medical emergencies obtain a PERS. The purpose of the study was to investigate the experience of seniors living with and using a PERS in their daily lives, using a qualitative grounded theory approach. Five focus groups and 10 semi-structured interviews, with a total of 30 participants, were completed using a grounded theory approach. All participants were PERS subscribers over the age of 80, living alone in a naturally occurring retirement community (NORC) with high health service utilization in a major urban centre in Ontario. Constant comparative analysis was used to develop themes and ultimately a model of why and how seniors obtain and use the PERS. Two core themes, unpredictability and decision-making around PERS activation, emerged as major features of the theoretical model. Being able to get help and the psychological value of PERS informed the context of living with a PERS. A number of theoretical conclusions related to unpredictability and the decision-making process around activating PERS were generated.
McCray, Janet; Warwick, Rob; Palmer, Adam
This paper aims to explore the influence of one cycle of a learning set experience in a postgraduate medical leadership development programme. It does so from two perspectives: first, from the self-reports of nine senior doctors working in leadership roles in England in the National Health Service; and second from a researcher perspective as we…
Conclusion: Whether or not the replacement of nasogastric tubes and urinary catheters among the LTCF senior resident population is an appropriate use of time and targeted medical resources needs further investigation. When addressing concerns about the community healthcare needs of senior residents of LTCFs, policymakers should carefully consider the current shortage of professional healthcare workers as they assess strategies to best meet the needs of the elderly in Taiwan.
Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur
The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Stoddart, Kathleen; Bugge, Carol; Shepherd, Ashley; Farquharson, Barbara
To investigate the experience and views of senior charge nurses in relation to the implementation of a national clinical leadership policy. The role of the senior charge nurse in providing clinical leadership is evolving. However, recent evidence suggests that research is needed to inform the development of leadership and quality improvement and to connect them. Data were collected using an electronic survey to all senior charge nurses in one locality and semi-structured interviews with a subsample of respondents. Fifty (54%) senior charge nurses responded to the survey and nine were interviewed. Senior charge nurses reported mainly positive perceptions of clinical leadership, clinical team performance and improvement of care delivery for patients following the leadership programme implementation. Themes related to confidence, quality improvement and team performance were generated. 'Leading Better Care' was reported to enhance senior charge nurse clinical leadership, with some development needed to link the details of change management with the wider strategic direction. Nurse managers may wish to ensure that their clinical leaders have clarity of role in order to inspire confidence. Some challenges were noted in achieving improvement in quality and it is possible that if improvement in quality is the cornerstone of patient-centred care then it needs to be placed centrally in workload considerations. © 2012 John Wiley & Sons Ltd.
Galam, Éric; Multon, Romain
Disagreements and conflicts have a negative impact on the satisfaction and the performances of working team members. Young doctors in training are part of the health care team. The management of the disagreements with which they are confronted is a part of their professionalization process. To clarify and analyze the disagreements between GP trainees and their seniors in patients care and their consequences in doctor curriculum. Qualitative descriptive study. Five focus groups including a total of 25 Parisian trainees were performed to explore situations of disagreements with their seniors about patients care. Phenomenical analysis was performed by two researchers. Thirty-seven situations were reported. A number of potential sources of conflicts were highlighted. Factors that can transform a disagreement into an insoluble conflict were identified. The consequences of these disagreements on the quality of care and their impact on the empowerment of trainees were analysed. Number of disagreements related patients facing end of life. Specificities of emergency contexts and ambulatory practice were underlined. The role of the hierarchical link in the genesis and the development of the conflicts was confirmed. The personality of the trainee, his conception of responsibility, the exchange of knowledge, the "commercial" aspects of doctors practice can be at the origin of conflicts. The disagreements can play a positive role in trainees empowerment. A training in the management of anticipated or known conflicts can usefully clarify and optimize the hidden curriculum of the medical students towards professionalism. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
New to social media? This easy-to-use guide will get you started in no time! Social media is a ton of fun, and this updated guide makes it easy to set up a Facebook or Twitter account to catch up with old friends, communicate with your family, and enjoy your online experience. You'll get hands-on guidance to connecting to the Internet with a computer or mobile device, creating social media accounts and profiles, searching for friends, joining groups, sharing photos and videos, and more. If you're one of the 100+ million seniors using Facebook or other social media sites, this 2nd Edition of Fa
Rudman, Deborah Laliberte; Friedland, Judith; Chipman, Mary; Sciortino, Paola
Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55-64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.
Nimrod, Galit; Berdychevsky, Liza
Focusing on sex, the most salient topic featured in ageist jokes, this study aims at exploring the extent to which seniors' own humor reflects common ageist stereotypes or rather echoes contemporary consumer society representations of seniors' sexuality. The study was based on a quantitative content analysis of 300 humorous sex-related messages posted during one full year by members of 14 leading online communities for seniors. Findings indicated that whereas the portrayal of older adults in humor typically relied on negative ageist stereotypes, their representation in seniors' online sex-related humor depended on the social identity of the butt of this humor. If it was an in-group member (oneself, another community member, or the community as a whole), the portrayal was rather positive, but when the butt belonged to the out-group (older adults in general), the depiction was far more ageist. Nonetheless, the representation of older butts of humor was generally more positive than that of the younger ones. These findings suggest that seniors tend to identify with current cultural representations of sexuality in later life and use sex-related humor as a personal means of resisting ageism. They apply two principal strategies: Distancing-reproducing certain ageist stereotypes by ascribing them to other older adults, but less so to their own group and even less than that to themselves-and equalizing older and younger individuals, even according the former an advantage regarding sexuality. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Gomez, J.M.G.; Prieto, C.
The seniority scheme is discussed in the framewok of quasi-spin formalism. It is shown that the ground-state wave function of the seniority scheme can be determined self-consistently from a set of Hartree-Fock seniority equations derived from the variational prinicple. The method takes into account the mean-field and the pairing correlations in nuclei at the same time. Angular momentum and particle number are exactly conserved. (author)
Attitude to old age varies depending on the cultural context - historical, like changing the public perception of the elderly and attitude to senior age. Since the 60s of the twentieth century in sociology is functioning the concept of ageism, describing the phenomenon of discrimination against older people because of their age. It manifests itself in a dismissive ratio deficits on offer for seniors or problems in the labor market. Social stigmatization of seniors has a direct impact on their...
Houston Public Library, TX.
A pamphlet on special aids for senior library users lists items available from the Houston Public Library. Magnifiers (some illuminated), bedspecs (prism glasses), book holders, large print telephone dials, and games suitable for the visually handicapped or bedridden are described. The library's collections of slides and films, both 8mm and 16mm,…
Abdul-Rahaman, Nurudeen; Rahaman, Abdul Basit Abdul; Ming, Wan; Ahmed, Abdul-Rahim; Salma, Abdul-Rahaman S.
Governments all over the world have been improving their educational sector through funding programs aimed at reducing the financial burden on parents, increasing access and quality to education. The government of Ghana in 2017 switched policy to a free senior high school policy to reduce poverty by finally eliminating the financial burdens…
Full Text Available Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions. While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid. As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values. While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism. The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.
Lambert, Trevor W; Smith, Fay; Goldacre, Michael J
To report doctors' views about the European Working Time Directive ('the Directive'). Survey of the medical graduates of 2002 (surveyed in 2013-2014). Medical graduates. UK. Questions on views about the Directive. The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work-life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors' training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Senior doctors agreed that the Directive benefited doctors' work-life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.
SHAMS VAHDATI, Samad; SARKHOSH KHIAVI, Reza; RAJAEI GHAFOURI, Rouzbeh; ADIMI, Ida
SUMMARY: Objectives: Lower back pain is one of the most common complaints among the general population and among health professionals. Multiple workplace-related risk factors may contribute to back pain among physicians. The aim of this study was to assess the prevalence of lower back pain among medical residents of different medical specialties and to evaluate the relevant risk factors. Methods: A Dutch Musculoskeletal Questionnaire (DMQ) was completed by 125 medical residents. Part I conce...
Die Zukunft der ärztlichen Weiterbildung in Deutschland – Positionspapier des Ausschusses Weiterbildung der Gesellschaft für Medizinische Ausbildung (GMA [The future of graduate medical education in Germany – Position paper of the committee on graduate medical education of the Society for Medical Education (GMA
Full Text Available [english] The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung, other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education.With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA would like to point out some central questions for this process and support the current discourse.As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy.In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.[german] Die ärztliche Weiterbildung in Deutschland befindet sich im Umbruch. Neben der aktuellen Reform der Musterweiterbildungsordnung spielen gesellschaftliche, demographische, gesundheits- und forschungspolitische Faktoren eine wichtige Rolle für die Zukunft und Konkurrenzfähigkeit der ärztlichen Weiterbildung.Der Ausschuss für Weiterbildung der Gesellschaft für Medizinische Ausbildung (GMA möchte mit diesem Positionspapier auf zentrale Fragen in diesem Prozess aufmerksam machen und Impulse für den aktuellen Diskurs geben.Dabei kann die GMA als interdisziplinäre und interprofessionelle Fachgesellschaft wichtige Beiträge zu einer evidenzbasierten und zukunftsorientierten Weiterbildungsstrategie liefern.Im vorliegenden Papier werden anhand von vier Leitfragen zu
This thesis "Nurse as a support of long-term hospitalized senior" is divided into a theoretical and an empirical part. It deals with the issue of long-term hospitalization of seniors at the aftercare department, especially with the nurses' support to seniors and their interrelationships. Three main goals were appointed. It was examined how the seniors perceive nurses who takes care of them. Then in which areas nurses are supportive and which techniques they try to use to be a support for seni...
Görlitz, Anja; Ebert, Thomas; Bauer, Daniel; Grasl, Matthäus; Hofer, Matthias; Lammerding-Köppel, Maria; Fabry, Götz
Recent developments in medical education have created increasing challenges for medical teachers which is why the majority of German medical schools already offer educational and instructional skills trainings for their teaching staff. However, to date no framework for educational core competencies for medical teachers exists that might serve as guidance for the qualification of the teaching faculty. Against the background of the discussion about competency based medical education and based upon the international literature, the GMA Committee for Faculty and Organizational Development in Teaching developed a model of core teaching competencies for medical teachers. This framework is designed not only to provide guidance with regard to individual qualification profiles but also to support further advancement of the content, training formats and evaluation of faculty development initiatives and thus, to establish uniform quality criteria for such initiatives in German-speaking medical schools. The model comprises a framework of six competency fields, subdivided into competency components and learning objectives. Additional examples of their use in medical teaching scenarios illustrate and clarify each specific teaching competency. The model has been designed for routine application in medical schools and is thought to be complemented consecutively by additional competencies for teachers with special duties and responsibilities in a future step. PMID:26038688
Zellner Keller, Brigitte; Singh, Nirbhay N; Winton, Alan S W
A number of cognitive interventions have been developed to enhance cognitive functioning in the growing population of the elderly. We describe the Mindfulness-Based Cognitive Approach for Seniors (MBCAS), a new training program designed especially for seniors. It was conceived in the context of self-development for seniors who wish to enhance their relationship with their inner and outer selves in order to navigate their aging process more easily and fluently. Physical and psychosocial problems related to aging, as well as some temporal issues, were taken into account in developing this program. Unlike clinically oriented mindfulness-based programs, which are generally delivered during an 8-week period, the MBCAS training program is presented over a period of 8 months. The main objectives of this program are to teach seniors to observe current experiences with nonjudgmental awareness, to identify automatic behaviors or reactions to current experiences that are potentially nonadaptive, and to enhance and reinforce positive coping with typical difficulties that they face in their daily lives. Details of the program development and initial implementation are presented, with suggestions for evaluating the program's effectiveness.
Full Text Available Recent studies show that seniors will soon become one of the major prospective segments in hospitality and travel industry. Given that population aged 65+ is usually retired with pensions, they have leisure time for travelling at any time of the year. They are also the most demanding expecting services excellence and high-level security while at the same time 63% of seniors aged 65-74 reported some sort of chronic illness. Hence, energy-efficient and health-focused facilities can be a significant potential for tourism development in Sarajevo region, which is a popular destination considering its unique nature, rich gastronomic, cultural and historical heritage. However, currently there is no market segmentation tailored to specific needs of senior tourists and research aims to explore opportunities for this type of services with the objective of introducing accommodation facilities for elderly based on eco-smart solutions with highlighted focus on well-being and health. Setting of still water machines and installation of renewable energy system for electricity, ventilation and heat can have various positive effects increasing security, providing more healthy conditions, influencing life expectancy and counteracting the aging. Methodology includes feasibility study of eco-smart and health-oriented facility for seniors while practical implications for future actions are given in the conclusion.
Prenestini, Anna; Calciolari, Stefano; Lega, Federico; Grilli, Roberto
Health care organizations are pressured to improve the cost-effectiveness of service delivery. Clinical governance is an important trigger to improve care quality and safety and rank high in the reform agenda of health systems. The senior management team culture plays a major role in establishing clinical governance practices, because it strongly influences the values, attitudes, and behaviors of the members of an organization. The aim of this study was to investigate the relationship between senior management team culture and clinical governance in the public health care organizations of three Italian regions. The assessment of senior management culture was conducted using the Competing Values Framework and a corresponding instrument adapted for the Italian context. Clinical governance was assessed using an ad hoc instrument focused on the senior management team's perception and attitude toward clinical governance. The survey achieved a 54% response rate. The results of four different models demonstrate that organizations characterized by different dominant cultures are associated with significant differences in attitudes toward clinical governance. In particular, on average, dominant cultures with a prevailing external focus are associated with a more positive attitude toward clinical governance. The selection and appointments of top managers should consider the style of leadership that is most apt to facilitate the growth of rational and developmental cultures. Furthermore, the training of top managers and leading doctors should reinforce leadership aptitude and approaches that are consistent with the desired organizational cultures.
Quesne, C.; Spitz, S.
Configuration-seniority spectral distributions as well as fixed seniority and fixed total seniority and parity distributions are studied in detail for mixed configurations of identitical nucleons. The decomposition of any (1+2) -body Hamiltonian into irreducible tensors with respect to the unitary and symplectic groups in each subshell is obtained. Group theoretical methods based on the Wigner-Eckart theorem for the higher unitary groups are used to get analytical expressions for the partial widths of configuration-seniority distributions. During this derivation, various isoscalar factors for the chain SU (2Ω) is contained inSp (2Ω) are determined. Numerical calculations of centroid energies, partial widths, and mixing parameters are performed in the Sn and Pb nuclei with a surface delta and a gaussian interactions. Average ordinary and total seniority breaking is studied. Total seniority space truncations in the ground state region are discussed in the Pb nuclei in connections with various approximation schemes
Full Text Available We have given a group of 56 Massachusetts Institute of Technology (MIT seniors who took mechanics as freshmen a written test similar to the final exam they took in their freshman course as well as the Mechanics Baseline Test (MBT and the Colorado Learning Attitudes about Science Survey (CLASS. Students in majors unrelated to physics scored 60% lower on the written analytic part of the final than they would have as freshmen. The mean score of all participants on the MBT was insignificantly changed from their average on the posttest they took as freshmen. However, the students’ performance on 9 of the 26 MBT items (with 6 of the 9 involving graphical kinematics represents a gain over their freshman posttest score (a normalized gain of about 70%, while their performance on the remaining 17 questions is best characterized as a loss of approximately 50% of the material learned in the freshman course. On multiple-choice questions covering advanced physics concepts, the mean score of the participants was about 50% lower than the average performance of freshmen. Although attitudinal survey results indicate that almost half the seniors feel the specific mechanics course content is unlikely to be useful to them, a significant majority (75%–85% feel that physics does teach valuable problem solving skills, and an overwhelming majority believe that mechanics should remain a required course at MIT.
Full Text Available Background. Today, young people are more focused on getting education as such, without taking into account the profession. The relevance of this study is the identification of the level of professional self-determination of senior pupils, the mechanisms of formation of professional preferences. The article contains the concept and content of professional self-determination in adolescence; the results of the study on the formation of professional self-determination in senior pupils are presented. The study conducted among 9th grade pupils of secondary schools has revealed that the further gradual self-determination of the future specialty depends not only on psychological readiness for conscious choice. Materials and methods. The study involved 982 pupils of secondary schools in Ukraine. To study the level of formation of professional readiness, there was conducted a survey on the developed questionnaire. Statistical analysis was carried out using MS Excel and SPSS 17. Results. The results showed that professional intents of 9-graders are a key feature for solving the problem of high school selection and future careers. But for most students, these intentions are contradictory due to objective reasons. Radio, television, books don’t have a significant impact on the choice of professional self-determination. Conclusions. The conducted survey is self-sufficient for the analysis of professional orientation. But the choice of profession by the students is influenced by many factors. Therefore, carrying out the studies on vocational guidance requires an integrated approach.
Full Text Available The main purpose of this study is to portray career orientation of Senior High School (SMA and Vocational High School (SMK students and the role that school counselors should play in providing vocational guidance. This study used a survey method involving 278 students from both SMA and SMK di Jakarta. Career Orientation Inventory (COI and Counselor Role in Career Guidance Inventory were used as an instrument of data collection. Descriptive statistics and t-test were conducted to analyze the data. The findings of the study reveal that majority of SMA and SMK students wanted to further their study to university and only small number of them wanted to find out jobs or run their own business. The findings also show that school counselors play a very important role in providing vocational guidance services for senior secondary students. Therefore, in order for students to have a bright career in future, school counselors should improve the quality of vocational guidance services and plan comprehensive vocational guidance programs.
van der Molen, Pieta; Maas, Anne H; Chen, Wei; van Pul, Carola; Cottaar, Eduardus J E; van Riel, Natal A W; Hilbers, Peter A J; Haak, Harm R
The Eindhoven Diabetes Education Simulator project was initiated to develop an educational solution that helps diabetes patients understand and learn more about their diabetes. This article describes the identification of user preferences for the development of such solutions. Young seniors (aged 50-65 years) with type 2 diabetes were chosen as the target group because they are likely to have more affinity with digital devices than older people and because 88% of the Dutch diabetes population is >50 years of age. Data about the target group were gathered through literature research and interviews. The literature research covered data about their device use and education preferences. To gain insight into the daily life of diabetes patients and current diabetes education processes, 20 diabetes patients and 10 medical experts were interviewed. The interviews were analyzed using affinity diagrams. Those diagrams, together with the literature data, formed the basis for two personas and corresponding customer journey maps. Literature showed that diabetes prevalence is inversely correlated to educational level. Computer and device use is relatively low within the target group, but is growing. The interviews showed that young seniors like to play board, card, and computer games, with others or alone. Family and loved ones play an important role in their lives. Medical experts are crucial in the diabetes education of young senior diabetes patients. These findings are translated into a list of design aspects that can be used for creating educational solutions.
Muehlbauer, Thomas; Besemer, Carmen; Wehrle, Anja; Gollhofer, Albert; Granacher, Urs
Deficits in strength, power and balance represent important intrinsic risk factors for falls in seniors. The purpose of this study was to investigate the relationship between variables of lower extremity muscle strength/power and balance, assessed under various task conditions. Twenty-four healthy and physically active older adults (mean age: 70 ± 5 years) were tested for their isometric strength (i.e. maximal isometric force of the leg extensors) and muscle power (i.e. countermovement jump height and power) as well as for their steady-state (i.e. unperturbed standing, 10-meter walk), proactive (i.e. Timed Up & Go test, Functional Reach Test) and reactive (i.e. perturbed standing) balance. Balance tests were conducted under single (i.e. standing or walking alone) and dual task conditions (i.e. standing or walking plus cognitive and motor interference task). Significant positive correlations were found between measures of isometric strength and muscle power of the lower extremities (r values ranged between 0.608 and 0.720, p power and balance (i.e. no significant association in 20 out of 21 cases). Additionally, no significant correlations were found between measures of steady-state, proactive and reactive balance or balance tests performed under single and dual task conditions (all p > 0.05). The predominately nonsignificant correlations between different types of balance imply that balance performance is task specific in healthy and physically active seniors. Further, strength, power and balance as well as balance under single and dual task conditions seem to be independent of each other and may have to be tested and trained complementarily. Copyright © 2012 S. Karger AG, Basel.
Full Text Available Woojung Lee, Youran Noh, Hyeonjin Kang, Song Hee Hong Research Institute of Pharmaceutical Sciences, College of Pharmacy, Seoul National University, Seoul, Korea Background: Understanding how patient–physician communication affects patients’ medication experience would help hypertensive patients maintain their regular long-term medication therapy. This study aimed to examine whether patient–physician communication (information and interpersonal treatment affects patients’ medication experience directly or indirectly through changing medication adherence for each of the two communication domains.Methods: A self-administered cross-sectional survey was conducted for older patients who had visited a community senior center as a member. Two communication domains were assessed using two subscales of the Primary Care Assessment Survey. Medication adherence and experience were measured using the Morisky Medication Adherence Scale and a five-point Likert scale, respectively. Mediatory effects were assessed via Baron and Kenny’s procedure and a Sobel test. Results: Patient–physician communication had a positive prediction on patients’ medication experience (β=0.25, P=0.03, and this was fully mediated by medication adherence (z=3.62, P<0.001. Of the two components of patient–physician communication, only informative communication showed a mediatory effect (z=2.21, P=0.03. Conclusion: Patient–physician communication, specifically informative communication, had the potential to improve patients’ medication experience via changes in medication adherence. This finding can inform health care stakeholders of the mediatory role of medication adherence in ensuring favorable medication experience for older hypertensive patients by fostering informative patient–physician communication. Keywords: patient medication experience, medication adherence, patient–physician communication, patient-centered practice, patient-reported outcome, mediation
Beckett, Laurel; Nettiksimmons, Jasmine; Howell, Lydia Pleotis; Villablanca, Amparo C.
Background: Balancing career and family obligations poses challenges to medical school faculty and contributes to dissatisfaction and attrition from academics. We examined the relationship between family setting and responsibilities, rank, and career and work–life satisfaction for faculty in a large U.S. medical school.
Sullivan, Kathleen M
The social environment impacts the ability of older adults to interact successfully with their community and age-in-place. This study asked, for the first time, residents of existing Lesbian, Gay, Bisexual, and Transgender (LGBT) senior living communities to explain why they chose to live in those communities and what, if any, benefit the community afforded them. Focus groups were conducted at 3 retirement communities. Analysis found common categories across focus groups that explain the phenomenon of LGBT senior housing. Acceptance is paramount for LGBT seniors and social networks expanded, contrary to socioemotional selectivity theory. Providers are encouraged to develop safe spaces for LGBT seniors.
Figueiredo, Sabrina; Rosenzveig, Alicia; Morais, Jose A.; Mayo, Nancy E.
Objectives The objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors. Methods This was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Forward stepwise logistic regression was performed to identify the strongest contributors of poor health. Positive predictive value (PPV),...
von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F
The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.
Grenard, Jerry L; Uy, Visith; Pagán, José A; Frosch, Dominick L
To conduct a pilot study exploring seniors' perceptions of direct-to-consumer advertising (DTCA) of prescription drugs and how the advertisements might prepare them for making informed decisions with their physicians. We interviewed 15 seniors (ages 63-82) individually after they each watched nine prescription drug advertisements recorded from broadcast television. Grounded Theory methods were used to identify core themes related to the research questions. Four themes emerged from the interviews about DTCA: (1) awareness of medications was increased, (2) information was missing or misleading and drugs were often perceived as more effective than clinical evidence would suggest, (3) most seniors were more strongly influenced by personal or vicarious experience with a drug - and by their physician - than by DTCA, and (4) most seniors were circumspect about the information in commercial DTCA. DTCA may have some limited benefit for informed decision making by seniors, but the advertisements do not provide enough detailed information and some information is misinterpreted. Physicians should be aware that many patients may misunderstand DTCA, and that a certain amount of time may be required during consultations to correct these misconceptions until better advertising methods are employed by the pharmaceutical industry. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
McCabe, Sean Esteban; Boyd, Carol J; Cranford, James A; Teter, Christian J
To assess motives for nonmedical use of prescription opioids among US high school seniors and examine associations between motives for nonmedical use and other substance use behaviors. Nationally representative samples of US high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires. Data were collected in public and private high schools. The sample consisted of 5 cohorts (2002-2006) of 12 441 high school seniors. Self-reports of motives for nonmedical use of prescription opioids and substance use behaviors. More than 1 in every 10 high school seniors reported nonmedical use of prescription opioids and 45% of past-year nonmedical users reported "to relieve physical pain" as an important motivation. The odds of heavy drinking and other drug use were lower among nonmedical users of prescription opioids motivated only by pain relief compared with nonmedical users who reported pain relief and other motives and those who reported non-pain relief motives only. The odds of medical use of prescription opioids were lower among nonmedical users who reported only non-pain relief motives compared with other types of nonmedical users. The findings indicate motives should be considered when working with adolescents who report nonmedical use of prescription opioids. Future efforts are needed to identify adolescents who may need appropriate pain management and those at increased risk for prescription opioid abuse.
Ramos, Guilherme P; Nakamura, Fábio Y; Penna, Eduardo M; Wilke, Carolina Franco; Pereira, Lucas A; Loturco, Irineu; Capelli, Luciano; Mahseredjian, Fábio; Silami-Garcia, Emerson; Coimbra, Cândido C
The aim of this study was to compare locomotor activity profiles of Brazilian top-class female soccer players competing at distinct age brackets (U17, U20, and Senior). External match load of 14 U17, 14 U20, and 17 Senior female soccer players competing in 6-7 full official international matches were assessed using global positioning systems (GPS). Total distance covered, distance covered in high intensity (HID:15.6-20 kmh), distance covered in sprints (sprint:>20 kmh), number of accelerations (Acc)>1 ms, decelerations (Dec) >-1 ms, and Player Load generally increased across the age brackets (U17Senior). For all playing positions, Senior athletes presented greater total distance, accelerations, and decelerations than U20 players. For high-intensity distance and sprints, only central defender and midfielder senior players presented greater values than U20 players. Senior players demonstrated higher values in all locomotor activities in comparison to U17 players, irrespective of playing positions. Except for central defenders that presented similar total distance, sprint distance, and number of accelerations between U20 and U17, the majority of match external loads evaluated in all playing positions were greater in U20 than in U17 players. These results provide useful information for player development and should be used to establish appropriate match-specific conditioning drills according to age categories.
The medical humanities have been introduced in medical curricula over the past 30 years in the western world. Having medical humanities in a medical school curriculum can nurture positive attitudes in the regular work of a clinician and contribute equally to personality development. Though substantial evidence in favour of a medical humanities curriculum may be lacking, the feedback is positive. It is recommended that medical humanities be introduced into the curriculum of every medical school with the purpose of improving the quality of healthcare, and the attitudes of medical graduates.
Full Text Available Background: In a high tuberculosis (TB burden county like India with different regional demography, knowledge about patient profile has a pivotal role in determining and identifying the factors associated with poor treatment outcomes among TB re-treatment cases. Aim: The aim was to describe the demography and clinical characteristics of TB re-treatment cases and to evaluate the factors associated with poor treatment outcomes among those patients. Settings and Design: A prospective longitudinal cohort study was carried out at chest medicine outdoor from February, 2011 to 2014 in a district medical college of West Bengal, India. Materials and Methods: Sputum smear positive re-treatment pulmonary TB patients attending our chest medicine outdoor during the 3 years study period were evaluated for demographic and clinical characteristics on the basis of previous treatment history and records at the beginning of the study. Patients were followed-up during the 8 months treatment period (Category II treatment regimen under Revised National TB Control Program. At the end of the study period, treatment outcomes were analyzed and factors associated with poor treatment outcomes were identified. Statistical Analysis: All variables were described by proportions, and differences between independent groups were compared using the Chi-square test and Fisher′s exact test, as applicable. Results: Among 74 patients, re-treatment was successful in 75.7% of relapse case, 66.7% of loss to follow-up cases and 53.8% of failure cases. Re-treatment failure was higher (38.5% in treatment failure cases compare to relapse cases (10.8% and initial loss to follow-up cases (16.7%. Young age, male, unmarried, employed who work outside appears to be the risk factors for loss to follow-up. Low body mass index, treatment from the private sector, history of alcoholism, radiological cavitory lesion, larger duration of previous treatment, lesser gap from previous treatment has
Trujillo, Antonio J; Hyder, Adnan A; Ruiz, Fernando
Injuries among seniors are recognised as an important public health problem not only in developed countries but also in middle-income countries. There is ample epidemiological literature that relates economic growth to the reduction of infectious and childhood diseases. Less evidence exists to document if economic growth alone is enough to reverse the increasing trends of injury mortality and morbidity among seniors in a middle-income country. To investigate the association between economic growth and injury deaths among older people in Colombia. Using data from Colombia, 1979-2006 (n=28), time-series models were used to ascertain if the variation over time in injury mortality among seniors is related to short-term oscillations in economic performance. Four empirical specifications usually used in the analysis of such data were implemented. Models were run by type of injury and gender. A negative but moderate effect of economic growth was found on injury deaths among older people. The reported elasticity was between -0.98 and -1.26. Men benefit from economic growth more than women. Economic growth seems to reduce traffic injuries, suicides and homicides. A positive association was also found between falls and growth in gross domestic product. The results indicate a non-homogeneous association between economic growth and injury deaths among seniors in Colombia. This association is usually stronger in a negative direction among children and younger adults. Although more research is needed to understand the causal relationship between economic growth and injury, the association found may suggest that economic growth may not be sufficient to reverse injury deaths among older people; therefore, additional health policies need to be in place to reduce mortality due to preventable injuries in seniors.
Full Text Available [b]Introduction and objective[/b]. Modern medicine is still searching for the antecedents which will lead to [i]successful aging[/i]. The article discusses the self-perception of life satisfaction and health of senior citizens. The aim of the study was to determine the relationship between self-evaluation of life satisfaction and health by senior citizens in comparison to different age groups. [b]Materials and method[/b]. The study included 463 persons – 230 men and 233 women. The age of the participants was in the range 16 – 83 years. All participants were asked to fill the Life Satisfaction Questionnaire ([i]Fragebogen zur Lebenszufriedenheit [/i]– FLZ. The FLZ questionnaire assesses the global life satisfaction of a person and health domain separately. [b]Results[/b]. The results show age-related differences in the evaluation of life satisfaction. Accordingly, there is a significant change in health evaluations in different age groups, but there are no significant gender differences in health self-report data. The senior citizens’ assessment of general health, although the lowest among all the age-subgroups, showed significant difference only in relation to the people below 45 years of age. The significant differences in satisfaction from mental health occurred only for the elderly and participants aged 25–34 and 35–44. [b]Conclusions[/b]. Life satisfaction is associated with subjective health evaluations. There are two domains (mental health and performance that are positively evaluated by more than two-thirds of senior citizens. The observed differences challenge stereotypes and prejudices relating to negative aging process. Senior citizens can improve their control beliefs and develop self-regulation and coping skills.
Ding, Yew Yoong; Abisheganaden, John; Chong, Wai Fung; Heng, Bee Hoon; Lim, Tow Keang
We sought to compare the effectiveness of acute geriatric units with usual medical care in reducing short-term mortality among seniors hospitalized for pneumonia in the real world. In a retrospective cohort study, we merged chart and administrative data of seniors aged 65 years and older admitted to acute geriatric units and other medical units for pneumonia at three hospitals over 1 year. The outcome was 30-day mortality. Hierarchical logistic regression modeling was carried out to estimate the treatment effect of acute geriatric units for all seniors, those aged 80 years and older, and those with premorbid ambulation impairment, after adjusting for demographic and clinical characteristics, and accounting for clustering around hospitals. Among 2721 seniors, 30-day mortality was 25.5%. For those admitted to acute geriatric and other medical units, this was 24.2% and 25.8%, respectively. Using hierarchical logistic regression modeling, treatment in acute geriatric units was not associated with significant mortality reduction among all seniors (OR 0.72, 95% CI 0.52-1.00). However, significant mortality reduction was observed in the subgroups of those aged 80 years and older (OR 0.73, 95% CI 0.54-0.99), and with premorbid ambulation impairment (OR 0.65, 95% CI 0.46-0.93). Acute geriatric units reduced short-term mortality among seniors hospitalized for pneumonia who were aged 80 years and older or had premorbid ambulation impairment. Further research is required to determine if this beneficial effect extends to seniors hospitalized for other acute medical disorders. © 2012 Japan Geriatrics Society.
The purpose of this study was to assess children's understanding of plant nutrition. The research was done on a sample of secondary school pupils in the age range of 16 to 19 years in two senior secondary schools in Botswana. The sample contained 137 senior secondary pupils all in their final year of study. These children were above average…
... DEPARTMENT OF DEFENSE Office of the Secretary Senior Executive Service Performance Review Board AGENCY: Department of Defense Office of Inspector General, Department of Defense (DoD). ACTION: Notice. SUMMARY: This notice announces the appointment of the members of the Senior Executive Service (SES...
Edwards, James G.
The Maslach Burnout Inventory (MBI) was used to assess the level and intensity of burnout in 165 California State University at Long Beach college seniors preparing for the human services professions, specifically teaching, nursing, criminal justice, and social welfare. A comparison group of 80 engineering seniors was also assessed. The 40-item…
The research investigated the effects of learning styles on career preferences of senior secondary school students in Jigawa State, Nigeria. A total of six hundred students, three hundred and sixty male, and two hundred and forty female were randomly selected from ten senior secondary schools across the state for the study ...
Abma, T.A.; Heijsman, A.M.
A health promotion programme focusing on the meaning of everyday activities was implemented and evaluated to test its usefulness for community-dwelling seniors in the Netherlands. To evaluate how senior migrants with a Surinamese-Hindustani background and professionals received the programme, and
Taziev, Saljakhutdin Fardievich
The paper presents reasons for including the senior citizens into educational process, as well as active age model. Education, communication and leisure system for the senior citizens, implemented by Yelabuga municipal district, is presented as a requirement for model realization. A core of the paper is the Active Age Institute. Its program…
The study investigated the prevalence of conduct disorder among adolescents in a senior secondary school in Benin City. This was a survey study. The population was made up of 1,540 students in one of the mixed schools that was randomly selected from the senior secondary schools in Benin City, Edo State Nigeria.
The purpose of the study was to compare chemistry teachers' answers in a question related to evaporation with that of their senior secondary students. Two hundred and seventy six senior secondary students and their seven teachers participated in the study. The main data collecting instrument was the pictorial and verbal ...
In the present study, the internet addiction status of high school senior students in Yesilyurt county of Malatya was analyzed and examined in terms of gender variable. The study population consisted of 3442 senior students who were studying at 37 high schools in state schools in Yesilyurt County of the city of Malatya in 2016-2017 academic year.…
Seniorers frivillige arbejde i idrætten. Hvor mange arbejder frivilligt, udviklingen deri, politiske forventninger til de frivillige mv.......Seniorers frivillige arbejde i idrætten. Hvor mange arbejder frivilligt, udviklingen deri, politiske forventninger til de frivillige mv....
Spitz, S.; Quesne, C.
Configuration-seniority spectral distributions are used to analyse some properties of Ni 62 , and the results compared with those of shell model. The goodness of the symplectic symmetry is discussed by investigating the distributions with fixed seniority in every orbit
Southeastern Regional Vision for Education (SERVE), Tallahassee, FL.
Mentoring is an integral part of SERVE's Senior Project program. Mentors provide support and guidance to students as they complete the requirements of Senior Project by meeting with them to offer input on their research papers and assistance with the design and implementation of their projects. Approximately 100 schools in SERVE's 6-state region…
Armour, Robert; And Others
A total of 1,135 senior faculty from 6 institutions of higher education responded to a questionnaire designed to determine the relationships between personal and career development for senior college faculty and the similarities and differences in satisfaction among faculty from various disciplines. Responses from the questionnaire showed that…
Calcagno, R.; Renneboog, L.D.R.
We show that the relative seniority of debt and managerial compensation has important implications on the design of remuneration contracts.Whereas the traditional literature assumes that debt is senior to remuneration, we show that this is frequently not the case according to bankruptcy regulation
Calcagno, R.; Renneboog, L.
We show that the relative seniority of debt and managerial compensation has important implications for the design of remuneration contracts. Whereas the traditional literature assumes that debt is senior to remuneration, there are in reality many cases in which remuneration contracts are de facto
Cselenszky, Mila P.
The number of women in senior administrative and leadership roles in higher education is minimal compared to the number of women in higher education jobs in general. This phenomenological study explored pathways women took to advance in their careers and barriers that prevent more women from gaining senior administrative and leadership roles.…
List, Karen; Sorcinelli, Mary Deane
Mentoring has long been viewed as a powerful means of enhancing the professional success and personal wellbeing of early-career faculty; however, little is known about its benefits for senior faculty. Using data from a peer mentoring community of six senior faculty women in leadership roles at a research university, this study explores the impact…
The "Unsolved Problems in Number Theory" book by Richard Guy provides nice problems suitable for a typical math major. We give examples of problems that have worked well in our senior seminar course and some nice results that senior math majors can obtain.
... COURT SERVICES AND OFFENDER SUPERVISION AGENCY FOR THE DISTRICT OF COLUMBIA Senior Executive Service; Performance Review Board; Members AGENCY: Court Services and Offender Supervision Agency for the... agency's Senior Executive Service. The PRB established for the Court Services and Offender Supervision...
Pardasani, Manoj; Goldkind, Lauri
As critical components of the aging continuum of care, senior centers promote older adult health and well-being by providing opportunities for recreation, socialization, nutrition, health education, and access to vital social services. Nationally, a vast network of 11,000 senior centers serves over four million older adults annually. As the United…
Sarros, James C.; Sarros, Anne M.; Cooper, Brian K.; Santora, Joseph C.; Baker, Robin
This study examines the degree to which senior executive members of a school's decision-making team (senior management team and board of directors) are aligned on fundamental principles of school strategy. Our study is based on a conceptual framework of strategic leadership as it applies in an Australian independent school context. We also examine…
Brown, J; Cooper, C; Kirkcaldy, B
From a survey of over 500 senior UK police officers completing the occupational stress inventory, it was observed that those serving in England and Wales exhibited the highest job stress related to structure and climate, co-worker relationships and their managerial role. There were no inter-regional differences on the individual difference variables, Type A behaviour, locus of control, or on physical health measures. Superintendents in Scotland used coping methods least frequently including domestic/home support, time management and social support, the latter strategy being most used by Northern Ireland officers. Findings relating job stress to job satisfaction were inconsistent with other police populations. Results are discussed in the context of organizational reform in the police service.
Bonsignori, G.; Savoia, M.; Allaart, K.
The author's have described the spectra and electromagnetic properties of even semimagic nuclei in a generalized seniority (v/sub g/) scheme in a model space including up to v/sub g/=4 states. The author's conclude that ground states are for about 90% v/sub g/=0 states, 2/sub 1//sup +/ and 3/sub 1//sup -/ are for about 95% v/sub g/=2 states, while for other excited states one has in general 10-30% v/sub g/=4 admixtures is predominantly v/sub g/=2 states. Experimental evidence for these v/sub g/=4 admixtures came mainly from E2 decay and E2/M1 mixing ratios. A v/sub g/ mixing mechanism of particle-phonon coupling type may explain qualitatively the v/sub g/=4 admixtures and their effect on electromagnetic properties
McAtee, Robin E; Crandall, Debra; Wright, Larry D; Beverly, Claudia J
Are hospital-based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital-based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults. The findings highlight the similarities and differences in the three clinics' operating and financial structures in addition to the clinics' and providers' productivity. The analysis presents an evidence-based illustration that SHCs can break even or lose large amounts of money.
Full Text Available Elissa Burton,1 Anne-Marie Hill,1 Simone Pettigrew,2 Gill Lewin,3 Liz Bainbridge,1 Kaela Farrier,1 Phil Airey,4 Keith D Hill1 1School of Physiotherapy and Exercise Science, 2School of Psychology and Speech Pathology, 3School of Nursing, Midwifery and Paramedicine, Curtin University, 4Council on the Ageing, Perth, WA, Australia Purpose: The proportion of the population, that is older, is growing at a faster rate than other age groups. Physical activity is important for older people because it assists in living independently. Participating in resistance training on a regular basis (twice weekly is recommended for older people; yet, fewer than 15% of people over 60 years achieve this level. The aim of this article was to investigate the factors contributing to older people’s decisions to stop participation in a resistance training program.Participants and methods: Participants were older people who had chosen to participate in a structured resistance training program specifically designed for seniors and then after a period of time discontinued. This population received a questionnaire in the mail focused on factors contributing to their cessation of resistance training exercise. Qualitative results were analyzed using inductive content analysis.Results: Fifty-six survey responses were received (average age 71.5 years, SD =9.0; 79% females. Injury, illness, and holidaying were the main reasons for ceasing participation. A small but important number of responses (11% reported that they considered they were not provided with sufficient support during the resistance training programs.Conclusions: To attract and retain their senior clients, the results indicate that program organizers need to provide tailored support to return to resistance training after injury and offer flexible and individualized services that accommodate older people’s life choices in retirement. Keywords: older people, strength training, gymnasium, retention, aging
Verhaak Peter FM
Full Text Available Abstract Background In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is to improve our understanding about preferences of this group of patients in relation to non-medical attributes of primary health care. This may help to develop strategies to improve the quality of care that senior citizens receive from their GP. Methods Semi-structured interviews (N = 13 with senior citizens (65-91 years in a judgement sample were recorded and transcribed verbatim. The analysis was conducted according to qualitative research methodology and the frame work method. Results Continuity of care providers, i.e. GP and practice nurses, GPs' expertise, trust, free choice of GP and a kind open attitude were highly valued. Accessibility by phone did not meet the expectations of the interviewees. The interviewees had difficulties with the GP out-of-office hours services. Spontaneous home visits were appreciated by some, but rejected by others. They preferred to receive verbal information rather than collecting information from leaflets. Distance to the practice and continuity of caregiver seemed to conflict for respondents. Conclusions Preferences change in the process of ageing and growing health problems. GPs and their co-workers should be also aware of the changing needs of the elderly regarding non-medical attributes of GP care. Meeting their needs regarding non-medical attributes of primary health care is important to improve the quality of care.
Nawaz, Ather; Skjæret, Nina; Ystmark, Kristine
Exergames technologies are increasingly used to help people achieve their exercise requirements including balance training. However, little is known about seniors' user experience of exergame technology for balance training and what factors they consider most important for using the exergames....... This study aims to evaluate user experience and preferences of exergame technologies to train balance and to identify different factors that affect seniors' intention to use exergames. Fourteen healthy senior citizens played three different stepping exergames in a laboratory setting. Seniors' experience...... of the exergames and their preference to use exergames was assessed using a semi-structured interview, the system usability scale (SUS), and card ranking. The results of the study showed that in order for seniors to use exergames to train their balance, the exergames should particularly focus on challenging tasks...
Full Text Available BackgroundSelf-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students.MethodThis cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions.ResultsA total of 200 students, 121 (60.5% female and 79 (39.5% male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time-saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%, fever (63% and headache (60%. The students consulted their textbooks (39% and seniors or classmates (38% for the medications. Antipyretics (71%, analgesics (65%, antihistamines (37% and antibiotics (34% were the most common self-medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64% of students advised medications to others, more often to family and friends.ConclusionThe prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students.
Sheryl F Vondracek
Full Text Available Sheryl F Vondracek, Sunny A LinneburDepartment of Clinical Pharmacy, School of Pharmacy C238-L15, University of Colorado Denver, Aurora, CO, USAAbstract: The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weightbearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis.Keywords: osteoporosis, aged, elderly, eighty and over, senior, diphosphonates
Lindquist, Lee A; Tam, Karen; Friesema, Elisha; Martin, Gary J
The purpose of this study was to determine the motivation of paid non-familial caregivers of seniors, understand more about their work conditions, and identify any links to negative outcomes among their senior clients. Ninety-eight paid caregivers (eighty-five female and thirteen male), recruited from multiple sites (i.e. senior centers, shopping malls, local parks, lobbies of senior apartments, caregiver agency meetings) completed face-to-face questionnaires and semi-structured interviews. We found that 60.7% of participants chose to become a caregiver because they enjoyed being with seniors while 31.7% were unable to obtain other work, and 8.2% stated it was a prerequisite to a different health related occupation. Caregivers stated that the most challenging conditions of their work were physical lifting (24.5%), behavioral and psychological symptoms of dementia (24.5%), senior depression/mood changes (18.4%), attachment with impending death (8.2%), missing injuries to client (5.1%), lack of sleep (4.1%), and lack of connection with outside world (3.1%). Caregivers who reported that the best part of their job was the salary, flexible hours, and ease of work were significantly more likely to have clients who fell and fractured a bone than those who enjoyed being with seniors (job characteristics, 62.5% vs. senior enjoyment, 25.6%; pmotivated commonly by their love of seniors and also by their lack of other job opportunities. Paid caregivers frequently face challenging work conditions. When seeking a caregiver for a senior, motivation of the caregiver should be considered when hiring. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Jun, Won Hee; Lee, Gyungjoo
The aim of this study was to identify the significance of spirituality in enhancing self-efficacy related to professional values in senior nursing students. Self-efficacy can predict job satisfaction and performance as professional nurses in clinical settings. Senior nursing students should have the level of self-efficacy that enables them to perform professional roles based on professional values, because they will enter clinical settings immediately after graduation. Spirituality may help senior nursing students during the transition to professional life to reflect on their skills, knowledge and situations to enhance self-efficacy based on professional values. An exploratory, cross-sectional design was used in this study. A total of 194 senior nursing students in South Korea were recruited in 2014. They completed self-reported questionnaires consisting of demographic questions, Spiritual Assessment Scale, Self-Efficacy Scale and Nursing Professional Values inventory. A Sobel test was done to determine the mediating effect of spirituality on the relationship between nursing professional values and self-efficacy. The findings showed a positive correlation between professional values, spirituality and self-efficacy in nursing students. According to the Sobel test, spirituality had a mediating effect on the relationship between professional values and self-efficacy in senior nursing students. Spirituality can be a foundation that provides senior nursing students with higher self-efficacy so that they are able to perform their professional roles based on their professional values. The findings can guide nursing educators to include spiritual development of nursing students to enhance the self-efficacy of senior nursing students, the future of the nursing profession. © 2016 John Wiley & Sons Ltd.
... AGENCY FOR INTERNATIONAL DEVELOPMENT Senior Executive Services (SES) Performance Review Board... International Development, Office of Inspector General's Senior Executive Service Performance Review Board... Performance Review Boards. The board shall review and evaluate the initial appraisal of each USAID OIG senior...
Stirling, Carolyn C.
Women educational leaders struggle to achieve and sustain success in senior positions due to their attempts to manage societal expectations for balancing work and family. Societal expectations of being the primary caregivers result in working women attempting to navigate multiple professional and personal roles. Those who have attained the highest…
Kennedy, Matthew Joel; Arcelus, Amaya; Guitard, Paulette; Goubran, R A; Sveistrup, Heidi
Multiple toilet grab-bar configurations are required by people with a diverse spectrum of disability. The study purpose was to determine toilet grab-bar preference of healthy seniors, seniors with a hip replacement, and seniors post-stroke, and to determine the effect of each configuration on centre of pressure (COP) displacement during toilet transfers. 14 healthy seniors, 7 ambulatory seniors with a hip replacement, and 8 ambulatory seniors post-stroke participated in the study. Toilet transfers were performed with no bars (NB), commode (C), two vertical bars (2VB), one vertical bar (1VB), a horizontal bar (H), two swing-away bars (S) and a diagonal bar (D). COP was measured using pressure sensitive floor mats. Participants rated the safety, ease of use, helpfulness, comfort and preference for instalment. 2VB was most preferred and had the smallest COP deviation. Least preferred was H and NB. C caused largest COP displacement but had favourable ratings. The preference and safety of the 2VB should be considered in the design of accessible toilets and in accessibility construction guidelines. However these results need to be verified in non-ambulatory populations. C is frequently prescribed, but generates large COP deviation, suggesting it may present an increased risk of falls.
In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. TARGET POPULATION AND CONDITION Urinary incontinence defined as "the complaint of any involuntary leakage of urine" was identified as 1 of the key predictors in a senior's transition from independent community living to admission to a long-term care
Acmg Board Of Directors
Disclaimer: These recommendations are designed primarily as an educational resource for medical geneticists and other health-care providers, to help them provide quality medical genetic services. Adherence to these recommendations does not necessarily assure a successful medical outcome. These recommendations should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen. It may be prudent, however, to document in the patient's record the rationale for any significant deviation from these recommendations.Genet Med advance online publication 05 January 2017.
Full Text Available Objectives: The present study was designed to compare the level of happiness among the elderly population living at home with that of senior home residents. Methods & Materials: This was a causative-comparative study. The statistical population consisted of all 60 plus men and women residing at home and senior homes in the city of Tabriz, from whom 100 samples were selected in two groups of 50 individuals (25 females and 25 males using an availability non-random sampling method. The oxford happiness questionnaire was used in order to collect data, which were then analyzed using an independent t-test. Results: Results showed that the level of happiness among the elderly living at home was significantly higher than that of senior home residents. Furthermore, among indicators of happiness, life satisfaction levels, psychological health, positive mood, and efficiency were significantly higher among the elderly living at home. However, there was no significant difference between the two in terms of self-esteem. Conclusion: Findings indicate that, due to better social and family support, the level of happiness among the elderly living at home is significantly higher than that of senior home residents. Conversely, residing at senior homes consequent to financial and family conditions, for those who would otherwise live with family, leads to depressed mood, dissatisfaction with life, and ultimately lack of happiness.
Fogg, Christiana N; Kovats, Diane E
The International Society for Computational Biology (ISCB; http://www.iscb.org) honors a senior scientist annually for his or her outstanding achievements with the ISCB Accomplishment by a Senior Scientist Award. This award recognizes a leader in the field of computational biology for his or her significant contributions to the community through research, service and education. Cyrus Chothia, an emeritus scientist at the Medical Research Council Laboratory of Molecular Biology and emeritus fellow of Wolfson College at Cambridge University, England, is the 2015 ISCB Accomplishment by a Senior Scientist Award winner.Chothia was selected by the Awards Committee, which is chaired by Dr Bonnie Berger of the Massachusetts Institute of Technology. He will receive his award and deliver a keynote presentation at 2015 Intelligent Systems for Molecular Biology/European Conference on Computational Biology in Dublin, Ireland, in July 2015. email@example.com. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org.
Jelacic, Srdjan; Bowdle, Andrew; Togashi, Kei; VonHomeyer, Peter
The authors evaluated the educational benefits of using a first-generation HeartWorks simulator to teach senior anesthesiology residents basic echocardiography skills. Prospective observational study. A single academic medical center (teaching hospital). Thirty-seven senior (fourth-year) anesthesiology residents participated in this study. Groups of 3 senior anesthesiology residents participated in a single 3-hour tutorial in the simulation laboratory in the authors' institution during their cardiothoracic anesthesiology rotation. A cardiothoracic anesthesiology faculty member demonstrated the use of the transesophageal echocardiography (TEE) simulator and instructed the residents on obtaining standard TEE views of normal anatomy. Prior to the laboratory session, the residents took an online multiple-choice pretest with 25 questions related to safety, probe manipulation, clinical application, and pathology, which was accompanied by echo images of normal cardiac anatomy and video clips of pathology. Three to four weeks after the TEE tutorial, the residents completed an online post-test and evaluation of the teaching session. There was a statistically significant increase in knowledge of normal echocardiographic anatomy (p = 0.04), with an average improvement in normal echocardiographic anatomy scores of 15%. Virtual reality TEE simulation technology was endorsed strongly by residents, produced a statistically significant improvement in knowledge of normal echocardiographic anatomy, and could be effective for teaching basic echocardiography to anesthesiology residents. Copyright © 2013 Elsevier Inc. All rights reserved.
In the fall of 2007, the Government of Quebec set up a Public Consultation on Living Conditions of Seniors. Fifty sessions were held in 26 cities across all 17 regions of the province. More than 4000 seniors attended the sessions and 275 briefs were received from scientists and associations. Three themes were identified in the report published in 2008: supporting seniors and their caregivers, reinforcing the place of seniors in society, and preventing problems associated with aging (suicide, abuse, addictions). The main actions that I recommended included: Increasing the Guaranteed Income Supplement to prevent poverty; Modifying pension plans and working conditions to allow for progressive retirement; Making a major investment in home care to provide access to services regardless of place of residence; Introducing an Autonomy Support Benefit and autonomy insurance program for financing services to support people with disabilities; Generalizing an Integrated Service Delivery Network providing services to frail older people; Better training for professionals in gerontology. I also recommended setting up a National Policy on Seniors to align all government departments and agencies, municipalities and the private sector around a vision, objectives and a set of actions for improving the integration of seniors in an aging society. This would contribute to a more equitable, interdependent and wiser society. Unfortunately, the Government did not support these recommendations. It is now time for scientists to get involved in leading policy on seniors and in the political arena.
Boyal, Amunpreet; Hewison, Alistair
Purpose - The aim of this paper is to explore Senior nurses' experiences of leading organizational change. There is a substantial literature reporting middle-level nurse managers' experiences of change; however, there is less evidence concerning senior nurses' perspectives. In view of this, interview data collected from senior nurses, as part of a study of major organizational change, were analysed to redress this imbalance. Design/methodology/approach - In-depth semi-structured interviews (n = 14) were conducted with senior nurses (between 2009 and 2012). Findings - Senior nurses' activity centred on leadership and workforce issues, internal influences and external pressures. In periods of change, appropriate leadership was vital, and "weak" leaders were considered to have an adverse effect on teams. Concerns were expressed about financial strictures and their impact on patient care and service provision. The senior nurses were striving to provide the best quality of service delivery with the limited resources available. Concentration on operational matters was necessary to maintain stability in periods of change. However, this prevented senior nurses from influencing strategic decision-making in their organizations. Practical implications - If senior nurses are to realise their potential to operate at a strategic level, they need to be given time and support to lead, rather than just react to change. This research emphasises the importance of a "nursing voice" to inform board-level decisions and maintain a focus on patient care. Originality/value - This research sheds light on the work of a key group of staff in health-care organizations. Understanding senior nurses' experience of and contribution to change is a useful contribution to health services research.
Full Text Available The theoretical and practical aspects of the problem of bringing senior officials of the RF subjects to criminal liability are analyzed. Legal immunity as the most important feature of their legal status is considered. General characteristic of the liability of such senior officials in the context of the institute of state and law enforcement is provided. The current Russian legislation and judicial practice in this area are analyzed. Special attention is paid to the history of the issue of bringing senior officials to justice, on the example of the Federation Council member status. Basing on the other authors’ researches, the author proposes his own view on the issues of senior officials’ immunity. It’s suggested that in modern legal science the problems of the liability of senior officials of the RF regions aren’t given due attention. There’s no clear understanding of what should be the grounds of such liability, its procedures and application, the legal nature of its sanctions. The author substantiates the position that it’s not necessary to include the regional leaders or heads of executive authorities of the RF subjects in the list of persons having immunity from criminal or administrative prosecution. The arguments are the federal practice – the ministers of the RF Government don’t possess the immunity, and the recent practice – dismissal as a result of loss of confidence. The need to control the activities of the senior officials of the RF subjects and other persons holding the highest positions in the authorities of the RF subjects is substantiated.
Figueiredo, Sabrina; Rosenzveig, Alicia; Morais, Jose A; Mayo, Nancy E
The objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors. This was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Forward stepwise logistic regression was performed to identify the strongest contributors of poor health. Positive predictive value (PPV), sensitivity, and specificity were calculated to identify whether health perception could be used to identify people in need of physical rehabilitation services. 142 seniors agreed to answer the survey, yielding a response rate of 73%. Among the respondents (mean age 79±7; 60% women), 40% rated their health as fair or poor. Seniors perceiving their health as fair or poor had higher odds of reporting impairments, activity limitations, and participation restrictions (OR ranging from 2.37 95%CI: 1.03-5-45 to 12.22 95%CI: 2.68-55.78) in comparison to those perceiving their health as good or better. The strongest contributors for poor/fair health were depression, difficulty performing household tasks, pain, and dizziness (c-statistic = 0.91 and a maximum adjusted r -squared of 0.60). Self-rated health used as single-item showed a positive predictive value (PPV) of 1, sensitivity of 52%, and specificity of 100%. Our results indicate that all seniors participating in this study and reporting fair or poor health have indicators of need for further rehabilitation services. Asking patients to rate their own health may be an alternate way of querying about need, as many older persons are afraid to report disability because of fear of further institutionalization.
Full Text Available Background Evidence of reduced cardiovascular morbidity and mortality as well as cost support thiazide diuretics as the first-line choice for treatment of hypertension. The purpose of this study was to determine the proportion of senior hypertensives that received thiazide diuretics as first-line treatment, and to determine if cardiovascular and other potentially relevant comorbidities predict the choice of first-line therapy. Methods and Findings British Columbia PharmaCare data were used to determine the cohort of seniors (residents aged 65 or older who received their first reimbursed hypertension drug during the period 1993 to 2000. These individual records were linked to medical and hospital claims data using the British Columbia Linked Health Database to find the subset that had diagnoses indicating the presence of hypertension as well as cardiovascular and other relevant comorbidities. Rates of first-line thiazide prescribing as proportion of all first-line treatment were analysed, accounting for patient age, sex, overall clinical complexity, and potentially relevant comorbidities. For the period 1993 to 2000, 82,824 seniors who had diagnoses of hypertension were identified as new users of hypertension drugs. The overall rate at which thiazides were used as first-line treatment varied from 38% among senior hypertensives without any potentially relevant comorbidity to 9% among hypertensives with previous acute myocardial infarction. The rate of first-line thiazide diuretic prescribing for patients with and without potentially relevant comorbidities increased over the study period. Women were more likely than men, and older patients were more likely than younger, to receive first-line thiazide therapy. Conclusions Findings indicate that first-line prescribing practices for hypertension are not consistent with the evidence from randomized control trials measuring morbidity and mortality. The health and financial cost of not selecting the most
Azizi-Fini, Ismail; Hajibagheri, Ali; Adib-Hajbaghery, Mohsen
Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students' critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students' CTS. Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students. This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson's correlation coefficients were used in the data analysis. Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students' score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession. The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students' critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested.
Maheshwari, Bhoomika; Jain, Ashok Kumar
The generalized seniority approach proposed by us to understand the B(E1)/B(E2)/B(E3) properties of semi-magic nuclei has been widely successful in the explanation of the same and has led to an expansion in the scope of seniority isomers. In the present paper, we apply the generalized seniority scheme to understand the behavior of g-factors in semi-magic nuclei. We find that the magnetic moment and the gfactors do show a particle number independent behavior as expected and the understanding is consistent with the explanation of transition probabilities.
Sheng, Xiaojing; Simpson, Penny M
While seniors are the most likely population segment to have chronic diseases, they are the least likely to seek information about health and diseases on the Internet. An understanding of factors that impact seniors' usage of the Internet for health care information may provide them with tools needed to improve health. This research examined some of these factors as identified in the comprehensive model of information seeking to find that demographics, trust in health information websites, perceived usefulness of the Internet, and internal locus of control each significantly impact seniors' use of the Internet to seek health information.
Harmer, Bonnie McKay; Huffman, Jaime; Johnson, Barbara
The authors describe a clinical peer mentoring (CPM) program that partnered 16 pairs of senior (mentors) and sophomore (novices) BSN students to provide patient care on a dedicated education unit at a VA Medical Center. Situated learning theory and Tanner's Clinical Judgment Model provided frameworks for CPM implementation. Survey findings suggested novices and mentors perceived improvements in self-confidence, prioritization, time management, clinical judgment, and evidence-based practice use. Many mentors spontaneously expressed an interest in becoming a preceptor or nurse educator. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Roney, Linda; Kazer, Meredith Wallace
To gain insight into the aging sexual health experiences and concerns of older adults aged 60 years or older. Despite the prevalence of sexual activity among older adults and the documented health benefits, little is known about how sexual health changes as individuals age. Participants for this study were recruited through a local senior center and qualitative interviews were conducted. Eight older adults (six female, two male) between the ages of 62 and 95 participated in this study. Some participants commented that expression of sexuality changed due to partner's health. Some identified less sexual frequency and spontaneity, while others stated that they were now more open with their sexual relationship. Participants stated that they wished their or their partner's physicians would discuss their sexual needs. Sexual changes reported by participants in this study were consistent with the research relating sexual health to overall health. The finding that half the sample did not discuss sexual problems with anyone highlights the opportunity for nursing research to further explore this phenomenon. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available The paper deals with the issue of seniors’ security and safety, namely the security problems related to falls of independently living elderly citizens. The number of elderly people is growing very fast worldwide and very often they live unattended in their house or flat. In case of accidently falling down, they are often unable help themselves and stay on the floor for hours or even longer. This may lead even to the death if no help comes. Various possibilities of their fall detection are studied. We analyze the historical development, current capabilities and efficiency of different approaches and methods. We address the willingness and ability of seniors to actively use technology, detection limits, privacy, personal data security and other important factors. In addition, we discuss the challenges, current shortcomings, issues and trends in fall detection or operation reliability in real-life conditions. The main future goal would be to maintain the personal privacy and security of irrelevant information in modern fall detection systems.