Davidhizar, R; Dowd, S; Giger, J
Opportunities for minorities in healthcare increased with the Civil Rights movement in the 1960s. More recently, funds from the U.S. Public Health Service have been targeted toward disadvantaged minorities. The workforce in healthcare, and in business in general, has become increasingly multicultural. Much of the literature in healthcare management lacks practical guidelines for managing a diverse workforce. Communication, both verbal and nonverbal, and culture are closely intertwined. Managers, as they develop multicultural teams, will need to understand how culture influences communication in their organizations. Space, spatial behavior, and cultural attitudes influence people's behavior. This is a particularly important consideration for a radiology staff, which must often work in close quarters. For some cultural groups, the family as an organization has more significance than even personal, work-related or national causes. People's orientation to time, whether for the past, present or future, is usually related to the culture in which they grew up. Again, this may become an important issue for a radiology administrator whose organization must run punctually and time-efficiently. How patients feel about their environment, whether they believe they are in control or believe in an external locus of control, is of particular interest to those who attempt therapeutic changes in a patient's healthcare. Does the patient believe that illness is divine will or that suffering is intrinsic to the human condition? There is increasing research in the United States to show that people do differ biologically according to race. Such differences exist among patients as well as among staff members. It has been popular to assume that differences among races do not exist. Unfortunately such an attitude does not allow for different attributes and responses of individuals. Managing a multicultural staff presents a challenge to administrators who must be skilled in working with
Black, D A; Taggart, J; Jayasinghe, U W; Proudfoot, J; Crookes, P; Beilby, J; Powell-Davis, G; Wilson, L A; Harris, M F
There is evidence for a team-based approach in the management of chronic disease in primary health care. However, the standard of care is variable, probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients. This study aimed to evaluate the impact of a structured intervention involving non-GP staff in GP practices on the quality of care for patients with diabetes or cardiovascular disease. A cluster randomised trial was undertaken across 60 GP practices. The intervention was implemented in 30 practices with staff and patients interviewed at baseline and at 12-15 months follow up. The change in team roles was evaluated using a questionnaire completed by practice staff. The quality of care was evaluated using the Patient Assessment of Chronic Illness Care questionnaire. We found that although the team roles of staff improved in the intervention practices and there were significant differences between practices, there was no significant difference between those in the intervention and control groups in patient-assessed quality of care after adjusting for baseline-level score and covariates at the 12-month follow up. Practice team roles were not significantly associated with change in Patient Assessment of Chronic Illness Care scores. Patients with multiple conditions were more likely to assess their quality of care to be better. Thus, although previous research has shown a cross-sectional association between team work and quality of care, we were unable to replicate these findings in the present study. These results may be indicative of insufficient time for organisational change to result in improved patient-assessed quality of care, or because non-GP staff roles were not sufficiently focussed on the aspects of care assessed. The findings provide important information for researchers when designing similar studies.
Todays project management requires a number of abilities which involve finding quick solutions to shortage of staff members with possession of specific qualities. When persons with team responsibilities are under pressure or due to various circumstances are unable to perform exhaustive search in databases, an interactive visualization tool can come in quite handy in finding good solutions unforeseen occurrences. In particular we propose application of selected graphs for facilitating mobile human resource management.
Dräger, Dagmar; Budnick, Andrea; Kuhnert, Ronny; Kalinowski, Sonja; Könner, Franziska; Kreutz, Reinhold
Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement. A modified German version of the Brief Pain Inventory was used to assess pain sites, pain intensity and pain interference with function in various domains of life. The intervention consisted of separate training measures for nursing staff and treating physicians. The primary objective of reducing the mean pain intensity by 2 points was not achieved, partly because the mean pain intensity at baseline was relatively low. However, marginal reductions in pain were observed in the longitudinal assessment at 6-month follow up. The intervention and control groups differed significantly in the intensity sum score and in the domain of walking. Furthermore, the proportion of respondents with pain scores >0 on three pain intensity items decreased significantly. Given the multifocal nature of the pain experienced by nursing home residents, improving the pain situation of this vulnerable group is a major challenge. To achieve meaningful effects not only in pain intensity, but especially in pain interference with function, training measures for nursing staff and physicians need to be intensified, and long-term implementation appears necessary. Geriatr Gerontol Int 2017; 17: 1534-1543. © 2016 Japan Geriatrics Society.
Makino, Hitoshi; Umeki, Hiroyuki; Capouet, M.; Depaus, C.; Berckmans, A.
Staff management/training and knowledge management are organisational issues that are particularly sensitive in long-term projects stretching over decades like the development and operation of a geological repository. The IAEA has already issued several publications that deal with this issue (IAEA, 2006, 2008). Organisational aspects were also discussed in the framework of a topical session organised by the Integration Group for the Safety Case (IGSC) at its annual meeting in 2009 and were regarded as a topic deserving future attention (NEA, 2009a). More recently, the Forum on Stakeholder Confidence (FSC) identified organisational, mission and behavioural features as attributes of confidence and trust (NEA, 2013). They also identified that aspects such as structural learning capacity, high levels of skill and competence in relevant areas, specific management plan, good operating records, transparency and consistency are associated with confidence building in a safety case. These aspects are considerably related to staff training/management and knowledge management. The IGSC has initiated a proposal of study dedicated to staff training/management and knowledge management with the objective to highlight how these recent concerns and the requirements issued by the IAEA are concretely implemented in the national programmes. The goal of this study is to acknowledge the differences of views and needs for staff management and knowledge management at different stages of individual programmes and between implementer and regulator. As a starting point to this study, the JAEA and ONDRAF/NIRAS prepared a draft questionnaire in order to succinctly capture processes and tools that the national organisations have implemented to meet the requirements and address the issues set out in the field of staff and knowledge management. For the purpose of this study, a questionnaire is now under development, which will be presented on the occasion of this symposium with guidance based on a
"German General Staff Officer Education and Current Challenges" examines the institutional education of German General Staff Officers, as experienced by the author, and offers a "Conceptual Competency...
There are many possibilities of the division of the managing styles. In theory one can distinguish two basic styles: directive and integrative. Generalisations describing both styles result in the fact that they do not reflect reality taking place at work. Because of it they cannot be applied in such a form. Therefore, it is necessary to build up the theoretical concept of the managing styles through decreasing their generality and adjusting them to the reality requirements at the same time. For the reality of management Reddin concept seems to be useful. It describes the organizational behaviour of managers. He noticed that the managing style is effective when it fits into the manager's situation whereas it is ineffective in such a situation, when the manager cannot select and adjust the managing techniques to the circumstances of the concrete decision-taking situation. Putting together 3 handling ways: orientation on assignments, orientation on staff, effectiveness, 8 managing can be differentiated. The aim of the paper was an attempt to check what managing styles are used by the nursing management staff working in hospitals. To determine the managing style a questionnaire consisting of 64 statements divided into 8 groups was applied. The examined persons were assigned to distribute 10 points among the statements belonging to each group of tasks which are supposed to specify their solution in the best way. The nursing management staff prefer the styles belonging to the more effective one in which there is a high orientation on staff.
Morrow, Susan; Daines, Luke; Wiener-Ogilvie, Sharon; Steed, Liz; McKee, Lorna; Caress, Ann-Louise; Taylor, Stephanie J C; Pinnock, Hilary
Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices. The 12 interviews and three focus groups were transcribed, coded and analysed thematically. Supported self-management was largely a nurse-led task within clinic-based annual reviews. Barriers included poor attendance at asthma clinics, lack of time, demarcation of roles, limited access to a range of tailored resources, and competing agendas in consultation, often due to multimorbidity. Suggestions for initiatives to improve the provision of supported self-management included emphasising the evidence for benefit (to influence prioritisation), improving teamwork (including team-based education), organisational strategies (including remote consulting) which need to fit within existing practice routines. Technology offers some potential solutions (e.g., improved templates, 'app'-based plans), but must be integrated with the practice information technology systems. Building on these insights, we will now develop a theoretically-based implementation strategy that will address patient, professional, and organisational buy-in, provide team-based education and offer a range of practical options and tools, which can be adapted and integrated within existing routines of individual practices.OVERCOMING THE ORGANISATIONAL BARRIERS TO IMPLEMENTING ASTHMA SELF-MANAGEMENT: Understanding the routines of primary care practices can suggest strategies to implement supported self-management
Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine
In this article, the term "churn" is used not only because of the degree of change to staffing, but also because some of the reasons for staff movement are not classified as voluntary turnover. The difficulties for the nurse managing a unit with the degree of "churn" should not be under-estimated. Changes to skill mix and the proportions of full-time, agency, and temporary staff present challenges in providing clinical leadership, scheduling staff, performance management, and supervision. Perhaps more importantly, it is likely that there is an impact on the continuity of care provided in the absence of continuity of staffing. A greater understanding of the human and financial costs and consequences, and a willingness to change established practices at the institutional and ward level, are needed.
The purpose of Technical Staff and Technical Staff Managers training is to provide job skills enhancement to individuals selected to fill key technical positions within a nuclear utility. This training is unique in that unlike other training programs accredited by the National Academy for Nuclear Training, it does not lead to specific task qualification. The problems encountered when determining the student population and curriculum are a direct result of this major difference. Major problems encountered are determining who should attend the training, what amount of training is necessary and sufficient, and how to obtain the best feedback in order to effect substantive program improvements. These topics will be explored and possible solutions discussed
Nurses must constantly adapt to a variety of radical and incremental changes in the way they work, but their emotional responses can inhibit changes from being sustained in practice. Implementing sustainable and meaningful change means supporting each individual to find value in new ways of working. This article shows how a team of community nurses were empowered to improve their practice by using an electronic caseload tool. This was done in a structured and supportive way by using Lewin's change management process, an approach that has benefits for supporting and sustaining changes in practice.
In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, 24 April 2018 from 14.00 to 16.00, Main Auditorium, Meyrin (500-1-001). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its management, and an opportunity to express your opinion, particularly by taking part in votes. Other items are listed on the agenda, as proposed by the Staff Council. Who can vote? Ordinary members (MPE) of the SA can take part in all votes. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give their opinion, and how? The Ordinary General Assembly is also the opportunity for members of the SA to express themselves through the addition of discus...
In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Thursday, 24 April 2018 from 14.00 to 16.00, Main Auditorium, Meyrin (500-1-001). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its management, and an opportunity to express your opinion, particularly by taking part in votes. Other items are listed on the agenda, as proposed by the Staff Council. Who can vote? Ordinary members (MPE) of the SA can take part in all votes. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give their opinion, and how? The Ordinary General Assembly is also the opportunity for members of the SA to express themselves through the addition of disc...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Professional management and staff... management and staff. A CDC must have full-time professional management, including an Executive Director (or the equivalent) managing daily operations. It must also have a full-time professional staff qualified...
Failla, Kim Reina; Stichler, Jaynelle F
The purpose of this study was to look at manager and staff perceptions of the manager's leadership style and to determine what effect transformational leadership style has on job satisfaction. Nursing job satisfaction is a critical element in addressing the nursing shortage. Literature supports that job satisfaction is related to nurse manager leadership style. This fact has caused nurse managers to carefully consider their leadership style and the impact it has on the nurses they manage. A descriptive correlational, comparative design was used in a convenience sample of nurse managers and their direct report nursing staff (n = 92). A correlation was found between nurse manager transformational leadership style and nurse job satisfaction (r = 0.348, P leadership style was associated with higher levels of job satisfaction. The findings added to the knowledge about variables that are correlated with job satisfaction, which is a critical issue to nursing.
Williams, C. A.
Staff development, one of the nine main functions in personnel management, is not an isolated function. Administrators with whom the ultimate responsibility for personnel management rests, determine the extent to which the personnel and staff development specialists can be utilized. The staff development specialist has three major roles, as…
van Oorsouw, Wietske M. W. J.; Embregts, Petri J. C. M.; Bosman, Anna M. T.; Jahoda, Andrew
Background: A training package for staff working with clients presenting challenging behaviour was developed to (1) increase their knowledge regarding challenging behaviour, and (2) to improve the quality of physical intervention techniques. The latter aim was intended to reduce staff anxiety about dealing with incidents and limit physical risk of…
Oorsouw, W.M.W.J. van; Embregts, P.J.C.M.; Bosman, A.M.T.; Jahoda, A.
Background - A training package for staff working with clients presenting challenging behaviour was developed to (1) increase their knowledge regarding challenging behaviour, and (2) to improve the quality of physical intervention techniques. The latter aim was intended to reduce staff anxiety about
Burgio, L D; Whitman, T L; Reid, D H
The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed. PMID:6833168
Riisgaard, Helle; Søndergaard, Jens; Munch, Maria; Le, Jette V; Ledderer, Loni; Pedersen, Line B; Nexøe, Jørgen
Recent research has shown that a high degree of task delegation is associated with the practise staff's overall job satisfaction, and this association is important to explore since job satisfaction is related to medical as well as patient-perceived quality of care. This study aimed: (1) to investigate associations between degrees of task delegation in the management of chronic disease in general practice, with chronic obstructive pulmonary disease (COPD) as a case and the staff's work motivation, (2) to investigate associations between the work motivation of the staff and their job satisfaction. The study was based on a questionnaire to which 621 members of the practice staff responded. The questionnaire consisted of a part concerning degree of task delegation in the management of COPD in their respective practice and another part being about their job satisfaction and motivation to work. In the first analysis, we found that 'maximal degree' of task delegation was significantly associated with the staff perceiving themselves to have a large degree of variation in tasks, odds ratio (OR) = 4.26, confidence interval (CI) = 1.09, 16.62. In the second analysis, we found that this perceived large degree of variation in tasks was significantly associated with their overall job satisfaction, OR = 2.81, confidence interval = 1.71, 4.61. The results suggest that general practitioners could delegate highly complex tasks in the management of COPD to their staff without influencing the staff's work motivation, and thereby their job satisfaction, negatively, as long as they ensure sufficient variation in the tasks. © The Author 2017. Published by Oxford University Press.
manual the description of General Staff officer insignia reads as follows: Dull grey embroidery , stitched by hand, on a crimson underground, 2 x 11...small prongs on either side. The angles of the V-shaped embroidery point downwards. The epaulettes have a crimson underlay. 2 1 General Staff officers...insubordination. Even the French General Staff system does not provide for a jointly responsible adviser. In his Reflexions sur 1 ’ art de la querre, General
Gray, Linda R; Shirey, Maria R
To describe what nurse manager engagement means to nurse managers and staff nurses by incorporating an organizational dashboard to document engagement outcomes. Retaining engaged nurse managers is crucial for individual performance and organizational outcomes. However, nurse manager engagement is currently underreported in the literature. Existing data from the 2010 Employee Opinion Survey at the Baylor University Medical Center in Dallas, Texas, were used to measure staff engagement among 28 nurse managers and 1497 staff nurses. The data showed a 21% gap between manager and staff nurse engagement levels, with managers showing higher engagement levels than staff. No clear depiction of nurse manager engagement emerged. Consequently, an expanded definition of nurse manager engagement was developed alongside a beginning dashboard of engagement outcomes. The findings have implications for overcoming barriers that affect staff nurse engagement, improving outcomes, and creating definitions of nurse manager engagement.
James Avoka Asamani
Full Text Available Introduction: Nursing is a people-centred profession and therefore the issue of leadership is crucial for success. Nurse managers’ leadership styles are believed to be important determinant of nurses’ job satisfaction and retention. In the wake of a global nursing shortage, maldistribution of health workforce, increasing healthcare costs and expanding workload, it has become imperative to examine the role of nurse managers’ leadership styles on their staff outcomes. Using the Path-Goal Leadership theory as an organised framework, this study investigated the leadership styles of nurse managers and how they influence the nursing staff job satisfaction and intentions to stay at their current workplaces.Methods: The study employed a cross-sectional survey design to collect data from a sample of 273 nursing staff in five hospitals in the Eastern Region of Ghana. Descriptive and regression analyses were performed using SPSS version 18.0Results: Nurse managers used different leadership styles depending on the situation, but were more inclined to the supportive leadership style, followed by the achievement-oriented leadership style and participative leadership style. The nursing staff exhibited moderate levels of job satisfaction. The nurse managers’ leadership styles together explained 29% of the variance in the staff job satisfaction. The intention to stay at the current workplace was low (2.64 out of 5 among the nursing staff. More than half (51.7% of the nursing staff intended to leave their current workplaces, and 20% of them were actively seeking the opportunities to leave. The nurse managers’ leadership styles statistically explained 13.3% of the staff intention to stay at their current job position.Conclusions: These findings have enormous implications for nursing practice, management, education, and human resource for health policy that could lead to better staff retention and job satisfaction, and ultimately improve patient care.
Wright, Penny; Bingham, Laura; Taylor, Sally; Hanif, Naheed; Podmore, Emma; Velikova, Galina
Implementation of guidance on assessment and management of psychosocial and supportive-care problems or needs will be successful only if consideration is given to existing skills, experience and expectations of staff and patients. This study examines the roles and responsibilities of staff, patients and families in relation to management of social difficulties and proposes a pathway for response. A qualitative study was performed using staff and patient interviews. Seventeen doctors and 16 nurses were interviewed using patient scenarios and a support service questionnaire. Patients (n = 41) completed a screening questionnaire (the Social Difficulties Inventory) and were interviewed. Interviews were audio-recorded, transcribed and subjected to a Framework analysis. Analysis examined (1) actions taken by staff and patients in response to social difficulties, (2) reasons given for action taken and (3) perceptions of staff and patients of who was responsible for taking action. Staff were confident concerning clinically related issues (i.e. mobility) but more hesitant concerning difficulties related to money, work and family concerns. Patients liked to cope with problems on their own where possible, would have liked information or support from staff but were uncertain how to access this. Results led to development of a hierarchy of interventions in response to detected social difficulties. For routine assessment of social difficulties, patients, nurses and doctors will have to work collaboratively, with nurses taking a lead in discussion. For specific clinically related problems doctors would play a more primary role. Copyright © 2010 John Wiley & Sons, Ltd.
Irtwange, S. V.; Orsaah, S.
The objective of this study is to assess the impact of management style on academic staff performance with University of Agriculture, Makurdi as a case study. The management style of the vice chancellor of the University of Agriculture, Makurdi between the periods, September 3, 1996 to September 3, 2001 was determined using the Ohio State…
Duffield, Christine M; Roche, Michael A; Blay, Nicole; Stasa, Helen
This paper examined the impact of leadership characteristics of nursing unit managers, as perceived by staff nurses, on staff satisfaction and retention. A positive work environment will increase levels of job satisfaction and staff retention. Nurse leaders play a critical role in creating a positive work environment. Important leadership characteristics of the front-line nurse manager include visibility, accessibility, consultation, recognition and support. Secondary analysis of data collected on 94 randomly selected wards in 21 public hospitals across two Australian states between 2004-2006. All nurses (n = 2488, 80·3% response rate) on the selected wards were asked to complete a survey that included the 49-item Nursing Work Index-Revised [NWI-R] together with measures of job satisfaction, satisfaction with nursing and intention to leave. Subscales of the NWI-R were calculated. Leadership, the domain of interest, consisted of 12 items. Wards were divided into those reporting either positive or negative leadership. Data were analysed at the nurse level using spss version 16. A nursing manager who was perceived to be a good leader, was visible, consulted with staff, provided praise and recognition and where flexible work schedules were available was found to distinguish the positive and negative wards. However, for a ward to be rated as positive overall, nurse leaders need to perform well on all the leadership items. An effective nursing unit manager who consults with staff and provides positive feedback and who is rated highly on a broad range of leadership items is instrumental in increasing job satisfaction and satisfaction with nursing. Good nurse managers play an important role in staff retention and satisfaction. Improved retention will lead to savings for the organisation, which may be allocated to activities such as training and mentorship to assist nurse leaders in developing these critical leadership skills. Strategies also need to be put in place to
Hogan, Tierney D
A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.
Graham, Andrew T.
This small-scale case study focused on academic managers to explore the ways in which they control the workload of academic staff and the extent to which they use the workload model in performance management of academic staff. The links that exist between the workload and performance management were explored to confirm or refute the conceptual…
Turner, II, Frank L
.... This monograph examined the Intermediate Level Education, the Advanced Military Studies Program, and the Tactical Commanders Development Program curricula at the Command and General Staff College...
This podcast highlights the role of bus drivers and transportation staff in the management of food allergies in schools. It also identifies CDC food allergy resources for schools. Created: 1/20/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 1/20/2015.
The issue of Local Staff (LS) has been discussed since May 2002 at successive meetings of TREF and the Committees, leading to a proposal document by the Management, which was examined at TREF last November. As reported by the Chairman of TREF to the Finance Committee in December, the Management has now revised its proposal in the light of discussions at the Forum. This document summarises the background, the main aims, scope and features of LS, as well as estimated consequences of implementing the Management's proposal, including those indicated in the Human Resources Plan submitted last December. Related modifications of the Staff Rules and Regulations required to implement the Management's proposal are set out in Annex 8. After discussion at TREF in February 2003, the Management hereby submits its proposal for approval by the Finance Committee and the Council, for entry into force as of 1 April 2003. This time-scale would permit gradual implementation of LS starting this year, which is consistent with the f...
One of the main organizational factors among staff is job satisfaction. This inner feeling assumed as basic factor that emerged by various elements at workplace. According to the different role of elements that effect on job satisfaction, organizations managers should be consider the correct styles of management. In reality, lack of consideration to this human need leads to appear various abnormal behaviors at organization. The main purpose of present literature review is focused on the vit...
Garvey, Frank; Wigram, Tony; Balakumar, Thanusha
People with learning disabilities often experience health inequalities and barriers to healthcare services as a result of poor communication and discriminatory attitudes. We developed an educational package for healthcare staff as well as an attitude questionnaire to measure the impact of this training; the questionnaire is called the Attitudes of Secondary Healthcare Personnel Toward People with Severe Learning Disabilities (ASH-LD). This article describes the process of designing and piloting the ASH-LD questionnaire, and how it will be used to measure the effect of the planned training on staff attitudes.
Hills, Laura Sachs
Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.
In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Thursday, 29 June 2017 from 15.30 to 17.30, Main Auditorium, Meyrin (500-1-001). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its management, and an opportunity to express your opinion, particularly by taking part in votes. Other items are listed on the agenda, as proposed by the Staff Council. Who can vote? Ordinary members (MPE) of the SA can take part in all votes. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give their opinion, and how? The Ordinary General Assembly is also the opportunity for members of the SA to express themselves through the addition of disc...
This self-instructional unit for supervisors and managers in the British hotel and catering industry is based on the view that problems in staff recruitment and retention are directly linked to the level of job satisfaction. The document begins with an introduction and advice on how to use the unit. Five sections cover the following topics: (1)…
Al-Hamdan, Zaid; Nussera, Hayat; Masa'deh, Rami
To explore the relationship between conflict management styles used by nurse managers and intent to stay of staff nurses. Nursing shortages require managers to focus on the retention of staff nurses. Understanding the relationship between conflict management styles of nurse managers and intent to stay of staff nurses is one strategy to retain nurses in the workforce. A cross-sectional descriptive quantitative study was carried out in Jordan. The Rahim organization conflict inventory II (ROCI II) was completed by 42 nurse managers and the intent to stay scale was completed by 320 staff nurses from four hospitals in Jordan. The anova analysis was carried out. An integrative style was the first choice for nurse managers and the last choice was a dominating style. The overall level of intent to stay for nurses was moderate. Nurses tend to keep their current job for 2-3 years. There was a negative relationship between the dominating style as a conflict management style and the intent to stay for nurses. The findings of the present study support the claim that leadership practices affect the staff nurses' intent to stay and the quality of care. Nurse managers can improve the intent to stay for staff nurses if they use the appropriate conflict management styles. © 2015 John Wiley & Sons Ltd.
Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth
Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.
Minas, H; Zamzam, R; Midin, M; Cohen, A
Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours...
Tzeng, Huey-Ming; Yin, Chang-Yi
This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.
Introduction. Psychiatric disorders are a major burden of disease worldwide, often treated by non-psychiatrist health workers in general health facilities. In general health facilities, once patients are seen by non-psychiatric health workers, referral to psychiatrists or other mental health professionals is imperceptible.1-3 This ...
Saleh, Usama; O'Connor, Tom; Al-Subhi, Hattan; Alkattan, Rana; Al-Harbi, Saad; Patton, Declan
to explore the nature of leadership styles used by the nursing management team, as perceived by nurses working at the bedside. leadership style is related to job satisfaction, staff retention, costs, and quality of care. The leadership styles of managers can be crucial in the healthcare setting, but very few studies have focused on them. the study employed qualitative methodology, involving 35 nurses working in different specialties of a medical city in Saudi Arabia. Data collection consisted of completing demographic and professional information and a semi-structured interview using open-ended questions. a phenomenologic-hermeneutic approach was used to identify major themes. the findings showed that participants described four types of leadership styles: relational leadership, preferential leadership, communication chain leadership, and ineffectual leadership. the leadership style employed by nurse managers has a major impact on nurses' satisfaction, turnover, and the quality of patient care they deliver.
Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris
The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups. The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.
M. Talebzadeh Nobarian
Full Text Available Empowering employees in specialized and general qualifications fields is required for urban management organization (Tehran Municipality. Planning and establishment of comprehensive system of electronic learning is considered the main goal of human resource and educational managers. . This study tried to investigate the feasibility and execution of electronic learning courses for in-service staff. Training system for in-service staff is the most effective method in educating staff. Implantation of the system includes five necessary variables such as, hardware, software, electronic content, human resources and cultural proceedings. Initially, the main variables and the associated data of 550 people were recorded in the Likert-type scale through the information on the questionnaires. Then correlation analysis, variance and multiple regressions were performed. Description of data containing the collection of general characteristics of respondents, including managers, expertise of human resource and educational managers of Tehran municipality were summarized. The results indicated that the correlation coefficient of variables was R = 0.804 which represents the total correlation of the model. The next output showed the certainty of a linear relationship between the variables through analysis of variance. Then according to the standardized regression coefficients and the initial linear regression equation, the model with five variables was drawn and the effectiveness of each of the variables on the dependent variable (the deployment of Electronic-learning system was examined and interpreted.
Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses. The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement. Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form. Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement. Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.
Radke, Taylor J.; Brown, Laura G.; Hoover, E. Rickamer; Faw, Brenda V.; Reimann, David; Wong, Melissa R.; Nicholas, David; Barkley, Jonathan; Ripley, Danny
Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers’ food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant’s ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. PMID:28221943
Full Text Available Aim: The purpose of this study was investigate to level of subjective happiness levels of staff who works in provincial organization of General Directorate of Sport. Material and Methods: The study group of the research consisted of 400 staff (164 female, 236 male who works in General Directorate of Sport’s İstanbul, Trabzon, Malatya and Tokat Youth Services and Sport provincial directorates. In the study as data collection tool; Subjective Happiness Scale (SHS which developed by Lyubomirsky & Lepper (1999 and adapted to Turkish by Akın and Satıcı (2011 was used. And also “personal data form” which created by the researchers was used. The data analyzed by descriptive statistics, T-test and Anova test. Also, Scheffe test was used to find out the significant differences of groups. Results: In accordance with t-test results obtained from the present study, there are significant differences with respect to variables such as marital status, income state and sport participation (p<0.05. Conclusion: As a result, it was determined that married staff is happier than single staff. Also, the staff who determined themselves in moderate income level is happier than the staff who determined themselves in lower income level.
Training, training Support software, and measurement instruments were developed to help Army brigade and below staff manage information and overcome information overload in a digital messaging environment...
Full Text Available The article deals with theoretical analysis of the higher school teaching staff professional development system creation on the adaptive management principles. It is determined the background and components of the higher school teaching staff professional development adaptive management system. It is specified the mechanisms for higher school teaching staff professional development adaptive management: monitoring and coaching. It is shown their place in the higher school teaching staff professional development system on the adaptive management principles. The results of the system efficiency are singled out.
Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.
Stevenson, Fiona; Lloyd, Nigel; Harrington, Louise; Wallace, Paul
Electronic patient records offer unique opportunities to undertake population-based research. The Health Research Support Service (HRSS) pilot project sought to extract electronic records on a national basis from across health and social care and transfer them together with identifiers to a designated 'safe haven'. To determine the feasibility and acceptability of the HRSS pilot in primary care. Interviews and focus groups with patients and practice staff. There was general support from both patients and staff for the principle of the HRSS. The 'opt-out' basis for participation in the HRSS drew mixed responses from patients and staff, with an appreciation of the advantages in relation to participation by default, but concerns about the extent to which this constituted true consent. Concerns were expressed about confidentiality and the safety and security of the extracted data. The patient information pack was roundly criticized by both patients and staff. Trust in individual GPs, practices and the National Health Service (NHS) was a crucial factor in patients' decisions about participation. Although patients and staff were generally supportive of the HRSS, they require clear information about the proposed use of medical records for research purposes. The question of 'opt out' versus 'opt in' remains controversial and further consideration will be needed if research using routine medical records is to achieve its full potential as a 'core' activity in the NHS.
Akram G H A D I R I
Full Text Available The aim of the present study is relationship between perfectionism of managers and empowerment staff of physical education offices in Tehran. This research is a descriptive – correlation, from Perspective of Nature, Applicable. The po pulation of this research consisted of managers and administrative staff in physical education offices of Tehran are the number of 351 persons. The sample estimate of the population and with using Morgan’s table And Karjsi and 185 patients were selected us ing stratified random number, of which 50 were managers and 135 employees. Independent variables were instrumented perfectionism of managers, 59 item questionnaires of Hill and Associates (2004 and tools to measure the dependent variable of empowerment pe rsonnel was 16 - item questionnaire Aspretizr (2002 . Statistical methods was included descriptive statistics and inferential statistics (Pearson and Friedman and the results in general showed a there is significant relationship between perfectionism of man agers and capabilities of personnel. And so dimensions of perfectionism of Managers had a meaningful significant negative relationship with empowerment personnel. However, discipline and stress had the strongest associations with empowerment personnel.
Sunday S. AKPAN
Full Text Available This paper examined safety and security risk management in tertiary institutions in Nigeria. The frequent attacks at workplace, especially schools, have placed safety and security in the front burner of discussion in both business and political circles. This therefore, forms the imperative for the conduct of this study. The work adopted a cross sectional survey research design and collected data from respondents who are security personnel of the University of Uyo. Analysis of data was done with simple percentage statistics while the research hypotheses were tested with mean and simple regression and correlation statistics. The findings of the study revealed that assassination, kidnappings and bombings were principal risk incidents threatening the safety and security of staff in University of Uyo. A significant positive relationship was found between the funding of security management and workers’ performance. It was discovered specifically that employment screening, regular training of security personnel, regular safety and security meetings and strategic security policy formation were the main strategies for managing safety and security in University of Uyo. The paper concluded that safety and security management and control involves every worker (management and staff of University of Uyo. It was recommended, among others, that management should be more committed to safety and security management in the University by means of making safety and security issues an integral part of University’s strategic plan and also by adopting the management line model – one form of management structure-where safety and security are located, with other general management responsibilities. This way, the resurgent cases of kidnapping, hired assassination, etc. would be reduced if not completely eradicated in the University.
Casida, Jesus; Parker, Jessica
To explore the correlations of leadership styles of nurse managers (NMs) and outcomes. Little is known about the linkages among leadership styles [transformational (TFL), transactional (TRL)] of NMs and outcomes [a leader's extra effort (LEE), leadership satisfaction (LS) and effectiveness (LE)] using the full-range leadership theory. Methods An exploratory correlational design was employed using data from a 2007 study in which staff nurses (n = 278) from four hospitals in the Northeastern US were asked to rate the leadership styles of NMs (n = 37) and outcomes using the Multifactor Leadership Questionnaire Form 5x-Short. Data were analysed using descriptive and inferential statistical methods. TFL leadership has strong correlations to LEE, LS and LE, and was a predictor for leadership outcomes. Conversely, TRL leadership has week correlations to LEE, LS and LE and did not predict leadership outcomes. NMs who frequently display TFL leadership styles will probably achieve goals in a satisfying manner, warranting further research. TFL leadership training should be a basic competency requirement of NMs. Placing successful and effective TFL leaders in nursing units are the professional and moral obligations of nurse executives. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Porter, Toccara D.
This article reports on the author's enrollment in the SuccessfUL Supervisor Series course. As a new distance education library coordinator the author sought out formal supervisor training to address staff misconduct and establish staff training initiatives for distance library service needs. Structured as a case study, the author discusses how…
Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.
With the growth in social networking and the potential for larger and larger breaches of sensitive data,it is vital for all enterprises to ensure that computer users adhere to corporate policy and project staff design secure systems. Written by a security expert with more than 25 years'' experience, this book examines how fundamental staff awareness is to establishing security and addresses such challenges as containing threats, managing politics, developing programs, and getting a business to buy into a security plan. Illustrated with real-world examples throughout, this is a must-have guide for security and IT professionals.
Elkhuizen, Sylvia G.; Bor, Gert; Smeenk, Marjolein; Klazinga, Niek S.; Bakker, Piet J. M.
Background: Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model
In 1975, the General Electric Company (GE) published a Nuclear Reactor Study, also referred to as ''the Reed Report,'' an internal product-improvement study. GE considered the document ''proprietary'' and thus, under the regulations of the Nuclear Regulatory Commission (NRC), exempt from mandatory public disclosure. Nonetheless, members of the NRC staff reviewed the document in 1976 and determined that it did not raise any significant new safety issues. The staff also reached the same conclusion in subsequent reviews. However, in response to recent inquiries about the report, the staff reevaluated the Reed Report from a 1987 perspective. This re-evaluation, documented in this staff report, concluded that: (1) there are no issues raised in the Reed Report that support a need to curtail the operation of any GE boiling water reactor (BWR); (2) there are no new safety issues raised in the Reed Report of which the staff was unaware; and (3) although certain issues addressed by the Reed Report are still being studied by the NRC and the industry, there is no basis for suspending licensing and operation of GE BWR plants while these issues are being resolved
The Ordinary General Assembly is an opportunity for members of the Staff Association, and also non-members, to get an overview of: the Staff Association’s activities over the last year; the financial report and the estimated budget of the Staff Association; the work programme of the current year. This is very interesting for anyone wishing to learn about the work carried out by the CERN Staff Association. 2017 Activities Report Isabelle Mardirossian, Vice-President of the Staff Association, presented the 2017 Activities Report. The main aspects of the report were: a follow-up on the 2015 Five-yearly review: the decisions taken by the Council in December 2015, their implementation, and work that remains to be done; definition and implementation of the Promotion Guide and the 2018 MERIT Guidelines; work carried out within the CERN working groups, the subgroups of the Standing Concertation Committee (SCC) and the Pension Fund, on diverse themes such as religious practice in the workplace, mobility o...
Minas, Harry; Zamzam, Ruzanna; Midin, Marhani; Cohen, Alex
The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions.
Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented
Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris
Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co...
Henderson, Amanda; Burmeister, Liz; Schoonbeek, Sue; Ossenberg, Christine; Gneilding, Julieanne
This study evaluated the impact of different levels of engaging middle management in ward based strategies implemented by a project educator. The challenge for learning in practice is to develop effective teams where experienced staff engage and foster learning with students and other novice staff. A quasi-experimental pre- and post- intervention four group design was conducted from November 2009 to May 2010 across four general surgical and four general medical inpatient matched units in two settings in South East Queensland, Australia. Staff survey data was used to compare control and intervention groups (one actively engaging nurse managers) before and after 'practice learning' interventions. The survey comprised demographic data and data from two validated scales (support instrument for nurses facilitating learning and clinical learning organisational culture). Number of surveys returned pre- and post-intervention was 336 from 713 (47%). There were significant differences across many subscales pertaining to staff perception of support in the intervention groups, with only one change in the control group. The number of significant different subscales in the learning culture was also greater when middle management supported the intervention. Middle management should work closely with facilitators to assist embedding practice interventions. © 2013 John Wiley & Sons Ltd.
Shin, Yong Ha; Jang Dong Hun; Lee, In Woo
The content of this book are technology and management, conception of technology management, feature and model of technology management system, elements of technology management, performance measurement of technology management, connectivity between technology and business function, system management of technology, manpower management, readership and technology management, motivation and technology management, management of technical investment evaluation, new item development and marketing, product liability management, intellectual property rights and transfer of technology.
Shin, Yong Ha; Jang Dong Hun; Lee, In Woo
The content of this book are technology and management, conception of technology management, feature and model of technology management system, elements of technology management, performance measurement of technology management, connectivity between technology and business function, system management of technology, manpower management, readership and technology management, motivation and technology management, management of technical investment evaluation, new item development and marketing, product liability management, intellectual property rights and transfer of technology.
Holmes, Kathryn A.; Prieto-Rodriguez, Elena
Higher education institutions routinely use Learning Management Systems (LMS) for multiple purposes; to organise coursework and assessment, to facilitate staff and student interactions, and to act as repositories of learning objects. The analysis reported here involves staff (n = 46) and student (n = 470) responses to surveys as well as data…
Skytt, Bernice; Hagerman, Heidi; Strömberg, Annika; Engström, Maria
To elucidate first-line managers' descriptions and reflections regarding their staff's access to empowering structures using Kanter's theory of structural empowerment. Good structural conditions within workplaces are essential to employees' wellbeing, and their ability to access empowerment structures is largely dependent on the management. Twenty-eight first-line managers in elderly care were interviewed. Deductive qualitative content analysis was used to analyse data. Managers perceived that staff had varying degrees of access to the empowering structures described in Kanter's theory - and that they possessed formal power in their roles as contact persons and representatives. The descriptions mostly started from the managers' own actions, although some started from the needs of staff members. All managers described their staff's access to the empowering structures in Kanter's theory as important, yet it seemed as though this was not always reflected on and discussed as a strategic issue. Managers could make use of performance and appraisal dialogues to keep up to date on staff's access to empowering structures. Recurrent discussions in the management group based on such current information could promote staff's access to power through empowering structures and make job definitions a strategic issue in the organisation. © 2014 John Wiley & Sons Ltd.
Verkaik, Renate; van Antwerpen-Hoogenraad, Paulien; de Veer, Anke; Francke, Anneke; Huis In Het Veld, Judith
Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: 'What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and 'Do nursing staff feel sufficiently trained and skilled for self-management support?'. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider 'helping people with dementia to maintain control over their lives by involving them in decisions in daily care' the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN's and CNA's did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations
Kodama, Yoshimi; Fukahori, Hiroki; Sato, Kana; Nishida, Tomoko
To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital. In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan. Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression. Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses. The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment. To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills. © 2016 John Wiley & Sons Ltd.
Scerri, Anthony; Innes, Anthea; Scerri, Charles
Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals. Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed. Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients' outcomes. This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.
Hartzler, Bryan; Rabun, Carl
Community adoption of contingency management (CM) varies considerably, and executive innovativeness may help explain variance due to its presumed influence on clinic decision-making. Sixteen U.S. opioid treatment programs (OTPs) were visited, with ethnographic interviewing used in casual contacts with executives to inform their eventual classification by study investigators into one of Rogers' (2003) five adopter categories. Audio-recorded interviews were also conducted individually with the executive and three staff members (N = 64) wherein they reported reactions to clinic CM implementation during the prior year, from which study investigators later identified salient excerpts during interview transcript reviews. The executive sample was progressive, with 56% classified as innovators or early adopters. Implementation reports and corresponding staff reactions were generally consistent with what might be expected according to diffusion theory. Clinics led by innovators had durably implemented multiple CM applications, for which staff voiced support. Clinics led by early adopters reported CM exposure via research trial participation, with mixed reporting of sustained and discontinued applications and similarly mixed staff views. Clinics led by early majority adopters employed CM selectively for administrative purposes, with staff reticence about its expansion to therapeutic uses. Clinics led by late majority adopters had either deferred or discontinued CM adoption, with typically disenchanted staff views. Clinics led by a laggard executive evidenced no CM exposure and strongly dogmatic staff views against its use. Study findings are consistent with diffusion theory precepts, and illustrate pervasive influences of executive innovativeness on clinic practices and staff impressions of implementation experiences. Published by Elsevier B.V.
Flora, Parminder K; McMahon, Casey J; Locke, Sean R; Brawley, Lawrence R
Cardiac rehabilitation (CR) exercise therapy facilitates patient recovery and better health following a cardiovascular event. However, post-CR adherence to self-managed (SM)-exercise is suboptimal. Part of this problem may be participants' view of CR staff as mainly responsible for help and program structure. Does post-CR exercise adherence for those perceiving high CR staff responsibility suffer as a consequence? Participants in this prospective, observational study were followed over 12 weeks of CR and one month afterward. High perceived staff responsibility individuals were examined for a decline in the strength of adherence-related social cognitions and exercise. Those high and low in perceived staff responsibility were also compared. High perceived staff responsibility individuals reported significant declines in anticipated exercise persistence (d = .58) and number of different SM-exercise options (d = .44). High versus low responsibility comparisons revealed a significant difference in one-month post-CR SM-exercise volume (d = .67). High perceived staff responsibility individuals exercised half of the amount of low responsibility counterparts at one month post-CR. Perceived staff responsibility and CR SRE significantly predicted SM-exercise volume, R 2 adj = .10, and persistence, R 2 adj = .18, one month post-CR. Viewing helpful well-trained CR staff as mainly responsible for participant behavior may be problematic for post-CR exercise maintenance among those more staff dependent. © 2017 The International Association of Applied Psychology.
Taunton, R L; Krampitz, S D; Woods, C Q
This is the second article in a two-part series based on a study of the impact of middle managers on retention of 71 hospital professionals. Research design, methods, and descriptive results were presented in Part 1 (March 1989). In Part 2, the impact of managers' motivation to manage, power, influence, and leadership style on retention is detailed. Recommendations for improving retention include interventions to increase employee job satisfaction and intent to stay, and to improve managers' performance and leadership.
Van Bogaert, Peter; Peremans, Lieve; de Wit, Marlinde; Van Heusden, Danny; Franck, Erik; Timmermans, Olaf; Havens, Donna S
To study nurse managers' perceptions and experiences of staff nurse structural empowerment and its impact on the nurse manager leadership role and style. Nurse managers' leadership roles may be viewed as challenging given the complex needs of patients and staff nurses' involvement in both clinical and organizational decision-making processes in interdisciplinary care settings. Qualitative phenomenological study. Individual semi-structured interviews were conducted with 8 medical or surgical nurse managers in a 600-bed Belgian university hospital between December 2013 and June 2014. This hospital was undergoing conversion from a classical hierarchical, departmental structure to a flat, interdisciplinary model. Nurse managers were found to be familiar with the structural empowerment of clinical nurses in the hospital and to hold positive attitudes toward it. They confirmed the positive impact of empowerment on their staff nurses, as evidenced by increased responsibility, autonomy, critical reflection and enhanced communication skills that in turn improved the quality and safety of patient care. Structural empowerment was being supported by several change initiatives at both the unit and hospital levels. Nurse managers' experiences with these initiatives were mixed, however, because of the changing demands with regard to their manager role and leadership style. In addition, pressure was being experienced by both staff nurses and nurse managers as a result of direct patient care priorities, tightly scheduled projects and miscommunication. Nurse managers reported that structural empowerment was having a favorable impact on staff nurses' professional attitudes and the safety and quality of care in their units. However, they also reported that the empowerment process had led to changes in the managers' roles as well as daily practice dilemmas related to the leadership styles needed. Clear organizational goals and dedicated support for both clinical nurses and nursing unit
Bruno, E; Tranghese, A
Nowadays, a ward coordinator should own not only technical knowledge but managements skills as well. Communication is an important tool for organizing work team. The persons are core otherwise of the structure that could be the hardstone otherwise unuseful in case of bad managing. Transitional analysis is a valid mean for whom to ménage interpersonal relationship.
Parand, Anam; Burnett, Susan; Benn, Jonathan; Pinto, Anna; Iskander, Sandra; Vincent, Charles
Arguably, a shared perspective between managers and their clinical staff on an improvement initiative would allow for most effective implementation and increase programme success. However, it has been reported that research has failed to differentiate between managers and line employees on quality management implementation and examine their differences in perceptions of quality and safety initiatives. The aim of this study was to compare clinical frontline staff and senior managers' perceptions on the importance of an organization-wide quality and safety collaborative: the Safer Patients Initiative (SPI). A quantitative study obtained 635 surveys at 20 trusts participating in SPI. Participants included the teams and frontline staff involved within the programme at each organization. Independent T-tests were carried out between frontline staff and senior managers' perceptions of SPI programme elements, success factors and impact & sustainability. Statistically significant differences were found between the perceptions of frontline staff and senior managers on a wide number of issues, including the frontline perceiving a significantly larger improvement on the timeliness of care delivery (t = 2.943, P = 0.004), while managers perceived larger improvement on the culture within the organization for safe, effective and reliable care (t = -2.454, P = 0.014). This study has identified statistically significant disparities in perceptions of an organization-wide improvement initiative between frontline staff and senior managers. This holds valuable implications for the importance of getting both frontline and management perspectives when designing such interventions, in monitoring their performance, and in evaluating their impact. © 2010 Blackwell Publishing Ltd.
Yanson, Adam; Hilts, Asante Shipp; Mack, Stephanie; Eidson, Millicent; Nguyen, Trang; Birkhead, Guthrie
This study collected and summarized feedback from staff at the New York State (NYS) Office of Emergency Management (OEM) and three county OEMs within NYS to understand lessons learned from the 2012 Superstorm Sandy. Cross-sectional qualitative and quantitative analysis. One staff person from each identified critical role from the state and county OEMs who were still employed in the roles identified. In-person interviews in 2014 followed by an anonymous survey in 2015 examined the response strengths, challenges, and recommendations using federally and study-defined Public Health Preparedness Capabilities. Quantitative analysis of staff survey ratings was used to summarize perceptions of interagency collaboration, communication effectiveness, and differences by staff position. Response rates were 78 percent for interviews (n = 7) and 45 percent for surveys (n = 36). In interviews, "emergency operations coordination" was cited most frequently (48 percent), specifically for successful interagency coordination. "Emergency operations coordination" was also cited most among challenges (45 percent), with emphasis on problems with uniformity of software systems across agencies. Survey responses indicated that "volunteer management" (50 percent) and the "safety and health of responders" (40 percent) were frequently reported as challenges. Additionally, 38 percent of OEM staff reported that situation reports submitted by health departments need improvement. Recommendations from OEM staff included "emergency operations coordination" (36 percent) such as sharing of resources and "training" (16 percent) including hospital evacuation training. Analysis of OEM staff feedback identified specific challenges, and concrete recommendations were made to improve response going forward.
Kamchuchat, Chalermrat; Chongsuvivatwong, Virasakdi; Oncheunjit, Suparnee; Yip, Teem Wing; Sangthong, Rassamee
This study aimed to document the characteristics of workplace violence directed at nursing staff, an issue which has rarely been studied in a developing country. Two study methods, a survey and a key informant interview, were conducted at a general hospital in southern Thailand. A total of 545 out of 594 questionnaires sent were returned for statistical analysis (response rate=91.7%). The 12-month prevalence of violence experience was 38.9% for verbal abuse, 3.1% for physical abuse, and 0.7% for sexual harassment. Psychological consequences including poor relationships with colleagues and family members were the major concerns. Patients and their relatives were the main perpetrators in verbal and physical abuse while co-workers were the main perpetrators in cases of sexual harassment. Common factors to incidents of violence were psychological setting, illness of the perpetrators, miscommunication, and alcohol use. Logistic regression analysis showed younger age to be a personal risk factor. Working in the out-patient unit, trauma and emergency unit, operating room, or medical or surgical unit increased the odds of violence by 80%. Training related to violence prevention and control was found to be effective and decreased the risk of being a victim of violence by 40%. We recommend providing training to high risk groups as a means of controlling workplace violence directed at nursing staff.
The objective of the presentation is to outline some general infrastructure of nuclear industry with regard to the quality management; to emphasise significance of safety management as an integral part of the quality management; and to highlight different steps of the management process in a near-time working, at an annual level and as a strategic process
Kadi, Aysegül; Beytekin, Osman Ferda
It is necessary to know how the members of a school perceive their school management to investigate how they are related to their organizations. In this case, we can refer to metaphors, which are excellent tools for people to express their subconscious thoughts and perceptions about their organizations. On the other hand, metaphors help us to…
Tânia Cristina Malezan Fleig
Full Text Available Backgrounds and Objective: Exposure to carbon monoxide (CO can be harmful to human health and the first effects of intoxication may go unnoticed. Our objective was to evaluate the functional capacity and respiratory muscle strength of staff of a general hospital opposite the inhalation of carbon monoxide. Methods: cross-sectional study with a convenience sample. It was used as evaluation tools: clinical research roadmap; the MicroCO for analysis of CO concentration, CO cutoff for non-smokers among 1- 6ppm, light smokers 7-10ppm, moderate smokers 11-20ppm and heavy smokers >20ppm; the manometer to determine the respiratory muscle strength (MIP and MEP; Six minute walk test (6MWT to evaluate functional capacity. Statistical analysis was performed hair Pearson correlation test to verify the association of variables. Results:The study included 14 volunteer subjects (08 men, mean age 35.14±8,76years, working in maintenance (n=5; laundry (n=6; kitchen (n=1; engineering (n=2 of the hospital. For active smokers only 03 subjects were above the cutoff (CO>6ppm then being considered active smokers. The MIP (99.50±27.37% predicted and MEP (105.64±21,39% predicted are within normal parameters. The functional capacity of smokers (6MWT=71% of predicted, with high CO (17ppm, underperformed the baseline when compared with nonsmokers (CO=0,9ppm; 6MWT=92, 6% predicted. Moderate and negative correlation was observed between 6MWT and CO (r=-0.577, p=0.031. Conclusion: adult staff of a general hospital with preserved respiratory muscle strength and higher levels of CO exhaled have worse functional performance in the 6MWT. KEYWORDS:Muscle Strength. Carbon Monoxide.Occupational Health.Public Health.
Association du personnel
The Staff Association, your representative with the Management and the Member States The article VII 1.01 of the Staff Rules and Regulations (SR&R) provides that “the relations between the Director-General and the personnel shall be established either on an individual basis or on a collective basis with the Staff Association as intermediary”. This essential role of the Staff representatives, of being the spokesperson of the entire staff of the Organization vis-à-vis the Director-General and the Members States, is achieved through regular participation in the various joint advisory committees defined in the SR&R. The most important are the Standing Concertation Committee and the TREF, tripartite forum where your representatives meet with the Member States delegates, in the presence of the Management, to explain the position of the staff on the various issues concerning employment conditions. The Finance Committee also gives the opportunity to the Staff Association to ...
Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J
To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.
Schreuder, Jolanda A H; Roelen, Corné A M; van Zweeden, Nely F; Jongsma, Dianne; van der Klink, Jac J L; Groothoff, Johan W
Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population. This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff. The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence. High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence. Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.
Narang, Ramandeep S; Manchanda, Adesh; Singh, Simarpreet; Verma, Nitin; Padda, Sarfaraz
The aim of this study was to determine awareness of biomedical waste (BMW) management policies and practices among dental professionals and auxiliary staff in a dental hospital/clinics in Amritsar, India, to inform the development of future policies for effective implementation of BMW rules. The study involved 160 staff members at the Amritsar hospital/clinics (80 dentists and 80 auxiliary staff) to whom a questionnaire was distributed regarding policies, practices and awareness relating to BMW. The questionnaire was first piloted. Completed questionnaires were returned anonymously. The resulting data were statistically tested using the chi-square test for differences between the dentists and auxiliary staff. In respect of BMW management policies, there was a highly significant difference in the responses of the dentists, whose answers suggested far greater knowledge than that of the auxiliaries (Pmanagement practices, the dentists were significantly more aware (Pwaste collection in the hospital and the disposal of various items into different colour-coded bags. As for employee education/awareness, there was a significant difference (Pmanagement among dental auxiliary staff in the dental hospital/clinics in Amritsar and a lack of awareness of some aspects among dentists who work in the hospital/clinics. The results provide the hospital authorities with data upon which they can develop a strategy for improving BMW management.
Ulhassan, Waqar; von Thiele Schwarz, Ulrica; Westerlund, Hugo; Sandahl, Christer; Thor, Johan
Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.
Klazinga Niek S
Full Text Available Abstract Background Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level. Methods A capacity model was developed to calculate required nursing staff capacity. The model used historical bed utilization, nurse-patient ratios, and parameters concerning contract hours to calculate beds and nursing staff needed per shift and the number of nurses needed on an annual basis in a ward. The model was applied to three different capacity management problems on three separate groups of hospital wards. The problems entailed operational, tactical, and strategic management issues: optimizing working processes on pediatric wards, predicting the consequences of reducing length of stay on nursing staff required on a cardiology ward, and calculating the nursing staff consequences of merging two internal medicine wards. Results It was possible to build a model based on easily available data that calculate the nursing staff capacity needed daily and annually and that accommodate organizational improvements. Organizational improvement processes were initiated in three different groups of wards. For two pediatric wards, the most important improvements were found to be improving working processes so that the agreed nurse-patient ratios could be attained. In the second case, for a cardiology ward, what-if analyses with the model showed that workload could be substantially lowered by reducing length of stay. The third case demonstrated the possible savings in capacity that could be achieved by merging two small internal medicine wards. Conclusion A comprehensive capacity model was developed and successfully applied to
Full Text Available The main objective of this study is to describe and analyze personal knowledge management skills among staff of Ferdowsi University of Mashhad. To achieve this goal, the case study research was used. The study population included all the staff which is permanent post formed expert, which means all the staff except the faculty staff of Ferdowsi University of Mashhad. Data collection was performed in two stages. First, in order to describe the amount of having the personal knowledge management skills of the staff of the Ferdowsi University of Mashhad, 137 experts of university were chosen for study. At this stage in order to collect data, the questionnaire of personal knowledge management skills Avery et al (2001 was used. The results of the quantitative data analysis showed that the experts at the University of Mashhad have an appropriate information in the personal management skills. In the second stage, to identify activities focused on each individual's knowledge management skills, the semi-structured interviews were used. The main number of informants at this stage of research consisted of sixteen permanent experts of Ferdowsi University of Mashhad. Based on the findings of qualitative data analysis at this stage, The most important activities related to personal knowledge management skills are: data recovery (data collection and schooling and gain information, ask, etc., evaluation of information (recognize of good bases, evaluation of information, Check information proportion with the needs, etc., Organizing information (prioritize, mentally planning, writing the key words, etc., the sharing of knowledge and information (identification and problem solving, communicating with colleagues, adopt practices, etc., Data analysis (analysis of information, use of information, the dissemination of knowledge and information (data exchange, information, putting information at the disposal of clients, etc., security
Sinclair, Jane; Aho, Anne-Maria
Learning management systems (LMSs) are widely used in higher education and offer a gateway to innovative, technology-enhanced teaching and learning. However, many university staff still choose not to adopt them or do not explore the more creative functionality. Previous research has developed models of technology adoption which map observed…
Cheng, Alison Lai Fong; Yau, Hon Keung
The study aims to examine the effectiveness of the implementation of "Meeting Pupil Needs and Empowering Staff" in the quality management in Hong Kong primary schools. A case study of nine primary schools was conducted and a qualitative method of interviews was adopted in this study. A total of 9 principals and 9 teachers from 9 primary…
Training programs at DOE facilities should prepare personnel to safely and efficiently operate the facilities in accordance with DOE requirements. This guide contains information that can be used to develop or validate training programs for technical staff and managers at DOE nuclear facilities. Training programs based on the content of this guide should provide assurance that these personnel perform their jobs safely and competently
Vigo, D.; Caremi, C.; Gordini, A.; Bosso, S.; D'Aleo, G.; Beleggia, B.
In this paper, we discuss a decision support system for optimizing staff management of desk customer relations services at Hera, a large Italian multiutility company. The system, SPRINT, which is based on state-of-the-art demand forecasting, implements a novel two-phase optimization procedure based
Hartzler, Bryan; Jackson, T. Ron; Jones, Brinn E.; Beadnell, Blair; Calsyn, Donald A.
Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (interventio...
Duijn, H.J. van; Kuyvenhoven, M.M.; Schellevis, F.G.; Verheij, T.J.M.
OBJECTIVES: To explore views on respiratory tract symptoms (cough, sore throat and earache) and antibiotics of GPs, practice staff, and patients. METHODS: In a nationwide study, 181 GPs, 204 practice staff members and 1250 patients from 90 practices participated by answering 14 items relating to
Full Text Available Orientation: Academic staff members have a crucial role in the success of higher education institutions (HEIs. Therefore, it is imperative to cultivate an appealing organisational brand that will attract them to HEIs as an employer of choice. Research purpose: The main objective of this study was to explore management perceptions on a higher educational institution as a brand for the attraction of talented academic staff. Motivation for the study: Although a substantial amount of research has been conducted on organisational branding, not much has emphasised the higher educational sector. Research approach, design and method: A qualitative research approach was adopted, using semi-structured interviews to collect data from management (N = 12 of a merged South African HEI. Main findings: The findings revealed six themes that should form the core of a higher educational brand for academic staff: reputation and image, organisational culture and identity, strategic vision, corporate social responsibility and work and surrounding environment. Practical/managerial implications: The findings of the study will assist higher education management to create a compelling organisational brand and work environment to attract and retain talented academic staff members. Contribution/value-add: This research makes a valuable contribution towards creating new knowledge in the key that should form part of an appealing higher education brand that will attract and retain current and future talent.
Clarke, Sue; Taylor, Georgina; Bolderston, Helen; Lancaster, Joanna; Remington, Bob
Patients diagnosed with a personality disorder (PD) are often stigmatized by the healthcare staff who treat them. This study aimed to compare the impact on front-line staff of a self-management Acceptance and Commitment Therapy-based training intervention (ACTr) with a knowledge- and skills-based Dialectical Behaviour Training intervention (DBTr). A service-based randomized controlled trial was conducted comparing the effects of 2-day ACTr (N = 53) and DBTr (N = 47) staff workshops over 6 months. Primary outcome measures were staff attitudes towards patients and staff-patient relationships. For both interventions, staff attitudes, therapeutic relationship, and social distancing all improved pre- to postintervention, and these changes were maintained at 6-month follow-up. Although offering different resources to staff, both ACTr and DBTr were associated with an improved disposition towards PD patients. Future research could evaluate a combined approach, both for staff working with PD patients and those working with other stigmatized groups.
Full Text Available Background: Carpal tunnel syndrome (CTS is a neurologic disease affecting hands, which is closely related to work, and is the most prevalent nerve compression disease. The incidence of CTS quite often occur in people working with their hands, for instance the administrative staff, especially in a busy workplace such as Dr.Hasan Sadikin General Hospital Bandung. CTS causes reduction in work productivity, and consequently degrading family welfare and the quality of public service. For that very reason, the prevalence and characteristics of CTS among administrative staff at Dr.HasanSadikin General Hospital Bandung needed to be revealed. Methods: This quantitative descriptive study involved 94 administrative staff in the Medical record department of Dr. Hasan Sadikin General Hospital using the Carpal-tunnel.net questionnaire and further examinations by neurologists. Variables involved in this study were the subject characteristics. Results: Out of the 90 subjects, 22 stated having symptoms related to CTS (prevalence, 24.4%. On further clinical examination, 3 were diagnosed of suffering from CTS (prevalence, 3.3%. Conclusions: Carpal tunnel syndrome is found among the administrative staff at Dr. Hasan Sadikin General Hospital Bandung and the prevalence is lower than in the general population. A further study is required to reveal ther specific division in the hospital with the most prevalent CTS case. DOI: 10.15850/amj.v4n2.1077
Modic, Mary Beth; Canfield, Christina; Kaser, Nancy; Sauvey, Rebecca; Kukla, Aniko
The purpose of this project was to enhance the knowledge of the bedside nurse in diabetes management. A forum for ongoing support and exploration of clinical problems, along with the distribution of educational tools were the components of this program. Diabetes accounts for 30% of patients admitted to the hospital. It has become more challenging to manage as the treatment choices have increased. There are a number of researchers who have identified nurse and physician knowledge of diabetes management principles as suboptimal. DESCRIPTION OF THE INNOVATION: Staff nurses are educated for a role as a Diabetes Management Mentor and are expected to educate/dialogue with peers monthly, model advocacy and diabetes patient education skills, facilitate referrals for diabetes education, and direct staff to resources for diabetes management. Diabetes Management Mentors feel more confident in their knowledge of diabetes and their ability to resolve clinical issues as they arise. The Diabetes Management Mentor role is another avenue for nurses to refine their clinical knowledge base and acquire skills to share with colleagues while remaining at the bedside. The clinical nurse specialist is expertly prepared to foster the professional development of bedside nurses while simultaneously making a positive impact on disease management. Opportunity for future investigation includes efficacy of teaching tools on diabetes mastery, the effect of clinical nurse specialist mentoring on a select group of bedside nurses, and the Diabetes Management Mentor's impact on prevention of near-miss events.
Kuy, SreyRam; Romero, Ramon A L
Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service. Second, to assess whether staff CRM training is related to improvement in staff perception of a safety climate. Mandatory CRM training was implemented for all surgical service staff at a VA Hospital at 0 and 12 mo. Safety climate questionnaires were completed by operating room staff at a baseline, 6 and 12 mo after the initial CRM training. Participants reported improvement on all 27 points on the safety climate questionnaire at 6 mo compared with the baseline. At 12 mo, there was sustained improvement in 23 of the 27 areas. This is the first published report about the effect of CRM training on staff perception of a safety climate in a VA surgical service. We demonstrate that CRM training can be successfully implemented widespread in a surgical program. Overall, there was improvement in 100% of areas assessed on the safety climate questionnaire at 6 mo after CRM training. By 1 y, this improvement was sustained in 23 of 27 areas, with the areas of greatest improvement being the performance of briefings, collaboration between nurses and doctors, valuing nursing input, knowledge about patient safety, and institutional promotion of a patient safety climate. Published by Elsevier Inc.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Bureau of Land Management 43 CFR Part 3000 Minerals Management: General CFR Correction In Title 43 of the Code of Federal Regulations, Part 1000 to End, revised as of October 1, 2009, on page 331, in ] Sec...
Bennett, Michelle K.; Ward, Elizabeth C.; Scarinci, Nerina A.
Background: There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in…
Dokukina S. M.
Full Text Available The statement «the main asset of any company is its staff» has already become axiomatic. People is the only competitive advantage the companies have now, although for many years the possession of technologies is considered as a competitive advantage. The article covers essential questions connecting with staff management to executive strategy of value based management. The problems connected with the estimation of human capital as long-term factor of the company’s value growth are described. However one can implement in practice only in condition that it may be estimated or measured. The author puts forth his conception of the technique of human capital estimation. Approaches and methods of the estimation of human capital of company are systematized and described. The estimation of human capital elements allows to find out the potential of this intangible asset in order to increase the value of company.
Rowan, Anderson B
This article describes the Critical Incident Stress Management outreach to Pentagon staff conducted after the terrorist attack by a team of Air Force mental health and chaplain personnel. Also discussed are lessons learned from the author's experience while leading the mental health component and working in a larger tri-service outreach. Finally, the observed impacts of the outreach effort are examined along with recommendations for future postcritical incident outreach efforts.
technical problems in utilities management and engineering at: (1) Activities (2) Claimants or Major Commands (Includes UIP surveys, fuel conversions, CAPSE ...PWC SAN DIEGO - TOTAL PUBLIC WORKS SUPPORT A search of PWC San Diego instructions, PWC Insturction 5450. 2E of April 1975, Manual of Organization and...OPNAVINST 5310. 5A of 30 Apr 1965, Staffing Criteria Manual for Activities Ashore (b) OPNAVINST 1000. 16A of 5 Feb 1969 End: (1) Staff Civil
Hartzler, Bryan; Jackson, T Ron; Jones, Brinn E; Beadnell, Blair; Calsyn, Donald A
Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, and sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a historical control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted patient indices. Collective results offer support for the study's collaborative intervention design and the applied, skills-based focus of staff training processes. Implications for CM dissemination are discussed. Published by Elsevier Inc.
Geboers, H.J.A.M.; Mokkink, H.G.A.; Montfort, P.A.P. van; Hoogen, H.J.M. van den; Bosch, W.J.H.M. van den; Grol, R.P.T.M.
OBJECTIVES: Continuous quality improvement (CQI) offers opportunities to improve care in small-scale office-based practice. Little is yet known about the implementation of CQI in small primary care practices. We studied the attitudes of physicians and staff in small family practices to a model of
Webb, Marianne Julie; Wadley, Greg; Sanci, Lena Amanda
Technology-based screening of young people for mental health disorders and health compromising behaviors in general practice increases the disclosure of sensitive health issues and improves patient-centered care. However, few studies investigate how general practitioners (GPs) and practice support staff (receptionists and practice managers) integrate screening technology into their routine work, including the problems that arise and how the staff surmount them. The aim of this study was to investigate the implementation of a health and lifestyle screening app, Check Up GP, for young people aged 14 to 25 years attending an Australian general practice. We conducted an in-depth implementation case study of Check Up GP in one general practice clinic, with methodology informed by action research. Semistructured interviews and focus groups were conducted with GPs and support staff at the end of the implementation period. Data were thematically analyzed and mapped to normalization process theory constructs. We also analyzed the number of times we supported staff, the location where young people completed Check Up GP, and whether they felt they had sufficient privacy and received a text messaging (short message service, SMS) link at the time of taking their appointment. A total of 4 GPs and 10 support staff at the clinic participated in the study, with all except 3 receptionists participating in the final interviews and focus groups. During the 2-month implementation period, the technology and administration of Check Up GP was iterated through 4 major quality improvement cycles in response to the needs of the staff. This resulted in a reduction in the average time taken to complete Check Up GP from 14 min to 10 min, improved SMS text messaging for young people, and a more consistent description of the app by receptionists to young people. In the first weeks of implementation, researchers needed to regularly support staff with the app's administration; however, this support
Cleary, Michelle; Horsfall, Jan
In clinical settings, nursing staff often find themselves responsible for students who have varying time management skills. Nurses need to respond sensitively and appropriately, and to teach nursing students how to prioritize and better allocate time. This is important not only for developing students' clinical skills but also for shaping their perceptions about the quality of the placement and their willingness to consider it as a potential work specialty. In this column, some simple, practical strategies that nurses can use to assist students with improving their time management skills are identified. Copyright 2011, SLACK Incorporated.
Sadoughi, Farahnaz; Ebrahimi, Kamal
Self esteem (SE) and organizational commitment (OC)? have significant impact on the quality of work life. This study aims to gain a better understanding of the relationships between SE and OC among health information management staff in tertiary care hospitals in Tehran (Iran). This was a descriptive correlational and cross sectional study conducted on the health information management staff of tertiary care hospitals in Tehran, Iran. A total of 155 participants were randomly selected from 400 staff. Data were collected by two standard questionnaires. The SE and OC was measured using Eysenck SE scale and Meyer and Allen's three component model, respectively. The collected data were analyzed with the SPSS (version 16) using statistical tests of of independent T-test, Pearson Correlation coefficient, one way ANOVA and F tests. The OC and SE of the employees' were 67.8?, out of 120 (weak) and 21.0 out of 30 (moderate), respectively. The values for affective commitment, normative commitment, and continuance commitment were respectively 21.3 out of 40 (moderate), 23.9 out of 40 (moderate), and 22.7 out of 40 (moderate). The Pearson correlation coefficient test showed a significant OC and SE was statistically significant (Pwork experience with SE and OC. This research showed that SE and OC ?are moderate. SE and OC have strong correlation with turnover, critical thinking, job satisfaction, and individual and organizational improvement. Therefore, applying appropriate human resource policies is crucial to reinforce these measures.
Morsiani, Giuliana; Bagnasco, Annamaria; Sasso, Loredana
To describe staff nurses' perceptions related to the leadership styles adopted by their nurse managers, identify which leadership style ensured job satisfaction in staff nurses and describe which behaviours nurse managers should change. Empirical literature suggests that leadership styles of nurse managers significantly influence staff satisfaction. However, few studies investigate how staff nurses perceive the leadership styles of their nurse managers, and how these impact upon the staff nurses' job satisfaction. This was a mixed method study, which included the administration of the Multi-factor Leadership Questionnaire and three focus groups. Ward nurse managers mostly adopted a transactional leadership style ('Management by exception active') aimed at monitoring errors and intervening to correct errors and punish, which had a negative impact on staff nurses' levels of job satisfaction. In contrast, the transformational leadership style, which is mostly correlated with satisfaction ('Idealized Influence Attributed', which staff nurses perceived as 'respect', 'caring for others', 'professional development' and 'appreciation'), was rarely practiced by nurse managers. The transformational leadership skills of Italian nurse managers need to be improved through behaviours based on greater respect, caring for others, professional development and appreciation. The present study could also serve as model to improve the leadership style of nurse managers in other countries. The themes of transformational leadership could serve as a guide for nurse managers to help them improve their leadership style, and improve the levels of job satisfaction in staff nurses. Owing to the complexity and the importance of this issue, classroom educational interventions would not be sufficient: it should be dealt as a strategic priority by nursing directors. © 2016 John Wiley & Sons Ltd.
Full Text Available Background: General anesthesia is a reversible state of a temporary loss of consciousness, analgesia, muscle paralysis, blunted autonomic responses and amnesia. To achieve this, an adequate depth of anesthesia should be maintained throughout the surgery. Awareness is a serious complication of general anesthesia, which occurs when the depth of anesthesia is not appropriate due to various causes.In this paper the underlying neurobiology of intraoperative awareness is presented, as well as risk factors for awareness and methods for assessing the depth of anesthesia. Possible psychological consequences of awareness and their management are also discussed. At the end, the recommendations for preventing intraoperative awareness are given.Conclusions: Awareness during general anesthesia may have adverse psychological sequelae in individual patients, therefore guidelines for preventing and managing of intraoperative awareness need to be adopted. In case of a possible awareness, the recommendations for offering a psychological support should also be followed.
Kjeldsen, Hans Christian; Kier, Svend; Husum, Gitte
Aim: To compare the effect of two strategies for management of dyspepsia. Evaluation based on GP's assessment after two weeks and patients assessment after three months. Design: Prospective randomised controlled trial in general practice Methods: 357 patients with dyspepsia where the general...... practitioner (GP) finds indication for treatment with antisecretory therapy and/or diagnostic Helicobacter Pylori test were included in general practice between June 2000 and June 2002. Patients the GP want to refer to endoscopy were not included. Dyspepsia definition: persistent or recurrent pain...... or discomfort centred in the upper abdomen with or without nausea, vomiting, heartburn, acid regurgitation, early satiety or bloating. Patients were initially treated according to one of two management strategies. The patient was the unit of randomisation. Strategy 1: Proton pump inhibitor (40 mg omeprazol...
Esther M. Maimela
Full Text Available Orientation: Institutions of higher learning in South Africa are fast embracing performance management system (PMS as a mechanism for the achievement of teaching excellence and enhancement of research productivity. However, literature provided evidence to show that application of PMS in the private sector had failed to drive competition, efficiency and productivity. Research purpose: The main purpose of this article was to evaluate the perception of academic staff members of an open distance learning institution regarding the implementation of a PMS. Motivation for the study: PMS as a mechanism through which performance of academics is measured has been described as inconsistent with the long tradition of academic freedom, scholarship and collegiality in the academy. Moreso, previous research on the implementation of PMS was limited to private sector organisations, thus resulting in the dearth of empirical literature relating to its practice in service-driven public sector institutions. Research design, approach and method: The article adopted a quantitative research approach using census survey methodology. Data were collected from 492 academic staff from the surveyed institution using a self-developed questionnaire that was tested for high content validity with a consolidated Cronbach’s alpha value of 0.83. Data were analysed using a onesample t-test because of the one-measurement nature of the variable under investigation. Main findings: Major findings of the study indicated that respondents were satisfied with the implementation of the PMS by management. However, the payment of performance bonuses was not considered as sufficiently motivating, thus necessitating a pragmatic review by management. Practical/managerial implications: The findings of this article provided a practical guide to managers on the implementation and management of PMS as an employee performance reward mechanism in non-profit and service-oriented organisations
Ahanchian, Mohammad Reza; Emami Zeydi, Amir; Armat, Mohammad Reza
Conflict among nurses has been recognized as an extremely important issue within health care settings throughout the world. Identifying the conflict management style would be a key strategy for conflict management. The aim of this study was to evaluate the prevalence of conflict management styles and its related factors among Iranian critical care nursing staff. In a descriptive cross-sectional study, a total of 149 critical care nurses who worked in the critical care units of 4 teaching hospitals in Sari (Iran) were evaluated. A 2-part self-reported questionnaire including personal information and Rahim Organizational Conflict Inventory II was used for data collection. Although Iranian critical care nurses used all 5 conflict management styles to manage conflict with their peers, the collaborating style was the most prevalent conflict management style used by them, followed by compromising, accommodating, avoiding, and competing. Male gender was a predictor for both compromising and competing styles, whereas position and shift time were significant predictors for compromising and competing styles, respectively. Based on the results of this study, nurse managers need to take these factors into account in designing programs to help nurses constructively manage unavoidable conflicts in health care setting.
Cummings, Greta G; Hewko, Sarah J; Wang, Mengzhe; Wong, Carol A; Laschinger, Heather K Spence; Estabrooks, Carole A
Extended lifespans and complex resident care needs have amplified resource demands on nursing homes. Nurse managers play an important role in staff job satisfaction, research use, and resident outcomes. Coaching skills, developed through leadership skill-building, have been shown to be of value in nursing. To test a theoretical model of nursing home staff perceptions of their work context, their managers' use of coaching conversations, and their use of instrumental, conceptual and persuasive research. Using a two-group crossover design, 33 managers employed in seven Canadian nursing homes were invited to attend a 2-day coaching development workshop. Survey data were collected from managers and staff at three time points; we analyzed staff data (n = 333), collected after managers had completed the workshop. We used structural equation modeling to test our theoretical model of contextual characteristics as causal variables, managers' characteristics, and coaching behaviors as mediating variables and staff use of research, job satisfaction, and burnout as outcome variables. The theoretical model fit the data well (χ 2 = 58, df = 43, p = .06) indicating no significant differences between data and model-implied matrices. Resonant leadership (a relational approach to influencing change) had the strongest significant relationship with manager support, which in turn influenced frequency of coaching conversations. Coaching conversations had a positive, non-significant relationship with staff persuasive use of research, which in turn significantly increased instrumental research use. Importantly, coaching conversations were significantly, negatively related to job satisfaction. Our findings add to growing research exploring the role of context and leadership in influencing job satisfaction and use of research by healthcare practitioners. One-on-one coaching conversations may be difficult for staff not used to participating in such conversations. Resonant leadership, as
Full Text Available The Statutory Instrument of September 2007 approved as part of the regulatory powers of the Education Act (DfES, 2002 established regulations for a minimum undertaking of 30 hours’ Continuing Professional Development (CPD for all teaching staff on a year-on-year basis. Seen as part of the professionalisation agenda for the Further Education (FE sector, this regulation has placed additional responsibilities on the role of Middle Managers. Here we report on a small-scale research project based in one College of Further Education which set out to explore and better understand the role of Middle Managers in supporting the professionalisation agenda. The study determined to explore how Middle Managers, defined as those with operational rather than strategic roles, were supporting their colleagues whilst also trying to secure time for their own Continuing Professional Development (CPD. The impact of the IfL’s approach to dual professionalism is also explored.
This report aims to stimulate scientists of all disciplines to consider the advantages of using a generalized data management system (GDMS) for storage, manipulation and retrieval of the data they collect and often need to share. It should also be of interest to managers and programmers who need to make decisions on the management of scientific (numeric or non-numeric) data. Another goal of this report is to expose the features that a GDMS should have which are specifically necessary to support scientific data, such as data types and special manipulation functions. A GDMS is a system that provides generalized tools for the purpose of defining a database structure, for loading the data, for modification of the data, and for organizing the database for efficient retrieval and formatted output. A data management system is 'generalized' when it provides a user-oriented language for the different functions, so that it is possible to define any new database, its internal organization, and to retrieve and modify the data without the need to develop special purpose software (program) for each new database
Full Text Available Abstract Background Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF staff and General Practitioners (GPs relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. Methods A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey and 202 GPs (19% of metropolitan GPs. Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Results Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern
Sizakele L.T. Khoza
Full Text Available Background: Neonatal pain management has received increasing attention over the past four decades. Research into the effects of neonatal pain emphasises the professional, ethical and moral obligations of staff to manage pain for positive patient outcomes. However, evaluation studies continuously report evidence of inadequate neonate pain management and a gap between theory and practice. Objective: This study reviewed current practice in neonatal pain management to describe the knowledge, attitudes and practices of nurses and doctors regarding pain management for neonates in two academic hospitals. Method: A non-experimental, prospective quantitative survey, the modified Infant Pain Questionnaire, was used to collect data from 150 nurses and doctors working in the neonatal wards of two academic hospitals in central Gauteng. Results: The response rate was 35.33% (n = 53, most respondents being professional nurses (88.68%; n = 47 working in neonatal intensive care units (80.77%; n = 42; 24 (45.28% had less than 5 years’ and 29 respondents 6 or more years’ working experience in neonatal care. A review of pain management in the study setting indicated a preference for pharmacological interventions to relieve moderate to severe pain. An association (p < 0.05 was found between pain ratings on 5 procedures and frequency of administration of pharmacological pain management. Two-thirds of respondents (64% reported that there were no pain management guidelines in the neonatal wards in which they worked. Conclusion: The interventions to manage moderate neonatal pain are in line with international guidelines. However, neonatal pain management may not occur systematically based on prior assessment of neonatal pain, choice of most appropriate intervention and evaluation. This study recommends implementation of a guideline to standardise practice and ensure consistent and adequate pain management in neonates.
material which accelerates the har- dening of certain coatinss. Acoustic paint - paint which absorbs or deadens sound . Acrylic resin-a clear resin...AUG 1983 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Work Managemaent Manual - Blast and Paint General 5a. CONTRACT NUMBER...WORK MANAGEMENT MANUAL BLAST/ PAINT GENERAL INDEX SECTION PAGE 1.0 .1 .2 .3 .4 2.0 .1 .2 .3 .4 .5 .6 .8 .9 3.0 .1 4.0 .1 5.0 .1 7.0 .1 .3 8.0 SCOPE PLANT
Soo, Yien Yien; Luckie, Kate Helen; Saini, Bandana; Kritikos, Vicky; Brannan, John D; Moles, Rebekah Jane
This study aimed to evaluate the effectiveness of an asthma first-aid training tool for childcare staff in Australia. The effects of training on both asthma knowledge and skills were assessed. A pre/post-study design was utilised to assess changes in asthma knowledge and asthma first-aid skills in childcare staff before and after an educational intervention. Asthma first-aid skills were assessed from the participant's response to two scenarios in which a child was having a severe exacerbation of asthma. Asthma knowledge and asthma skills scores were collected at base-line and 3 weeks post the education session, which involved feedback on each individual's skills and a brief lecture on asthma delivered via PowerPoint presentation. There was a significant improvement after intervention in asthma knowledge (Z = -3.638, p < 0.001) and asthma first-aid skills for both scenario 1 (Z = -6.012, p < 0.001) and scenario 2 (Z = -6.018, p < 0.001). In scenario 1 and 2, first-aid skills improved by 65% (p < 0.001) and 57% (p < 0.001), respectively. Asthma knowledge was high at baseline (79%) and increased by 7% (p < 0.001) after the educational intervention. These asthma knowledge results were not significant when adjusted for prior knowledge. Results suggest that knowledge assessment alone may not predict the practical skills needed for asthma first-aid. Skills assessment is a useful adjunct to knowledge assessment when gauging the ability of childcare staff to manage acute asthma exacerbation. Skills assessment could be considered for incorporation into future educational interventions to improve management of acute asthma exacerbation.
Raup, Glenn H
Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.
Sarokoff, Randi A.; Sturmey, Peter
A limited number of studies have investigated the effects of behavioral skills training (BST) on staff acquisition and generalization of discrete trial teaching (DTT) and student behavior. BST was used to improve three staff's use of DTT interactions with four children with autism. A multiple baseline design across participants was used to assess…
Nelson, E G
Because of the roles traditionally required of them, and because of the insularity of ancillary staff in general medical practice, many senior ancillary staff may not have been giving their doctors the most effective support of which they are capable. This is changing as a result of the change-promoting activities of the North of England Faculty of the Royal College of General Practitioners.A survey of ancillary staff and general practitioners in the North of England has shown that the Royal College of General Practitioners has assisted ancillary staff to a greater consensus of more progressive views about the emerging role of practice manager than is the case amongst general practitioners. The results also show that differences in the size of practices have determined whether or not a need for a practice manager is perceived.The focus of interest created by this faculty of the Royal College of General Practitioners has resulted in the formation of special interest groups of senior ancillary staff in the North of England. These groups form a valuable resource for exploration and innovation to discover more effective means of organising and managing general medical practice.
Storkholm, Marie Højriis
-structured interviews with managers and staff in a clinical department successful in achieving the Triple Aim. Results Participants identified themselves with the Triple Aim along classic professional divides. Four mental models that underlie these affinities suggest that while staff tended to see the Triple Aim......Money’s (not) on my mind: A qualitative study of how staff and managers understand health care’s Triple Aim Purpose The “Triple Aim” – provision of a better care experience and improved population health at a lower cost – seems theoretically sound but in practice it´s difficult to achieve....... This study aimed to explore staff and manager’s understandings and underlying mental models, which guide planning and change strategies to implement organizational interventions when facing efficiency requirements. Design/methodology We performed an inductive content analysis of thirty semi...
Esther M. Maimela
Full Text Available Orientation: Institutions of higher learning in South Africa are fast embracing performance management system (PMS as a mechanism for the achievement of teaching excellence and enhancement of research productivity. However, literature provided evidence to show that application of PMS in the private sector had failed to drive competition, efficiency and productivity.Research purpose: The main purpose of this article was to evaluate the perception of academic staff members of an open distance learning institution regarding the implementation of a PMS.Motivation for the study: PMS as a mechanism through which performance of academics is measured has been described as inconsistent with the long tradition of academic freedom, scholarship and collegiality in the academy. Moreso, previous research on the implementation of PMS was limited to private sector organisations, thus resulting in the dearth of empirical literature relating to its practice in service-driven public sector institutions.Research design, approach and method: The article adopted a quantitative research approach using census survey methodology. Data were collected from 492 academic staff from the surveyed institution using a self-developed questionnaire that was tested for high content validity with a consolidated Cronbach’s alpha value of 0.83. Data were analysed using a onesample t-test because of the one-measurement nature of the variable under investigation.Main findings: Major findings of the study indicated that respondents were satisfied with the implementation of the PMS by management. However, the payment of performance bonuses was not considered as sufficiently motivating, thus necessitating a pragmatic review by management.Practical/managerial implications: The findings of this article provided a practical guide to managers on the implementation and management of PMS as an employee performance reward mechanism in non-profit and service-oriented organisations
Full Text Available to identify staff and institutional factors associated with substandard care by midwives managing postpartum hemorrhage (PPH.A multicenter vignette-based study was e-mailed to a random sample of midwives at 145 French maternity units that belonged to 15 randomly selected perinatal networks. Midwives were asked to describe how they would manage two case-vignettes about PPH and to complete a short questionnaire about their individual (e.g., age, experience, and full- vs. part-time practice and institutional (private or public status and level of care characteristics. These previously validated case-vignettes described two different scenarios: vignette 1, a typical immediate, severe PPH, and vignette 2, a severe but gradual hemorrhage. Experts consensually defined 14 criteria to judge adherence to guidelines. The number of errors (possible range: 0 to 14 for the 14 criteria quantified PPH guideline adherence, separately for each vignette.450 midwives from 87 maternity units provided complete responses. Perfect adherence (no error for any of the 14 criteria was low: 25.1% for vignette 1 and 4.2% for vignette 2. After multivariate analysis, midwives' age remained significantly associated with a greater risk of error in guideline adherence in both vignettes (IRR 1.19 [1.09; 1.29] for vignette 1, and IRR 1.11 [1.05; 1.18] for vignette 2, and the practice of mortality and morbidity reviews in the unit with a lower risk (IRR 0.80 [0.64; 0.99], IRR 0.78 [0.66; 0.93] respectively. Risk-taking scores (IRR 1.41 [1.19; 1.67] and full-time practice (IRR 0.83 [0.71; 0.97] were significantly associated with adherence only in vignette 1.Both staff and institutional factors may be associated with substandard care in midwives' PPH management.
Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans
This qualitative research examines the similarities and differences between three teaching departments within Universities of Applied Sciences (UAS) in the Netherlands that provide effective and three that provide less effective quality management. What are staff members' conceptions and perceptions of quality, quality management and…
The practice of documenting the credibility of quality management system of companies in the medical sector in Poland does not have a long history. In the recent years hospitals have started to work in a system similar to a competitive market with features specific for medical service preserved. As a result quality focused activity instruments were introduced to the medical service market, such as ISO family of standards. The aim of the work objective was to get to know the opinion of medical staff about the changes resulting in the quality management system implementation. The answers of a team of 200 medical staff from two Polish hospitals were analysed. The respondents were employed in medical institutions before and after the introduction of ISO 9001. A large number of participants claimed that standardization in work organization made a significant improvement (45.50%, n = 91), but part of them (36.50%, n = 73) claimed that this new organization improved the situation not very much. And a small group (18,00%, n = 36) said that the organization did not change after the introduction of standardization. Nurses and medical rescue workers more often claimed (the result being statistically significant) that their work organization improved after the standardization implementation (48.54%), differently from doctors (27.59%, p = 0.008). Doctors in the research often claimed that the changes after the introduction of standardization caused an increase in the requirements of their professional qualifications (79.13%), but the nurses and medical rescue workers found it a bit less (74.85%). Most participants (87.50%, n = 175) claimed that the changes which appeared as a result of the introduction of standardization motivated them to compete against others health care institutions. Medical staff in the research claimed that the changes after the introduction of standardization resulted in work organization improvement. Nurses and medical rescue workers more often claimed
Positron Emission. Tomography (PET) imaging has expanded in Australia in recent years and is a recognised technique to diagnose cancer, neurological and heart disease. The high-energy gamma rays (51 I KeV) produced from the annihilation reaction in PET and their increased penetration compared to Tc- 99 m (HOKeV) emissions results in a higher radiation exposure to staff compared to other types of imaging such as X-Ray, CT (computer tomography) and MR1 (magnetic resonance imaging) and general nuclear medicine. The project scope was to reduce the occupational radiation exposure to staff working within the imaging section of the WA PET/Cyclotron Service by utilising a continuous quality improvement, process. According to the Australian Council on Healthcare Standards (ACHS) continual quality improvement is critical for healthcare in Australia (The EQUIP Guide, 2002, p. 1-1 ). The continuous quality improvement approach selected is appropriate for the organisation and the PET imaging process based on the Evaluation and Quality Improvement Program (EQUIP) which is the recognised standard for the health care industry in Australia
The objective of this research was to investigate the concept of competencies, explore and identify the management competencies of hotel owner-managers and general managers in the hospitality industry in the Republic of Ireland. In other words, this research explored how hotel owner-managers and general managers identified, interpreted and made sense of their notion of managerial competencies in a complex work environment. The research was set within the context of the Irish hospitality and t...
Full Text Available Health care managers realize that job satisfaction impacts on nursing staff retention. This study examined the job satisfaction of nursing staff (N = 109 at a government hospital. Just more than half of the respondents were generally satisfied. Feelings that nursing is worthwhile and satisfying, and financial stability at the hospital could promote staff retention. Specific intrinsic - (promotion, and extrinsic factors (routinization, working conditions, pay, interaction with supervisors, and organizational support could impact negatively on retention. Management should use these findings as a basis for staff consultation, developmental strategies, and interventions. Future research on other nursing populations is recommended.
Full Text Available Background: Hospitals are the centre of cure and also the important centres of infectious waste generation. Effective management of Biomedical Waste (BMW is not only a legal necessity but also a social responsibility. Aims and Objectives: To assess the knowledge and practice in managing the biomedical wastes among nursing staff and student nurses in RIMS, Ranchi. Materials and methods: The study was conducted at RIMS, Ranchi from Oct 2013 to March 2014 (6 months. It was a descriptive, hospital based, cross-sectional study. A total of 240 nurses participated in the present study, randomly chosen from various departments A pre-designed, pre-tested, structured proforma was used for data collection after getting their informed consent. Self-made scoring system was used to categorize the participants as having good, average and poor scores. Data was tabulated and analyzed using percentages and chi-square test. Results: The knowledge regarding general information about BMW management was assessed(with scores 0-8,it was found that level of knowledge was better in student nurses than staff nurses as student nurses scored good(6-8correct answers in more than half of the questions (65%.Whereas staff nurses scored good in only 33.33% questions. When the practical information regarding the BMW management is assessed (with scores 0-8, it was found that staff nurses had relatively better practice regarding BMW management than students as they scored good(6-8correct answers in 40% and 30% respectively. Conclusion: Though overall knowledge of study participants was good but still they need good quality training to improve their current knowledge about BMW.
The US Army Command and General Staff College (CGSC) is organized in five schools, one of which, Command and General Staff School (CGSS), is not formally established. These schools provide instruction to officers, noncommissioned officers, and civilians through 4 primary courses and approximately 20 shorter courses. The primary courses are CAS/sup 3/ (Combined Arms and Services Staff School) Phase I Nonresident Course, CAS/sup 3/ Phase II Resident Course, CGSOC (Command and General Staff Officers Course), and SAMS (School of Advanced Military Studies). The shorter courses are primarily provided through SPD (School of Professional Development). Task A analyzed the curricula of the primary courses in terms of organization and cognitive level with the goal of providing the project team sufficient understanding of the College to seriously address the issue of the application of computers to learning in Task G.
Health care managers realize that job satisfaction impacts on nursing staff retention. This study examined the job satisfaction of nursing staff (N = 109) at a government hospital. Just more than half of the respondents were generally satisfied. Feelings that nursing is worthwhile and satisfying, and financial stability at the hospital could promote staff retention. Specific intrinsic - (promotion), and extrinsic factors (routinization, working conditions, pay, interaction with supervisors, a...
This Handbook sets forth those transportation and general traffic management responsibilities, guidelines, and procedures governing the use of commercial and Government transportation for NASA. Transportation is an integral function of the logistic process, involving all activities incident to the movement of persons and things. The fundamental and continuous objectives of transportation are to control and diminish the time-distance of lines of communication by the most suitable means. The function of transportation is accomplished through, and encompasses all, the planning, direction, supervision, and execution of the technical, operational, and administrative tasks required to procure or furnish efficient and economical conveyance of cargo and personnel by all modes of commercial and Government transportation. This Handbook is applicable to NASA Headquarters and Field Installations.
Little, P; Williamson, I
This paper discusses primary care management of sore throat in the context of recent national 'consensus' guidelines from the Drugs and Therapeutics Bulletin. The guidelines advise taking a throat swab, using typical clinical features where swabs are not available, and suggest that antibiotics shorten the duration of symptoms and prevent complications. Systematic reviews and individual studies indicate that the evidence for prescribing antibiotics for most presentations of sore throat in general practice is marginal, and the benefits are probably outweighed by the likely costs of antibiotics. Using clinical scorecards or symptom clusters to identify individuals who would benefit from treatment is insensitive with low predictive value, although inexpensive. Using throat swabs as a gold standard for diagnosis is inappropriate since they are neither very specific nor sensitive, and will greatly increase costs of management. The relative lack of evidence for the efficacy of antibiotics and for the use of throat swabs from primary care research, and also an unbalanced perspective of dangers and complications related predominantly to a secondary care setting, underlines the problem of achieving valid consensus guidelines. Guidelines not firmly based on evidence appropriate to the intended setting are more likely to be received sceptically and hinder getting research into practice.
Full Text Available Introduction: The purpose of this study was to assess the level of primary Knowledge among school staffs in Iran with regards to the immediate management of dental trauma. Methods: The data, from 160 participants, were collected using questionnaire, which surveyed staff’s background, attitude and knowledge of dental trauma management. Results: The total number of school staff who responded to all of the questions in the questionnaire was 138; the response rate was 86%. 91.3% of the participants had more than 10 years of teaching experience. Only 24 cases (17.4% have participated in training courses in regards to the dental trauma. 46.4% of the participants estimated their level of knowledge regarding the dental trauma as moderate and 42.8% as low and 7.2% without knowledge, however, 56.5% of them were highly interested in attending the training courses. Overall, the teachers’ knowledge on emergency management of the dental trauma cases presented in this study was deficient, especially in avulsed tooth management. Chi-square test showed that there was no statistically significant difference in the responses to the knowledge part of the questionnaire on age, gender, teaching experience and responsibility in school. Conclusion: The present report indicated the lack of knowledge among school staff on dental injuries managements. Organizing educational courses to improve the knowledge and awareness of school staff, as the first encounters of dental trauma in schools, seems necessary.
Judith L. Stella
Full Text Available Understanding cat owners’ housing, care, and management practices is important for promoting cat welfare. A survey study was conducted on the housing and management practices used for cats by students, faculty, and staff of The Ohio State University and Purdue University veterinary colleges. Subjects were 138 cat-owner dyads. Most cats (74% were housed strictly indoors in keeping with common US veterinary recommendations. However, many did not implement best practices outlined for behavior and other welfare needs of indoor cats. The percentage of respondents placing resources where cats could be disrupted while using them was 31%, 53%, and 30% for resting areas, food/water dishes, and litter boxes, respectively. Many cats were not provided a litter box in a private area (35%, in multiple areas of the house (51%, or that was regularly washed (73%. Horizontal scratching opportunities were not provided to 38% of cats; 32% were not provided toys that mimic prey and 91% of cats were fed a diet consisting of >75% dry food. These findings suggest a need for more concerted efforts to educate owners about meeting their cats’ welfare needs so as to attenuate risks and improve cat physical and behavioral welfare outcomes.
Amzat, Ismail Hussein; Idris, Datuk Abdul Rahman
Purpose: The purpose of this paper is to discuss the effect of management and decision-making styles on the job satisfaction of academic staff in a Malaysian Research University. Design/methodology/approach: The sample consisted of 218 respondents. The instruments used in the study were the Teacher Job Satisfaction Questionnaire and the Decision…
US Agency for International Development — E3 Staff database is maintained by E3 PDMS (Professional Development & Management Services) office. The database is Mysql. It is manually updated by E3 staff as...
Walker, Christopher; White, Melanie
When student plagiarism occurs, academic interest and institutional policy generally assume the fault rests with the student. This paper questions this assumption. We claim that plagiarism is a shared responsibility and a complex phenomenon that requires an ongoing calibration of the relative skills and experiences of students and staff in…
Full Text Available The purpose of present research is to study the relationship between job performance and employees’ mental health in one of Iranian natural gas refinery located in city of Jam, Iran. Data collection was conducted based on two major characteristics of job performance and mental health based on questionnaire methods among 42 people. The methodology is descriptive and correlation – type and to analyze the data, Pearson’s correlation coefficient, variances equality tests as well as t-student were utilized. The findings show that there was a significant relationship between employees’ job performance and mental health and any increase in mental health aspects promotes job performance proportionally. In the meantime, there was no significant relationship between employees’ job performance and their gender and there was no significant difference on mental health status between male and female staff. Based on the results, one can conclude that low mental health level among employees can reduce their performance. Managers should use proper methods to decrease the negative consequences resulted from the lack of mental health in workplaces.
Zwetsloot, G.I.J.M.; Gort, J.; Steijger, N.; Moonen, C.
Increasing global competition and shareholder pressure are causing major changes in the chemical industry. Over the last decade companies have been continuously improving staff efficiency. As a result, most modern chemical plants can be regarded as lean. Plans to further reduce the number of staff
Riveros S, Jorge; Berné M, Carmen
The implementation of the marketing strategies in public hospitals provides management advantages and improves the relationship between customers and staff. To analyze the application of marketing strategies in a public hospital, from the perspective of the staff. A structured survey that asked about perceptions in 50 items about communication between personnel and customers/users, customer satisfaction, participation in the development of new policies and incentives for efficiency was applied to a stratified sample of the staff. Factorial and regression analyses were performed to define the impact of marketing strategies on the degree of preoccupation and orientation of the organization towards the satisfaction of customer needs. The survey was applied to 74 males and 122 females. The survey showed that the orientation of the hospital towards the satisfaction of its beneficiaries basically depends on the generation of an organizational culture oriented towards them and the implementation of adequate policies in staff management and quality of service. These basic aspects can be accompanied with practices associated to the new marketing approaches such as a market orientation, customer orientation and relational marketing. All these factors presented positive and significant relations. New marketing strategies should be applied, to achieve an efficient and customer oriented hospital management.
This book presents the papers given at a symposium on radioactive waste management. Topics considered at the symposium included the status of radioactive waste disposal, the status of international nuclear waste management, waste management activities at the Idaho National Engineering Laboratory, legal and liability issues, risk perceptions and public involvement, waste transportation, waste processing, remedial action, decontamination, predisposal processing and treatment processes, low-level and mixed waste management, and mixed chemical and radioactive waste disposal
Ahmed, Osman I
With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.
Gollop, R; Whitby, E; Buchanan, D; Ketley, D
To explore scepticism and resistance towards changes in working practice designed to achieve service improvement. Two principal questions were studied: (1). why some people are sceptical or resistant towards improvement programmes and (2). what influences them to change their minds. Semi-structured qualitative interviews were conducted with 19 clinicians and 19 managers who held national and regional roles in two national programmes of service improvement within the NHS involving systematic organisational changes in working practices: the National Booking Programme and the Cancer Services Collaborative (now the Cancer Services Collaborative Improvement Partnership). Scepticism and resistance exist in all staff groups, especially among medical staff. Reasons include personal reluctance to change, misunderstanding of the aims of improvement programmes, and a dislike of the methods by which programmes have been promoted. Sceptical staff can be influenced to become involved in improvement, but this usually takes time. Newly won support may be fragile, requiring ongoing evidence of benefits to be maintained. The support of health service staff, particularly doctors, is crucial to the spread and sustainability of the modernisation agenda. Scepticism and resistance are seen to hamper progress. Leaders of improvement initiatives need to recognise the impact of scepticism and resistance, and to consider ways in which staff can become positively engaged in change.
De Kock, E
Full Text Available comfort level with the use of technology tools. The academic staff are qualified and experienced subject matter experts but this does not translate to having the necessary technical competencies to do online teaching. They consequently could experience...
The General Safety and Waste Management page offers section-specific safety and waste management details for chemicals, radiochemicals, pathogens, and biotoxins included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).
Internal Audit, Military. Museums, Documentation. Service, Language. Service, Financial Co-ordination, Chief Pay Mas- ter, Programming and Budget, Electronic Data. Processing and Expenditure Control. Chief of Staff Finance. With effect from 13 February 1978 Chief of Staff. Management Services became Chief of Staff.
Stephen J. Mallaby
Full Text Available Orientation: Understanding the nature and challenges of making the transition from a functional role to a general management role in South African organisations. Research purpose: The objective of this study was to gain insight into the obstacles that affect the transition from functional to general management and identify steps that may be taken to overcome these challenges. Motivation for the study: One of the most difficult crossroads for a manager is making the shift from being a functional specialist to becoming a general manager. New competencies and behaviours are required, as well as a more strategic mind set. If the transition is not made successfully, the manager and the organisation suffer. Research design, approach and method: A qualitative design was used consisting of in-depth, semi-structured interviews, with 19 senior business leaders who had successfully made the transition. The interviews were used to gather insights into the challenges they faced during their transitions, and how these were overcome. Main findings: To make the transition successfully, functional managers need to gain relevant experience to prepare them for the broader scope of a general management role. They need to develop appropriate skills, attitudes and personal characteristics. Mentoring is an effective development process. Newly appointed general managers need to learn to let go of control while maintaining ownership, build relationships and strike the right balance between strategic thinking and execution. There are unique aspects of being a general manager in South Africa, such as dealing with Black Economic Empowerment and challenges of race and identity, given the country’s history. Practical and managerial implications: Specific interventions are suggested which are directed at both aspiring general managers and organisations seeking to assist middle managers to make the transition to general managers. Contribution: This study contributes to
Teshuva, Karen; Wells, Yvonne
To investigate aged care managers' perceptions of staff preparedness for working with older people who experienced genocide or mass trauma earlier in their lives (referred to in this paper as 'older survivors'). A survey of 60 aged care service managers was conducted (50% response rate). Trauma knowledge and skills scales with Cronbach's alpha scores of 0.74 and 0.90 respectively, were used. Scores across groups were compared using Student's t-tests. Three-quarters of the respondents reported that their agency had provided aged care services for older survivors. The majority of these managers perceived their staff to be moderately informed about trauma-related issues and half rated staff trauma-related skills positively. These ratings were positively associated with trauma-related staff training, service type and service location. Results suggest that, overall, managers perceive a need to improve aged care staff's preparedness for providing care for older survivors. © 2016 AJA Inc.
Seyedeh Nafiseh Askarinejad
Conclusion This study showed that there is a significant difference in the attitude of managers and staff of municipality regarding urban modification. Recruiting people with higher educational qualifications and awareness or familiarity with the phenomenon of disability could help in the process of urban modification in the community. It is recommended to utilize the findings of this study to formulate urban modification programs across communities for the benefit of the disabled.
Mbukusa, Nchindo Richardson
Managing distance education regional centres as one staff member in Namibia is a challenge that calls for greater administrative and academic interventions. Although much work on student support by researchers and practitioners has been published, few scholars have recently begun to explore, through qualitative research, the challenges of managing…
Partial Contents: General Principles, A Spectrum of Implementation, OMB Guidance, A Special Note about DOD, Risk Factors to Consider, How can EVMS be tailored, Tailor EVMS to Inherent Risk, Application Thresholds-DoD...
Systematic Management of Change Is the Key to Successful Staff Development. An Initial Study of the Bloomfield Public Schools Staff Development Project. Teacher Essentials, Styles & Strategies (TESS).
Celso, Nicholas; Morris, Harold
Confronted by a maturing staff, lower teacher turnover rates, declining enrollments, and more sophisticated instructional methods, the Bloomfield (New Jersey) Public School District adopted an ambitious staff development initiative in 1983. This paper describes the planning and implementation strategies used to launch Bloomfield's Teaching…
Downing, Tacy E; Kim, Yuli Y
Repaired tetralogy of Fallot (TOF) is one of the most common diagnoses encountered when caring for adults with congenital heart disease. Although long-term survival after childhood TOF repair is excellent, morbidity is common and most patients require reintervention in adulthood. This review provides an overview of key surveillance and management issues for adults with TOF, including residual right ventricular outflow tract disease and timing of pulmonary valve replacement, arrhythmias and risk stratification, left-sided heart disease and heart failure, and pregnancy management. Copyright © 2015 Elsevier Inc. All rights reserved.
Reese, T. G.; Wadle, R. C.
Potential ways of providing solid-waste management for a building complex serviced by a modular integrated utility system (MIUS) were explored. Literature surveys were conducted to investigate both conventional and unusual systems to serve this purpose. The advantages and disadvantages of the systems most compatible with MIUS are discussed.
Cunningham, James J.; Emukah, Reginald
A study was done of individual job involvement as it affects support services in some areas of higher education. The basic research question was: Given selected personal characteristics of support services staff members and certain situational characteristics, which set of variables would most effectively account for the variations in the degree…
This paper describes an empirical study associated with earlier reviews of the changing roles and identities of contemporary professional staff in UK higher education (Whitchurch, 2004; 2006a; 2006b). The study draws on the narratives of 24 individuals to illustrate that identity movements cannot be captured solely in terms of a shift from…
van Oorsouw, Wietske M W J; Embregts, Petri J C M; Bosman, Anna M T; Jahoda, Andrew
Helping staff serving clients with intellectual disability and challenging behaviour to cope with stress has implications for their own well-being and for the lives of those they support. This study examined staff members' views of stress and the effectiveness of a stress-management intervention. Effectiveness was assessed using written assignments regarding stress management, and changes in views presented were tested in a pre- and post-test control group design. In the first phase, a content analysis was conducted across groups, which revealed that participants expressed a broad variety of views about stress and coping mechanisms, with considerable individual differences. In the second phase, a more fine-grained quantitative analysis was conducted to assess training effectiveness. Results showed an increase in the proportion of coping strategies referred to by the experimental group post-training. This positive change remained at follow-up. The results of the content analysis and the outcome data have implications for staff training. © 2013 John Wiley & Sons Ltd.
The article elucidates main scientific approaches to understanding of essence of management accounting. From scientific studies of domestic scientists it is concluded that most of them classify management accounting under competence of accounting in general. It is shown that the first institutional factors concomitant with division of general theory of accounting into financial and management components were development of forms of business and implementation of accounting standards and manua...
Kibanov Ardalon Iakovlevich
This article examines the history of the essence and value concepts "Personnel Management" and "Human Resources Management". Proved that "Personnel Management and Human Resource Management" - is a single and continuous process baziruschihsya theories on the same paradigm, and human resource management - a new stage of the science of management personnel. Methodologically incorrect to contrast two completely contrived "approach": traditional (personnel management) and the new (human resource m...
Full Text Available Introduction: In Total Quality Management, Quality is not only an admirable phenomenon but also is a customer inalienable right and will be created through the involvement and participation of all employees, managers and customers of an organization. This study was designed to evaluate staff attitudes in teaching hospitals of Yazd in the field of Total Quality Management by using fuzzy logic. Methods: This was a descriptive, analytical, cross – sectional study. Research population, were all staff in teaching hospitals of Yazd that among them 235 people were randomly Stratified, selected and studied. Data for this study were collected through a questionnaire. Since the theory of fuzzy is more suitable approach for measuring linguistic variables, so this paper determines the attitude of staff in the field of Quality Management by the use of fuzzy logic. Results: Results showed that the dimensions of the “Identification and training of staff," "empowerment and teamwork of Employees" and "support and leadership of the top management organization" respectively ranked first, second and third importance In terms of staff. Conclusion: Criteria of identification and training of staff and teamwork and support and leadership of the top management organization are Important in motivating Total Quality Management. So in total quality management improve programs, these aspects should be prioritized according to the degree of importance and effort to improve the quality of service.
Kavan, Michael G; Elsasser, Gary; Barone, Eugene J
Generalized anxiety disorder is common among patients in primary care. Affected patients experience excessive chronic anxiety and worry about events and activities, such as their health, family, work, and finances. The anxiety and worry are difficult to control and often lead to physiologic symptoms, including fatigue, muscle tension, restlessness, and other somatic complaints. Other psychiatric problems (e.g., depression) and nonpsychiatric factors (e.g., endocrine disorders, medication adverse effects, withdrawal) must be considered in patients with possible generalized anxiety disorder. Cognitive behavior therapy and the first-line pharmacologic agents, selective serotonin reuptake inhibitors, are effective treatments. However, evidence suggests that the effects of cognitive behavior therapy may be more durable. Although complementary and alternative medicine therapies have been used, their effectiveness has not been proven in generalized anxiety disorder. Selection of the most appropriate treatment should be based on patient preference, treatment success history, and other factors that could affect adherence and subsequent effectiveness. Copyright (c) 2009 American Academy of Family Physicians.
Rosopa, Patrick J; Schaffer, Meline M; Schroeder, Amber N
Heteroscedasticity refers to a phenomenon where data violate a statistical assumption. This assumption is known as homoscedasticity. When the homoscedasticity assumption is violated, this can lead to increased Type I error rates or decreased statistical power. Because this can adversely affect substantive conclusions, the failure to detect and manage heteroscedasticity could have serious implications for theory, research, and practice. In addition, heteroscedasticity is not uncommon in the behavioral and social sciences. Thus, in the current article, we synthesize extant literature in applied psychology, econometrics, quantitative psychology, and statistics, and we offer recommendations for researchers and practitioners regarding available procedures for detecting heteroscedasticity and mitigating its effects. In addition to discussing the strengths and weaknesses of various procedures and comparing them in terms of existing simulation results, we describe a 3-step data-analytic process for detecting and managing heteroscedasticity: (a) fitting a model based on theory and saving residuals, (b) the analysis of residuals, and (c) statistical inferences (e.g., hypothesis tests and confidence intervals) involving parameter estimates. We also demonstrate this data-analytic process using an illustrative example. Overall, detecting violations of the homoscedasticity assumption and mitigating its biasing effects can strengthen the validity of inferences from behavioral and social science data.
Kravchenko Olena S.; Brahina Olha S.
The article grounds urgency of identification of the place of budget management in the general system of trade enterprise management. It analyses points of view of economists with respect to definitions of the “budgeting” and “budget management” terms. It considers main functions of budget management. It identifies the place of budget management in the general system of enterprise management. Pursuant to definition of the budget management as a managerial technology, which should meet a numbe...
Heckemann, B; Zeller, A; Hahn, S; Dassen, T; Schols, J M G A; Halfens, R J G
Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. Systematic, narrative review. Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level. Copyright © 2014 Elsevier Ltd. All rights reserved.
Jeremy C Ganz
Full Text Available A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined
This regulation extends to all the entities that appears in the list of entities subjected to supervision. It establishes the general requirements of the State Supervision Bodies for the organization, certification and checking of knowledge to the management and technical personnel. It is related to important activities for the safety of nuclear installations such as the site selection, design, construction, start-up and operation. This is also important for the design and manufacture the systems, equipment, elements, structure and important buildings for the safety of such installations and with the required quality control
The labor conditions and environment of electric power production are quite complicated. It is very difficult to realize the real-time supervision of the employees' working conditions and safety. Using the existing base stations in the power plant, the wireless fidelity network is established to realize the wireless coverage of the work site. We can use mobile phone to communicate and achieve positioning. The main content of this project is based on the special environment of the power plant, designed a suitable for ordinary Android mobile phone indoor wireless fidelity positioning system, real-time positioning and record the scene of each employee's movement trajectory, has achieved real-time staff check Gang, Staff in place, and for the safety of employees to provide a guarantee.
Lester, Richard K.; Piore, Michael J.; Malek, Kamal M.
An analytical management approach reflects a traditional perspective and an interpretive approach involves a perspective suited to rapidly changing, unpredictable markets. Both approaches are valid, but each serves different purposes and calls for different strategies and skills. (JOW)
Full Text Available Background. The prevalence of diabetes is growing. Development of chronic complications of diabetes can be prevented by intensive treatment. It is of utmost importance to know characteristics of treated population to follow it up and adjust measures. We conducted an evaluation of population of diabetic patients treated in Celje General Hospital.Methods. We studied 156 outpatients treated in Celje General Hospital in January 2000. We collected data on basic anthropologic characteristics, data on type, duration and treatment modality of diabetes, metabolic parameters, risk factors for developement and presence of chronic complications. We specially presented a subgroup of diabetics treated in our outpatient service less than two years.Results. The mean age of patients was 58 years. They have been treated for diabetes in average for 10 years. 94% of patients were type 2. 3% of patients had secondary diabetes and 3% had type 1 diabetes. 74% were overweight. 37% of patients had HbA1c equal or below 7.5%, 45% of patients had LDL equal or below 3.0 mmol/l, and 52% of patients had blood pressure equal or below 140/90 mmHg. Retinopathy was present in 34%, renal failure in 10% and neuropathy in 35%. Amputation on a lower limb had had 1% of patients. 56% of patients were treated only with oral hypoglycaemic drugs, 6% diet only and 38% of patients were treated with insulin either alone or in combination with oral hypoglycaemic drugs. In diabetics that we treat less than two years at least one late complication was present in 73%.Conclusions. Diabetics are referred to our service when complications of treatment of diabetes or chronic complications of diabetes are present. In the beginning of year 2000 we achieved acceptable value of HbA1c in 37% of patients, that of LDL and blood pressure in 45% and 52%, respectively. Prevalence of chronic complications of diabetes was comparable with the data from the literature.
Thousand, J S; Burchard, S N; Hasazi, J E
Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles.
Ramón-Jerónimo, Juan Manuel; Flórez-López, Raquel; Domínguez-Lario, Natalia
To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. Qualitative study (case study) based on grounded theory performed between January and June 2014. Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. UGCAP managers and Health Area (CEO) managers. Data were collected through 8 semi-structured interviews using non-probabilistic intentional sampling with representation and sufficiency criteria of discourse. Interviews were recorded, literally transcripted and analysis through in-vivo codes. Both tools are fully implemented but differently used in primary care centers. Budget is perceived as a coercive management tool, which has been imposed for cost saving; however, it is scarcely adequate for day-by-day management. While balanced scorecard is a more flexible tool that allows identifying financial and welfare problems, budgeting limits heavily reduce the possibility of implementing adequate solutions. The policy of incentives is not adequate either, leading on de-motivation. This study shows that budgeting restrictions have led to a significant reduction in autonomy of Spanish Primary Care centers. Management decision making is much centralised, also focused on cost saving over quality of healthcare. As a result, two needs emerge for the future: increasing centers' autonomy and improving staff commitment through training and professional development programs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Tee, Yvonne; Huang, Mary
Stigma and discrimination towards people living with HIV have been widely documented, and have extended their impact into the workplace. Stigmatising attitudes towards people living with HIV (PLHIV) in the workplace significantly hinder HIV prevention efforts and indirectly affect national development. This cross-sectional study was designed to determine the level of knowledge about HIV and AIDS and assess attitudes towards PLHIV among the general staff of Universiti Putra Malaysia (UPM), as well as to identify factors that are associated with it. Self-administered questionnaires were posted to a total of 344 general staff from six randomly selected faculties, and they were a given a week to return the questionnaires. The response rate was 38%. Data were analysed using Pearson's correlation, independent t-test and multiple linear regression. The respondents showed a considerably high level of knowledge about HIV/AIDS (mean knowledge score of 15.57+/-1.93 out of 18 points) although there were some misconceptions (N=129). Likert scale responses to 20 attitude statements revealed that respondents generally had moderately positive attitudes toward PLHIV (average score of 69.65+/-10.08 out of 100 points). Attitudes were inconsistent when it involved direct contact and interaction with PLHIV. Factors significantly associated with level of knowledge and attitudes included age, education and income. There was no difference in mean score for knowledge and attitudes by gender. Further efforts are necessary to improve attitudes of the general staff towards PLHIV, particularly in areas of direct contact with PLHIV.
Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng
The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.
Williams, Kathryn S; Shalom, Dara F; Winkler, Harvey A
The objective of this article is to provide an informative and narrative review for the general Gynaecologist regarding the pathophysiology and conservative treatments available for faecal incontinence (FI). A PubMed search was performed by library staff and an author using the keywords: anal incontinence, faecal incontinence, accidental bowel leakage, outpatient clinic management of faecal incontinence and defecatory dysfunction. As the social limitations of FI can be devastating and long-term patient satisfaction rates after anal sphincteroplasty remain reportedly-low, the role of clinic-based management of FI has continued to grow. The purpose of this article is to provide the Obstetrician and Gynaecologist with a basic template for screening, evaluation and management of faecal incontinence in the clinical setting.
The aim of this study was to examine the relationship between, and factors influencing, staff nurse perceptions of nurse manager caring (NMC) and the perceived exposure to workplace bullying (WPB) in multiple healthcare settings. Workplace bullying is commonplace, increasing, and detrimental to the health and availability of our nursing workforce. Positive relationships between a nurse manager (NM) and staff increase staff satisfaction and reduce turnover. Still unknown, however, is whether a caring relationship between manager and staff can reduce staff nurse perception of exposure to WPB. On the basis of Watson's theory that caring is reciprocal in nature, a descriptive correlational design was used to assess 156 staff nurses' self-report of NMC and their exposure to negative acts using the Caring Factor Survey-Caring of the Manager and the Negative Acts Questionnaire-Revised instruments. There is a significant inverse relationship between NMC and exposure to WPB in the nursing workplace. Gender, work environment, and a high workload influenced these findings. This study highlights the importance of caring leadership to reduce exposure to negative behaviors. The data lend support to the idea of educating NMs regarding the application of caring behaviors to support staff at the point of care.
Kroetz, M.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.; Bode, P.J.; Haeuser, H.
Objective. To analyse common and divergent features of staff-related, equipmental and spatial/logistical concepts of three large trauma centers of highest health care level.Methods. The health care mandate as well as the staff management, the organisational and the constructional-spacial structure of trauma room diagnostics and therapy of the trauma centers of the Universities of Leiden and Munich (Innenstadt) and the Zentralklinikum Augsburg are described. In particular the technical equipment and the process of the radiological diagnostic procedures in the trauma room are outlined.Results. Staff availability and basic technical equipment of the trauma rooms are comparable between the three hospitals. Divergent concepts exist concerning the complexity of the initial radiologic examination protocols. Spacial connection and importance of computed tomography are also discussed controversially. Urgent interventional procedures are increasingly performed within the trauma room. Magnetic-resonance-tomography does not play a role in early care from multiple injured patients.Conclusion. Trauma centers have to meet certain personnel and technical prerequisites to guarantee a temporally optimised care for multiple injured patients. Differences between the three centers concerning the logistic sequence and the radiologic examination techniques used are mainly due to variable emphasis put on CT in the initial phase of patient care. (orig.) [de
served as division, corps, and army-level general staff officers and executed the planning behind the AEF’s operations. George C. Marshall, popular ...eight students were Joseph W. Beacham and Conrad H. Lanza. Beacham, who coached Dwight D. Eisenhower’s West Point football team in 1911, served as...rather normal relief, arranged hurriedly and in a battle sector . I am also enclosing copies of a portion of the Plan of Defense, and a map which will
Walston, Stephen L; Chou, Ann F
Healthcare organizations have undergone major change efforts in the past decade. Sustained change is related to continued alignment among organizational participants and may fail with incongruent perceptions of change. This study identifies factors contributing to the alignment in perceptions of organizational change outcomes between executives and all other employees. The sample included 10 hospitals with survey responses from 421 executives and other employees. Using hierarchical linear modeling (HLM), perceptual alignment was modeled at the first level as a function of goal commitment, goal clarity, goal acceptance, goal specificity, staff participation, available skill set, and knowledge and at the second level as organizational size. Descriptive statistics showed employee perception of outcomes differed among personnel levels. HLM results showed that goal specificity, appropriate staff training, reward incentives, effective communication, information sharing, and organization's ability to sustain changes induced perceptual alignment in change outcomes. Staff involvement in designing change efforts increased perceptual misalignment, whereas involvement during implementation and maintenance phases increased alignment. This research uses cross-sectional data from 10 hospitals. Data were gathered from surveys that may have recall bias as hospitals were surveyed at different times after the implementation of their restructuring. Our findings enhance the understanding of processes and mechanisms that enable healthcare organizations to align organizational participants' efforts during change. Results suggest that decision-makers should create incentives to encourage innovative practices, institute effective communication mechanisms, selectively disseminate information, and involve participants in implementing and maintaining changes to achieve intended outcomes. ORIGINALITY/VALUE OF ARTICLE: This article provides unique insight into the importance and causes of
Darney, Blair G; VanDerhei, Deborah; Weaver, Marcia R; Stevens, Nancy G; Prager, Sarah W
Including support staff in practice change initiatives is a promising strategy to successfully implement new reproductive health services. The Resident Training Initiative in Miscarriage Management (RTI-MM) is an intervention designed to facilitate implementation of manual vacuum aspiration (MVA) for management of spontaneous abortion. The purpose of this study was to identify training program components that enhanced interprofessional training and provide lessons learned for engaging support staff in implementing uterine evacuation services. We conducted a secondary analysis of qualitative data to identify themes within three broad areas: interprofessional education, the role of support staff, and RTI-MM program components that facilitated support staff engagement in the process of implementing MVA services. We identified three key themes around interprofessional training and the role of support staff: "Training together is rare," "Support staff are crucial to practice change," and "Transparency, peers and champions." We present lessons learned that may be transferrable to other clinic sites: engage site leadership in a commitment to interprofessional training; engage support staff as teachers and learners and in shared values and building professionalism. This manuscript adds to what is known about how to employ interprofessional education and training to engage support staff in reproductive health services practice change initiatives. Lessons learned may provide guidance to clinical sites interested in interprofessional training, improving service delivery, or implementing new services. Copyright © 2013 Elsevier Inc. All rights reserved.
Deveau, Roy; McGill, Peter
Practice leadership (PL) style of frontline management has been shown to be associated with better experiences for staff working with people who may exhibit challenging behaviours (Deveau & McGill, 2014). This study aimed to examine additional staff experience factors with a different, larger sample and to partially replicate the findings of (Deveau & McGill, 2014). This study was a survey of staff self-reported data collected as part of a larger study. Information was collected on PL and staff experiences of: stress, turnover, job satisfaction and positive work experiences. The results broadly supported Deveau and McGill (2014) and demonstrated an association between PL and greater job satisfaction and positive experiences for staff. Results on staff turnover were inconsistent. The positive impact of PL on staff experience was further supported by this study. Suggestions are made for further research. These findings suggest further research is needed to examine the potential of interventions in frontline management/leadership practice to improve staff experience of working in challenging environments. Copyright © 2016 Elsevier Ltd. All rights reserved.
Verkaik, R.; Antwerpen-Hogenraad, P. van; Veer, A. de; Francke, A.; Huis in het Veld, J.
Background: Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management
... mmol/l, high-density lipoprotein (HDL) cholesterol 0.7 mmol/l, triglycerides 3.2 mmol/l, and serum creatinine normal. His urine shows glycosuria and microalbuminuria. What would be your approach to this patient's management? Keywords: type 2 diabetes mellitus, management, general practitioners, lifestyle interventions ...
Boissoneau, R; McPherson, J
Employee participation and involvement are at the leading edge of management thinking today. Not only behaviorally oriented managers, but managers of all styles include personnel in decision-making. The purpose of this article is to communicate to clinical laboratory managers some recent developments in people management. Several suggestions for team building and the desired outcome of worker participation are included. Although employee participation has been a major issue in management for 10 years, many business schools still emphasize only the traditional quantitative subjects of accounting, finance, statistics, and systems engineering. Obviously, these subjects are important, but modern managers must learn qualitative or behavioral material as well. Students are affected by the lack of a notable behavioral emphasis. Unfortunately, some students think that learning in the behavioral domain is unimportant. Too often, these students encounter problems later in their careers with employees and can only wish for greater knowledge.
Pain is one of the most common complaints that general practitioners encounter in everyday practice. The swift and effective management of pain is a medical mandate, not only to fulfil an ethical obligation to the patient, but also to prevent long-term complications, such as chronic pain. General practitioners are often ...
In addition to describing how the concept of stigma continues to be a pervasive influence in encounters between people with intellectual disability and others, the present study suggests that the management of this situation has passed into the control of care staff. An ethnographic study of young adults and community relationships suggests that the activities of staff are crucial in shaping the social profile of people with intellectual disability. The views of care staff about the taken-for-granted rights which characterize presence and participation in the community domain encourage them to adopt a semi-insulation approach to their work. Staff extend this approach by adopting information control strategies to conceal important information from students. The present author argues that there is a need for on-going research into staff activity in the community domain.
Elvish, Ruth; Burrow, Simon; Cawley, Rosanne; Harney, Kathryn; Pilling, Mark; Gregory, Julie; Keady, John
Objectives The aims were to evaluate a second phase roll-out of a dementia care training programme for general hospital staff and to further develop two outcome scales: the Confidence in Dementia scale for measuring confidence in working with people with dementia and the Knowledge in Dementia scale for measuring knowledge in dementia. Method Following a 'training the trainers' phase, the study involved the delivery of the 'Getting to Know Me' training programme to a large number of staff (n = 517) across three National Health Service (NHS) Trusts situated in North-West England. The impact of the programme was evaluated using a pre-post design which explored: (i) changes in confidence in dementia, (ii) changes in knowledge in dementia, and (iii) changes in beliefs about behaviours that challenge. Results Statistically significant change was identified between pre-post training on all outcome measures (Confidence in Dementia: eight point increase, p Staff knowledge in dementia and confidence in working with people with dementia significantly increased following attendance at the training sessions. The findings are consistent with preliminary findings and strengthen current knowledge about the impact of dementia care training in general hospitals. The Confidence in Dementia and Knowledge in Dementia scales continue to demonstrate psychometrically sound properties and demonstrate utility in the field of dementia research.
Hofman, W.H.A.; Hofman, R.H.
Purpose: In this study the authors focus on different (configurations of) leadership or management styles in schools for general and vocational education. Findings: Using multilevel (students and schools) analyses, strong differences in effective management styles between schools with different
Poulter, Christopher; Stewart, Michelle; Fitzpatrick, Cliona; Keech, Wendy; Stavreski, Bill; Grenfell, Robert
General practice requires systems to deal with patients presenting with urgent needs. BeAWARE was developed to support non-clinical staff to promptly identify patients with symptoms of heart attack or stroke. Data were collected from May 2012 to December 2012 on participants completing the BeAWARE learning module, including pre- and post-assessments on knowledge, confidence and intended action. From May 2012 to December 2012, 1865 participants completed the module. There were significant increases in recall of heart attack and stroke symptoms among non-clinical participants, including chest tightness (23.4-48.7%, P DISCUSSION: BeAWARE fulfils a practice gap in patient safety by improving non-clinical staff's knowledge, confidence and intended action in response to patients presenting with heart attack or stroke warning signs.
The turnover of the Japanese contractors and the consulting firms has kept the same level since 1983, in spite of the fact that the size of domestic market is shrinking. This is why they do not have a proper management system, especially risk management system for the overseas construction projects. This study aims at building risk management system and developing education program that can be applied to reinforcing the ability, based on the author’s experience. Risk is defined as “uncertain ...
Haywood, Jeff; Anderson, Charles; Coyle, Helen; Day, Kate; Haywood, Denise; Macleod, Hamish
As part of an evaluation of the Scottish Learning Technology Dissemination Initiative (LTDI), a survey was conducted of the views of academic staff, members of computer‐assisted learning and staff development units, and senior managers in all Scottish higher education institutions (HEIs). Most respondents across all subject areas and types of institutions (including those who rated themselves as less experienced with use of C&IT in teaching than their colleagues) believed that learning techno...
O'Neill, Barbara J; Dwyer, Trudy; Reid-Searl, Kerry; Parkinson, Lynne
To predict the factors that are most important in explaining nursing staff intentions towards early detection of the deteriorating health of a resident and providing subacute care in the nursing home setting. Nursing staff play a pivotal role in managing the deteriorating resident and determining whether the resident needs to be transferred to hospital or remain in the nursing home; however, there is a dearth of literature that explains the factors that influence their intentions. This information is needed to underpin hospital avoidance programs that aim to enhance nursing confidence and skills in this area. A convergent parallel mixed-methods study, using the theory of planned behaviour as a framework. Surveys and focus groups were conducted with nursing staff (n = 75) at a 94-bed nursing home at two points in time, prior to and following the implementation of a hospital avoidance program. The quantitative and qualitative data were analysed separately and merged during final analysis. Nursing staff had strong intentions, a positive attitude that became significantly more positive with the hospital avoidance program in place, and a reasonable sense of control; however, the influence of important referents was the strongest predictor of intention towards managing residents with deteriorating health. Support from a hospital avoidance program empowered staff and increased confidence to intervene. The theory of planned behaviour served as an effective framework for identifying the strong influence referents had on nursing staff intentions around managing residents with deteriorating health. Although nursing staff had a reasonable sense of control over this area of their work, they believed they benefitted from a hospital avoidance program initiated by the nursing home. Managers implementing hospital avoidance programs should consider the role of referents, appraise the known barriers and facilitators and take steps to identify those unique to their local situation
Cucco, J P
Recently, there has been much interest in developing and refining a uniform reporting system as a means toward productivity analysis within the radiology department. The management of the Department of Radiology at Morristown Memorial Hospital realizes that the efficiency of most departments varies at different times during the work week. We have developed a system which we feel is adaptable to many institutions and will allow the radiology manager to allocate resources in an informed and controlled manner.
21 September 2010 - Chairman of the Pakistan Atomic Energy Commission A. Parvez, CERN Director-General R. Heuer, Staff Association President G. Deroma, Ambassador to the UN Z. Akram (showing a symbol of the funds raised by CERN Staff for Pakistan)and Adviser for Non-Member States R. Voss.
21 September 2010 - Chairman of the Pakistan Atomic Energy Commission A. Parvez, CERN Director-General R. Heuer, Staff Association President G. Deroma, Ambassador to the UN Z. Akram (showing a symbol of the funds raised by CERN Staff for Pakistan)and Adviser for Non-Member States R. Voss.
Akhtar, M.U.; Nazir, A.; Montmorency College of Dentistry, Lahore; Kiran, S.; Montmorency College of Dentistry, Lahore
Generalized gingival enlargement is characterized by massive and exuberant gingival overgrowth that poses social, aesthetic, phonetic and functional problems for the patient. Therefore, it requires meticulous management. Objective: To describe the surgical management of generalized gingival enlargement by electrosurgical excision of patients presenting to a tertiary care centre. Study Design: Case series. Materials and Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore, from January 2010 to December 2012. A total of sixteen patients were operated by using electrosurgical approach under general anaesthesia for surgical excision of generalized gingival enlargement. Results: All of the sixteen patients, 11 males and 5 females, showed excellent healing postoperatively without any recurrent gingival overgrowth. Discussion: To the best of our knowledge, the current study presents the largest case series of generalized gingival enlargement. Most of these cases were with massive disease due to lack of information of the study population about their disease, delay in referral by the general dental practitioners, painless and innocent nature of the problem. Early referral of such patients to tertiary care centers can prevent the patients from social and psychological embarrassment. Conclusion: Electrosurgical excision is an excellent surgical technique for management of generalized gingival enlargement. Moreover, cross comparative studies are required to establish some diagnostic and therapeutic standards for such patients. (author)
Rayen, R; Hariharan, V S; Elavazhagan, N; Kamalendran, N; Varadarajan, R
Hemophilia is the most common inherited bleeding disorder. Hemophilic patients should be cosidered as special patients. There is no contraindication to general dental treatment for hemophiliacs, as they generally do not involve bleeding. But caution must be used with any surgical procedures that involve the local and general anesthesia. Such patients should always be managed in the setting of specialized units with appropriate clinical expertise and laboratory support. Recent advances in the management of hemophilia have enabled many hemophiliac patients to receive surgical dental procedures in an outpatient dental care on a routine basis. The purpose of this case report is to provide a few management strategies when providing full mouth rehabilitation under anesthesia and replacement therapies that are available. In addition, overviews of possible complication that may be encountered when providing such treatment are discussed here.
Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming
The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.
Clarke, M; Jinks, M; McMurran, M
One third of people diagnosed with PD do not complete treatment and non-completion is associated with poorer clinical outcomes. Equipping staff to be better able to engage this client group is important, and web-based, self-directed learning is a potentially cost-effective way to train staff. This study examined the implementation of a web-based training programme called Readiness Enhancement Management Strategies (REMS) in three types of service. Completion rates were 94.4% in community health services; 92.3% in prison offender health services; and 46.5% in probation services. Staff found the content of REMS acceptable and useful. This study demonstrated that staff in NHS and criminal justice settings can complete REMS, but staff in probation services are challenged by time pressures and limited computer access. Staff at probation sites were less familiar with PD issues compared with the NHS staff. A web-based staff training programme called Readiness Enhancement Management Strategies (REMS) was developed to promote the engagement of people with personality difficulties in treatment. This 'proof of concept' study examined the REMS implementation process, its acceptability and the feasibility of using service data for future evaluation. Staff in six services working with people diagnosed with personality disorder or undiagnosed people with personality difficulties were eligible to participate: two community health services, two prison offender health services and two probation services. Of 92 eligible staff, 74 were available to undertake REMS. These staff completed knowledge and acceptability surveys and rated service user engagement with treatment. The proportion of treatment sessions attended by service users was collected for a 30-week period. REMS completion rates were community - 94.4%, prison - 92.3% and probation - 46.5%. Three quarters of participants rated REMS as 7 out of 10 or higher. All teams were able to provide service data for the study period
KHOSRAVAN, SHAHLA; KARIMI MOONAGHI, HOSSEIN; YAZDANI, SHAHRAM; AHMADI, SOLEIMAN; MANSOORIAN, MOHAMMAD REZA
Introduction: Leadership and management are two expected features and competencies for general practitioners (GPs). The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern’s curriculum planning cycle. Methods: This study was conducted in 2011-2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured in...
Full Text Available Oromaxillofacial infection is still a common case in daily dental practice. Usually, teeth are the sources of infection. Oromaxillofacial infection is usually mild, easily treated, and may only require the administration of antibiotics. If it is not treated appropriately, it will become severe, or be more complex that requires the hospitalization. A general practitioner dentist must understand the management of this infection in early stage to prevent the infection from becoming severe. This article will be comprehensively discussing the management of oromaxillofacial infection by general practitioner dentist.
Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon
Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.
Full Text Available Introduction: Recent evidence suggests that, with a well-trained staff, severe exacerbations of chronic obstructive pulmonary disease (COPD with moderate respiratory acidosis (pH > 7.3 can be successfully treated with noninvasive mechanical ventilation (NIMV on a general respiratory care ward. We conducted an open prospective study to evaluate the efficacy of this approach on a general medicine ward. Material and methods: This study population consisted in 27 patients admitted to a general medicine ward (median nurse:patient ratio 1:12 December 1, 2004 May 31, 2006 for acute COPD exacerbation with hypercapnic respiratory failure and acidosis (arterial pH < 7.34, PaC02 > 45 mmHg. All received assist-mode NIMV (average 12 h / day via oronasal masks (inspiratory pressure 10-25 cm H2O, expiratory pressure 4-6 cm H2O to maintain O2 saturation at 90-95%. Treatment was supervised by an experienced pulmonologist, who had also provided specific training in NIMV for medical and nursing staffs (90-day course followed by periodic refresher sessions. Arterial blood pressure, O2 saturation, and respiratory rate were continuously monitored during NIMV. Based on baseline arterial pH, the COPD was classified as moderate (7.25-7.34 or severe (< 7.25. Results: In patients with moderate and severe COPD, significant improvements were seen in arterial pH after 2 (p < 0.05 and 24 h (p< 0.05 of NIMV and in the PaC02 after 24 hours (p < 0.05. Four (15% of the 27 patients died during the study hospitalization (in-hospital mortality 15%, in 2 cases due to NIMV failure. For the other 23, mean long-term survival was 14.5 months (95% CI 10.2 to 18.8, and no significant differences were found between the moderate and severe groups. Over half (61% the patients were alive 1 year after admission. Conclusions: NIMV can be a cost-effective option for management of moderate or severe COPD on a general medicine ward. Its proper use requires: close monitoring of ventilated subjects
Tang, Thomas Li-Ping; Butler, Edie Aguilar
Quality circles, a management practice that involves groups of workers from the same work area voluntarily meeting on a regular basis to identify, analyze, and solve various work-related problems, have been used in Japan for over 40 years. In the United States, quality circles have been tried in many organizations during the past 2 decades and…
Deboeck, Guido; Kinsey, Bill
The study summarizes discussions and conclusions of the Regional Workshop on Monitoring and Evaluation of Rural Development Projects in East Africa (Nairobi, Kenya, April 1979), whose purpose was to share lessons learned from field experiences in managing information for rural development. An initial section summarizes information in papers…
Farnham, David, Ed.
This collection of 17 essays focuses on how faculty are employed, rewarded, and managed at universities in developed and developing nations. The essays, which include an introduction, 10 essays discussing European practices, two that focus on Canada and the United States, three which focus on Australia, Japan, and Malaysia, and a concluding…
Higher education is a key sector for the United Kingdom contributing over £70 billion of output. It functions in an increasingly complex operating, regulatory, and legislative environment that has led to an increased need for effective nonacademic business managers. This study evaluates the benefits of a specialist master of business…
Full Text Available Aim To determine the effect of anger management levels and communication skills of emergency department staff on their frequency of being exposed to violence. Methods This cross-sectional study was conducted in the Training and Research Hospital, Istanbul, Turkey between 11 April and 15 October 2013 by using a questionnaire including descriptive features, anger management scale, and communication skills scale applied to 283 health personnel working in children and adult emergency department clinics. Results Statistically significant differences were found between the health workers’ ages and their anger control levels, marital status and anger-in and anger control levels, working position and anger-in levels, and between anger-in, anger-out and anger control levels based on their level of education. Statistically significant differences were also found between age and communication levels based on the personnel’s working position. Statistically significant difference between the anger-in subscale of health personnel based on their state of being exposed to violence was found (78.4% of the health workers had been exposed to violence. Conclusion In the in-service programs of institutions, there should be trainings conducted about anger management and effective communication techniques so that the health personnel can be aware of their own feelings and express anger in a suitable way.
Yildiz Das, Gozde; Aydin Avci, Ilknur
To determine the effect of anger management levels and communication skills of emergency department staff on their frequency of being exposed to violence. This cross-sectional study was conducted in the Training and Research Hospital, Istanbul, Turkey between 11 April and 15 October 2013 by using a questionnaire including descriptive features, anger management scale, and communication skills scale applied to 283 health personnel working in children and adult emergency department clinics. Statistically significant differences were found between the health workers' ages and their anger control levels, marital status and anger-in and anger control levels, working position and anger-in levels, and between anger-in, anger-out and anger control levels based on their level of education. Statistically significant differences were also found between age and communication levels based on the personnel's working position. Statistically significant difference between the anger-in subscale of health personnel based on their state of being exposed to violence was found (78.4% of the health workers had been exposed to violence). In the in-service programs of institutions, there should be trainings conducted about anger management and effective communication techniques so that the health personnel can be aware of their own feelings and express anger in a suitable way
O. S. Logunova
Full Text Available This paper deals with the problem of constructing a system of rating indicators for stimulating the work of the academic staff in higher educational institution. Many areas of teacher activity (for example, educational, scientific, international, etc. laid the basis of selection the groups of indicators in the system. Social challenge in improving the quality of educational services determines the relevance of research in the field of modeling and prediction of indicators which characterize the work of high school teacher. To predict the dynamics of the structure of the rating indicators in the system, the authors introduced the concept of drift and variability of each group. Using informational hypercube for the structure of input data allowed authors to take into account the individual characteristics of each parameter included in a mathematical model to describe the rating indicators. To make the prediction of the structure and values of rating system indicators the authors introduced the concept of drift. Drift of indicators takes into account the introduction of new indicators, the removal of existing indicators, and movement of indicators between the groups. In the article, authors introduced a novel quantitative indicator of group variability. The value of this indicator determines the prediction strategy of the teacher work in higher school in the future period. To predict the total amount of stimulating, the complex technique offered and it includes four modules: modeling values within the existing range in the previous period; modeling new index value based on the assumptions introduced using a random number generator; exclusion a range of values of deleted indicators; modeling new values based on the study of the modern trend of indicators. The presence of flexible information structure in the form of a hypercube and complex mathematical model allowed authors to carry out numerical simulation for predicting the values of individual
Dalum, Helle Stentoft; Waldemar, Anna Kristine; Korsbek, Lisa
BACKGROUND: Psychoeducational interventions for people with severe mental illness are developed to enable them to manage their illness effectively to improve prognosis and recovery. AIM: The aim was to investigate the benefits and harms of the Illness Management and Recovery (IMR) program among...... people with severe mental illness in Denmark. IMR builds among other approaches on a psychoeducational approach. METHODS: A randomized, multi-center, clinical trial of the IMR program compared with treatment as usual among 198 participants with schizophrenia or bipolar disorder investigating outcomes....... CONCLUSIONS: IMR appears not to be better than treatment as usual in any of the outcomes. Further studies with a longer follow-up period, better assessments of recovery and a systematic review of the existing trials are needed to assess if the program is effective....
Tyler, Denise A; Parker, Victoria A
The purpose of this study was to describe the organizational factors associated with high and low amounts of teamwork among direct-care workers in long-term care (LTC) facilities. A systematic analysis of observation data collected at 20 LTC facilities was first used to categorize facilities as high-, moderate-, or low-teamwork facilities. Next, qualitative analysis of 59 interviews collected in 4 high-teamwork and 5 low-teamwork facilities was used to identify the organizational factors associated with high and low teamwork. Findings showed that high- and low-teamwork LTC facilities in this study differed in three organizational areas: management style, training, and feedback and recognition. As such, improved teamwork in LTC facilities may result from changes to basic management practices, such as training and employee feedback. Copyright 2011, SLACK Incorporated.
Keywords: Environmental policy; General equilibrium modeling; Negishi format; Waste management policies; Market distortions.
About 40% of the entire budget spent on environmental problems in the
Conversations with school and crisis personnel following large scale emergencies in and around schools, such as shootings, wildfires, and the attack on the World Trade Center on September 11, 2001, indicated a need for pre-incident training in managing student behavior during emergencies. This article outlines a training program of this kind and offers suggestions regarding both content and process of this training. The suggestions follow discussion of the unique context and needs of the school setting.
Dennis L Kodner
Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program
Berry, Natalie; Bucci, Sandra; Lobban, Fiona
Researchers are currently investigating the feasibility, acceptability, and efficacy of digital health interventions for people who experience severe mental health problems such as psychosis and bipolar disorder. Although the acceptability of digital health interventions for severe mental health problems appears to be relatively high and some people report successfully using the Internet and mobile phones to manage their mental health, the attitudes of mental health care staff toward such approaches have yet to be considered. The aim of this study was to explore mental health care staff experiences of clients with severe mental health problems engaging with the Internet and mobile phones to self-manage their mental health and their views toward these behaviors. The study also sought to examine the opinions expressed by mental health care staff toward digital health interventions for severe mental health problems to identify potential facilitators and barriers to implementation. Four focus groups were conducted with 20 staff working in mental health care services in the North West of the England using a topic guide. Focus groups involved 12 staff working in secondary care psychological services (7 participants in focus group 1 and 5 participants in focus group 4), 4 staff working in a rehabilitation unit (focus group 2), and 4 staff working in a community mental health team (focus group 3). Focus groups were transcribed verbatim, and transcripts were analyzed thematically to identify key themes that emerged from the data. Four overarching themes, two with associated subthemes, were identified: (1) staff have conflicting views about the pros and cons of using Web-based resources and digital health interventions to manage mental health; (2) digital health interventions could increase access to mental health support options for severe mental health problems but may perpetuate the digital divide; (3) digital health interventions' impact on staff roles and
Full Text Available Background and Aims: Traumatic dental injuries (TDIs are of the most common dental problems in children and adolescents, which usually occur in the anterior segment and have a significant role in patient’s physical and psychological health. Immediate intervention for damaged teeth can elevate the success rate of treatment in TDI. Thus, general dentists’ knowledge and their effective intervention in TDI are important factors in prognosis of traumatized teeth. The objective of this study was to assess the general dentists’ knowledge and awareness regarding the diagnosis and management of traumatic dental injuries. Materials and Methods: In this cross-sectional study, the questionnaire data were collected from 130 general dentists, including the demographic data and general dentists’ knowledge about TDIs. The data were analyzed using the Student t-test and Analysis of Variance (ANOVA, Spearman’s and Pearson’s correlation coefficient. Results: The mean score of general dentists’ knowledge was 8.5 ± 1.5 (total score:10 and it was the same between both males and females (P=0.083. Dentists’ work place does not have any influence in their knowledge (P=0.133. Also, there was no statically significant relationship between the age, job experience and dentists’ knowledge (P=0.805. The relationship between the frequency of TDI managed cases and dentists’ knowledge was not significant (P=0.507. Conclusion: Considering that the overall knowledge of general dentists regarding the management of TDI was sufficient, it could be a good opportunity in treating these injuries. As TDI is a developing science, it is important to motivate general dentists being up to date regarding this matter.
Forbat, Liz; Simons, Jean; Sayer, Charlotte; Davies, Megan; Barclay, Sarah
Conflict is a recognised component of healthcare. Disagreements about treatment protocols, treatment aims and poor communication are recognised warning signs. Conflict management strategies can be used to prevent escalation, but are not a routine component of clinical training. To report the findings from a novel training intervention, aimed at enabling paediatric staff to identify and understand the warning signs of conflict, and to implement conflict resolution strategies. Self-report measures were taken at baseline, immediately after the training and at 6 months. Questionnaires recorded quantitative and qualitative feedback on the experience of training, and the ability to recognise and de-escalate conflict. The training was provided in a tertiary teaching paediatric hospital in England over 18 months, commencing in June 2013. A 4-h training course on identifying, understanding and managing conflict was provided to staff. Baseline data were collected from all 711 staff trained, and 6-month follow-up data were collected for 313 of those staff (44%). The training was successful in equipping staff to recognise and de-escalate conflict. Six months after the training, 57% of respondents had experienced conflict, of whom 91% reported that the training had enabled them to de-escalate the conflict. Learning was retained at 6 months with staff more able than at baseline recognising conflict triggers (Fischer's exact test, p=0.001) and managing conflict situations (Pearson's χ 2 test, p=0.001). This training has the potential to reduce substantially the human and economic costs of conflicts for healthcare providers, healthcare staff, patients and relatives. 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/.
Powell, David M; Ardaiolo, Matthew
The humane euthanasia of animals for population management, or culling, has been suggested as one possible tool for managing animal populations for sustainability, and recent, highly publicized euthanasia of zoo animals in Copenhagen has stimulated global conversation about population management in zoos. We conducted a nationwide survey of U.S. zoo and aquarium personnel, including keepers, managers, and leaders of AZA animal programs, to assess their overall attitudes regarding population management euthanasia. The surveyed populations were generally very aware of the concept of population management euthanasia. Managers and animal program leaders were more supportive of euthanasia than keepers. We found that regardless of role, men were more supportive of euthanasia than women. Those personnel who were aware of instances of population management euthanasia at their institutions before were more supportive of it than those who were not. Support for culling varied with the kind of animal being considered for it, with three general taxon acceptability groupings emerging. Education, tenure in the profession, taxonomic expertise, and whether or not the responder took the survey before or after the Copenhagen events were not strong predictors of attitudes. Overall, the surveyed populations were approximately evenly split in terms of being in favor of euthanasia, not supporting euthanasia, or being unsure. Most responders indicated that they would be more likely to accept culling if more information was provided on its rationale. These results will form the basis for further discussions on the role of humane euthanasia for population management. Zoo Biol. 35:187-200, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Kravchenko Olena S.
Full Text Available The article grounds urgency of identification of the place of budget management in the general system of trade enterprise management. It analyses points of view of economists with respect to definitions of the “budgeting” and “budget management” terms. It considers main functions of budget management. It identifies the place of budget management in the general system of enterprise management. Pursuant to definition of the budget management as a managerial technology, which should meet a number of requirements, which would be determined by specific features of enterprise practical activity, the article identifies its main principles. It groups principles of budget management in accordance with the functions it performs.
Rodrigo Z Megale
Full Text Available The pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition.To describe usual care provided by general practitioners (GPs in Australia for the management of vertebral compression fractures.Data from the Bettering the Evaluation And Care of Health (BEACH program collected between April 2005 and March 2015 was used for this study. Each year, a random sample of approximately 1,000 GPs each recorded information on 100 consecutive encounters. We selected those encounters at which vertebral compression fracture was managed. Analyses of management options were limited to encounters with patients aged 50 years or over.i patient demographics; ii diagnoses/problems managed; iii the management provided for vertebral compression fracture during the encounter. Robust 95% confidence intervals, adjusted for the cluster survey design, were used to assess significant differences between group means.Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018-0.025 of the 977,300 BEACH encounters recorded April 2005- March 2015. That provides a national annual estimate of 26,000 (95% CI: 22,000-29,000 encounters at which vertebral fractures were managed. At encounters with patients aged 50 years or over (those at higher risk of primary osteoporosis, prescription of analgesics was the most common management action, particularly opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4-55.7. Prescriptions of paracetamol (8.2; 95% CI: 4-12.4 or non-steroidal anti-inflammatory drugs (4.1; 95% CI: 1.1-7.1 were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1. At least one referral (to hospital, specialist, allied health care or other was given for 12.3 per 100 vertebral fractures (95% CI: 7.8-16.8.The prescription of oral
Rajbhandari-Thapa, Janani; Bennett, Ashley; Keong, Farrah; Palmer, Wendy; Hardy, Trisha; Welsh, Jean
The goal of the Strong4Life School Nutrition Program is to promote healthy eating in school cafeterias in Georgia by training school nutrition managers and staff members to implement changes in the cafeteria to nudge children to make healthier choices. The objective of our study was to evaluate program effect on (1) school nutrition manager and staff member knowledge of evidence-based strategies and their self-efficacy to make positive changes, (2) the school cafeteria environment, and (3) National School Lunch Program participation. We assessed changes in participant knowledge, beliefs, and self-efficacy by administering a survey before and after training (February-July 2015); a follow-up survey (3 school months posttraining) assessed changes in the cafeteria. A total of 842 school nutrition managers and staff members were trained and completed pre- and posttraining surveys; 325 managers completed the follow-up survey. We used cafeteria records from a subsample of the first schools trained (40 intervention and 40 control) to assess National School Lunch Program participation. From pretraining to posttraining, we found a significant increase in manager and staff member (n = 842) knowledge of strategies for enhancing taste perception through the use of creative menu item names (from 78% to 95%, P food placement in the lunch line influences food selection (from 78% to 95%, P cafeteria environment (from 91% to 96%, P 2 locations, P School Lunch Program participation did not change significantly. Training cafeteria managers and staff members in Smarter Lunchrooms Movement techniques may be an effective way to make changes in the school cafeteria environment to encourage healthier choices among students. Additional studies allowing time for more complex changes to be implemented are needed to assess the full effect of the program.
Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine; King, Madeleine
Despite recent increases in nursing recruitment in Australia, participation in the workforce is still below the numbers predicted to meet future needs. This paper discusses factors impacting on nurses' job satisfaction, satisfaction with nursing and intention to leave in public sector hospitals in New South Wales (NSW), Australia. Staffing and patient data were collected on 80 medical and surgical units during 2004/5. This included a wide range of individual nurse data from a Nurse Survey; detailed and comprehensive staffing data including skill mix variables; patient characteristics; workload data; a profile of the ward's characteristics; and adverse event patient data. Nurses who were intending to remain in their job were more likely to be satisfied, be older, and have dependents. They were also likely to be experiencing good leadership and to have allied health support on the ward. Most nurses reported being satisfied with their profession, while a lower proportion reported satisfaction with their current position. Work environment factors such as nurses' autonomy, control over their practice and nursing leadership on the ward were statistically significant predictors of job satisfaction. This study will inform decision-making and policy for managers in both the public and private hospital sectors. This is the first large study which explored the work environment at the ward/unit level in public hospitals in NSW (Australia). It illustrates that there are no typical wards; each ward functions differently. The importance of nursing leadership at the ward level to job satisfaction, satisfaction with nursing and intention to leave, cannot be overstated.
Fraenkel, Alison; Lee, Lawrence R; Lee, Graham A
Patients with a corneal foreign body may first present to their general practitioner (GP). Safe and efficacious management of these presentations avoids sight-threatening and eye-threatening complications. Removal of a simple, superficial foreign body without a slit lamp is within The Royal Australian College of General Practitioners' (RACGP's) curriculum and scope of practice. Knowing the rele-vant procedural skills and indications for referral is equally important. The objective of this article is to provide an evidence-based and expert-based guide to the management of corneal foreign bodies in the GP's office. History is key to identifying patient characteristics and mechanisms of ocular injury that are red flags for referral. Examination tech-niques and methods of superficial foreign body removal without a slit lamp are outlined, as well as the procedural threshold for referral to an ophthalmologist.
Jeon, Yun-Hee; Simpson, Judy M; Li, Zhicheng; Cunich, Michelle M; Thomas, Tamsin H; Chenoweth, Lynn; Kendig, Hal L
To evaluate the effectiveness of a leadership and management program in aged care. Double-blind cluster randomized controlled trial. Twelve residential and community-aged care sites in Australia. All care staff employed for 6 months or longer at the aged care sites were invited to participate in the surveys at 3 time points: baseline (time 1), 9 months from baseline (time 2), and 9 months after completion of time 2 (time 3) from 2011 to 2013. At each time point, at least 500 care staff completed a survey. At baseline (N = 503) the largest age group was 45 to 54 years (37%), and the majority of care staff were born in Australia (70%), spoke English (94%), and had at least completed secondary education (57%). A 12-month Clinical Leadership in Aged Care (CLiAC) program for middle managers, which aimed to further develop their leadership and management skills in creating positive workplace relationships and in enabling person-centered, evidence-based care. The primary outcomes were care staff ratings of the work environment, care quality and safety, and staff turnover rates. Secondary outcomes were care staff's intention to leave their employer and profession, workplace stress, job satisfaction, and cost-effectiveness of implementing the program. Absenteeism was excluded due to difficulty in obtaining reliable data. Managers' self-rated knowledge and skills in leadership and management are not included in this article, which focuses on care staff perceptions only. At 6 months after its completion, the CLiAC program was effective in improving care staff's perception of management support [mean difference 0.61, 95% confidence interval (CI) 0.04-1.18; P = .04]. Compared with the control sites, care staff at the intervention sites perceived their managers' leadership styles as more transformational (mean difference 0.30, 95% CI 0.09-0.51; P = .005), transactional (mean difference 0.22, 95% CI 0.05-0.39; P = .01), and less passive avoidant (mean difference 0.30, 95% CI 0
Odusola, A.O.; Stronks, K.; Hendriks, M.E.; Schultsz, C.; Akande, T.; Osibogun, A.; van Weert, H.; Haafkens, J.A.
Background: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective: We explored perspectives of primary care staff and health insurance managers on enablers and
Odusola, Aina O.; Stronks, Karien; Hendriks, Marleen E.; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; Weert, Henk van; Haafkens, Joke A.
Background Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective We explored perspectives of primary care staff and health insurance managers on enablers and
Rostow, Eugene V.
A staff paper to the President's Task Force on Communications Policy analyses the use of the electromagnetic spectrum for communications and suggests improvements. The evolution of spectrum use and its present federal management are described together with the problem of achieving efficient use in the areas of electromagnetic congestion. Criticism…
Full Text Available In response to increasing concerns with the legitimacy and efficiency of public spending, performance management as a part of world-wide public sector reform, called New Public Management (NPM has taken place. This is also the case of educational sector. In Estonian education system, legislation formally enables to design an integrated performance management system. But there is few research done to investigate how these policies and regulations ought to be put into force in order to gain the benefits considering the schools' and pupils' better performance. This study investigates how different stakeholders are involved into the performance management in Estonian general schools. The study is based on empirical survey data gathered from 303 schools providing secondary education in Estonia. The research findings have three main implications. Firstly, the paper contributes to the scarce knowledge about implementation of performance management issues in public schools. Our analysis revealed that compilation of school development plans in Estonian schools is rather a formal obligation. Therefore we propose that the analysis and discussion of the school development plans is needed to organize on regional level, involving all main stakeholders of a school. Secondly, we suggest that in the circumstances of a decentralised education system, like in Estonia, it is needed to implement, central practical performance assessment principles and guidance for the schools. Thirdly, it is highly necessary to improve schools’ cooperation with different stakeholder groups. Also the framework involving different stakeholder groups in the decentralized schools management system should be built up.
Laing, Brian Yoshio; Dixit, Ravi K; Berry, Sandra H; Steers, W Neil; Brook, Robert H
Unit-based teams (UBTs), initially developed by Kaiser Permanente and affiliated unions, are natural work groups of clinicians, managers, and frontline staff who work collaboratively to identify areas for improvement and implement solutions. We evaluated the UBT model implemented by the Los Angeles County Department of Health Services in partnership with its union to engage frontline staff in improving patient care. We conducted a quasi-experimental study, comparing surveys at baseline and 6 months, among personnel in 10 clinics who received UBT training to personnel in 5 control clinics. We also interviewed staff from 5 clinics that received UBT training and 3 control clinics. We conducted 330 surveys and 38 individual, semi-structured interviews with staff at an outpatient facility in South Los Angeles. Each UBT leader received an 8-hour training in basic performance improvement methods, and each UBT was assigned a team "coach." Our outcome measure was 6-month change in the "adaptive reserve" score, the units' self-reported ability to make and sustain change. We analyzed transcripts of the interviews to find common themes regarding the UBT intervention. The survey response rate was 63% (158/252) at baseline and 75% (172/231) at 6 months. There was a significant difference-in-change in adaptive reserve between UBTs and non-UBTs at 6 months (+0.11 vs -0.13; P = .02). Nine of the 10 UBTs reported increases in adaptive reserve and 8 UBTs reported decreased no-show rates or patient length of stay in clinic. Staff overwhelmingly felt the UBTs were a positive intervention because it allowed all levels of staff to have a voice in improvement. Our results indicate that partnership between management and unions to engage frontline staff in teams may be a useful tool to improve delivery of health care in a safety-net setting.
As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.
Full Text Available Introduction: Leadership and management are two expected features and competencies for general practitioners (GPs. The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern’s curriculum planning cycle. Methods: This study was conducted in 2011-2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern’s curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin’s method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14. Results: In the qualitatively stage of this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a
Khosravan, Shahla; Karimi Moonaghi, Hossein; Yazdani, Shahram; Ahmadi, Soleiman; Mansoorian, Mohammad Reza
Leadership and management are two expected features and competencies for general practitioners (GPs). The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern's curriculum planning cycle. This study was conducted in 2011- 2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern's curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin's method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14. In the qualitatively stage of this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a mean of 3.59. Other results were shown in the paper
Effectiveness is one of the management concepts considered and studied always by management scientists and experts. The aim of this study was to investigate the effects of different dimensions of empowerment (servicing staff, staff monitoring, consulting staff, and training staff) on dimensions of effectiveness of staff (staff ...
Goldberg, R J
Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.
This paper describes the training process for a nuclear project on a new site. When AECL opened a project office Saskatoon, senior management recognized the need for large scale staff training and made the necessary commitments. Two types of training programs were initiated, general and technical. The general training plan included topics related to nuclear project life cycle. Technical training was discipline and task specific. Based on the job descriptions and staff qualifications, technical training requirements were documented for the entire staff. The training strategy was developed and implemented. Detailed records were maintained to monitor the progress, draw conclusions, and plan training for future nuclear facilities. (author)
Hofman, W. H. Adriaan; Hofman, Roelande H.
Purpose: In this study the authors focus on different (configurations of) leadership or management styles in schools for general and vocational education. Findings: Using multilevel (students and schools) analyses, strong differences in effective management styles between schools with different student populations were observed. Conclusions: The…
Remove of the staff association office The Staff Association offices are going to be renovated during the coming four months, February to May 2014. The physical move from our current premises 64/R-002 to our temporary office in 510/R-010 will take place on Friday January 31st, so the Secretariat will be closed on that day. Hence, from Monday February 3rd until the end of May 2014 the Staff Association Secretariat will be located in 510/R-010 (entrance just across the CERN Printshop).
Luehrman, T A
Behind every major resource-allocation decision a company makes lies some calculation of what that move is worth. So it is not surprising that valuation is the financial analytical skill general managers want to learn more than any other. Managers whose formal training is more than a few years old, however, are likely to have learned approaches that are becoming obsolete. What do generalists need in an updated valuation tool kit? In the 1970s, discounted-cash-flow analysis (DCF) emerged as best practice for valuing corporate assets. And one version of DCF-using the weighted-average cost of capital (WACC)-became the standard. Over the years, WACC has been used by most companies as a one-size-fits-all valuation tool. Today the WACC standard is insufficient. Improvements in computers and new theoretical insights have given rise to tools that outperform WACC in the three basic types of valuation problems managers face. Timothy Luehrman presents an overview of the three tools, explaining how they work and when to use them. For valuing operations, the DCF methodology of adjusted present value allows managers to break a problem into pieces that make managerial sense. For valuing opportunities, option pricing captures the contingent nature of investments in areas such as R&D and marketing. And for valuing ownership claims, the tool of equity cash flows helps managers value their company's stake in a joint venture, a strategic alliance, or an investment that uses project financing.
Oorsouw, W.M.W.J. van; Embregts, P.J.C.M.; Bosman, A.M.T.; Jahoda, A.
Background Helping staff serving clients with intellectual disability and challenging behaviour to cope with stress has implications for their own well-being and for the lives of those they support. Method This study examined staff members' views of stress and the effectiveness of a
Aina O. Odusola
Full Text Available Background: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA that can be modified through timely and long-term treatment in primary care. Objective: We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design: Qualitative study using semi-structured individual interviews with primary care staff (n = 11 and health insurance managers (n=4. Data were analysed using standard qualitative techniques. Results: Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions: By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.
Odusola, Aina O.; Stronks, Karien; Hendriks, Marleen E.; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A.
Background Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. Objective We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Results Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA. PMID:26880152
Odusola, Aina O; Stronks, Karien; Hendriks, Marleen E; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A
Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider-insurer relationships; automated administration systems; and tailoring guidelines/patient education. By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.
Vildósola, H; Colichón, A; Bardales, F; Serván, J C
A seroepidemiological assessment for Hepatitis B was performed in 199 workers, apparently healthy, of Hospital de Apoyo Iquitos of them were health care workers (representing 29.96% of health workers) and 42 were administrative personnel (22.82% of hospital's administrative personnel). We evaluated the HBsAg and anti-HBc IgG total by the microelisa technique. The total prevalence of HBsAg carriers was 3.36% and 20.1% of the anti-HBc; in the health group the 3.89% had HBsAg and the 16.88% anti-HBc, while the administrative group presented 2.38% of HBsAg and 26.19% the anti-HBc. There was no significative statistical difference between both groups. There was not either in the presence of the different studied epidemiological variables. We presume that it can exist a common epidemilogical factor which would conditioned a similarity of risk for infection in the health personnel as well the administrative personnel and even in the general population. If this find in other Amazon cities is confirmed, we could conclude that this represents a epidemilogical characteristic of the intermediate endemicity urban areas.
Ainsworth, J G; Weaver, T; Murphy, S; Renton, A
OBJECTIVES: To describe the immediate reported management, by general practitioners (GPs), of men presenting with symptoms of urethral discharge, or dysuria only. SUBJECTS: All 692 GPs in practice in Brent, Harrow, Ealing, Hammersmith, and Hounslow (UK). METHOD: Data were collected using a GP completed questionnaire concerning the management of the last male patient seen, aged less than 40 years, complaining of urethral discharge, and the last male patient under 40 years complaining of dysuria only. RESULTS: The response rate among GPs was 52%. Fifty three per cent of men with urethral symptoms, 86% of men with a urethral discharge and 24% with dysuria only, were identified by GPs and referred without investigation or treatment to a genitourinary medicine clinic. Of men with dysuria only, 93% of investigations by GPs were reported to include a mid-stream urine (MSU) specimen for bacteriology, and 19% a urethral swab for chlamydia. Seventy eight per cent of GPs reported using treatments with a broad spectrum antibiotic, 53% with trimethoprim, whilst 14% of GPs reported using a tetracycline in common use to treat non-gonococcal urethritis. Urine specimens were reported to be "culture positive" in 41% of men who had an MSU specimen tested, and 15% of men who had a urethral swab tested were reported to be chlamydia positive. CONCLUSION: The GPs included in this study were not a full sample, or representative of all the GPs, and the data are retrospective. Nevertheless, we found a large difference in GPs reported management for men with urethral symptoms according to whether or not urethral discharge was a reported complaint. Reported management is likely to be, at least, indicative of actual management. Therefore, the results suggest that assessment by GPs of men presenting with dysuria should be explored and more appropriate management strategies defined. PMID:9038640
Gunaratnam, Praveena; Massey, Peter D; Eastwood, Keith; Durrhein, David; Graves, Stephen; Coote, Diana; Fisher, Louise
Zoonotic infections such as Q fever, brucellosis and leptospirosis can lead to serious complications but pose diagnostic and management challenges to general practitioners (GPs) as patients often present with non-specific symptoms such as fever. To develop a tool to assist GPs in the diagnosis and management of common zoonotic infections An algorithm was developed with advice and comments from GPs, laboratory specialists and infectious disease specialists. Emphasis is placed on understanding patient risk factors, such as non-household contact with animals, excluding other possible causes of fever, such as influenza, and commencing empirical treatment as soon as a zoonotic infection is suspected. The algorithm is not exhaustive and GPs are urged to consult infectious disease specialists and medical microbiologists for further guidance if required.
It makes easier the mechanization of a General Fill for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)
It makes easier the mechanization of a 'General File' for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)
Max Joseph Herman
Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.
Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital
It makes easier the mechanization of a General Fill for a great Center as it allows the management, storage, maintenance and retrieval of all the circulating documents, involving any unit or section, to be considered officially or not. Shortly, it is a system which makes possible the inclusion, within the same Data Base, of references to official and unofficial documents of different classes, as well as document associated with them, under a number of registration correlative for each document and originated by the application. (Author)
Heckemann, Birgit; Peter, Karin A; Halfens, Ruud Jg; Schols, Jos Mga; Kok, Gerjo; Hahn, Sabine
To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. A qualitative descriptive study underpinned by the Reasoned Action Approach. Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff. © 2017 John Wiley & Sons Ltd.
Facchinetti, Emanuele; Sulzer, Sabine
The transition toward a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered, and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed, and compared. Through a market review, a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.
Full Text Available Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.
Full Text Available The transition towards a more sustainable global energy system, significantly relying on renewable energies and decentralized energy systems, requires a deep reorganization of the energy sector. The way how energy services are generated, delivered and traded is expected to be very different in the coming years. Business model innovation is recognized as a key driver for the successful implementation of the energy turnaround. This work contributes to this topic by introducing a heuristic methodology easing the identification of general business model patterns best suited for Local Energy Management concepts such as Energy Hubs. A conceptual framework characterizing the Local Energy Management business model solution space is developed. Three reference business model patterns providing orientation across the defined solution space are identified, analyzed and compared. Through a market review a number of successfully implemented innovative business models have been analyzed and allocated within the defined solution space. The outcomes of this work offer to potential stakeholders a starting point and guidelines for the business model innovation process, as well as insights for policy makers on challenges and opportunities related to Local Energy Management concepts.
Full Text Available Jens Georg HansenDepartment of Clinical Epidemiology, Aarhus University Hospital and Aalborg Hospital, Aalborg, DenmarkPurpose: To evaluate whether the ongoing debate over diagnostic problems and treatment choices for acute rhinosinusitis has had any influence on the management of the disease.Methods: We randomly selected 300 Danish general practitioners (GPs from the files of the Research Unit for General Practice at Aarhus University. Invitations to participate and a questionnaire were sent to the GPs by mail.Results: A total of 149 (49% GPs answered the questionnaire. When asked about symptoms, the highest priority was given to sinus pain and signs of tenderness. The most frequent examinations were objective examination of the ear-nose-throat (ENT, palpation of the maxillofacial area, and C-reactive protein point-of-care testing (or CRP rapid test. Nearly all GPs prescribed local vasoconstrictors, and in 70% of cases, antibiotics were prescribed. Phenoxymethylpenicillin was the preferred antibiotic. Use of the CRP rapid test, years in practice, or employment in an ENT department did not have a significant impact on the diagnostic certainty and antibiotic prescribing rate.Conclusion: The clinical diagnoses are based on a few symptoms, signs, and the CRP rapid test. Other examinations, including imaging techniques, are seldom used. Phenoxymethylpenicillin is the preferred antibiotic, and the GPs' diagnostic certainty was 70%.Keywords: general practice, acute rhinosinusitis, diagnosis, treatment, antibiotic
McCabe, Marita R P; Goldhammer, Denisa; Mellor, David; Hallford, David; Davison, Tanya
This study was designed to evaluate the effectiveness of a training program to improve the knowledge, attitudes, and self-efficacy of palliative care staff and thus enable them to better detect and manage depression among palliative care patients and their families. Participants were 90 professional carers who completed a four-session training program. Knowledge, attitudes, self-efficacy, and barriers to working with depressed patients were assessed preintervention, post-intervention, and at a three-month follow-up. The results demonstrated that compared to the control group, the intervention group had improved in all of these areas. Improvements were maintained at the three-month follow-up in all areas except attitudes. The results of this study indicate the importance of training in managing depression among palliative care staff. Booster sessions will likely be needed to ensure that training program gains are maintained.
Wong, S; van Middendorp, J; Belci, M; van Nes, I; Roels, E; Smith, É; Hirani, S P; Forbes, A
To (1) examine the opinions of medical staff working in spinal cord injury (SCI) centres (SCICs); (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management; (3) report the number of beds and dietitians available at each SCIC. A 37-item questionnaire was sent to 23 SCICs in the UK, the Netherlands, Belgium and the Republic of Ireland between September 2012 and January 2013. Eighteen SCICs returned the questionnaires for analysis. All respondents stated that they had an interest in obesity treatment but only 2.3% of the respondents received training in obesity management. Sixty-one percent of staff did not consider body mass index (BMI) to be appropriate for use in SCI patients and subsequently less than half of the respondents use BMI routinely. The majority of respondents reported that they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight and obese SCI children. Respondents also indicated the need for nationally adopted guidelines and a lack of physical activity provision. There were 17.5 whole-time equivalent (WTE) dietitians recorded in 22 SCICs, equivalent to 47.8 beds per WTE dietitians (range 10-420). Non-UK SCIC dietitians are significantly better resourced than in UK SCICs (beds per WTE dietitian: 36 vs 124, P=0.035). Medical staff expressed the need to participate in obesity prevention and management. Appropriate training should be considered for all medical staff and the development of specific weight management guidelines and dietetic provision should be considered.
Elnour, Ahmed Mohammed; Moussa, Mayada Mohamed Reda; El-Borgy, Mohamed Darwish; Fadelella, Nur Eldin Eltahir; Mahmoud, Aleya Hanafy
The present study aims at assessing nursing and sanitation staff knowledge and practice regarding Healthcare Waste (HCW) management before and after the implementation of an educational intervention program at the main hospitals of the White Nile State in Sudan. Quasi-experimental study design was applied to assess the impact of an intervention program on knowledge and practice regarding HCW management. The same questionnaire used in the pre-test was used immediately after the end of the intervention program and then again three months later for a second post-test. The results showed that the majority of nursing and sanitation staff had fair knowledge regarding HCW management before the educational intervention program (17% good, 58% fair, and 25% poor). After implementation of the educational program, the majority had good knowledge (56% good, 34% fair, and 10% poor) in the immediate post-test, and also in the post-test three months later (59% good, 35% fair, and 6% poor). More than half the nursing and sanitation staff had fair level of practice before the educational intervention program (42% good, 55% fair, and 3% poor). After the implementation of the intervention program, the immediate post-test showed a similar result (45% good, 54% fair, and 1% poor), while the post-test three months later showed that the majority demonstrated good practice level (55% good, 42% fair, and 3% poor). The nursing and sanitation staff at the main hospitals of the White Nile State in Sudan recorded significant improvement in their knowledge and practice with regard to HCW management immediately after the educational intervention program and three months later.
Full Text Available The purpose of the article is to improve the model of the enterprise (institution, organization management process on the basis of general management functions. The graphic model of the process of management according to the process-structured management is presented. It has been established that in today's business environment, the model of the management process should include such general management functions as: 1 controlling the achievement of results; 2 planning based on the main goal; 3 coordination and corrective actions (in the system of organization of work and production; 4 action as a form of act (conscious, volitional, directed; 5 accounting system (accounting, statistical, operational-technical and managerial; 6 diagnosis (economic, legal with such subfunctions as: identification of the state and capabilities; analysis (economic, legal, systemic with argumentation; assessment of the state, trends and prospects of development. The prospect of further research in this direction is: 1 the formation of a system of interrelation of functions and management methods, taking into account the presented research results; 2 development of the model of effective and efficient communication business process of the enterprise.
The NRC staff uses probabilistic risk assessment (PRA) and risk management as important elements its licensing and regulatory processes. In October 1991, the NRC`s Executive Director for Operations established the PRA Working Group to address concerns identified by the Advisory Committee on Reactor Safeguards with respect to unevenness and inconsistency in the staff`s current uses of PRA. After surveying current staff uses of PRA and identifying needed improvements, the Working Group defined a set of basic principles for staff PRA use and identified three areas for improvements: guidance development, training enhancements, and PRA methods development. For each area of improvement, the Working Group took certain actions and recommended additional work. The Working Group recommended integrating its work with other recent PRA-related activities the staff completed and improving staff interactions with PRA users in the nuclear industry. The Working Group took two key actions by developing general guidance for two uses of PRA within the NRC (that is, screening or prioritizing reactor safety issues and analyzing such issues in detail) and developing guidance on basic terms and methods important to the staff`s uses of PRA.
Spurgeon, P; Barwell, F
As Hales (1986) has observed, the problem of much of the managerial research to date has been the reluctance to ask why managers behave in the way they do. The behaviour of general managers in tackling organisational change in the NHS needs to be viewed not only with respect to what is done but also with respect to how personal and organisational objectives are construed. In other words, the implementation of organisational change ultimately rests on how general managers perceive the nature of this change and their role in structuring their own personal and organisational objectives into appropriate activities. Examining the compatibility of managerial activities and the underlying values and intentions which support them is of critical importance in any cognitively-based approach. These intentions provide an important link between perceptions (i.e. how the organisation is construed) and behaviour (i.e. what activities managers choose to perform). Understanding the conceptual frameworks which underpin managerial activities could have profound implications for assessing the performance of general managers.
McCloughen, Andrea; Foster, Kim
To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations. Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences and development of effective relationships. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations is not well known. A qualitative design, using semi-structured interviews to explore experiences of challenging interpersonal situations during clinical placement (Phase two of a larger mixed-methods study). Final-year Australian university nursing and pharmacy students (n = 20) were purposefully recruited using a range of Emotional Intelligence scores (derived in Phase one), measured using the GENOS Emotional intelligence Inventory (concise version). Challenging interpersonal situations involving student-staff and intrastaff conflict, discourteous behaviour and criticism occurred during clinical placement. Students used personal and relational strategies, incorporating emotionally intelligent behaviours, to manage these encounters. Strategies included reflecting and reframing, being calm, controlling discomfort and expressing emotions appropriately. Emotionally intelligent behaviours are effective to manage stressful interpersonal interactions. Methods for strengthening these behaviours should be integrated into education of nursing and pharmacy students and qualified professionals. Education within the clinical/workplace environment can incorporate key interpersonal skills of collaboration, social interaction and reflection, while also attending to sociocultural contexts of the healthcare setting. Students and staff are frequently exposed
Charalambous, Marianna; Konstantinos, Mitosis; Talias, Michael A
In this article, we present the data related to motivational factors given by the medical (n=118) and nursing (n=217) staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015) . The incentives-rewards included amount in a total to 11 (both financial and non-financial). The data contains 4 parts: (1) demographics, (2) assessment of the degree to which this hospital provided such incentives-rewards, (3) personal assessment of the participants about the significance of these incentive-rewards and (4) to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses) for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.
Hendel, Tova; Fish, Miri; Galon, Vered
To identify conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. Head nurses (N = 60) in five general hospitals in central Israel were surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X) and demographic data. Head nurses perceive themselves significantly more as transformational leaders than as transactional leaders. Compromise was found to be the most commonly used conflict management strategy. Approximately half of the nurses surveyed used only one mode in conflict management. Transformational leadership significantly affected the conflict strategy chosen. Head nurses tend to choose a conflict-handling mode which is concerned a form of a Lose-Lose approach. Preparation in conflict management should start from undergraduate education.
...] General Management Plan, Draft Environmental Impact Statement, Gateway National Recreation Area, New... (NPS) is releasing a Draft Environmental Impact Statement (DEIS) for the General Management Plan (GMP), Gateway National Recreation Area (Gateway), New York. The draft describes and analyzes several...
Uduma, Ogenna; Galligan, Marie; Mollel, Henry; Masanja, Honorati; Bradley, Susan; McAuliffe, Eilish
A systematic and structured approach to the support and supervision of health workers can strengthen the human resource management function at the district and health facility levels and may help address the current crisis in human resources for health in sub-Saharan Africa by improving health workers' motivation and retention. A supportive supervision programme including (a) a workshop, (b) intensive training and (c) action learning sets was designed to improve human resource management in districts and health facilities in Tanzania. We conducted a randomised experimental design to evaluate the impact of the intervention. Data on the same measures were collected pre and post the intervention in order to identify any changes that occurred (between baseline and end of project) in the capacity of supervisors in intervention a + b and intervention a + b + c to support and supervise their staff. These were compared to supervisors in a control group in each of Tanga, Iringa and Tabora regions (n = 9). A quantitative survey of 95 and 108 supervisors and 196 and 187 health workers sampled at baseline and end-line, respectively, also contained open-ended responses which were analysed separately. Supervisors assessed their own competency levels pre- and post-intervention. End-line samples generally scored higher compared to the corresponding baseline in both intervention groups for competence activities. Significant differences between baseline and end-line were observed in the total scores on 'maintaining high levels of performance', 'dealing with performance problems', 'counselling a troubled employee' and 'time management' in intervention a + b. In contrast, for intervention a + b + c, a significant difference in distribution of scores was only found on 'counselling a troubled employee', although the end-line mean scores were higher than their corresponding baseline mean scores in all cases. Similar trends to those in the supervisors' reports are seen in
Murphy, Norman L.
Describes the process of staff selection for the general studies department at Piedmont Technical College. Makes suggestions on how to write a job description, establish selection criteria, develop the selection process, and make the selection itself. Includes sample forms used in the process. (DR)
... Environmental Impact Statement/General Management Plan, Golden Gate National Recreation Area, CA AGENCY... Impact Statement/General Management Plan, Golden Gate National Recreation Area. SUMMARY: The National Park Service has prepared a Draft General Management Plan and Environmental Impact Statement (Plan/DEIS...
Pivarnik, Lori F.; Patnoad, Martha S.; Nyachuba, David; McLandsborough, Lynne; Couto, Stephen; Hagan, Elsina E.; Breau, Marti
Food safety training materials, targeted for residential childcare institution (RCCI) staff of facilities of 20 residents or less, were developed, piloted, and evaluated. The goal was to assist in the implementation of a Hazard Analysis Critical Control Points (HACCP)-based food safety plan as required by Food and Nutrition Service/United States…
Haapakorpi, Arja; Geirsdóttir, Guðrún; Jóhannsdóttir, Gyða
With quality assurance related to the Bologna goals, universities are required to fulfil internationally accepted standardized criteria of quality. This tends to reinforce control in assessment. However, control-oriented evaluations seem to lack meaning for academic staff. The article explored the possibilities and space for improvement-oriented…
Interviews with faculty, administrators, staff, and students at four engineering programs reveal the role of undergraduate student employment on retention and timely degree completion among engineering students. Dueling narratives reveal how student approaches to earning an engineering degree differ greatly from faculty, administrator, and staff…
Heslop, Liza; Plummer, Virginia
Coding, costing, and accounting for nursing care requirements in Australian public and private hospitals lacks systematic research. Nurse costing for two nurse staffing allocation methods--nurse patient ratios and a computerized nurse dependency management system--were compared. Retrospective nursing workload management data were obtained from hospital information systems in 21 acute care public and private hospitals in Australia and New Zealand. Descriptive statistics, cost analysis, and cost modeling were conducted for 103,269 shifts of nursing care. The comparison of costs for nursing staff by nurse-patient ratios and by a computerized nurse dependency management system demonstrated differences. The provision of nursing care using the computerized nurse dependency management system was, overall, lower in cost than for nurse-patient ratios.
Vance, Charles David
This qualitative case study explored how U.S. Army Command and General Staff College (CGSC) students decided whether or not to attend graduate school. The focus was on how U.S. Army students made their decision. The purpose of the study was to illuminate the issues related to this decision in adult development, adult learning, career decision…
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.
This paper discusses the strategies and best practices for staff renewal in the electricity sector. Strategic initiatives for staff renewal include strategic recruiting, succession planning, employee relations, knowledge management and strategic partnerships
Richard Philip Lee
Full Text Available Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those with cancer; with increased hospitalisation, inadequate pain control and fewer palliative care interventions. Understanding the views of those service managers and frontline staff who organise and provide care is crucial in order to develop better end of life care for people with dementia.Qualitative interviews and focus groups were conducted from 2013 to 2015 with 33 service managers and 54 staff involved in frontline care, including doctors, nurses, nursing and care home managers, service development leads, senior managers/directors, care assistants and senior care assistants/team leads. All were audio recorded and transcribed verbatim. Participants represented a diverse range of service types and occupation. Transcripts were subject to coding and thematic analysis in data meetings. Analysis of the data led to the development of seven key themes: Recognising end of life (EOL and tools to support end of life care (EOLC, Communicating with families about EOL, Collaborative working, Continuity of care, Ensuring comfort at EOL, Supporting families, Developing and supporting staff. Each is discussed in detail and comprise individual and collective views on approaches to good end of life care for people with dementia.The significant challenges of providing good end of life care for people with dementia requires that different forms of expertise should be recognised and used; including the skills and knowledge of care assistants. Successfully engaging with people with dementia and family members and helping them to recognise the dying trajectory requires a supportive integration of emotional and technical expertise. The study strengthens the existing evidence base in this area and will be used with a related set of studies (on the views of other stakeholders and observations and interviews conducted in four services to develop an
Brodaty, Henry; Low, Lee-Fay; Liu, Zhixin; Fletcher, Jennifer; Roast, Joel; Goodenough, Belinda; Chenoweth, Lynn
To test the hypothesis that individual and institutional-level factors influence the effects of a humor therapy intervention on aged care residents. Data were from the humor therapy group of the Sydney Multisite Intervention of LaughterBosses and ElderClowns, or SMILE, study, a single-blind cluster randomized controlled trial of humor therapy conducted over 12 weeks; assessments were performed at baseline, week 13, and week 26. One hundred eighty-nine individuals from 17 Sydney residential aged care facilities were randomly allocated to the humor therapy intervention. Professional performers called "ElderClowns" provided 9-12 weekly humor therapy 2-hour sessions, augmented by trained staff, called "LaughterBosses." Outcome measures were as follows: Cornell Scale for Depression in Dementia, Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and proxy-rated quality of life in dementia population scale. Facility-level measures were as follows: support of the management for the intervention, commitment levels of LaughterBosses, Environmental Audit Tool scores, and facility level of care provided (high/low). Resident-level measures were engagement, functional ability, disease severity, and time-in-care. Multilevel path analyses simultaneously modeled resident engagement at the individual level (repeated measures) and the effects of management support and staff commitment to humor therapy at the cluster level. Models indicated flow-on effects, whereby management support had positive effects on LaughterBoss commitment, and LaughterBoss commitment increased resident engagement. Higher resident engagement was associated with reduced depression, agitation, and neuropsychiatric scores. Effectiveness of psychosocial programs in residential aged care can be enhanced by management support, staff commitment, and active resident engagement. Copyright © 2014 American Association for
Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations
Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations
Lawal Yazid Ibrahim
Despite the growth of leisure travel and stress coping research based analysis of leisure and tourism, stress coping have been performed rarely. The purpose of the present study is to examine how University staffs cope with stress through participation in leisure and tourism activities, and how work related stress affect their organizational commitment using data collected from a focus group interview approach and a self-developed questionnaire consisting of 25 items design to elicit informat...
Full Text Available Central concerns within the field of learning technology in higher education have been the promotion of institutional change and staff awareness and development. This focus on the need to bring about a 'culture shift' and the importance of 'change agents' is reflected in the Dearing Report (DfEE, 1997 and in Funding Council initiatives such as TLTP and TLTSN (Davies, 1995. It is common for many of us who work in this area to feel that although we see clearly the task ahead, we have little at our disposal by way of evidence about how far we have come. Much of the evidence which does exist, and which has been incorporated into lectures and reports, is anecdotal, local and small scale, although there have been some larger studies, notably the Information Technology Assisted Teaching and Learning project (ITATL, 1997, and a 1999 study of C&IT materials funded by the Funding Councils (HEFCE, 1999a, and in the United States the national survey of desktop computing and IT in higher education (Green, 1989-99. These showed a rapidly increasing use of learning technology in higher education, and some of the limitations and restrictions which staff feel, such as technical support. However, there had been no indepth study of the subject and institution-specific influences on academic staff use of, and attitudes to, learning technology.
Geisler, K.I.; Neumann, S.A.; Nielsen, T.D.; Bower, P.K. (Empros Systems International (US)); Hughes, B.A.
This article presents a system solution approach that meets the requirements being imposed by industry trends and the electric utility customer. Specifically, the solution addresses electric distribution management systems. Electrical distribution management is a particularly well suited area of application because it involves a high diversity of tasks, which are currently supported by a proliferation of automated islands. Islands of automation which currently exist include (among others) distribution operations, load management, automated mapping, facility management, work order processing, and planning.
Full Text Available Background: 5S is a lean method for workplace organization; it is an abbreviation representing five Japanese words that can be translated as sort, set in order, shine, standardize, and sustain. The 5S management method has been recognized recently as a potential solution for improving the quality of government healthcare services in low- and middle-income countries. Objective: To assess how the 5S management method creates changes in the workplace and in the process and outcomes of healthcare services, and how it can be applicable in a resource-poor setting, based on data from a pilot intervention of the 5S program implemented in a health facility in Senegal. Design: In this qualitative study, we interviewed 21 health center staff members 1 year after the pilot intervention. We asked them about their views on the changes brought on by the 5S program in their workplace, daily routines, and services provided. We then transcribed interview records and organized the narrative information by emerging themes using thematic analysis in the coding process. Results: Study participants indicated that, despite resource constraints and other demotivating factors present at the health center, the 5S program created changes in the work environment, including fewer unwanted items, improved orderliness, and improved labeling and directional indicators of service units. These efforts engendered changes in the quality of services (e.g. making services more efficient, patient-centered, and safe, and in the attitude and behavior of staff and patients. Conclusions: The pilot intervention of the 5S management method was perceived to have improved the quality of healthcare services and staff motivation in a resource-poor healthcare facility with a disorderly work environment in Senegal. Quantitative and qualitative research based on a larger-scale intervention would be needed to elaborate and validate these findings and to identify the cost-effectiveness of such
Kanamori, Shogo; Sow, Seydou; Castro, Marcia C; Matsuno, Rui; Tsuru, Akiko; Jimba, Masamine
5S is a lean method for workplace organization; it is an abbreviation representing five Japanese words that can be translated as sort, set in order, shine, standardize, and sustain. The 5S management method has been recognized recently as a potential solution for improving the quality of government healthcare services in low- and middle-income countries. To assess how the 5S management method creates changes in the workplace and in the process and outcomes of healthcare services, and how it can be applicable in a resource-poor setting, based on data from a pilot intervention of the 5S program implemented in a health facility in Senegal. In this qualitative study, we interviewed 21 health center staff members 1 year after the pilot intervention. We asked them about their views on the changes brought on by the 5S program in their workplace, daily routines, and services provided. We then transcribed interview records and organized the narrative information by emerging themes using thematic analysis in the coding process. Study participants indicated that, despite resource constraints and other demotivating factors present at the health center, the 5S program created changes in the work environment, including fewer unwanted items, improved orderliness, and improved labeling and directional indicators of service units. These efforts engendered changes in the quality of services (e.g. making services more efficient, patient-centered, and safe), and in the attitude and behavior of staff and patients. The pilot intervention of the 5S management method was perceived to have improved the quality of healthcare services and staff motivation in a resource-poor healthcare facility with a disorderly work environment in Senegal. Quantitative and qualitative research based on a larger-scale intervention would be needed to elaborate and validate these findings and to identify the cost-effectiveness of such intervention in low- and middle-income countries.
Design management has not yet formed a theoretical system recognized, general contractor design managers under nuclear power project EPC Mode lack the clear theory basis. This paper aims to discuss Design management from the angle of general contractor under nuclear power project EPC mode, Gives the concept of design management Clearly, by Combining the characteristics of nuclear power project, Gives the specific content and meaning of the design management of nuclear power project. (authors)
There are a large number of facilities and activities around the world in which radioactive material is produced, handled and stored. This Safety Requirements publication presents international consensus requirements for the management of radioactive waste prior to its disposal. It provides the safety imperatives on the basis of which facilities can be designed, operated and regulated. The publication is supported by a number of Safety Guides that provide up to date recommendations and guidance on best practices for management of particular types of radioactive waste, for storage of radioactive waste, for assuring safety by developing safety cases and supporting safety assessments, and for applying appropriate management systems. Contents: 1. Introduction; 2. Protection of human health and the environment; 3. Responsibilities associated with the predisposal management of radioactive waste; 4. Steps in the predisposal management of radioactive waste; 5. Development and operation of predisposal radioactive waste management facilities and activities; Annex: Predisposal management of radioactive waste and the fundamental safety principles.
Almdal, T.; Viggers, L.; Beck, Anne Marie
Background and Aims: To assess the amount of food produced in a hospital kitchen and the amount wasted. To assess the amount of food eaten by patients in relation to their energy needs. To assess whether the food production and wastage could be reduced by training members of the staff. Methods...... was determined. Following training of the hospital staff the first part was repeated. Results: On average, 11.1 MJ and 112 g of protein were ordered per patient per day. From these amounts on average 31 MJ and 33 g protein were wasted per patient per day. The total average energy expenditure was calculated....... Following training of the hospital staff, a new investigation showed no significant changes in the amount of food ordered and wasted. Conclusion: Despite a supply of food, which was much higher than the patients' needs, the patients have only approx. 60% of their energy need covered. We suggest...
... management or general business operations. (a) To qualify for the administrative exemption, an employee's... operations of the employer or the employer's customers. The phrase “directly related to the management or... 29 Labor 3 2010-07-01 2010-07-01 false Directly related to management or general business...
...-INTRODUCTION 1.1-Regulations System § 105-1.101 General Services Administration Property Management Regulations... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false General Services Administration Property Management Regulations. 105-1.101 Section 105-1.101 Public Contracts and Property...
Darney, Blair G.; VanDerhei, Deborah; Weaver, Marcia R.; Stevens, Nancy G.; Prager, Sarah W.
Background Including support staff in practice change initiatives is a promising strategy to successfully implement new reproductive health services. The Resident Training Initiative in Miscarriage Management (RTI-MM) is an intervention designed to facilitate implementation of manual vacuum aspiration (MVA) for management of spontaneous abortion. The purpose of this study was to identify training program components that enhanced interprofessional training and provide lessons learned for engaging support staff in implementing uterine evacuation services. Study design We conducted a secondary analysis of qualitative data to identify themes within three broad areas: interprofessional education, the role of support staff, and RTI-MM program components that facilitated support staff engagement in the process of implementing MVA services. Results We identified three key themes around interprofessional training and the role of support staff: “Training together is rare,” “Support staff are crucial to practice change,” and “Transparency, peers and champions.” Conclusions We present lessons learned that may be transferrable to other clinic sites: engage site leadership in a commitment to interprofessional training; engage support staff as teachers and learners and in shared values and building professionalism. Implications This manuscript adds to what is known about how to employ interprofessional education and training to engage support staff in reproductive health services practice change initiatives. Lessons learned may provide guidance to clinical sites interested in interprofessional training, improving service delivery, or implementing new services. PMID:23876430
This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.
This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factor, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations (registrants and licensees) and other organizations concerned with facilities and activities that give rise to radiation risks
This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.
This Safety Requirements publication establishes requirements that support Principle 3 of the Fundamental Safety Principles in relation to establishing, sustaining and continuously improving leadership and management for safety and an integrated management system. It emphasizes that leadership for safety, management for safety, an effective management system and a systemic approach (i.e. an approach in which interactions between technical, human and organizational factors are duly considered) are all essential to the specification and application of adequate safety measures and to the fostering of a strong safety culture. Leadership and an effective management system will integrate safety, health, environmental, security, quality, human-and-organizational factors, societal and economic elements. The management system will ensure the fostering of a strong safety culture, regular assessment of performance and the application of lessons from experience. The publication is intended for use by regulatory bodies, operating organizations and other organizations concerned with facilities and activities that give rise to radiation risks.
Hardina, Donna; Montana, Salvador
In this article, findings from a national survey of social service managers are described. Respondents were asked to identify theories and models of management that influenced their administrative activities. The results indicate that many of the respondents used an empowerment-oriented approach to management. Respondents were more likely to…
Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model. Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation. Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes. Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve
Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve
Dias, António; Amorim, António; Tomé, António
An effective experiment is dependent on the ability to store and deliver data and information to all participant parties regardless of their degree of involvement in the specific parts that make the experiment a whole. Having fast, efficient and ubiquitous access to data will increase visibility and discussion, such that the outcome will have already been reviewed several times, strengthening the conclusions. The CLOUD project aims at providing users with a general purpose data acquisition, management and instrument monitoring platform that is fast, easy to use, lightweight and accessible to all participants of an experiment. This work is now implemented in the CLOUD experiment at CERN and will be fully integrated with the experiment as of 2016. Despite being used in an experiment of the scale of CLOUD, this software can also be used in any size of experiment or monitoring station, from single computers to large networks of computers to monitor any sort of instrument output without influencing the individual instrument's DAQ. Instrument data and meta data is stored and accessed via a specially designed database architecture and any type of instrument output is accepted using our continuously growing parsing application. Multiple databases can be used to separate different data taking periods or a single database can be used if for instance an experiment is continuous. A simple web-based application gives the user total control over the monitored instruments and their data, allowing data visualization and download, upload of processed data and the ability to edit existing instruments or add new instruments to the experiment. When in a network, new computers are immediately recognized and added to the system and are able to monitor instruments connected to them. Automatic computer integration is achieved by a locally running python-based parsing agent that communicates with a main server application guaranteeing that all instruments assigned to that computer are
Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.
Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu
The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.
Gordon, John E.; Crofts, Roger
Development of more integrated approaches to the management of protected areas requires not only the protection of geosites, but also the effective application of geoconservation principles that apply more widely to the sustainable management of natural systems. Key guiding principles include: working with natural processes; managing natural systems and processes in a spatially integrated manner; accepting the inevitability of natural change; considering the responses of geomorphological processes to the effects of global climate change; recognising the sensitivity of natural systems and managing them within the limits of their capacity to absorb change; basing conservation management of active systems on a sound understanding of the underlying physical processes; making provision for managing visitors at sensitive sites; and acknowledging the interdependency of geodiversity and biodiversity management. As well as recognising the value of geoheritage in its own right, a more integrated approach to conservation across the full range of IUCN Protected Area Management Categories would benefit both biodiversity and geodiversity, through application of the concept of 'conserving nature's stage' and adopting an ecosystem approach.
Price, Owen; Baker, John; Bee, Penny; Lovell, Karina
De-escalation techniques are a recommended non-physical intervention for the management of violence and aggression in mental health. Although taught as part of mandatory training for all National Health Service (NHS) mental health staff, there remains a lack of clarity around training effectiveness. To conduct a systematic review of the learning, performance and clinical safety outcomes of de-escalation techniques training. The review process involved a systematic literature search of 20 electronic databases, eligibility screening of results, data extraction, quality appraisal and data synthesis. A total of 38 relevant studies were identified. The strongest impact of training appears to be on de-escalation-related knowledge, confidence to manage aggression and deescalation performance (although limited to artificial training scenarios). No strong conclusions could be drawn about the impact of training on assaults, injuries, containment and organisational outcomes owing to the low quality of evidence and conflicting results. It is assumed that de-escalation techniques training will improve staff's ability to de-escalate violent and aggressive behaviour and improve safety in practice. There is currently limited evidence that this training has these effects. © The Royal College of Psychiatrists 2015.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Staff supervision. 551.32 Section 551.32 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MISCELLANEOUS Inmate Organizations § 551.32 Staff supervision. (a) The Warden shall appoint a staff member as the...
Backer, Vibeke; Bornemann, Maja; Knudsen, Anja Dorte Brandt
Successful asthma management involves guideline-based treatment and regular follow-up. We aimed to study the level of disease control in asthmatic individuals managed by their GP and a dedicated nurse when using a systematic asthma consultation guide based on Global Initiative of Asthma guidelines...
The English National Programme, part of the Lycée International de Ferney-Voltaire (France) needs the following staff for September 2001: A part-time teacher of primary English The post involves teaching the English curriculum to pupils who are within the French educational system: Classes take place on Tuesday afternoons at the Lycée, Team spirit necessary as teachers work as a team, Induction & training are offered. A part time teacher of senior secondary history-geography in English A part time teacher of secondary mathematics in English Teachers must be mother-tongue English speakers and have a relevant degree and/or teaching qualification. For the history-geography post, either history or geography degrees are acceptable. Please send your c.v. and a letter of application to Peter Woodburn, Head, English National Programme, Lycée International, 01216 Ferney-Voltaire, France. (Email: firstname.lastname@example.org) Telephone 04 50 40 82 66 for further details of posts. Ple...
Background: The aim of the study was to determine the knowledge of general practitioners in the rural areas of the Free State and Northern Cape regarding snake bites and their treatment. Methods: Telephonic interviews using structured questionnaires were conducted with a random sample of 50 general practitioners from ...
5th April, 2016 – Ordinary General Assembly of the Staff Association! In the first semester of each year, the Staff Association (SA) invites its members to attend and participate in the Ordinary General Assembly (OGA). This year the OGA will be held on Tuesday, April 5th 2016 from 11:00 to 12:00 in BE Auditorium, Meyrin (6-2-024). During the Ordinary General Assembly, the activity and financial reports of the SA are presented and submitted for approval to the members. This is the occasion to get a global view on the activities of the SA, its financial management, and an opportunity to express one’s opinion, including taking part in the votes. Other points are listed on the agenda, as proposed by the Staff Council. Who can vote? Only “ordinary” members (MPE) of the SA can vote. Associated members (MPA) of the SA and/or affiliated pensioners have a right to vote on those topics that are of direct interest to them. Who can give his/her opinion? The Ordinary General Asse...
Corporate sustainability is not just a buzzword - for many industry leaders and corporations, it has become an invaluable tool for exploring ways to reduce costs, manage risks, create new products, and drive fundamental internal changes in culture and structure. However, integrating sustainability thinking and practice into organizational structure is not a trivial task and it requires a vision, commitment and leadership. It also requires a systems approach with an appropriate management fram...
Dehghan Nayeri, Nahid; Nazari, Ali Akbar; Salsali, Mahvash; Ahmadi, Fazlollah; Adib Hajbaghery, Mohsen
As the biggest proportion of hospital personnel, Iranian nurses have a major role in providing quality care to patients. Nursing managers and nurses no longer feel that nurses' work is valued and they are concerned about their productivity. Nurses' views about productivity and management factors affecting it have been identified as the most important aspects affecting productivity. Thus, this study assesses productivity from the nurse's view. A grounded theory approach was used for this research. Purposive sampling and semistructured interviews were used. The data were analyzed using constant comparative analysis. Most participants felt that the qualitative nature (effectiveness) of productivity is very important. Also, participants indicated that management is the most important factor that can promote or impede their productivity. They suggested that managers' performance and their skill level are the factors influencing productivity. Effective management can improve nurses' productivity and the quality of care that nurses provide.
Association du personnel
Following a decision taken at the Staff Association General Assembly in May 2008, staff delegates are elected in the autumn of odd-numbered years. The next elections which will lead to a total renewal of the Staff Council will thus take place in November 2009. Will you be a candidate?
The NRC staff uses probabilistic risk assessment (PRA) and risk management as important elements its licensing and regulatory processes. In October 1991, the NRC's Executive Director for Operations established the PRA Working Group to address concerns identified by the Advisory Committee on Reactor Safeguards with respect to unevenness and inconsistency in the staff's current uses of PRA. After surveying current staff uses of PRA and identifying needed improvements, the Working Group defined a set of basic principles for staff PRA use and identified three areas for improvements: guidance development, training enhancements, and PRA methods development. For each area of improvement, the Working Group took certain actions and recommended additional work. The Working Group recommended integrating its work with other recent PRA-related activities the staff completed and improving staff interactions with PRA users in the nuclear industry. The Working Group took two key actions by developing general guidance for two uses of PRA within the NRC (that is, screening or prioritizing reactor safety issues and analyzing such issues in detail) and developing guidance on basic terms and methods important to the staff's uses of PRA
Cain, Steven M; Moore, Robert; Sturm, Lauren; Mason, Travis; Fuhrman, Caitlin; Smith, Robin; Bojicic, Irfan; Carter, Brandon
Objective This paper describes how a clinical team at Landstuhl Regional Medical Center (LRMC) successfully integrated synchronous telehealth (TH) into their routine clinical practice. Methods and materials Synchronous TH encounters were performed using Polycom® software on surgeons' computers with high-definition (HD) cameras on monitors at distant sites and PolyCom HDX9000® Telehealth Practitioner Carts at originating sites. Patients provided consented and were presented to general surgeons by nurses and medical technicians at Army health clinics throughout the European Theater. Results In calendar year (CY) 2014, five general surgeons and two surgical physician assistants (PAs) at Landstuhl Regional Medical Center along with registered nurses (RNs) at six originating clinic sites throughout Europe completed 130 synchronous TH encounters for 101 general surgery patients resulting in 73 completed and 16 recommended surgeries. Eighty-eight percent of patients had a completed or recommended surgery. No surgeries or procedures planned after initial TH evaluation were cancelled. Originating site clinics ranged in distance from 68 miles to 517 miles. Acceptance by providers, patients and clinic staff was high. Conclusion Synchronous TH was effective and safe in evaluating common general surgical conditions. We excluded sensitive and complex conditions requiring a nuanced physical examination. The TH efforts of the general surgery staff have resulted in high-quality, seamless and predictable TH activities that continue to expand into other surgical and medical specialties beyond general surgery. Seven surgeons and two PAs use synchronous TH regularly serving patients over a broad geographic area.
Jennings, Aisling A; Foley, Tony; McHugh, Sheena; Browne, John P; Bradley, Colin P
general practitioners (GPs) have identified the management of behavioural and psychological symptoms of dementia (BPSD) as a particularly challenging aspect of dementia care. However, there is a paucity of research on why GPs find BPSD challenging and how this influences the care they offer to their patients with dementia. to establish the challenges GPs experience when managing BPSD; to explore how these challenges influence GPs' management decisions; and to identify strategies for overcoming these challenges. qualitative study of GPs experiences of managing BPSD. semi-structured interviews were conducted with 16 GPs in the Republic of Ireland. GPs were purposively recruited to include participants with differing levels of experience caring for people with BPSD in nursing homes and in community settings to provide maximum diversity of views. Interviews were analysed thematically. three main challenges of managing BPSD were identified; lack of clinical guidance, stretched resources and difficulties managing expectations. The lack of relevant clinical guidance available affected GPs' confidence when managing BPSD. In the absence of appropriate resources GPs felt reliant upon sedative medications. GPs believed their advocacy role was further compromised by the difficulties they experienced managing expectations of family caregivers and nursing home staff. this study helps to explain the apparent discrepancy between best practice recommendations in BPSD and real-life practice. It will be used to inform the design of an intervention to support the management of BPSD in general practice. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.
Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki
Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.
Clarkson, Earl; Bhatia, Sanjeev
This article reviews trends in the dental marketplace. Marketing is an essential element of dentistry. Communicating treatment options with patients is one aspect of marketing. Treatment planning helps patients understand the relationships between oral health, occlusion, temporomandibular joint function, and systemic health. Through marketing, dental practice owners inform patients of ever-changing treatment modalities. Understanding treatment options allows patients to make better, informed choices. More options leads to a higher level of care and more comprehensive dental treatment. Managing a practice requires tracking its financial health. Economic statistics measure the effect of management decisions that mark the direction of a dental practice.
An emerging literature is beginning to create a theoretical framework for analysing the role of professional managers – that is, those without an ongoing academic background – in the context of UK higher education. Here I argue, drawing on my own experience in a range of higher education institutions, that this literature misses a crucial distinction amongst professional managers, namely that between generic HE professionals, and specialists from professions which exist outside the world of h...
Vazirnia, Aria; Cohen, Philip R
Lichen planus is an inflammatory disease that affects the skin, the oral mucosa, or both. Generalized cutaneous lichen planus may pose a therapeutic challenge for clinicians if the condition persists or flares after topical or systemic corticosteroid therapy. Acitretin, a systemic retinoid, can be considered a potential second-line treatment for patients with generalized cutaneous lichen planus. Herein, we describe a postmenopausal woman with generalized cutaneous lichen planus who was successfully treated with acitretin. A 58-year-old woman presented with generalized cutaneous lichen planus involving her upper and lower extremities as well as her lower back. After failing corticosteroid therapy, she was started on acitretin 20 mg/day, which was later increased to 30 mg/day. To review the literature on the use of acitretin in cutaneous lichen planus, we used the PubMed search engine and searched for the terms "acitretin" and "cutaneous lichen planus." Our patient had complete resolution of pruritus within one week of initiating acitretin 20 mg/day. After an increase in dose to 30 mg/day, the cutaneous lesions completely resolved over a 3-month period. There was no recurrence of disease as acitretin was tapered and discontinued. Generalized cutaneous lichen planus may pose a therapeutic challenge for the symptomatic relief of skin lesions. Topical and systemic corticosteroids are first-line treatments. In patients who fail corticosteroids, relapse after corticosteroid therapy, or have contraindications to corticosteroids, acitretin may be considered a potential second-line therapy.
Debes, M.; Bordier, M.
During the last fifteen years a significant decrease in solid radioactive waste generated by nuclear power plants of Electricite de France (EDF) has taken place. Technology used by EDF is described, with emphasis on innovative technologies. Experience and lessons learned are described showing how EDF has responded to meet increasingly stringent regulations for radioactive waste management. (author)
Stern, Z; Naveh, E
A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.
The present work underlines and synthesises the essential principles, directions and methodologies developed by Industrialized Nations and by the International Organizations for management of radioactive waste of high, intermediate and low levels. It fills a gap in scientific Italian literature and represents a valid introduction to the subject. (author)
Dominick, Wayne D.; Weathers, Peggy G.
This overview of potential for utilizing database management systems (DBMS) within numeric database environments highlights: (1) major features, functions, and characteristics of DBMS; (2) applicability to numeric database environment needs and user needs; (3) current applications of DBMS technology; and (4) research-oriented and…
You must submit one risk management plan (RMP) to EPA for all of your covered processes. The internet-based RMP*eSubmit allows you to submit your RMP in EPA's Central Data Exchange (CDX), where you can access and change/correct existing RMPs.
José García Pérez
Full Text Available The beta distribution has traditionally been employed in the PERT methodology and generally used for modeling bounded continuous random variables based on expert’s judgment. The impossibility of estimating four parameters from the three values provided by the expert when the beta distribution is assumed to be the underlying distribution has been widely debated. This paper presents the generalized bicubic distribution as a good alternative to the beta distribution since, when the variance depends on the mode, the generalized bicubic distribution approximates the kurtosis of the Gaussian distribution better than the beta distribution. In addition, this distribution presents good properties in the PERT methodology in relation to moderation and conservatism criteria. Two empirical applications are presented to demonstrate the adequateness of this new distribution.
Full Text Available Abstract Background Obesity has become a global pandemic, considered the sixth leading cause of mortality by the WHO. As gatekeepers to the health system, General Practitioners are placed in an ideal position to manage obesity. Yet, very few consultations address weight management. This study aims to explore reasons why patients attending General Practice appointments are not engaging with their General Practitioner (GP for weight management and their perception of the role of the GP in managing their weight. Methods In February 2006, 367 participants aged between 17 and 64 were recruited from three General Practices in Melbourne to complete a waiting room self – administered questionnaire. Questions included basic demographics, the role of the GP in weight management, the likelihood of bringing up weight management with their GP and reasons why they would not, and their nominated ideal person to consult for weight management. Physical measurements to determine weight status were then completed. The statistical methods included means and standard deviations to summarise continuous variables such as weight and height. Sub groups of weight and questionnaire answers were analysed using the χ2 test of significant differences taking p as Results The population sample had similar obesity co-morbidity rates to the National Heart Foundation data. 74% of patients were not likely to bring up weight management when they visit their GP. Negative reasons were time limitation on both the patient's and doctor's part and the doctor lacking experience. The GP was the least likely person to tell a patient to lose weight after partner, family and friends. Of the 14% that had been told by their GP to lose weight, 90% had cardiovascular obesity related co-morbidities. GPs (15% were 4th in the list of ideal persons to manage weight after personal trainer Conclusion Patients do not have confidence in their GPs for weight management, preferring other health
White, J.R.; Chapman, D.M.; Biswas, D.
A general methodology for optimization of assembly shuffling and burnable poison (BP) loadings for LWR reload design has been developed. The uniqueness of this approach lies in the coupling of Generalized Perturbation Theory (GPT) methods and standard Integer Programming (IP) techniques. An IP algorithm can simulate the discrete nature of the fuel shuffling and BP loading problems, and the use of GPT sensitivity data provides an efficient means for modeling the behavior of the important core performance parameters. The method is extremely flexible since the choice of objective function and the number and mix of constraints depend only on the ability of GPT to determine the appropriate sensitivity functions
....5180 Interest rate risk management by banks—general. The board of directors of each Farm Credit Bank, bank for cooperatives, and agricultural credit bank shall develop and implement an interest rate risk... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Interest rate risk management by banks-general...
Kloek, C.J.J.; Tol, J.; Veenhof, C.; Wulp, I. van der; Swinkels, I.C.S.
Background: General practitioners (GPs) can play an important role in both the prevention and management of overweight and obesity. Current general practice guidelines in the Netherlands allow room for GPs to execute their own weight management policy. Objective: To examine GPs’ current weight
... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Purpose-General policy on financial... HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT THE PUBLIC HOUSING OPERATING FUND PROGRAM Financial Management Systems, Monitoring, and Reporting § 990.310 Purpose—General policy on financial management...
... Environmental Impact Statement for General Management Plan, Ross Lake National Recreation Area, North Cascades... a final environmental impact statement (Final EIS) for the proposed General Management Plan for Ross Lake National Recreation Area (Ross Lake NRA) in Washington State. This Final EIS describes and...
... DEPARTMENT OF THE INTERIOR National Park Service [NPS-PWR-PWRO-0411-10062: 9082-NOCA-409] General Management Plan/Environmental Impact Statement, Ross Lake National Recreation Area, North Cascades National... Impact Statement for the new General Management Plan (GMP) for Ross Lake National Recreation Area, part...
Verhoeven, AAH; Jong, BMD
Background. As a result of changes in information technology and the rapid growth of publications methods of searching the literature have changed. Systematic searching of the growing literature has become very important. It is not known whether researchers in general practice search systematically,
Alterescu, S.; Friedman, C. A.; Hipkins, K. R.
An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.
Lau, Rosalind; Cross, Wendy; Moss, Cheryle; Campbell, Annie; De Castro, Magali; Oxley, Victoria
A key finding of this qualitative exploratory descriptive study into advanced nursing for general practice nurses (Australian setting) revealed that participants viewed leadership and management as best learnt 'apprenticeship' style on the job by years of experience. Participants (48) comprised of general practice nurses, practice managers and general practitioners from metropolitan Melbourne were interviewed. Other findings demonstrated that the participants generally had limited awareness that postgraduate education can assist in the development of leadership and management in advanced nursing practice. The participants lacked clarity about professional competencies and generally did not connect these to leadership and management. Professional bodies need to take the opportunity to promote awareness of the national competency standards. All three groups of participants expressed hopes about the future provision of professional development opportunities and support by the Medicare Local for leadership and management aspirations within advanced practice nursing.
Tordrup Heeager, Lise; Svejvig, Per; Schlichter, Bjarne Rerup
compares ten characteristics of agile software development (identified in theory) and the general project management method developed by the Danish Project Half Double (PHD) initiative. The method consists of 10 leading stars for rethinking project management the impact, flow and leadership (ILF) method......Increased complexity in projects has forced new project management initiatives. In software development several agile methods have emerged and methods such as Scrum are today highly implemented in practice. General project management practice has been inspired by agile software development....... But in order to fully understand and to provide suggestions for future practice on how agility can be incorporated in general project management, this paper addresses how agile methods have inspired general project management practices. To answer the research question, the paper provides an analysis which...
This paper describes the training process for a nuclear project on a new site. When Atomic Energy of Canada Ltd. opened a project office in Saskatoon, senior management recognized the need for large-scale staff training and made the necessary commitments. Two types of training program were initiated: general and technical. The general training plan included topics related to the nuclear project life cycle. Technical training was discipline and task specific. Based on the job descriptions and staff qualifications, technical training requirements were documented for the entire staff. The training strategy was developed and implemented. Detailed records were maintained to monitor the progress, draw conclusions and plan training for future nuclear facilities. (orig.)
Abad, Ismael; Cerrada, Carlos; Cerrada, Jose A; Heradio, Rubén; Valero, Enrique
RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS) is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA) systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc…) inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM) this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command) and RRTL (RFID Reader Topology Language). MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster).
Abad, Ismael; Cerrada, Carlos; Cerrada, Jose A.; Heradio, Rubén; Valero, Enrique
RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS) is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA) systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc…) inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM) this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command) and RRTL (RFID Reader Topology Language). MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster). PMID:22969370
Full Text Available BACKGROUND AND CONTEXT: In New Zealand, the highest prevalence of gout is in Maori and Pacific people. Counties Manukau District Health Board (CMDHB has the highest Maori and Pacific population of any New Zealand District Health Board. A CMDHB study found that a high proportion of patients with gout were also at increased risk of cardiovascular disease. ASSESSMENT OF PROBLEMS: The primary objective was to examine whether the control of gout had changed over time at one clinic. The secondary objective was to assess the management of cardiovascular risk factors in patients with gout at that clinic. RESULTS: The mean serum uric acid level of patients with gout in the practice had risen in comparison with a similar audit carried out in March 2009. This indicates that the control of gout for patients at the practice has worsened over time. Many patients had not had an annual serum uric acid test. STRATEGIES FOR IMPROVEMENT: A repeat uric acid level was scheduled for all patients with gout in the practice, with follow-up appointments to be arranged if the result was abnormal. LESSONS: Gout is often suboptimally managed. Serum uric acid levels may only be tested when a patient presents with an acute attack of gout. Consideration should be given to a minimum of annual serum uric acid levels. Appropriate management of modifiable cardiovascular risk factors in this particular cohort is important and should be a particular focus of care.
Liliana Adela ZIMA
Full Text Available Brand is a trustworthy, relevant, and distinctive promise to the consumer. The Brand Manager must understand that he is responsible for the building of long term brand equity and he must keep the brand from both a Strategic and Tactical standpoint.The strategy of Adam Opel AG is focused on brand equity because it is important to add value for customer from products and services. The total sum of all the benefits, features, and associations, both functional and non-functional that make a brand competitive and distinctive in its market is the process of Brand Positioning. I made a study at Adam Opel AG in particularly at European Business In this study are observed the main tasks and responsibilities of each member of the team. The European Business Team has a lot of influence over the company which is a Marketing lead company. Brand Management is the management of the marketing value chain to consistently build brand equity, market share and profitability. In present, it is shifting our focus to brands, which include all the five “P”s of marketing: Product, Price, Place, Promotion and People. Our vehicles will always be a critical factor to our success. We are simply going to enhance our market potential by building on our brands at both the umbrella and vehicle line levels.
Zhang Jinyong; Zhao Xiaobo
The paper introduces the characteristics of bulk material management mode in construction project, and the advantages and disadvantages of bulk material management mode of general contractors in nuclear power project. In combination with the bulk material management mode of China Nuclear Power Engineering Co., Ltd, some improvement measures have been put forward as well. (authors)
Full Text Available In this study, 31 workers at a university were randomly selected for indoor environmental monitoring in Wuhan. Two indicators, formaldehyde and total volatile organic compounds (TVOC, and using 139 monitoring points, monitored the indoor environment (including home and workplace as well as the interior space of the main furniture. This study carried out the environmental quality assessment for TVOC based on the dB index method and the health risk assessment of indoor formaldehyde for the university staff receptors and, then focused on health risk in home environment to carry out detailed environmental health management. The results showed that TVOC in the three types of home spaces exceeded about 80% of the national standard. The excessive formaldehyde ratios for kitchens (79%, bedrooms (77% and living rooms (74% were calculated. Formaldehyde health risks all exceeded the United States Environmental Protection Agency, (USEPA acceptable risk threshold. The formaldehyde concentrations in workplaces were about 0.03 mg·m−3. While the risk contribution of the home environment to the total average health risk (0.0014, whether male and female is about 96%. For the adapted and unadapted persons, 90% and 55% of the monitoring points were located within the long-term tolerable range of TVOC decibel application, respectively. Long-term exposure to such an environment can lead to the Sick Building Syndrome (SBS. On the other hand, through comparison of the concentration of pollutants in the interior spaces of furniture and home spaces, it was determined tentatively that the pollutants were mainly concentrated in rarely used furniture. In summary, the air pollution in the studied homes of university staff was much serious than that in workplaces, which showed a need to manage TVOC and formaldehyde pollution by the three means: the purchase of green products, removal of internal pollution from furniture, and creating a good indoor volatile diffusion
Smith, Pam; Pearson, Pauline H; Ross, Fiona
This paper sets the discussion of emotions at work within the modern NHS and the current prioritisation of creating a safety culture within the service. The paper focuses on the work of students, frontline nurses and their managers drawing on recent studies of patient safety in the curriculum, and governance and incentives in the care of patients with complex long term conditions. The primary research featured in the paper combined a case study design with focus groups, interviews and observation. In the patient safety research the importance of physical and emotional safety emerged as a key finding both for users and professionals. In the governance and incentives research, risk emerged as a key concern for managers, frontline workers and users. The recognition of emotions and the importance of emotional labour at an individual and organizational level managed by emotionally intelligent leaders played an important role in promoting worker and patient safety and reducing workplace risk. Nurse managers need to be aware of the emotional complexities of their organizations in order to set up systems to support the emotional wellbeing of professionals and users which in turn ensures safety and reduces risk.
Full Text Available Abstract Background The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC, a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. Methods The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7 and disciplinary allied health professional and public health nurse managers (N = 25 were interviewed (94% response rate. Results Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years. The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. Conclusions This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care
Liliana Adela ZIMA
Brand is a trustworthy, relevant, and distinctive promise to the consumer. The Brand Manager must understand that he is responsible for the building of long term brand equity and he must keep the brand from both a Strategic and Tactical standpoint.The strategy of Adam Opel AG is focused on brand equity because it is important to add value for customer from products and services. The total sum of all the benefits, features, and associations, both functional and non-functional that make a brand...
CAMELIA I. LUNGU
Full Text Available Purpose: Highlighting risks and uncertainties reporting based on a literature review research. Objectives: The delimitation of risk management models and uncertainties in fundamental research. Research method: Fundamental research study directed to identify the relevant risks’ models presented in entities’ financial statements. Uncertainty is one of the fundamental coordinates of our world. As showed J.K. Galbraith (1978, the world now lives under the age of uncertainty. Moreover, we can say that contemporary society development could be achieved by taking decisions under uncertainty, though, risks. Growing concern for the study of uncertainty, its effects and precautions led to the rather recent emergence of a new science, science of hazards (les cindyniques - l.fr. (Kenvern, 1991. Current analysis of risk are dominated by Beck’s (1992 notion that a risk society now exists whereby we have become more concerned about our impact upon nature than the impact of nature upon us. Clearly, risk permeates most aspects of corporate but also of regular life decision-making and few can predict with any precision the future. The risk is almost always a major variable in real-world corporate decision-making, and managers that ignore it are in a real peril. In these circumstances, a possible answer is assuming financial discipline with an appropriate system of incentives.
Zacher, M T; Högele, A M; Hanschen, M; von Matthey, F; Beer, A-K; Gebhardt, F; Biberthaler, P; Kanz, K-G
Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The next step is débridement of contaminated and devitalized tissue. There are several wound closure techniques available, including adhesive tapes, staples, tissue adhesives and numerous forms of sutures. Management of specific wounds requires particular strategies. A bleeding control problem frequently occurs with scalp lacerations. Superficial scalp lacerations can be closed by alternative wound closure methods, for example by twisting and fixing hair and the use of tissue adhesives, i.e. hair apposition technique (HAT). For strongly bleeding lacerations of the scalp, the epicranial aponeurosis should be incorporated into the hemostasis. Aftercare varies depending on both the characteristics of the wound and those of the patient and includes adequate analgesia as well as minimizing the risk of infection. Sufficient wound aftercare starts with the treating physician informing the patient about the course of events, potential complications and providing relevant instructions.
Full Text Available RFID middleware is anticipated to one of the main research areas in the field of RFID applications in the near future. The Data EPC Acquisition System (DEPCAS is an original proposal designed by our group to transfer and apply fundamental ideas from System and Data Acquisition (SCADA systems into the areas of RFID acquisition, processing and distribution systems. In this paper we focus on how to organize and manage generic RFID sensors (edge readers, readers, PLCs, etc… inside the DEPCAS middleware. We denote by RFID Sensors Networks Management (RSNM this part of DEPCAS, which is built on top of two new concepts introduced and developed in this work: MARC (Minimum Access Reader Command and RRTL (RFID Reader Topology Language. MARC is an abstraction layer used to hide heterogeneous devices inside a homogeneous acquisition network. RRTL is a language to define RFID Reader networks and to describe the relationship between them (concentrator, peer to peer, master/submaster.
Muniraju, T M; Lillicrap, M H; Horrocks, J L; Fisher, J M; Clark, R M W; Kanagasundaram, N S
Enhanced education has been recommended to improve non-specialist management of acute kidney injury (AKI). However, the extent of any gaps in knowledge has yet to be defined fully. The aim of this study was to assess understanding of trainee doctors in the prevention, diagnosis and initial management of AKI. An anonymised questionnaire was completed by hospital-based trainees across Newcastle Renal Unit's catchment area. Responses were evaluated against a panel of pre-defined ideal answers. The median score was 9.5 out of 20 (n = 146; range 0-17) and was lower in more junior trainees. Fifty percent of trainees could not define AKI, 30% could not name more than two risk factors for AKI and 37% could not name even one indication for renal referral. These serious gaps in knowledge highlight the need for enhanced education aimed at all training grades. Organisational changes may also be required to optimise patient safety.
Barr, Margaret J.; Hurst, James C.
Creative use of future planning as a staff development tool can have short- and long-term benefits for the individual and the organization. Its potential for stimulating creativity, reducing crisis management, and developing staff cohesion is unequaled. The individual, the organization, the technology and the manager are the important factors.…
Abedi, G; Molazadeh-Mahali, Q A; Mirzaian, B; Nadi-Ghara, A; Heidari-Gorji, A M
Todays people are spending most of their time life in their workplace therefore investigation for job satisfaction related factors is necessities of researches. The purpose of this research was to analyze the effect of manager's personality traits on employee job satisfaction. The present study is a descriptive and causative-comparative one utilized on a statistical sample of 44 managers and 119 employees. It was examined and analyzed through descriptive and inferential statistics of Student's t -test (independent T), one-way ANOVA, and Kolmogorov-Smirnov test. Findings showed that the managers and supervisors with personality traits of extraversion, eagerness to new experiences, adaptability, and dutifulness had higher subordinate employee job satisfaction. However, in the neurotic trait, the result was different. The results showed that job satisfaction was low in the aspect of neurosis. Based on this, it is suggested that, before any selection in managerial and supervisory positions, candidates receive a personality test and in case an individual has a neurotic trait, appropriate interference takes place both in this group and the employees' one.
Longheu, A; Medas, F; Corrias, F; Farris, S; Tatti, A; Pisano, G; Erdas, E; Calò, P G
Gynecomastia is a common finding in male population of all ages. The aim of our study was to present our experience and goals in surgical treatment of gynecomastia. Clinical records of patients affected by gynecomastia referred to our Department of Surgery between September 2008 and January 2015 were analyzed. 50 patients were included in this study. Gynecomastia was monolateral in 12 patients (24%) and bilateral in 38 (76%); idiopathic in 41 patients (82%) and secondary in 9 (18%). 39 patients (78%) underwent surgical operation under general anaesthesia, 11 (22%) under local anaesthesia. 3 patients (6%) presented recurrent disease. Webster technique was performed in 28 patients (56%), Davidson technique in 16 patients (32%); in 2 patients (4%) Pitanguy technique was performed and in 4 patients (8%) a mixed surgical technique was performed. Mean surgical time was 80.72±35.14 minutes, median postoperative stay was 1.46±0.88 days. 2 patients (4%) operated using Davidson technique developed a hematoma, 1 patient (2%) operated with the same technique developed hypertrophic scar. Several surgical techniques are described for surgical correction of gynecomastia. If performed by skilled general surgeons surgical treatment of gynecomastia is safe and permits to reach satisfactory aesthetic results.
Full Text Available Obesity is a multifaceted subject. It has increased at an alarming rate in recent years. Being overweight increases the likelihood of a patient having associated health and social problems which may affect dental services and dental management. A review of the literature on obesity and periodontal disease suggested that they both confound each other and obesity itself has been recognized as a major risk factor for periodontal disease. It has been found that adverse effects of obesity on the periodontium may be mediated through pro-inflammatory cytokines and various other bioactive substances. This article tries to focus on the possible role of obesity and obesity-related diseases like diabetes and coronary heart diseases (CHD, as a potential contributor to periodontal disease and vice versa. The meanings of these associations can be useful for various diagnostic and treatment planning purposes.
Schaller, M; Schöfer, H; Homey, B; Hofmann, M; Gieler, U; Lehmann, P; Luger, T A; Ruzicka, T; Steinhoff, M
Although there is presently no cure for rosacea, there are several recommended treatment options available to control many of the symptoms and to prevent them from getting worse. In addition to self-help measures like avoidance of trigger factors and proper skin care, rosacea management should include topical medications as one of the first-line choices for patients with erythematous and mild to severe papulopustular rosacea. Since mixed forms of characteristic rosacea symptoms are more common, medical treatment must be symptom-tailored for each individual case and will often involve a combination therapy. Approved topical agents for the major symptoms of rosacea encompass brimonidine for erythema and ivermectin, metronidazole or azelaic acid for inflammatory lesions, all of which have shown their efficacy in numerous valid, well-controlled trials. In addition, there are several other, not approved topical treatments which are possible options that require further validation in larger well-controlled studies. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Staff Offices. 1.25 Section 1.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL STATEMENT OF ORGANIZATION AND GENERAL INFORMATION Headquarters § 1.25 Staff Offices. (a) Office of Administrative Law Judges. The Office of...
Association du personnel
The Staff Association will shortly be renewing the mandate of half of the Staff Council. This is an opportunity for you to become more directly involved in the Staff Association's work and help promote and defend the staff's interests and, more broadly, those of the Organization itself.
You were many to attend the public information meetings organised in October and we thank you for your interest. In this decision phase of the current Five-Yearly Review of our employment conditions they provided an opportunity to review the Management proposals in detail. They were a moment of exchange also on the various topics under review, and your comments were many and very valuable. Meeting on Thursday 29th October, the Staff Council discussed once more these proposals. It considered that the "package" of proposed measures is not balanced enough in its current form. It decided to formulate additional requests to the Management, relating mainly to the effects of the introduction of the proposed new career system. The resolution adopted this morning also implies that the consultation of staff, originally foreseen next week, is postponed. The staff Council will reconvene in a special session on Thursday, 5th November to reassess its position depending on the progress made regarding its d...
Moniz, Jr, Richard
Aimed at library science students and librarians with newly assigned administrative duties the book is about improving one's thinking and decision making in a role as a library manager. Most librarians get very little exposure to management issues prior to finding themselves in a management role. Furthermore, most library science students do not expect that they will need to understand management yet they quickly find that there is a need to understand this perspective to be effective at almost any library job. Effective library management is about having some tools to make decisions (such as
... Management Plan/Final Environmental Impact Statement, Hampton National Historic Site, Maryland AGENCY...) announces the availability of the Final Environmental Impact Statement for the General Management Plan.../Baltimore County Library, 320 York Avenue, Towson, Maryland 21204. Baltimore County Tourism Office and...
... 7 Agriculture 11 2010-01-01 2010-01-01 false Chief of Staff. 1700.27 Section 1700.27 Agriculture... GENERAL INFORMATION Agency Organization and Functions § 1700.27 Chief of Staff. The Chief of Staff aids and assists the Administrator and the Deputy Administrator. The Chief of Staff advises the...
Hutton, Scott; Gates, Donna
The purpose of this study was to examine incivility experienced by direct health care staff in their workplaces. The sample (N = 184) was 91% female and 77% White, with 71% of the participants having earned an associate degree or above and 81% being registered nurses. The Work Limitations Questionnaire and the Incivility in Healthcare Survey were distributed to all direct care staff at a major metropolitan hospital (22% response rate). Correlations were found between workplace incivility from direct supervisors and productivity (r = 0.284, p = .000) and workplace incivility from patients and productivity (r = 0.204, p = .006). Incivility from physicians, incivility from other direct care staff, and general environmental incivility were not shown to be significantly related to productivity. Demographics were not related to levels of workplace incivility. Workplace incivility from patients and management appears to have a greater impact on employees' productivity than workplace incivility from other sources.
Rayner, Jennifer; Muldoon, Laura
To examine perceptions of different staff groups about team functioning in mature, community-governed, interprofessional primary health care practices. Cross-sectional online survey. The 75 community health centres (CHCs) in Ontario at the time of the study, which have cared for people with barriers to access to traditional health services in community-governed, interprofessional settings, providing medical, social, and community services since the 1970s. Managers and staff of primary care teams in the CHCs. Scores on the short version of the Team Climate Inventory (with subscales addressing vision, task orientation, support for innovation, and participative safety), the Organizational Justice Scale (with subscales addressing procedural justice and interactional justice), and the Organizational Citizenship Behavior Scale, stratified by staff group (clinical manager, FP, nurse practitioner [NP], registered nurse, medical secretary, social worker, allied health provider, counselor, outreach worker, and administrative assistant). A total of 674 staff members in 58 of 75 (77%) CHCs completed surveys. All staff groups generally reported positive perceptions of team function. The procedural justice subscale showed the greatest variation between groups. Family physicians and NPs rated procedural justice much lower than nurses and administrators did. This study provides a unique view of the perceptions of different groups of staff in a long-standing interprofessional practice model. Future research is needed to understand why FPs and NPs perceive procedural justice more negatively than other team members do, and whether such perceptions affect outcomes such as staff turnover and health outcomes for patients. Copyright© the College of Family Physicians of Canada.
Ji Cunxing; Ran Muzi; Shi Lei; Cui Hannan; Wang Gang; Hou Yanli; Li Qilong
In view of some questions encountered in operation process of quality management system in general agent of nuclear plants of CNNC China Nuclear Power Engineering Co., Ltd. Discussion is made on the questions from four aspect, which should be paid attentions in operation and improvement in order to perfect enterprise management system, increase management level, competitive power to ensurereliable and stable incomes for enterprises. (authors)
Ormel, J.; Koeter, M. W. J.; van den Brink, W.; van de Willige, G
This article addresses the issues of recognition of psychiatric disorders by general physicians (GPs) and the effects of recognition on management and course. Among 1994 patients who were screened with the General Health Questionnaire and who were rated by their GP, 1450 (72.7%) had not been
Association du personnel
Becoming a member of the Staff Association (SA) is above all a personal choice, showing that the joining person’s commitment and adherence to values such as solidarity, social cohesion, etc.In September, the SA launches a membership campaign to convince a maximum number to join, to inform, arouse interest and support. Posters, emails and individual contacts are part of the campaign programme, just like this editorial. As far as individual contacts are concerned, we ask you to give time and lend an ear to the delegates of your department in the Staff Council, who will approach you, in order to make an open and constructive discussion possible. Do not hesitate to ask questions and let them know your thoughts about the SA, as (constructive) criticism enables us to progress. The Staff Association and its role of collective representation The Staff Association, via its delegates, represents collectively all staff of the Organization before the Director-General and Member States. To do this, staff rep...
Page S20: NMR compound 4i. Page S22: NMR compound 4j. General: Chemicals were purchased from Fluka, Merck and Aldrich Chemical Companies. All the products were characterized by comparison of their IR, 1H NMR and 13C NMR spectroscopic data and their melting points with reported values. General procedure ...
Jensen, J. [Jensen Consult, Virum (Denmark)
With more than 100 participants entering the exercise RESUME-95 the Exercise Planning Committee decided to establish an operational staff named Directing Staff (DISTAFF) to ensure that the exercise plan was followed, the planned activities were carried out and to intervene if anything went wrong. In general the duties of the operational staff involve tasks such as secretarial assistance, keeping log of the progress of the situation and gathering, updating and distributing information on all aspects of the situation. Throughout the entire event it is the staff`s responsibility to keep a general view of the current situation and to make the necessary plans for the progress of the situation based on the available information. Furthermore the staff should ensure necessary contact to the public and to the media. (au).
Stoesz, Brenda M.; Shooshtari, Shahin; Montgomery, Janine; Martin, Toby; Heinrichs, Dustin J.; Douglas, Joyce
Members of a knowledge translation and exchange (KTE) research team assessed the training needs of the teaching staff at a school for individuals with intellectual/developmental disabilities (IDD). In response to this need, KTE researchers retrieved peer-reviewed articles for training staff working with individuals with IDD who exhibit challenging…
Full Text Available Abstract Background The influenza vaccination rate in hospitals among health care workers in Europe remains low. As there is a lack of research about management factors we assessed factors reported by administrators of general hospitals that are associated with the influenza vaccine uptake among health care workers. Methods All 81 general hospitals in the Netherlands were approached to participate in a self-administered questionnaire study. The questionnaire was directed at the hospital administrators. The following factors were addressed: beliefs about the effectiveness of the influenza vaccine, whether the hospital had a written policy on influenza vaccination and how the hospital informed their staff about influenza vaccination. The questionnaire also included questions about mandatory vaccination, whether it was free of charge and how delivered as well as the vaccination campaign costs. The outcome of this one-season survey is the self-reported overall influenza vaccination rate of health care workers. Results In all, 79 of 81 hospitals that were approached were willing to participate and therefore received a questionnaire. Of these, 42 were returned (response rate 52%. Overall influenza vaccination rate among health care workers in our sample was 17.7% (95% confidence interval: 14.6% to 20.8%. Hospitals in which the administrators agreed with positive statements concerning the influenza vaccination had a slightly higher, but non-significant, vaccine uptake. There was a 9% higher vaccine uptake in hospitals that spent more than €1250,- on the vaccination campaign (24.0% versus 15.0%; 95% confidence interval from 0.7% to 17.3%. Conclusions Agreement with positive statements about management factors with regard to influenza vaccination were not associated with the uptake. More economic investments were related with a higher vaccine uptake; the reasons for this should be explored further.
Houenassi, Martin Dèdonougbo; Codjo, Léopold Houétondji; Dokoui, David; Dohou, Serge Hugues Mahougnon; Wanvoegbe, Armand; Agbodande, Anthelme; Attinsounon, Angelo Cossi; Alassani, Adebayo; Ahoui, Séraphin; Dovonou, Albert Comlan; Adoukonou, Thierry Armel
We aimed to assess the management of hypertensive patients by general practitioners in Cotonou city. This was a cross-sectional study based on a multicentre survey conducted from 1 May to 31 July 2011. We recruited all consenting general practitioners who worked in public and private centres in Cotonou city. We used the 7th report of the Joint National Committee to assess the management of hypertension by general practitioners. A tested and validated self-questionnaire was used to collect the data on hypertension management by general practitioners. In eight centres that approved the study, 41 general practitioners were included. The definition of hypertension was known by 20 (48.8%) practitioners. Only 25 (61.0%) could describe the conditions for blood pressure measurement. Ten of them were unable to list half of the minimum recommended tests for hypertension, and the majority (92.7%) did not have any idea of global cardiovascular risk. The blood pressure goal was known by only 18 (43.9%) practitioners. Lifestyle (82.9%) and monotherapy (70.7%) were the therapeutic modalities most prescribed. Antihypertensive agents commonly used by practitioners were calcium channel blockers (82.9%), angiotensin converting enzyme inhibitors (53.7%) and diuretics (36.6%). The general practitioners referred their patients to cardiologists mainly for uncontrolled hypertension (63.4%) and the onset of acute complications (56.1%). The general practitioners' knowledge of hypertension was insufficient and their management did not reflect international guidelines.
Best, Alexandra D; Shroff, Bhavna; Carrico, Caroline K; Lindauer, Steven J
To investigate differences in case selection, treatment management, and aligner treatment expertise between orthodontists and general practitioners. A parallel pair of original surveys with three sections (case selection, treatment management, and demographics) was sent to orthodontists (N = 1000) and general dentists (N = 1000) who were providers of aligner treatment. Orthodontists had treated significantly more patients with aligners, had treated more patients with aligners in the previous 12 months, and had received more aligner training than general dentists (P aligner case confidence between orthodontists and general dentists for several malocclusions. General dentists were more confident than orthodontists in treating deep bite, severe crowding, and Class II malocclusions with aligners (P ≤ .0001). Significant differences were also found for all treatment management techniques except interproximal reduction. There was a significant difference in case selection, treatment management, and aligner expertise between orthodontists and general dentists, although the differences in case selection were small. Overall, it was shown that orthodontists and general dentists elected to treat a variety of moderate to severe malocclusions with aligners but with different utilization of recommended auxiliaries, perhaps demonstrating a difference in treatment goals.
... 32 National Defense 2 2010-07-01 2010-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...
Chadès, Iadine; Martin, Tara G; Nicol, Samuel; Burgman, Mark A; Possingham, Hugh P; Buckley, Yvonne M
The efficient management of diseases, pests, or endangered species is an important global issue faced by agencies constrained by limited resources. The management challenge is even greater when organisms are difficult to detect. We show how to prioritize management and survey effort across time and space for networks of susceptible-infected-susceptible subpopulations. We present simple and robust rules of thumb for protecting desirable, or eradicating undesirable, subpopulations connected in typical network patterns (motifs). We further demonstrate that these rules can be generalized to larger networks when motifs are combined in more complex formations. Results show that the best location to manage or survey a pest or a disease on a network is also the best location to protect or survey an endangered species. The optimal starting point in a network is the fastest motif to manage, where line, star, island, and cluster motifs range from fast to slow. Managing the most connected node at the right time and maintaining the same management direction provide advantages over previously recommended outside-in strategies. When a species or disease is not detected and our belief in persistence decreases, our results recommend shifting resources toward management or surveillance of the most connected nodes. Our analytic approximation provides guidance on how long we should manage or survey networks for hard-to-detect organisms. Our rules take into account management success, dispersal, economic cost, and imperfect detection and offer managers a practical basis for managing networks relevant to many significant environmental, biosecurity, and human health issues.
Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.
Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko
In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.
Cerinus, Marie; Shannon, Marina
This article, the second in a series of articles on Leading Better Care, describes the actions undertaken in recent years in NHS Lanarkshire to improve selection processes for nursing, midwifery and allied health professional (NMAHP) posts. This is an area of significant interest to these professions, management colleagues and patients given the pivotal importance of NMAHPs to patient care and experience. In recent times the importance of selecting staff not only with the right qualifications but also with the right attributes has been highlighted to ensure patients are well cared for in a safe, effective and compassionate manner. The article focuses on NMAHP selection processes, tracking local, collaborative development work undertaken to date. It presents an overview of some of the work being implemented, highlights a range of important factors, outlines how evaluation is progressing and concludes by recommending further empirical research.
Lone Marie Larsen
Full Text Available Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs and practice nurses participating in a randomised controlled trial (RCT comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health professionals considered it their responsibility to offer a management programme to overweight children. They recognised that management of overweight during childhood was a complex task that required an evidence-based strategy with the possibility of supervision. Health professionals experienced a barrier to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised that they have a special obligation, capacity, and role in the management of obesity in childhood. Implementation of future management programmes must address existing barriers beyond an evidence-based standardised strategy.
Sørensen, M. D.; Clausen, Jens
Typically, ground staff scheduling is centrally planned for each terminal in an airport. The advantage of this is that the staff is efficiently utilized, but a disadvantage is that staff spends considerable time walking between stands. In this paper a decentralized approach for ground staff...... scheduling is investigated. The airport terminal is divided into zones, where each zone consists of a set of stands geographically next to each other. Staff is assigned to work in only one zone and the staff scheduling is planned decentralized for each zone. The advantage of this approach is that the staff...... work in a smaller area of the terminal and thus spends less time walking between stands. When planning decentralized the allocation of stands to flights influences the staff scheduling since the workload in a zone depends on which flights are allocated to stands in the zone. Hence solving the problem...
Association du personnel
The Staff Association will shortly be renewing the mandate of half of the Staff Council. This is an opportunity for you to become more directly involved in the Staff Association’s work and help promote and defend the staff’s interests and, more broadly, those of the Organization itself.
Full Text Available The purpose of this study was to investigate the effectiveness of parent behavioral management training on general health of mothers with ADHD children. A quasi-experimental design with pre-test, post-test and follow-up with control group was applied. This sample included 30 mothers of ADHD children who were selected through screening method with using CSI - 4 scale and psychiatrist clinical interview among recorded files in Esfahan counseling center and subjects were randomly assigned to experimental and control groups, and filled measure of general health questionaire. Mothers in the experimental group received nine 2-hour sessions of behavioral management training. Results of repeated measure analyzes showed that behavioral management training has been effective significantly in increasing general health of mothers.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Staff. 600.5 Section 600.5 Judicial Administration OFFICES OF INDEPENDENT COUNSEL, DEPARTMENT OF JUSTICE GENERAL POWERS OF SPECIAL COUNSEL § 600.5 Staff. A Special Counsel may request the assignment of appropriate Department employees to assist the...
Blankenship Charles L
Full Text Available Abstract Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.
2013 Elections to Staff Council Vote! Make your voice heard and be many to elect the new Staff Council. More details on the elections can be found on the Staff Association web site (https://ap-vote.web.cern.ch/elections-2013). Timetable elections Monday 28 October to Monday 11 November, 12:00 am voting Monday 18 and Monday 25 November, publication of the results in Echo Tuesday 19 November, Staff Association Assizes Tuesday 3 December, first meeting of the new Staff Council and election of the new Executive Committee The voting procedure is monitored by the Election Committee.
Friedl, W; Karches, C
Head traumas frequently occur in polytrauma patients but are also found as isolated injuries. In our hospital trauma center without a neurosurgical department, in a 21-month period, 489 patients with head/brain trauma were treated. This represents 6.5% of all patients treated in the trauma and reconstructive surgery clinic. In commotio cerebri (CC = 89.5% of the patients) constant conservative management and an uneventful course were observed; in 69 patients with contusio cerebri, 18 craniotomy operations had to be performed. In contrast, in only two cases was reoperation because of recurrent hematoma necessary. In four cases with complex and/or additional injuries, transfer to a neurosurgical center took place, and in two cases photophone consultation with that center was used. The mortality was 14.5%. The diagnostic and therapeutic regimens for the different types of injury and the requirements for the management of head/brain trauma in trauma centers without neurosurgical departments are presented: emergency service and medical staff, emergency room management, intensive care management, qualified neurological examination, X-ray imaging, including CT scan, OP-room equipment and trained surgeons. If these requirements are not available in a given hospital, early transfer of all patients for whom surgical management could be necessary to a neurosurgical department should be attempted. Only in patients with severe bleeding must immediate craniotomy be performed even in hospitals which do not have all the above mentioned facilities. In patients with intracerebral bleeding, bleeding in the dorsal fossa, injury of brain nerves, carotid artery or sinus cavernosus injuries, frontobasal injuries with liquor fistula or pneumonencephalon, transfer of the patients to specialized neurosurgical centers is indicated. With this selection, we obtained the same results in a trauma center without a neurosurgical department as reported in the literature. This avoids overloading
I. B. Ardashkin
Full Text Available The aim of the research is to analyze and summarize the Russian best practices of using the publication activity as a criterion to assess the professional activity of the academic staff; to identify the role of motivational factors as a method to manage and control the publication activity of the academic staff.Methods. The authors address the methodology of comprehensive research based on the method of document analysis, comparative analysis, and method of secondary use of sociological and psychological data.Results and scientific novelty concludes in presenting Russian and international best practices generalized on using the publication activity to assess the engagement of HEI (Higher Educational Institution academic staff; the most appropriate formats of using the publication activity as a criterion to assess the research component of the academic staff engagement are defined. Degree of reliability of this criterion is shown – its strengths and shortcomings. The conclusion is drawn on need of the essential changes in management of publication activity affecting both professional and motivational spheres of scientific and pedagogical staff. The most acceptable options of measurement of staff work efficiency of this category are formulated.Practical significance. The research outcomes can be the corpus for designing the assessment method for the professional engagement of the academic staff.
Full Text Available Introduction: General practitioners (GPs are key participants in osteoporosis (OP management. The aim was to evaluate their adherence to lege artis management of the disease, potential barriers, and to discuss differences observed in comparison with the baseline survey carried out in 2007; the focus was on secondary prevention.Methods: On behalf of two professional associations, 2-round postal survey among randomly selected GPs (>1/4 of all Czech GPs was performed in 2014. The questionnaire covered areas concerning GP's role in the fight against OP, knowledge about OP, management of OP-related fractures, barriers to the management of OP, system- and patient-related in particular, and availability and use of information sources.Results: The overall questionnaire return rate was 37% (551 respondents; mean age of the respondents was 53 year (37% men. The GP's role in the treatment of OP was rated as essential in 28 and 37% of men and women, respectively (P = 0.012. The guideline for diagnosis and treatment of OP for GPs was considered accessible by 92% of respondents. As much as 60% of the respondents were adherent to the guideline, i.e., used it repeatedly. The knowledge of several risk factors was very good, however, recommended daily intake of calcium was stated correctly by only 41% of respondents, and daily intake of vitamin D by only 40%. Three quarters reported active steps after a fracture: referral to a specialist, life-style recommendations, prescription of calcium/vitamin D supplements. Half of the respondents focus on fall prevention. System-related barriers, such as lack of possibility to prescribe selected drugs (61% and financial limits set by health insurance company (44% were most frequently reported. Patient-related barriers were also common, patient's non-adherence (reported by 29% and patient's reluctance to go to a specialist (18%.Conclusion: GPs adhered to OP management more than in 2007. Knowledge of risk factors and
Peters, I; Meyer, F
Clinical departments are constantly faced with complex and novel tasks, which have to be managed with suitable approaches. This article describes selected aspects of project management in this context. In particular, it concentrates on the advantages and limitations of project management methods that have been established in industrial companies when used in a clinical setting. Also it compares the daily reality in clinical departments and industrial companies and highlights possible associations between surgery and project management. Besides aspects such as project planning, role definitions within projects and their specific casting in clinics, the article also demonstrates key success factors for an effective implementation of projects and a general introduction to project management in clinics. The article combines theoretical approaches with practical experience and thought-provoking impulses. Georg Thieme Verlag KG Stuttgart · New York.
Robledo-Sierra, J; van der Waal, I
The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment.
Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)
To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated. 11 refs., 3 figs., 3 tabs. (Author)
Yang, Soo Hyung; Kim, Soo Hyung; Jeong, Young Hoon; Chang, Soon Heung
To enhance the safety of nuclear power plants, implementation of accident management has been suggested as one of most important programs. Specially, accident management strategies are suggested as one of key elements considered in development of the accident management program. In this study, generally applicable accident management strategies to domestic nuclear power plants are identified through reviewing several accident management programs for the other countries and considering domestic conditions. Identified strategies are as follows; 1) Injection into the Reactor Coolant System, 2) Depressurize the Reactor Coolant System, 3) Depressurize the Steam Generator, 4) Injection into the Steam Generator, 5) Injection into the Containment, 6) Spray into the Containment, 7) Control Hydrogen in the Containment. In addition, the systems and instrumentation necessary for the implementation of each strategy are also investigated
Zucconi, Aurélie; Courjon, Johan; Maruéjouls, Christophe; Saintpère, Fabrice; Degand, Nicolas; Pandiani, Lilli; Pradier, Christian; Mondain, Véronique
In Southern France, approximately 4% of E. coli isolates from community-acquired urinary tract infections are extended spectrum beta-lactamase producers, while carriage rates for enterobacteriaceae (ESBL-E) range from 3 to 6%. General practitioners (GP) are unfamiliar with the management of patients harboring ESBL-E. Providing them with a specific tool kit should assist in their therapeutic approach and optimize antimicrobial prescription an ESBL-E tool kit was developed by a multidisciplinary team: infectious diseases (ID) specialists, microbiologists, pharmacologists, and nursing home staff. This tool kit includes treatment protocols, GP and patient information leaflets, a list of infection control measures, and contact details of ID physicians for specialized advice. A community-based (including nursing homes) prospective study was conducted in 2012 in Southeastern France to test the tool kit in the context of ESBL-E-related urinary tract infections (UTI). ESBL-E-related UTI were identified in 88 patients, 66 GPs were contacted by the microbiology laboratory, 56 stated they were offered the tool kit, 48 said they had received it, and 41 stated they had read its contents. Use of the tool kit was significantly correlated with appropriate antibiotic prescription, which concerned 36/39 tool kit users versus 13/20 non-users (p = 0.0125) and 40 GPs expressed an average satisfaction rate of 4.2 on a scale of 0 to 5. Availability of a specific tool for managing patients harboring ESBL-E, now completed with a website, can assist community-based GPs and improve antimicrobial prescription.
Proudfoot, Judith; Jayasinghe, Upali W; Holton, Chris; Grimm, Jane; Bubner, Tanya; Amoroso, Cheryl; Beilby, Justin; Harris, Mark F
Teamwork in primary healthcare is associated with patient care processes and staff outcomes. The ability of teams to be innovative is a hypothesized mechanism. We examined the characteristics of general practices with good team climate for innovation, and assessed the impact of climate on chronically ill patients' assessment of their care and on the job satisfaction of the staff. Large cross-sectional study. Australian general practices. A total of 654 general practitioners and staff and 7505 chronically ill patients from 93 general practices in 6 Australian states and territories. The Team Climate Inventory and the Overall Job Satisfaction Scale, customized for use with general practices, were administered to general practitioners and practice staff, and the General Practice Assessment Survey was administered to patients. Practice characteristics were collected by survey from the principal doctor or practice manager. Mean scores of team climate in Australian general practices were similar to those reported in the UK, except that in our study there was no association between the number of doctors in a practice and their team climate. Better team climate was found in practices with fewer non-clinical staff. Team climate predicted the job satisfaction of the general practitioners and staff, irrespective of the number of practice staff. Better team climate was associated with greater satisfaction by patients with their care. Team climate is important for patient and staff satisfaction. In large general practices, separate sub-cultures may exist between administrative and clinical staff, which has implications for designing effective team interventions.
With more than 100 participants entering the exercise RESUME-95 the Exercise Planning Committee decided to establish an operational staff named Directing Staff (DISTAFF) to ensure that the exercise plan was followed, the planned activities were carried out and to intervene if anything went wrong. In general the duties of the operational staff involve tasks such as secretarial assistance, keeping log of the progress of the situation and gathering, updating and distributing information on all aspects of the situation. Throughout the entire event it is the staff's responsibility to keep a general view of the current situation and to make the necessary plans for the progress of the situation based on the available information. Furthermore the staff should ensure necessary contact to the public and to the media. (au)
Elmelegy, Reda Ibrahim
The current research aims at clarifying how school-based management (SBM) can contribute to achieve the decision-making quality in Egyptian general secondary schools and determine the requirements of quality decision-making. It depends on the descriptive method in order to acknowledge the basics of the SBM and its relationship with the quality of…
Griffiths, David; Evans, Peter
Purpose: The purpose of the paper is to explore coherence across key disciplines of knowledge management (KM) for a general model as a way to address performance dissatisfaction in the field. Design/methodology/approach: Research employed an evidence-based meta-analysis (287 aspects of literature), triangulated through an exploratory survey (91…
... written responses to: Cindy Orlando, Superintendent, Attn: General Management Planning Team, Hawaii..., Naalehu, Kailua-Kona), on Oahu (Honolulu), and on Maui (Kahului). Additional meetings were held in August..., including planning process milestones, meeting notices, reports and documents, and useful links associated...
Lee, Leslie A.; Wu, Michelle M.
Access services is not unique in its need for effective personnel management. A review of the literature indicates that there are many publications on or relating to library personnel administration; however, relatively few of them are dedicated to the narrow topic of access services. As such, this review encompasses literature that is general to…
Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.
This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were
Latour-Delfgaauw, C.H.M.; Vos, R.; Huyse, F.J.; de Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.
This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were
Latour-Delfgaauw, C.H.M.; van der Windt, D.A.W.M.; de Jonge, P.; Riphagen, II; Vos, R.; Huyse, F.J.; Stalman, W.A.B.
Objective: The aim of this study was to summarize the available literature on the effectiveness of ambulatory nurse-led case management for complex patients in general health care. Method: We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register, and Cinahl. We included randomized
Latour, C.H.M.; de Vos, R.; Huyse, F.J.; De Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.
This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)
Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.
This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)
Al dakeel, Taghreed M.; Almannie, Mohamed A.
The general school district of Riyadh is one of largest in the country of (45) school districts in Saudi Arabia. The school districts play an important roles in the development of education, therefore the objective of the study is to examine the roles of the management in the school districts to see if it is achieving competitive advantage. After…
Although many IS programs nationwide use capstone courses in the major, this paper reports on the use of an upper division Management Information Systems (MIS) class as a general education requirements (GER) capstone. The class is a core requirement for all majors in the Bachelor of Business Administration (BBA) program at the University of Alaska…
... Notice of Intent to prepare an EIS for the General Management Plan (GMP) was published in the Federal... parkwide cultural and natural resource protection, wilderness stewardship, administration and operations... quality of the human environment, nor any potential for impairment of monument resources and values. Most...
Tassone, Peter; Georgalas, Christos; Appleby, Esther; Kotecha, Bhik
This study aims to assess the management of patients with epistaxis by general practitioners (GPs) and to show whether previous experience as a junior doctor in ear, nose and throat (ENT) surgery influences their practice. A questionnaire was sent together with self-addressed reply envelopes to a
..., but will follow contemporary best practices for land management within select areas. A learning center... Record of Decision for the General Management Plan/Environmental Impact Statement for the Roosevelt... General Management Plan/Environmental Impact Statement (GMP/ EIS) for the Roosevelt-Vanderbilt National...
Appleby, Natalie J; Temple-Smith, Meredith J; Stacey, Margaret A; Bailey, Denise L; Deveny, Elizabeth M; Pirotta, Marie
Dry mouth (xerostomia) is common and can have significant consequences for a patient's general and oral health. Multiple medications may compromise the flow and quality of saliva. This study explored general practitioners' (GPs') perceptions, knowledge and management of dry mouth, and whether consideration of oral health influences prescribing patterns. Semi-structured interviews with 20 GPs in Melbourne, Victoria, were audiotaped, transcribed and analysed. GPs who participated in the study were aware of dry mouth, but diagnosed it infrequently. They had limited knowledge about the oral health implications and management of dry mouth, with some offering potentially harmful advice. Some participants reported that dry mouth would influence their prescribing, but few referred patients to dentists for management. Dry mouth is not on GPs' radar, and patients are rarely questioned about this during routine medical examinations. GPs in this study would welcome additional information to enhance patients' oral health and patient resources on dry mouth.
Marius Emil PATRICHI
Full Text Available The switch from conscript’s army to an all volunteer force military brought new challenges for the military organization. This is more obvious in the human resource domain than in any other area. In the competition to recruit and retain quality personnel, the military organizations should strategically align the human resource management to the overall strategy. The challenges are greater for the Special Forces because the need for a rigorous selection process to recruit from within the military. The rift already in place between the conventional military and the Special Forces need to be overcome to transform the strain relationship into a positive sum game..
In accordance with Article VII.E of the Statute and of the general principles approved by the General Conference in resolution GC.1(S)/RES/13, the Board of Governors has established 'the terms and conditions on which the Agency's staff shall be appointed, remunerated and dismissed.' The Provisional Staff Regulations thus approved and amended by the Board up to 15 January 1959 are reproduced in this document for the information of all Members of the Agency
The support-control continuum: An investigation of staff perspectives on factors influencing the success or failure of de-escalation techniques for the management of violence and aggression in mental health settings.
Price, Owen; Baker, John; Bee, Penny; Lovell, Karina
De-escalation techniques are recommended to manage violence and aggression in mental health settings yet restrictive practices continue to be frequently used. Barriers and enablers to the implementation and effectiveness of de-escalation techniques in practice are not well understood. To obtain staff descriptions of de-escalation techniques currently used in mental health settings and explore factors perceived to influence their implementation and effectiveness. Qualitative, semi-structured interviews and Framework Analysis. Five in-patient wards including three male psychiatric intensive care units, one female acute ward and one male acute ward in three UK Mental Health NHS Trusts. 20 ward-based clinical staff. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analysed using a qualitative data analysis software package. Participants described 14 techniques used in response to escalated aggression applied on a continuum between support and control. Techniques along the support-control continuum could be classified in three groups: 'support' (e.g. problem-solving, distraction, reassurance) 'non-physical control' (e.g. reprimands, deterrents, instruction) and 'physical control' (e.g. physical restraint and seclusion). Charting the reasoning staff provided for technique selection against the described behavioural outcome enabled a preliminary understanding of staff, patient and environmental influences on de-escalation success or failure. Importantly, the more coercive 'non-physical control' techniques are currently conceptualised by staff as a feature of de-escalation techniques, yet, there was evidence of a link between these and increased aggression/use of restrictive practices. Risk was not a consistent factor in decisions to adopt more controlling techniques. Moral judgements regarding the function of the aggression; trial-and-error; ingrained local custom (especially around instruction to low stimulus areas); knowledge of
Rabøl, Louise Isager; Andersen, Mette Lehmann; Østergaard, Doris
incidents. The objective of this study is to review RCA reports (RCAR) for characteristics of verbal communication errors between hospital staff in an organisational perspective. Method Two independent raters analysed 84 RCARs, conducted in six Danish hospitals between 2004 and 2006, for descriptions...... and characteristics of verbal communication errors such as handover errors and error during teamwork. Results Raters found description of verbal communication errors in 44 reports (52%). These included handover errors (35 (86%)), communication errors between different staff groups (19 (43%)), misunderstandings (13...... (30%)), communication errors between junior and senior staff members (11 (25%)), hesitance in speaking up (10 (23%)) and communication errors during teamwork (8 (18%)). The kappa values were 0.44-0.78. Unproceduralized communication and information exchange via telephone, related to transfer between...
Saito, Hajime; Minamiya, Yoshihiro
Due to the recent advances in radiological diagnostic technology, the role of video-assisted thoracoscopic surgery in thoracic disease has expanded, surgical indication extended to the elderly patients. Cancer patients receiving surgery, radiation therapy and/or chemotherapy may encounter complications in conjunction with the oral cavity such as aspiration pneumonia, surgical site infection and various type of infection. Recently, it is recognized that oral health care management is effective to prevent the postoperative infectious complications, especially pneumonia. Therefore, oral management should be scheduled before start of therapy to prevent these complications as supportive therapy of the cancer treatment. In this background, perioperative oral function management is highlighted in the remuneration for dental treatment revision of 2012,and the importance of oral care has been recognized in generally. In this manuscript, we introduce the several opinions and evidence based on the recent previous reports about the perioperative oral health care and management on thoracic surgery.
Full Text Available In the article, the analysis of the operation of power plants in the conditions of economic restructuring to ensure successful entry into the market is carried out. The analysis of the five management structures, including current, typical structure and re-designed by the authors is presented. There are developed the partial efficiency criteria of the management structures that characterize the most important properties - the balance, integrity, controllability and stability. Local criteria of the analyzed structures do not allow to make a definite conclusion about the effectiveness of one of the structures analyzed, formulated global efficiency criterion. There is developed the global criterion of the comparative effectiveness of the management systems based on the DEA method (Data envelopment analysis, taking into account the complex of the proposed local criteria. The considered management structures are ranked based on the generalized criterion of efficiency.
Outi Annelli Tuominen and colleagues write in Nursing Management about the use of an Excel-based scheduling system for reallocation of nursing staff, which was trialled on ward managers and assistant ward managers.
Rabøl, Louise Isager; Andersen, Mette Lehmann; Østergaard, Doris
Introduction Poor teamwork and communication between healthcare staff are correlated to patient safety incidents. However, the organisational factors responsible for these issues are unexplored. Root cause analyses (RCA) use human factors thinking to analyse the systems behind severe patient safety...... incidents. The RCARs rich descriptions of the incidents revealed the organisational factors and needs related to these errors....... incidents. The objective of this study is to review RCA reports (RCAR) for characteristics of verbal communication errors between hospital staff in an organisational perspective. Method Two independent raters analysed 84 RCARs, conducted in six Danish hospitals between 2004 and 2006, for descriptions...
Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth
This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.
De Rijdt, Catherine; Dochy, Filip; Bamelis, Sofie; van der Vleuten, Cees
Educational institutions offer diverse staff development programmes to allow staff members to keep up with educational innovations and to guarantee educational quality. The current study investigates by means of a survey and semi-structured interviews whether the teacher perceives staff development as a management model, a shop-floor model or a…
Cresswell Kathrin M
Full Text Available Abstract Background There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER intervention, which substantially reduced the risk of clinically important errors in medicines management in primary care. Methods Data were collected at two geographical locations in central England through a combination of one-to-one longitudinal semi-structured telephone interviews (one at the beginning of the trial and another when the trial was well underway, relevant documents, and focus group discussions following delivery of the PINCER intervention. Participants included PINCER pharmacists, general practice staff, researchers involved in the running of the trial, and primary care trust staff. PINCER pharmacists were interviewed at three different time-points during the delivery of the PINCER intervention. Analysis was thematic with diffusion of innovation theory providing a theoretical framework. Results We conducted 52 semi-structured telephone interviews and six focus group discussions with 30 additional participants. In addition, documentary data were collected from six pharmacist diaries, along with notes from four meetings of the PINCER pharmacists and feedback meetings from 34 practices. Key findings that helped to explain the success of the PINCER intervention included the perceived importance of focusing on prescribing errors to all stakeholders, and the credibility and appropriateness of a pharmacist-led intervention to address these shortcomings. Central to this was the face-to-face contact and relationship building between pharmacists and a range of practice staff, and pharmacists’ explicitly designated role as a change agent
An embedded longitudinal multi-faceted qualitative evaluation of a complex cluster randomized controlled trial aiming to reduce clinically important errors in medicines management in general practice.
Cresswell, Kathrin M; Sadler, Stacey; Rodgers, Sarah; Avery, Anthony; Cantrill, Judith; Murray, Scott A; Sheikh, Aziz
There is a need to shed light on the pathways through which complex interventions mediate their effects in order to enable critical reflection on their transferability. We sought to explore and understand key stakeholder accounts of the acceptability, likely impact and strategies for optimizing and rolling-out a successful pharmacist-led information technology-enabled (PINCER) intervention, which substantially reduced the risk of clinically important errors in medicines management in primary care. Data were collected at two geographical locations in central England through a combination of one-to-one longitudinal semi-structured telephone interviews (one at the beginning of the trial and another when the trial was well underway), relevant documents, and focus group discussions following delivery of the PINCER intervention. Participants included PINCER pharmacists, general practice staff, researchers involved in the running of the trial, and primary care trust staff. PINCER pharmacists were interviewed at three different time-points during the delivery of the PINCER intervention. Analysis was thematic with diffusion of innovation theory providing a theoretical framework. We conducted 52 semi-structured telephone interviews and six focus group discussions with 30 additional participants. In addition, documentary data were collected from six pharmacist diaries, along with notes from four meetings of the PINCER pharmacists and feedback meetings from 34 practices. Key findings that helped to explain the success of the PINCER intervention included the perceived importance of focusing on prescribing errors to all stakeholders, and the credibility and appropriateness of a pharmacist-led intervention to address these shortcomings. Central to this was the face-to-face contact and relationship building between pharmacists and a range of practice staff, and pharmacists' explicitly designated role as a change agent. However, important concerns were identified about the likely
Andrew K. Carlson,; William W. Taylor,; Hartikainen, Kelsey M.; Dana M. Infante,; Beard, Douglas; Lynch, Abigail
Global climate change is predicted to increase air and stream temperatures and alter thermal habitat suitability for growth and survival of coldwater fishes, including brook charr (Salvelinus fontinalis), brown trout (Salmo trutta), and rainbow trout (Oncorhynchus mykiss). In a changing climate, accurate stream temperature modeling is increasingly important for sustainable salmonid management throughout the world. However, finite resource availability (e.g. funding, personnel) drives a tradeoff between thermal model accuracy and efficiency (i.e. cost-effective applicability at management-relevant spatial extents). Using different projected climate change scenarios, we compared the accuracy and efficiency of stream-specific and generalized (i.e. region-specific) temperature models for coldwater salmonids within and outside the State of Michigan, USA, a region with long-term stream temperature data and productive coldwater fisheries. Projected stream temperature warming between 2016 and 2056 ranged from 0.1 to 3.8 °C in groundwater-dominated streams and 0.2–6.8 °C in surface-runoff dominated systems in the State of Michigan. Despite their generally lower accuracy in predicting exact stream temperatures, generalized models accurately projected salmonid thermal habitat suitability in 82% of groundwater-dominated streams, including those with brook charr (80% accuracy), brown trout (89% accuracy), and rainbow trout (75% accuracy). In contrast, generalized models predicted thermal habitat suitability in runoff-dominated streams with much lower accuracy (54%). These results suggest that, amidst climate change and constraints in resource availability, generalized models are appropriate to forecast thermal conditions in groundwater-dominated streams within and outside Michigan and inform regional-level salmonid management strategies that are practical for coldwater fisheries managers, policy makers, and the public. We recommend fisheries professionals reserve resource
This document was developed by the EPA to provide guidance to staff and managers regarding the EDSP universe of chemicals and general validation principles for consideration of computational toxicology tools for chemical prioritization.
Veenman, S.; Raemaekers, J.
This study describes the long-term effects of a staff development programme based on selected findings from teaching effectiveness research in schools with multigrade or mixed-age classes. The short-term effects of this programme were examined in two studies directed at schools with multigrade
Rabøl, Louise Isager; Andersen, Mette Lehmann; Østergaard, Doris
units and consults from other specialties, were particularly vulnerable processes. Conclusion With the risk of bias in mind, it is concluded that more than half of the RCARs described erroneous verbal communication between staff members as root causes of or contributing factors of severe patient safety...
Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 31st of October to the 14th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months and will keep the next Staff Council very busy. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (email@example.com). Do not forget to vote * * * * * * * Vote Make your voice heard and be many to elect the new Staff Council. More details on the election...
Full Text Available Introduction: At the beginning of the new century, organizations working in the field of healthcare, always felt the need of radical change and creativity work. Nowadays a new style of leadership as transformational leadership is considered, this style affects the employee careers to enhance their abilities, and thereby to create positive changes in the personnel to do things better and to strengthen and enhance the ability of employees to learn. In other hand, the concept of job involvement is also an organization important issue in which refers to psychological degree of the current jobs of the person. The purpose of this study was survey The Relationship between dimensions of Transformational leadership and Job Involvement From managers View In teaching hospitals of Yazd in 2013. Methods: This study was descriptive- analytic. The study population consisted of all managers (Senior, middle, operational of the teaching hospitals (Shahid Sadoughi, Rahnemon, Afshar, crashes and burns, Due to the limited number of general research community, they underwent all in the statistical population (N = 180. Data was collected by transformational leadership Questionnaire from the view of bass & olive managers and Job Involvement Questionnaire of Thomas and Data was analyzed by SPSS18. Results: Findings show that Between the transformational leadership and four dimension (intellectual persuasion, inspirational motivation, idealized influence, individualized considerationwith job involvement in four hospitals with p =./01 and r=./289 , there is a significant and positive relationship. Conclusion: Transformational leadership in hospitals has led to the creation of positive changes in employee performance for better work and to improve learning and increase the ability of employees.
Following discussion at TREF and on the recommendation of the Finance Committee, Council approved a new staff contract policy, which became effective on 1 January 2006. Its application is covered by a new Administrative Circular No. 2 (Rev. 3) 'Recruitment, appointment and possible developments regarding the contractual position of staff members'. The revised circular replaces the previous Circulars No. 9 (Rev. 3) 'Staff contracts' and No. 2 (Rev. 2) 'Guidelines and procedures concerning recruitment and probation period for staff members'. The main features of the new contract policy are as follows: The new policy provides chances for long-term employment for all staff recruits staying for four years without distinguishing between those assigned to long-term or short-term activities when joining CERN. In addition, it presents a number of simplifications for the award of ICs. There are henceforth only 2 types of contract: Limited Duration (LD) contracts for all recruitment and Indefinite Contracts (IC) for...
... 7 Agriculture 11 2010-01-01 2010-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...
... 32 National Defense 5 2010-07-01 2010-07-01 false Administration and discipline: Staff embarked... Commanders In Chief and Other Commanders Administration and Discipline § 700.720 Administration and discipline: Staff embarked. In matters of general discipline, the staff of a commander embarked and all...
Wulff, Christian N; Vedsted, Peter; Søndergaard, Jens
Case management (CM) models based on experienced nurses are increasingly used to improve coordination and continuity of care for patients with complex health care needs. Anyway, little is known about the effects of hospital-based CM in cancer care. Aim. To analyse the effects of hospital-based CM on (i) GPs' evaluation of information from the hospital and collaboration with the hospital staff and (ii) patients' contacts with GPs during daytime and out of hours. A randomized controlled trial allocated 280 colorectal cancer patients 1:1 to either a control group or CM intervention. Patients were recruited at a Danish surgical department. An ad hoc piloted questionnaire was sent to all patients' GPs 30 weeks after patients' recruitment and the responses from the two groups of GPs were compared. Registry data on patients' contacts with general practice during daytime and out of hours were collected 9 months after recruitment and the data from the two groups were compared quarterly. CM was associated with an overall tendency towards more positive GP evaluations, which for 3 of 20 items reached statistical significance. Statistically significantly fewer GPs of CM patients reported contacting the hospital. CM did not affect the number of patient contacts with the GPs during the daytime, but CM patients showed a tendency towards more contacts to the out-of-hours GP services than non-CM patients. CM was appreciated by the GPs and reduced their need for subsequent hospital contact. CM increased the number of patient contacts to the out-of-hours GP services.
Supporting Regional Aged Care Nursing Staff to Manage Residents' Behavioural and Psychological Symptoms of Dementia, in Real Time, Using the Nurses' Behavioural Assistant (NBA): A Pilot Site 'End-User Attitudes' Trial.
Klein, Britt; Clinnick, Lisa; Chesler, Jessica; Stranieri, Andrew; Bignold, Adam; Dazeley, Richard; McLaren, Suzanne; Lauder, Sue; Balasubramanian, Venki
This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.
Ris?r, Mette Bech; Spigt, Mark; Iversen, R; Godycki-Cwirko, M; Francis, N; Altiner, A; Andreeva, E; Kung, K; Melbye, H
Objectives To understand the concerns and challenges faced by general practitioners (GPs) and respiratory physicians about primary care management of acute exacerbations in patients with chronic obstructive pulmonary disease (COPD). Design 21 focus group discussions (FGDs) were performed in seven countries with a Grounded Theory approach. Each country performed three rounds of FGDs. Setting Primary and secondary care in Norway, Germany, Wales, Poland, Russia, The Netherlands, China (Hong Kong...
Cássia Cristina Braghini
Full Text Available Abstract Introduction: The work process in the Nucleus of Support for Family Health (NASF assumes the integration of its professionals with the family health staff. Objective: To present the perceptions of staff, coordinators of the Family Health Centers (CSF of reference, and NASF about the physiotherapist's role in the centers. Methods: This is a qualitative research guided by the case study method. The studied population was composed of the four coordinators of the CSF, the general coordinator of the centers, and eight members of NASF staff. Data collection consisted of semi-structured interviews with coordinators and focal group for the staff members. Data was analyzed using thematic content analysis. Results: The physiotherapist's role at NASF consists of actions about health education and disease prevention, organization and management of the flow of users with rehabilitation demand, prevention and treatment of occupational diseases and the development of complementary and integrative practices. The existence of obstacles in the work process of physiotherapists at NASF as disjointed planning of the Family Health Strategy (FHS and the prioritization of health rehabilitation activities was also highlighted. Conclusion: It is evident that the physiotherapist at NASF has an important role with the health teams, regarding the attention to demands of the municipality; however, the need to consolidate the matrix support and the collective action planning became evident.
McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L
The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.
Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John
Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.
Mazza, Danielle; Harrison, Christopher; Taft, Angela; Brijnath, Bianca; Britt, Helena; Hobbs, Melissa; Stewart, Kay; Hussainy, Safeera
To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.
Allen, Keith D; Wallace, Dustin P
In a randomized controlled trial, 151 children 2 to 9 years old were exposed to either usual behavior management or to a fixed-time schedule of brief breaks (noncontingent escape) from ongoing dental treatment. Results demonstrated that the routine delivery of scheduled breaks from treatment significantly reduced the vocal and physical disruptive behavior and the need for restraint in a nonclinical sample of children undergoing restorative dental treatment. In addition, the treatment did not add significantly to the typical time spent on behavior management by dentists. Together with findings from previous studies, these results suggest that using brief breaks from ongoing dental treatment has good efficacy, acceptability, and generality and may be a useful management tool, both in everyday dental practice and in more demanding instances of specialized need. © Society for the Experimental Analysis of Behavior.
Muffels, Christopher T.; Schreuder, Willem A.; Doherty, John E.; Karanovic, Marinko; Tonkin, Matthew J.; Hunt, Randall J.; Welter, David E.
GENIE is a model-independent suite of programs that can be used to generally distribute, manage, and execute multiple model runs via the TCP/IP infrastructure. The suite consists of a file distribution interface, a run manage, a run executer, and a routine that can be compiled as part of a program and used to exchange model runs with the run manager. Because communication is via a standard protocol (TCP/IP), any computer connected to the Internet can serve in any of the capacities offered by this suite. Model independence is consistent with the existing template and instruction file protocols of the widely used PEST parameter estimation program. This report describes (1) the problem addressed; (2) the approach used by GENIE to queue, distribute, and retrieve model runs; and (3) user instructions, classes, and functions developed. It also includes (4) an example to illustrate the linking of GENIE with Parallel PEST using the interface routine.
Donoghue, Christopher; Castle, Nicholas G
The purpose of this study was to examine the associations between nursing home administrator (NHA) leadership style and staff turnover. We analyzed primary data from a survey of 2,900 NHAs conducted in 2005. The Online Survey Certification and Reporting database and the Area Resource File were utilized to extract organizational and local economic characteristics of the facilities. A general linear model (GLM) was used to estimate the effects of NHA leadership style, organizational characteristics, and local economic characteristics on nursing home staff turnover for registered nurses (RNs), licensed practical nurses (LPNs), and nurse's aides (NAs). The complete model estimates indicate that NHAs who are consensus managers (leaders who solicit, and act upon, the most input from their staff) are associated with the lowest turnover levels, 7% for RNs, 3% for LPNs, and 44% for NAs. Shareholder managers (leaders who neither solicit input when making a decision nor provide their staffs with relevant information for making decisions on their own) are associated with the highest turnover levels, 32% for RNs, 56% for LPNs, and 168% for NAs. The findings indicate that NHA leadership style is associated with staff turnover, even when the effects of organizational and local economic conditions are held constant. Because leadership strategies are amenable to change, the findings of this study may be used to develop policies for lowering staff turnover.
The purposes of this study were to describe perceptions of managerial leadership behaviors associated with staff nurse turnover and to compare nurse manager leadership behaviors as perceived by managers and their staff nurses. Effective leadership styles among nurse managers have been associated with staff nurse job satisfaction and retention. Although both transformational and transactional leadership styles have been described as effective, it is unclear which nurse manager leadership behaviors contribute most to staff nurse retention. This descriptive, correlational study was conducted at a 465-bed community hospital in the northeastern United States. All staff nurses and nurse managers employed in both ambulatory and acute care nursing units were invited to participate in the study. The study sample comprised 79 staff nurses and 10 nurse managers, who completed demographic forms and the 45-item Multifactor Leadership Questionnaire, which measures 12 dimensions of leadership style. Data were collected from July through September 2003. Active management by exception as perceived by staff nurses was the only managerial leadership style associated with staff nurse turnover (r = .26, p = .03). Compared with the perceptions among their staff nurses, nurse managers consistently perceived that they demonstrated a higher mean frequency of transformational leadership behaviors. The transactional leadership style of active management by exception not only appeared to be a deterrent to staff nurse retention but also reflected leadership perceptions among staff nurses who work evening and night shifts. This study also provides further evidence regarding a trend in which nurse managers and staff nurses do not concur on the frequency of transformational leadership behaviors but do demonstrate agreement on the frequency of transactional leadership behaviors.
Jensen, Per Anker
building. Furthermore, the respondents were asked to prioritize the quality factors. In the analysis the quality factors were grouped into cultural value and use value and into quality as built and over time. The paper presents the general results of the survey with focus on the differences between......This paper is one of the results of a research project on real estate strategies and building values based on a case study of the corporate buildings of DR (Danish Broadcasting Corporation). The paper presents some of the results from a questionnaire survey among select groups of managers in DR...... concerning their evaluation of 5 buildings. The overall purpose of the survey was to evaluate the different buildings’ values and quality, both as built and over time. A second purpose was to develop and test a methodology to describe the values and quality of buildings at a general but still differentiated...
Michail, Maria; Tait, Lynda; Churchill, Dick
Aim To examine general practitioners' (GPs) clinical expertise in assessing, communicating with, and managing suicidal young people aged 14-25 to inform the development of an educational intervention for GPs on youth suicide prevention. Suicide is the second leading cause of death for young people worldwide. GPs are ideally suited to facilitate early identification and assessment of suicide risk. However, GPs' levels of competence, knowledge, and attitudes towards suicidal young people have not yet been explored. A cross-sectional survey on GPs' levels of confidence in assessing and managing young people at risk of suicide; knowledge of risk factors and warning signs of suicide in young people; attitudes towards young suicidal people; and training preferences on managing suicide risk. Findings Seventy GPs completed the survey (30 males). The majority of GPs reported high levels of confidence in assessing and managing suicidality in young people. Experienced GPs demonstrated high levels of knowledge of suicide risk factors in young people but low levels of knowledge of warning signs that might indicate heightened risk. Although 48% of GPs disagreed that maintaining compassionate care is difficult with those who deliberately self-harm, GPs perceived communication with young people to be difficult, with one-third reporting frustration in managing those at risk of suicide. A total of 75% of GPs said they would be interested in receiving further training on assessing and managing young people at risk of suicide. The study has important implications for providing specialist training to support GPs in assessing and managing youth suicide risk and facilitating attitudinal change. GP education on youth suicide risk assessment and management should promote a holistic understanding and assessment of risk and its individual, social and contextual influences in line with clinical recommendations to facilitate therapeutic engagement and communication with young people.
Phillips, Jennifer; Hebish, Linda J; Mann, Sharon; Ching, Joan M; Blackmore, C Craig
The relationship of staff satisfaction and engagement to organizational success, along with the integral influence of frontline managers on this dimension, is well established in health care and other industries. To specifically address staff engagement, Virginia Mason Medical Center, an integrated, single-hospital health system, developed an approach that involved leaders, through the daily use of standard work for leaders, as well as staff, through a Lean-inspired staff idea system. Kaizen Promotion Office (KPO) staff members established three guiding principles: (1) Staff engagement begins with leader engagement; (2) Integrate daily improve- ment (kaizen) as a habitual way of life not as an add-on; and (3) Create an environment in which staff feel psycho- logically safe and valued. Two design elements--Standard Work for Leaders (SWL) and Everyday Lean Ideas (ELIs) were implemented. For the emergency department (ED), an early adopter of the staff engagement work, the challenge was to apply the guiding principles to improve staff engagement while improving quality and patient and staff satisfaction, even as patient volumes were increasing. Daily huddles for the KPO staff members and weekly leader rounds are used to elicit staff ideas and foster ELIs in real time. Overall progress to date has been tracked in terms of staff satisfaction surveys, voluntary staff turnover, adoption of SWL, and testing and implementation of staff ideas. For example, voluntary turnover of ED staff decreased from 14.6% in 2011 to 7.5% in 2012, and 2.0% in 2013. Organizationwide, at least 800 staff ideas are in motion at any given time, with finished ones posted in an idea supermarket website. A leadership and staff engagement approach that focuses on SWL and on capturing staff ideas for daily problem solving and improvement can contribute to organization success and improve the quality of health care delivery.
Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam
In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners...... implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.......' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from...
Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 28 of October to the 11th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months, and in particular the Five-yearly-Review 2015, subject of the questionnaire that you probably recently filled out. All this will keep the next Staff Council very busy indeed. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (firstname.lastname@example.org). Do not forget to v...
Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis
This investigation examined 317 general education kindergarten through fifth-grade teachers' use of instructional and behavioral management strategies as measured by the Classroom Strategy Scale (CSS)-Observer Form, a multidimensional tool for assessing classroom practices. The CSS generates frequency of strategy use and discrepancy scores reflecting the difference between recommended and actual frequencies of strategy use. Hierarchical linear models (HLMs) suggested that teachers' grade-level assignment was related to their frequency of using instructional and behavioral management strategies: Lower grade teachers utilized more clear 1 to 2 step commands, praise statements, and behavioral corrective feedback strategies than upper grade teachers, whereas upper grade teachers utilized more academic monitoring and feedback strategies, content/concept summaries, student focused learning and engagement, and student thinking strategies than lower grade teachers. Except for the use of praise statements, teachers' usage of instructional and behavioral management strategies was not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. HLMs suggested that teachers' grade level was related to their discrepancy scores of some instructional and behavioral management strategies: Upper grade teachers had higher discrepancy scores in academic performance feedback, behavioral feedback, and praise than lower grade teachers. Teachers' discrepancy scores of instructional and behavioral management strategies were not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. Implications of results for school psychology practice are outlined. © 2013.
Background The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Material and Methods Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. Results: In most cases, the dentist should be able to establish a correct diagnosis. Results In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. Conclusions General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment. Key words:Oral mucosal disease, oral lichen planus. PMID:29476684
McGorry Patrick D
Full Text Available Abstract Background Although deliberate self-harm is prevalent among young people, many who engage in deliberate self-harm receive sub-optimal care. Although schools are a well placed setting to support young people who engage in self-harm there are no specific training packages designed to assist school welfare staff to support these young people. The current study aimed to design, deliver and evaluate a training course specifically for school staff. Methods The study employed a longitudinal design. Two hundred and thirteen people participated in the training and evaluation. A questionnaire was administered at baseline, immediately after the training and at 6-month follow-up in order to determine if the training led to improvements in confidence when working with young people who self-harm, perceived skill, knowledge of, and attitudes towards people who self harm. Results Prior to the course, the majority of participants demonstrated relatively high levels of confidence, perceived skill and knowledge of self-harm and endorsed relatively positive attitudes towards people who engage in self-harm. Despite this, significant improvements were observed in terms of increased confidence, increased perceptions of skill along with increased knowledge of deliberate self-harm. These improvements were sustained over the follow-up period. Conclusion The results demonstrated that the provision of specifically designed training can help school welfare staff to feel better equipped to support young people who are engaging in deliberate self-harm.
Full Text Available Bruno Chicoulaa,1 Hervé Haas,2 Jérôme Viala,3 Maryline Salvetat,4 Jean-Pierre Olives,5 1Faculty of Medicine, Toulouse Rangueil, Toulouse, 2Paediatric Emergency and Infectious Disease Departments, Lenval University Hospital, Nice, 3Gastroenterology Department, Robert-Debré Hospital, Paris, 4Sports and General Medicine Practice, Labruguière, 5Gastroenterology and Nutrition Department, Children’s Hospital, University Hospital, Toulouse, France Background: Recurrent respiratory tract infections (RRTIs are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose: To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods: A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results: A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84% prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions: French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse
Rainio, Anna-Kaisa; Ohinmaa, Arto E
RAFAELA is a new Finnish PCS, which is used in several University Hospitals and Central Hospitals and has aroused considerable interest in hospitals in Europe. The aim of the research is firstly to assess the feasibility of the RAFAELA Patient Classification System (PCS) in nursing staff management and, secondly, whether it can be seen as the transferring of nursing resources between wards according to the information received from nursing care intensity classification. The material was received from the Central Hospital's 12 general wards between 2000 and 2001. The RAFAELA PCS consists of three different measures: a system measuring patient care intensity, a system recording daily nursing resources, and a system measuring the optimal nursing care intensity/nurse situation. The data were analysed in proportion to the labour costs of nursing work and, from that, we calculated the employer's loss (a situation below the optimal level) and savings (a situation above the optimal level) per ward as both costs and the number of nurses. In 2000 the wards had on average 77 days below the optimal level and 106 days above it. In 2001 the wards had on average 71 days below the optimal level and 129 above it. Converting all these days to monetary and personnel resources the employer lost 307,745 or 9.84 nurses and saved 369,080 or 11.80 nurses in total in 2000. In 2001 the employer lost in total 242,143 or 7.58 nurses and saved 457,615 or 14.32 nurses. During the time period of the research nursing resources seemed not have been transferred between wards. RAFAELA PCS is applicable to the allocation of nursing resources but its possibilities have not been entirely used in the researched hospital. The management of nursing work should actively use the information received in nursing care intensity classification and plan and implement the transferring of nursing resources in order to ensure the quality of patient care. Information on which units resources should be allocated to
Mahomed, Rosemary; St John, Winsome; Patterson, Elizabeth
To investigate the process of patient satisfaction with nurse-led chronic disease management in Australian general practice. Nurses working in the primary care context of general practice, referred to as practice nurses, are expanding their role in chronic disease management; this is relatively new to Australia. Therefore, determining patient satisfaction with this trend is pragmatically and ethically important. However, the concept of patient satisfaction is not well understood particularly in relation to care provided by practice nurses. A grounded theory study underpinned by a relativist ontological position and a relativist epistemology. Grounded theory was used to develop a theory from data collected through in-depth interviews with 38 participants between November 2007-April 2009. Participants were drawn from a larger project that trialled a practice nurse-led, collaborative model of chronic disease management in three Australian general practices. Theoretical sampling, data collection, and analysis were conducted concurrently consistent with grounded theory methods. Patients undergo a cyclical process of Navigating Care involving three stages, Determining Care Needs, Forming Relationship, and Having Confidence. The latter two processes are inter-related and a feedback loop from them informs subsequent cycles of Determining Care Needs. If any of these steps fails to develop adequately, patients are likely to opt out of nurse-led care. Navigating Care explains how and why time, communication, continuity, and trust in general practitioners and nurses are important to patient satisfaction. It can be used in identifying suitable patients for practice nurse-led care and to inform the practice and organization of practice nurse-led care to enhance patient satisfaction. © 2012 Blackwell Publishing Ltd.
This report summarizes the management of the National General Aviation Design Competition on behalf of NASA, the FAA and the Air Force by the Virginia Space Grant Consortium (VSGC) for the time period October 1, 2000 through September 30, 2001. This was the VSGC's seventh and final year of managing the Competition, which the Consortium originally designed, developed and implemented for NASA and the FAA. The competition is now being managed in-house by NASA. Awards to winning university teams were presented at a ceremony held at AirVenture 2001, the Experimental Aircraft Association's Annual Convention and Fly-In at Oshkosh, Wis. by NASA and FAA officials. The competition called for individuals or teams of undergraduate and graduate students from U.S. engineering schools to participate in a major national effort to rebuild the U.S. general aviation sector. Participants were challenged to meet the engineering goals of the Advanced General Aviation Transport Experiment (AGATE) project. For the purpose of the contest, general aviation aircraft are typically defined as single or twin engine (turbine or piston), single-pilot, fixed-wing aircraft for 2 - 6 passengers. The competition seeks to raise student awareness of the importance of general aviation by having students address design challenges for a small aircraft transportation system. NASA, AFRL and the FAA hope to stimulate breakthroughs in technology and their application in the general aviation marketplace. National goals for revitalizing the industry offer excellent, open-ended design challenges with real world applications for the Innovative Design Category. Both individual and team submissions were encouraged. University faculty advisors and students consistently cite the value of this kind of educational experience for their engineering students. Eight proposals were submitted for the 2001 Competition for the Innovative Design Category. Eleven faculty members and 124 students participated. Since inception
Full Text Available Abstract Background Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs, even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. Methods This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS and qualitative (NVivo analyses were performed. Results At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks, and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are the records...) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 193-CREATION, MAINTENANCE, AND USE OF RECORDS § 102-193.15 What are the records management responsibilities of the Administrator of General Services (the...
The Staff Association has been organising for many years a cocktail with delegates of the Member States participating in Finance Committees of March and September. This cocktail is held at the end of the day, after the Finance Committee meeting. This direct and regular communication helps establish an ongoing contact between the Staff Association and CERN Member States and, more recently, the Associate Member States. Ambassadors of the CERN Staff Association, who are Members of the Personnel, have the opportunity to meet their national delegation in an informal and friendly atmosphere. These exchanges, facilitated by the use of the national language, allow the personnel via the Staff Association to express its ideas and positions on current affairs and fundamental issues, and also to hear about those of the delegations in return.
The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the ...
De Jonckheere, J; Bonhomme, V; Jeanne, M; Boselli, E; Gruenewald, M; Logier, R; Richebé, P
The aim of this paper is to review existing technologies for the nociception / anti-nociception balance evaluation during surgery under general anesthesia. General anesthesia combines the use of analgesic, hypnotic and muscle-relaxant drugs in order to obtain a correct level of patient non-responsiveness during surgery. During the last decade, great efforts have been deployed in order to find adequate ways to measure how anesthetic drugs affect a patient's response to surgical nociception. Nowadays, though some monitoring devices allow obtaining information about hypnosis and muscle relaxation, no gold standard exists for the nociception / anti-nociception balance evaluation. Articles from the PubMed literature search engine were reviewed. As this paper focused on surgery under general anesthesia, articles about nociception monitoring on conscious patients, in post-anesthesia care unit or in intensive care unit were not considered. In this article, we present a review of existing technologies for the nociception / anti-nociception balance evaluation, which is based in all cases on the analysis of the autonomous nervous system activity. Presented systems, based on sensors and physiological signals processing algorithms, allow studying the patients' reaction regarding anesthesia and surgery. Some technological solutions for nociception / antinociception balance monitoring were described. Though presented devices could constitute efficient solutions for individualized anti-nociception management during general anesthesia, this review of current literature emphasizes the fact that the choice to use one or the other mainly relies on the clinical context and the general purpose of the monitoring.
Aragon, Kathryn M.; Eaton, Shelley M.; McCornack, Marjorie Turner; Shannon, Sharon A.
When a requirements engineering effort fails to meet expectations, often times the requirements management tool is blamed. Working with numerous project teams at Sandia National Laboratories over the last fifteen years has shown us that the tool is rarely the culprit; usually it is the lack of a viable information architecture with well- designed processes to support requirements engineering. This document illustrates design concepts with rationale, as well as a proven information architecture to structure and manage information in support of requirements engineering activities for any size or type of project. This generalized information architecture is specific to IBM's Rational DOORS (Dynamic Object Oriented Requirements System) software application, which is the requirements management tool in Sandia's CEE (Common Engineering Environment). This generalized information architecture can be used as presented or as a foundation for designing a tailored information architecture for project-specific needs. It may also be tailored for another software tool. Version 1.0 4 November 201
Lourdes Jiménez Bajo
Full Text Available El objetivo de este estudio es evaluar la aceptación entre el personal de enfermería de los dispositivos de bioseguridad de material corto-punzante tras 20 meses de su implantación en un hospital terciario y su comparación con los resultados obtenidos en el estudio piloto previo a la implantación. Se realiza estudio descriptivo transversal en 5 servicios del hospital, Nefrología, Medicina Interna, Infecciosas, Unidad de Críticos y Cirugía General antes y tras 20 meses de implantación de los dispositivos. El cuestionario recoge variables como seguridad de usuario, comodidad y sencillez de uso, tiempo de maniobra y seguridad del paciente de cinco dispositivos, agujas intramusculares, agujas subcutáneas, jeringas de gasometría, catéter intravenoso y aguja de diálisis; valoración global de la importancia del uso generalizado de los dispositivos y necesidad de más información/ formación. El 62% considera importantísimo el uso generalizado de dispositivos de seguridad. Tras 20 meses de implantación, la aceptación de los dispositivos entre el personal de enfermería parece mayor, aunque estas diferencias no son estadísticamente significativas. Es necesario aumentar el período de estudio y reforzar las medidas de información-formación entre otras propuestas, ya que contribuyen a su mayor aceptación la frecuencia de utilización y la información/formación recibida.The purpose of this study is asses the acceptance of the safety devices in nursing staff after 20 months of implementation in general hospital and compare the results with pilot study before implementation. A descriptive study was conducted in 5 hospital services: Nephrology, Internal Medicine, Infectous Diseases Service, Intensive Care and General Surgery. The questionnaire includes following variables: user safety, comfort and ease of use, time to maneuver and patient safety of the five devices, intramuscular needle, needle subcutaneous, syringe of gas, intravenous
Staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden.
Hvitfeldt-Forsberg, Helena; Mazzocato, Pamela; Glaser, Daniel; Keller, Christina; Unbeck, Maria
To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. Two focus group discussions were performed. Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. Healthcare staff and managers (n=13) from the two settings. Two workshops were performed, one at each setting. Workshops were initiated by a short introduction to simulation modelling. Results from the respective simulation model were then presented and discussed in the following focus group discussion. Categories from the content analysis are presented according to the following research questions: how and when simulation modelling can assist healthcare improvement? Regarding how, the participants mentioned that simulation modelling could act as a tool for support and a way to visualise problems, potential solutions and their effects. Regarding when, simulation modelling could be used both locally and by management, as well as a pedagogical tool to develop and test innovative ideas and to involve everyone in the improvement work. Its potential as an information and communication tool and as an instrument for pedagogic work within healthcare improvement render a broader application and value of simulation modelling than previously reported. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Powell, Jane; Harris, Francesca; Condon, Louise; Kemple, Terry
This paper is a report of a study of the views and experiences of nurses and other prison healthcare staff about their roles and the nursing care they provide to prisoners. Nurses have become the key providers of healthcare in prison settings in England, replacing the previous prison service-run system. However, there is very little evidence about the health services they provide to meet the health needs of prisoners. A ethnographic study was conducted. Participants were 80 healthcare staff working in 12 prisons of all security categories in England. Twelve individual interviews with general healthcare managers and 12 key informant focus group discussions with healthcare staff were undertaken in 2005 using a semi-structured interview schedule. Issues investigated included participants' thoughts and experiences of nursing roles and delivery of primary healthcare. The group discussions and interviews were analysed to identify emerging themes. Participants gave accounts of day-to-day processes and the healthcare routine. They saw their work as identifying and meeting the health needs of prisoners and maintaining their health, and identified major influences that shaped their daily work, including new ways of working in primary care. They identified how policy and organizational changes were affecting their roles, and acknowledged the conflict between the custody regime and healthcare delivery. The move towards a NHS-led primary healthcare service within prisons, predominantly delivered by nurses, has made positive changes to healthcare. Healthcare managers have benefited from the involvement of the local NHS in improving the health of prisoners.
24 May 2013 - Rector of the Polish Stanislaw Staszic AGH University of Science and Technology T. Slomka in the LHC tunnel at Point 8 with Senior Polish Staff Member A. Siemko, in LHCb experimental cavern with LHCb Collaboration Spokesperson P. Campana and signing the guest book with Director-General R. Heuer. Adviser for Eastern Europe T. Kurtyka present.
24 May 2013 - Rector of the Polish Stanislaw Staszic AGH University of Science and Technology T. Slomka in the LHC tunnel at Point 8 with Senior Polish Staff Member A. Siemko, in LHCb experimental cavern with LHCb Collaboration Spokesperson P. Campana and signing the guest book with Director-General R. Heuer. Adviser for Eastern Europe T. Kurtyka present.
... Cadmium in General Industry Standard; Extension of the Office of Management and Budget's (OMB) Approval of... requirements specified in the Cadmium in General Industry Standard (29 CFR 1910.1027). DATES: Comments must be... information (29 U.S.C. 657). The information collection requirements specified in the Cadmium in General...
O'Sullivan, S S
OBJECTIVE: The purpose of this work was to assess the opinion of general practitioners (GPs) regarding the diagnosis of psychogenic nonepileptic seizures (PNES) and the role they feel they should play in the management of the disorder. METHODS: Patients with PNES were identified from hospital records. Seizure and patient characteristics were recorded. Their GPs were surveyed regarding their understanding of the diagnosis and ongoing management of PNES. RESULTS: Twenty-three patients were identified over a 3-year period as having been diagnosed with PNES. Sixty-five percent of GPs agreed with the diagnosis, and when asked to grade their understanding of the diagnosis (poor = 1, excellent = 10), the mean score was 5.7 (+\\/-SD 2.3). Thirty-five percent of GPs felt psychological input was of benefit to their patients. Fifty-two percent of GPs felt comfortable following up these patients, either with or without neurology outpatient services. CONCLUSIONS: PNES remains a difficult disease to manage. There is a high level of uncertainty regarding the optimum management of PNES among primary care physicians, for which further education is needed.
Diaz, Jose J; Cullinane, Daniel C; Dutton, William D; Jerome, Rebecca; Bagdonas, Richard; Bilaniuk, Jaroslaw W; Bilaniuk, Jarolslaw O; Collier, Bryan R; Como, John J; Cumming, John; Griffen, Maggie; Gunter, Oliver L; Kirby, John; Lottenburg, Larry; Mowery, Nathan; Riordan, William P; Martin, Niels; Platz, Jon; Stassen, Nicole; Winston, Eleanor S
The open abdomen technique, after both military and civilian trauma, emergency general or vascular surgery, has been used in some form for the past 30 years. There have been several hundred citations on the indications and the management of the open abdomen. Eastern Association for the Surgery of Trauma practice management committee convened a study group to organize the world's literature for the management of the open abdomen. This effort was divided into two parts: damage control and the management of the open abdomen. Only damage control is presented in this study. Part 1 is divided into indications for the open abdomen, temporary abdominal closure, staged abdominal repair, and nutrition support of the open abdomen. A literature review was performed for more than 30 years. Prospective and retrospective studies were included. The reviews and case reports were excluded. Of 1,200 articles, 95 were selected. Seventeen surgeons reviewed the articles with four defined criteria. The Eastern Association for the Surgery of Trauma primer was used to grade the evidence. There was only one level I recommendation. A patient with documented abdominal compartment syndrome should undergo decompressive laparotomy. The open abdomen technique remains a heroic maneuver in the care of the critically ill trauma or surgical patient. For the best outcomes, a protocol for the indications, temporary abdominal closure, staged abdominal reconstruction, and nutrition support should be in place.
Fletcher-Lartey, Stephanie; Khan, Rabia
Inappropriate prescribing of antibiotics for the management of respiratory tract infections (RTIs) has contributed to increased prevalence of antibiotic resistance, and this remains a challenge. The aim of this study was to evaluate the effect of general practitioners' (GPs) participation in the Antibiotics: Clinical e-Audit, a quality-improvement activity, on GP self-reported knowledge and practice change, and explored barriers encountered in the management of respiratory tract infections (RTIs). Participants completed a survey at the end of the activity to assess the usefulness of the audit, any reported changes made and barriers encountered to their clinical practice. More than half of the 872 participants reported the audit assisted them in reviewing patients with RTIs. The majority of GP registrars (48.2%, N=66) indicated that the clinical e-Audit had changed their practice in terms of identifying patients for whom an antibiotic was recommended. GPs identified several barriers to achieving best practice in the management of RTIs, including patient or carer expectations for an antibiotic prescription and non-adherence to symptomatic management by patients. Empowering GPs to overcome these barriers should be the aim of future education and behaviour change programs.
McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George
The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.
Koen, D; Muller, M; Poggenpoel, M
The nursing service manager is accountable for the quality of nursing care delivered in the nursing service. It is therefore important that the nursing service manager facilitates staff development in the nursing service. It is not only the nursing service manager's responsibility to make provision for staff development--the nurse also has a responsibility in this regard. He/she should purposefully make an effort to keep up to date with the latest developments. This article focuses on the co-responsibility of the psychiatric nurse and nursing service manager regarding staff development. A model for staff development is described, in accordance with the guidelines of Dickoff, James & Wiedenbach for theory development. An inductive approach was primarily followed to describe the provisional model, after which a literature study was employed to refine and purify the model. This model was exposed to expert evaluation, after which the final model for staff development of psychiatric nurses was described. Recommendations include the testing of certain hypotheses and utilisation of this model in psychiatric nursing practice.
..., DC, to the Director, Grievance Staff for State; Chief, Employee Relations Branch for AID and Chief, Employee-Management Relations Division for USIA. (2) The grievant has the right to a representative of the... 22 Foreign Relations 1 2010-04-01 2010-04-01 false General provisions. 16.2 Section 16.2 Foreign...
Abdelghany, A; Nolan, A; Freeman, R
To assess primary care dental practitioners' knowledge, attitudes and clinical management of patients presenting with dry mouth. A convenience sample of 200 dentists working in primary care in an NHS Health Board in Scotland was obtained. A questionnaire to assess knowledge, attitudes and clinical management of dry mouth patients was sent to all dentists on the NHS primary care service inventory. Ethical approval was obtained. Two hundred questionnaires were sent to the participants and 114 were returned, giving a valid response rate of 58%. Fifty percent were woman and 80% worked in the general dental service. Seventy-nine percent had been taught about xerostomia as undergraduates but only 21% had postgraduate educational experiences of dry mouth. The majority correctly stated that patients with Sjögren's syndrome would have an increased risk of dental caries, oral candidosis, frictional oral ulcers and squamous cell carcinoma. Participants had positive attitudes with regard to the importance of treating dry mouth; that it was not a trivial complaint; it affected patients' quality of life and their general health. The dentists were not confident to manage dry mouth patients. Knowledge, attitudes, confidence and intention to treat were affected by gender and type of primary care practice. Thirty-two percent of the variance of the intention to provide treatment was explained by working in the salaried dental service (SDS), confidence and attitudes regarding severity of the condition. Dentists working in the SDS had positive attitudes and increased confidence which were related to postgraduate educational experiences. Education at both undergraduate and postgraduate levels should be supported by clinical exposure to patients in order to improve dentists' confidence and competence to manage xerostomia and its complications.
Full Text Available An osteo-odonto-keratoprosthesis (OOKP procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement. We studied perioperative concerns of patients who underwent the staged OOKP procedure. This was a retrospective analysis of patients who underwent OOKP. The information regarding symptoms, associated comorbidities, perioperative events including anaesthetic management were collected. Eight patients (five females and three males underwent the staged OOKP procedure. The median age was 18 years. The median weight was 45 kg. The median duration of loss of vision was 4 years. The aetiology of blindness included Stevens-Johnson′s syndrome (SJS (7 and chemical burn (1. Four patients had generalized skin problem due to SJS. All cases were managed under general anaesthesia, and airway management included nasotracheal intubation for stage I and orotracheal intubation for stage II. The median mallampati classification was I prior to OOKP stage I procedure while it changed to II at stage II procedure. Two patients required fibreoptic nasotracheal intubation. One patient had excessive oozing from the mucosal harvest site and was managed conservatively. In one patient, tooth harvesting was done twice as the first tooth was damaged during creating a hole in it. We conclude that OOKP requires multidisciplinary care. Anaesthesiologist should evaluate the airway carefully and disease-associated systemic involvements. The use of various drugs requires caution and steroid supplementation should be done. Airway difficulty should be anticipated, mandating thorough evaluation. Re-evaluation of airway is prudent as it may become difficult during the staged OOKP procedure.
Mammucari, Massimo; Maggiori, Enrica; Lazzari, Marzia; Natoli, Silvia
Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with another tool for the treatment of local pain. However, it is important to provide patients with full details of the pros and cons of this approach and obtain informed patient consent.
Separate abstracts were prepared for 19 of the papers in this volume. Four additional papers have already been cited in ERA; these can be found by referring to CONF-771062-- in the Report Number Index. Five other papers were not in the scope of coverage of ERA; these dealt with an introduction to generalized data management systems and capabilities required of them in handling data, a programming language for data bases, and specialized applications of data bases to laboratory animals (environmental husbandry, hematology, clinical chemistry) and environmental chemicals. (RWR)
Juan David Dominguez-Sánchez
Full Text Available General practitioners must constantly face challenges imposed by their profession when performing interventions that are necessary for their patients. Many of these interventions not only require proper use of theoretical knowledge, but also putting into practice non-technical and psychomotor skills developed through professional training. Given the specific characteristics of each patient, the clinical setting in the which procedure takes place and the limited skills of the professional, the management of the airway of a patient with trauma injuries in the emergency room represents a major challenge for physicians.
Chambon, R.; Varin, E.; Rozon, D.
CANDU fuel management problems are solved using time-average representation of the core. Optimization problems based on this representation have been defined in the early nineties. The mathematical programming using the generalized perturbation theory (GPT) that was developed has been implemented in the reactor code DONJON. The use of the augmented Lagrangian (AL) method is presented and evaluated in this paper. This approach is mandatory for new constraint problems. Combined with the classical Lemke method, it proves to be very efficient to reach optimal solution in a very limited number of iterations. (authors)
Wadensten, Barbro; Engström, Maria; Häggström, Elisabeth
The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. The study was explorative and qualitative in design. The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.
Kleinman, Carol S
Nursing administrators are challenged to recruit and retain staff nurses in the midst of increasing job vacancies and staff nurse turnover rates averaging 21%. The prevailing issues related to staff nurse recruitment and retention in the current healthcare environment are briefly reviewed as introductory content. The article outlines the case from nursing administration literature that effective leadership styles of nurse managers and nurse administrators enhance staff nurse retention. As nurse administrators continue to struggle with staff nurse recruitment and retention, evidenced-based strategies are discussed that address leader preparation and organizational leadership structure including advanced education, leadership training, and shared leadership models.
Determining an adequate training staff size is a vital function of a training manager. Today's training requirements and standards have dictated a more stringent work load than ever before. A trainer's role is more than just providing classroom lectures. In most organizations the instructor must develop programs, lesson plans, exercise guides, objectives, test questions, etc. The tasks of a training organization are never ending and the appropriate resources must be determined and allotted to do the total job. A simple method exists for determining an adequate staff. Although not perfect, this method will provide a realistic approach for determining the needed training staff size. This method considers three major factors: instructional man-hours; non-instructional man-hours; and instructor availability. By determining and adding instructional man-hours and non-instructional man-hours a total man-hour distribution can be obtained. By dividing this by instructor availability a staff size can be determined
Daniela Teixeira Dias
Full Text Available The objective of this article was to analyze how the concept of bounded rationality has been treated in the educational manuals of General Theory of Management, with the objective to analyze its quality, in terms of quality and complexity. Therefore, three educational manuals provided by the Central Library of the Alfa Federal University were used: “General Theory of Administration” authored by Motta and Vasconcelos (Manual A; “Introduction to Management” by Chiavenato (Manual B, and “Management: Theory and Processes” by Caravantes, Caravantes, and Kloeckener (Manual C. These were observed from the content analysis in four dimensions defined a priori: delimitation of the approach and quality of the references; historical-concrete dimension; relationship dimension; and theoretical dimension. The results showed that all manuals presented considerations about the bounded rationality assumption and made reference to Simon and Barnard, although they have not discussed their work and their contribution more widely. Manual A was the most complete in the axes analysis herein. Manual B turned to a summarized and synthetic theoretical discussion. Whereas C Manual defined and conceptualized bounded rationality and was the only one to describe the types of rationality presented by Simon.
Full Text Available As drivers of human civilization, Knowledge Management (KM processes have co-evolved in line with General-Purpose-Technologies (GPT, such as writing, printing, and information and communication systems. As evidenced by the recent shift from information scarcity to abundance, GPTs are capable of drastically altering societies due to their game-changing impact on our spheres of work and personal development. This paper looks at the prospect of whether a novel Personal Knowledge Management (PKM concept supported by a prototype system has got what it takes to grow into a transformative General-Purpose-Technology. Following up on a series of papers, the KM scenario of a decentralizing revolution where individuals and self-organized groups yield more power and autonomy is examined according to a GPT's essential characteristics, including a wide scope for improvement and elaboration (in people's private, professional and societal life, applicability across a broad range of uses in a wide variety of products and processes (in multi-disciplinary educational and work contexts, and strong complementarities with existing or potential new technologies (like organizational KM Systems and a proposed World Heritage of Memes Repository. The result portrays the PKM concept as a strong candidate due to its personal, autonomous, bottom-up, collaborative, interdisciplinary, and creativity-supporting approach destined to advance the availability, quantity, and quality of the world extelligence and to allow for a wider sharing and faster diffusion of ideas across current disciplinary and opportunity divides.
Ulrik, Charlotte Suppli; Hansen, Ejvind Frausing; Jensen, Michael Skov
. DESIGN AND SETTING: Two cross-sectional surveys were performed precisely one year apart before and after an educational program for the participating GPs. A total of 124 GPs completed the study; 1716 and 1342 patients with GP-diagnosed COPD and no concomitant asthma, respectively, were included......BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease...... by focused education of GPs and their staff....
Full Text Available Staff meetings in general dental practices represent what is be-lieved to be a key management strategy to build teams and to enhance efficiency and effec-tiveness. However, very little research has been done regarding staff meetings in dental offices. This study examined staff meetings from the viewpoint of dental hygienists who grow in unique careers in that they work largely independently of the dentist and yet typically within a dental practice while providing patient care and education. One-hundred-six dental hygienists completed a survey about staff meetings in dental offices. Key findings include: only approximately 43% of dental offices conduct morning huddles to get the day off to a smooth and organized start, 72% of dental practices conduct longer staff meetings with largely positive outcomes, including increasing practice efficiency and productivity, few practices (12% hold specific meetings only for the hygiene-department (and probably thereby miss some opportunities for practice im-provement, the most important variable by far to hygienists' job satisfaction is respect from the owner-dentist, and there exists an important and synergistic relationship among job sa-tisfaction, relationships with other staff and relationship with the owner-dentist.
Bor, D.; Cekirge, S.; Tuerkay, T.; Turan, O.; Guelay, M.; Oenal, E.; Cil, B.
Radiation doses for interventional examinations are generally high and therefore necessitate dose monitoring for patients and staff. Relating the staff dose to a patient dose index, such as dose-area product (DAP), could be quite useful for dose comparisons. In this study, DAP and skin doses of 57 patients, who underwent neuro-interventional examinations, were measured simultaneously with staff doses. Although skin doses were comparable with the literature data, higher DAP values of 215 and 188.6 Gy cm 2 were measured for the therapeutical cerebral and carotid examinations, respectively, owing to the use of biplane system and complexity of the procedure. Mean staff doses for eye, finger and thyroid were measured as 80.6, 77.6 and 28.8 μGy per procedure. The mean effective dose per procedure for the radiologists was 32 μSv. In order to allow better comparisons to be made, DAP normalised doses were also presented. (authors)
Chicoulaa, Bruno; Haas, Hervé; Viala, Jérôme; Salvetat, Maryline; Olives, Jean-Pierre
Background Recurrent respiratory tract infections (RRTIs) are the most common reason for children’s visits to primary care physicians in France; however, little is known about general practitioners’ (GPs) opinions and expectations concerning the management and prevention of these common and recurrent pathologies. Purpose To describe French GPs’ daily practice in the management of respiratory infections and the prevention of their recurrence in children. Methods A sample group of French GPs answered a structured questionnaire on risk factors, RRTI management, antibiotic use and prevention measures. Results A total of 358 GPs participated in the survey. Rhinopharyngitis, the most frequent respiratory infection, was considered to be recurrent if six or more episodes occurred in a year. Four risk factors were acknowledged as substantial: living in communities, passive smoking, pollution and allergies. Around 63% of GPs said that RRTIs are too often treated with antibiotics. More than 85% thought that prevention of RRTIs is possible. Smoking cessation, vaccination, allergen avoidance and hygiene were identified as the main preventive measures. A large majority of GPs (84%) prescribed products for prevention and ~90% would prescribe a product stimulating immunity if the efficacy and tolerability of these agents was proven and confirmed in their daily practice. Conclusions French GPs are well aware of the health and socioeconomic burdens resulting from RRTIs, as well as the risk of antibiotic overuse. They have a prevention-oriented approach, implement preventive measures when possible and prescribe products for prevention. PMID:28293116
Full Text Available Intra-abdominal infections are multifactorial and present an complex inflammatory response of the peritoneum to microorganisms followed by exudation in the abdominal cavity and systemic response Despite advances in management and critical care of patients with acute generalized peritonitis due to hollow viscus perforation, prognosis is still very poor, with high mortality rate. Early detection and adequate treatment is essential to minimize complications in the patient with acute abdomen. Prognostic evaluation of complicated IAI by modern scoring systems is important to assess the severity and the prognosis of the disease. Control of the septic source can be achieved either by nonoperative or operative means. Nonoperative interventional procedures include percutaneous drainages of abscesses. The management of primary peritonitis is non-surgical and antibiotic- treatment. The management of secondary peritonitis include surgery to control the source of infection, removal of toxins, bacteria, and necrotic tissue, antibiotic therapy, supportive therapy and nutrition. "Source control" is sine qua non of success and adequate surgical procedure involves closure or resection of any openings into the gastrointestinal tract, resection of inflamed tissue and drainage of all abdominal and pelivic collections.
Full Text Available Abstract Background Psychological problems present a huge burden of illness in our community and GPs are the main providers of care. There is evidence that longer consultations in general practice are associated with improved quality of care; but this needs to be balanced against the fact that doctor time is a limited resource and longer consultations may lead to reduced access to health care. The aim of this research was to conduct a systematic literature review to determine whether management of psychological problems in general practice is associated with an increased consultation length and to explore whether longer consultations are associated with better health outcomes for patients with psychological problems. Methods A search was conducted on Medline (Ovid databases up to7 June 2006. The following search terms, were used: general practice or primary health care (free text or family practice (MeSH AND consultation length or duration (free text or time factors (MeSH AND depression or psychological problems or depressed (free text. A similar search was done in Web of Science, Pubmed, Google Scholar, and Cochrane Library and no other papers were found. Studies were included if they contained data comparing consultation length and management or detection of psychological problems in a general practice or primary health care setting. The studies were read and categories developed to enable systematic data extraction and synthesis. Results 29 papers met the inclusion criteria. Consultations with a recorded diagnosis of a psychological problem were reported to be longer than those with no recorded psychological diagnosis. It is not clear if this is related to the extra time or the consultation style. GPs reported that time pressure is a major barrier to treating depression. There was some evidence that increased consultation length is associated with more accurate diagnosis of psychological problems. Conclusion Further research is needed to
S K PULIST
Full Text Available Staff and educational development is relatively a new field in higher education. It has recently been emerging as a systematic activity in higher education. The staff and educational development as a professional function includes teaching and training, human resource development and management, organizational development, management and implementation of policy and strategy on teachingand learning. Though earlier, it had been limited to a few common activities like workshop, training programme for new teaching staff and the provision of written and multimedia material. Different authors have tried to provide a direction to the activity of staff and educational development.
Full Text Available Background Guidelines for early detection of chronic kidney disease (CKD emphasise regular testing of kidney health in high-risk individuals. However, evidence suggests that CKD is not being adequately detected or appropriately managed in primary care. Aims Assess Australian general practitioners’ (GP current practice in relation to CKD detection and management. Methods This was a cross-sectional study utilising a random sample of GPs identified by interrogation of the national online telephone directory, and stratified by geographical location. Data collection occurred between October 2014 and January 2015. Of 2,815 eligible contacts, the final response rate was 23 per cent. Results Of the 656 respondents, over 90 per cent assessed kidney health at least annually in people with diabetes or high blood pressure, and 71 per cent correctly assessed kidney health every 3–6 months in a patient with Stage 3b CKD. The tests most commonly used to assess kidney health were serum creatinine (with eGFR, blood pressure and urine albumin creatinine ratio. The most commonly reported CKD management strategies were ‘blood pressure reduction using pharmacological agents’ (81 per cent and ‘glycaemic control if diabetes present’ (64 per cent. Knowledge testing highlighted that 32 per cent of respondents were not able to correctly identify how to properly assess absolute cardiovascular risk, and this was significantly more common in more experienced GPs (p=0.003. Conclusion The results indicate that Australian GPs are mainly practising in accordance with current guidelines for detection and management of patients with CKD, but with room for improvement in some areas
Lack of Adoption of a Mobile App to Support Patient Self-Management of Diabetes and Hypertension in a Federally Qualified Health Center: Interview Analysis of Staff and Patients in a Failed Randomized Trial.
Thies, Kathleen; Anderson, Daren; Cramer, Benjamin
Thousands of mobile health (mHealth) apps have been developed to support patients' management of their health, but the effectiveness of many of the apps remains unclear. While mHealth apps appear to hold promise for improving the self-management of chronic conditions across populations, failure to balance the system demands of the app with the needs, interests, or resources of the end users can undermine consumers' adoption of these technologies. The original aim of this study was to evaluate the effectiveness of a commercial mHealth app in improving clinical outcomes for adult patients in a Federally Qualified Health Center (FQHC) with uncontrolled diabetes and/or hypertension. Patients entered clinical data into the app, which also supported messaging between patients and providers. After a 4-month period of vigorous recruitment, the trial was suspended due to low enrollment and inconsistent use of the app by enrolled patients. The project aim was changed to understanding why the trial was unsuccessful. We used the user-task-context (eUTC) usability framework to develop a set of interview questions for patients and staff who were involved in the trial. All interviews were done by phone and lasted 20 to 30 minutes. Interviews were not recorded. There was a poor fit between the app, end users, and recruitment and treatment approaches in our setting. Usability testing might have revealed this prior to launch but was not an option. There was not sufficient time during routine care for clinical staff to familiarize patients with the app or to check clinical data and messages, which are unreimbursed activities. Some patients did not use the app appropriately. The lack of integration with the electronic health record (EHR) was cited as a problem for both patients and staff who also said the app was just one more thing to attend to. This brief trial underscores the pitfalls in the utilization of mHealth apps. Effective use of mHealth tools requires a good fit between the
Sergiy I. Netyosov
Full Text Available The status and character of the use of ICT in the management of schools of general education and related utilization of information technology in the organization of management of educational institutions with the requirements of the formation of civil society is considered in the article. The author proves that the management of general education institutions involves a significant amount of social information, and the use of ICT in these activities contributes to the inclusion of the public in the mission of education. But the actual state of realization of ICTs in management of secondary schools is mainly directed at the use of technocratic information technology capabilities and the realization of social component in the management of institutions of general education is involved partially, that is an indicator of the rather slow progress of Ukraine toward the establishment of a civil society.
Lau, Arthur N; Ioannidis, George; Potts, Yelena; Giangregorio, Lora M; Van der Horst, Mary-Lou; Adachi, Jonathan D; Papaioannou, Alexandra
Compared to the general elderly population, those institutionalized in LTC facilities have the highest prevalence of osteoporosis and subsequently have higher incidences of vertebral and hip fractures. The goal of this study is to determine how well nurses at LTC facilities are educated to properly administer bisphosphonates. A secondary question assessed was the nurse's and PSW's attitudes and beliefs regarding the role and benefits of vitamin D for LTC patients. Eight LTC facilities in Hamilton were surveyed, and all nurses were offered a survey. A total 57 registered nurses were surveyed. A 21 item questionnaire was developed to assess existing management practices and specific osteoporosis knowledge areas. The questionnaire assessed the nurse's and personal support worker's (PSWs) education on how to properly administer bisphosphonates by having them select all applicable responses from a list of options. These options included administering the drug before, after or with meals, given with or separate from other medications, given with juice, given with or without water, given with the patient sitting up, or finally given with the patient supine. Only 52% of the nurses and 8.7% of PSWs administered the drug properly, where they selected the options: (given before meals, given with water, given separate from all other medications, and given in a sitting up position). If at least one incorrect option was selected, then it was scored as an inappropriate administration. Bisphosphonates were given before meals by 85% of nurses, given with water by 90%, given separately from other medication by 71%, and was administered in an upright position by 79%. Only 52% of the nurses and 8.7% of PSWs surveyed were administering the drug properly. Regarding the secondary question, of the 57 nurses surveyed, 68% strongly felt their patients should be prescribed vitamin D supplements. Of the 124 PSWs who completed the survey, 44.4% strongly felt their patients should be prescribed
Adachi Jonathan D
Full Text Available Abstract Background Compared to the general elderly population, those institutionalized in LTC facilities have the highest prevalence of osteoporosis and subsequently have higher incidences of vertebral and hip fractures. The goal of this study is to determine how well nurses at LTC facilities are educated to properly administer bisphosphonates. A secondary question assessed was the nurse's and PSW's attitudes and beliefs regarding the role and benefits of vitamin D for LTC patients. Methods Eight LTC facilities in Hamilton were surveyed, and all nurses were offered a survey. A total 57 registered nurses were surveyed. A 21 item questionnaire was developed to assess existing management practices and specific osteoporosis knowledge areas. Results The questionnaire assessed the nurse's and personal support worker's (PSWs education on how to properly administer bisphosphonates by having them select all applicable responses from a list of options. These options included administering the drug before, after or with meals, given with or separate from other medications, given with juice, given with or without water, given with the patient sitting up, or finally given with the patient supine. Only 52% of the nurses and 8.7% of PSWs administered the drug properly, where they selected the options: (given before meals, given with water, given separate from all other medications, and given in a sitting up position. If at least one incorrect option was selected, then it was scored as an inappropriate administration. Bisphosphonates were given before meals by 85% of nurses, given with water by 90%, given separately from other medication by 71%, and was administered in an upright position by 79%. Only 52% of the nurses and 8.7% of PSWs surveyed were administering the drug properly. Regarding the secondary question, of the 57 nurses surveyed, 68% strongly felt their patients should be prescribed vitamin D supplements. Of the 124 PSWs who completed the survey
Jackson, N G; Waterhouse, P J; Maguire, A
To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to
staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. Conclusion. HRM practices in this Eastern Cape medical complex were inadequate and a ...
Spector, Aimee; Revolta, Catherine; Orrell, Martin
Caring for people with dementia can be emotionally challenging and is often linked to low job satisfaction and burnout in care staff. Staff training within care settings is potentially valuable in improving well-being and quality of care. This review aimed to (i) establish the impact of training on staff outcomes; (ii) compare the impact of different training approaches; (iii) explore the influence of training intensity; and (iv) explore potential barriers to success. A database search of staff training interventions revealed 207 papers, 188 of which were excluded based on prespecified criteria. Nineteen studies were included and appraised using a quality rating tool. Overall, the studies were found to be of variable quality; however, 16 studies found a significant change following training in at least one staff domain, with knowledge improving most frequently. Approaches focusing on managing challenging behaviours appeared to be the most effective. Training staff can be an effective method of improving well-being, and programmes helping staff to manage challenging behaviour appear to be the most beneficial. There is no clear relationship between training intensity and outcome. Most studies point to the importance of addressing organisational factors as a barrier to change. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
... Management Plan, Draft Environmental Impact Statement, Lake Meredith National Recreation Area and Alibates... Management Plan, Lake Meredith National Recreation Area and Alibates Flint Quarries National Monument, Texas... management alternatives for Lake Meredith National Recreation Area and three management alternatives for...
Huntink, E; Wensing, M; Timmers, I M; van Lieshout, J
A tailored implementation programme to improve cardiovascular risk management (CVRM) in general practice had little impact on outcomes. The questions in this process evaluation concerned (1) impact on counselling skills and CVRM knowledge of practice nurses, (2) their use of the various components of the intervention programme and adoption of recommended practices and (3) patients' perceptions of counselling for CVRM. A mixed-methods process evaluation was conducted. We assessed practice nurses' motivational interviewing skills on audio-taped consultations using Motivational Interviewing Treatment Integrity (MITI). They also completed a clinical knowledge test. Both practice nurses and patients reported on their experiences in a written questionnaire and interviews. A multilevel regression analysis and an independent sample t test were used to examine motivational interviewing skills and CVRM knowledge. Framework analysis was applied to analyse qualitative data. Data from 34 general practices were available, 19 intervention practices and 14 control practices. No improvements were measured on motivational interviewing skills in both groups. There appeared to be better knowledge of CVRM in the control group. On average half of the practice nurses indicated that they adopted the recommended interventions, but stated that they did not necessarily record this in patients' medical files. The tailored programme was perceived as too large. Time, follow-up support and reminders were felt to be lacking. About 20% of patients in the intervention group visited the general practice during the intervention period, yet only a small number of these patients were referred to recommended options. The tailored programme was only partly used by practice nurses and had little impact on either their clinical knowledge and communication skills or on patient reported healthcare. If the assumed logical model of change is valid, a more intensive programme is needed to have an impact on CVRM
Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction
An example of the integration of CERN staff in the neighbouring communes is provided by the hamlet of Bugnon at St-Genis-Pouilly (Ain), FRance. The CERN installation on the Swiss site are visible on the left in the background. Behind them the Saleve mountain in Haute-Savoie.