The Influence of Staff Training on Challenging Behaviour in Individuals with Intellectual Disability: A Review

Science.gov (United States)

Cox, Alison D.; Dube, Charmayne; Temple, Beverley

2015-01-01

Many individuals with intellectual disability engage in challenging behaviour. This can significantly limit quality of life and also negatively impact caregivers (e.g., direct care staff, family caregivers and teachers). Fortunately, efficacious staff training may alleviate some negative side effects of client challenging behaviour. Currently, a…

Engagement and avoidance in support staff working with people with intellectual disability and challenging behavior : A multiple-case study

NARCIS (Netherlands)

Zijlmans, L.J.M.; Bosman, A.M.T.; Gerits, L.; Derksen, J.; Embregts, P.J.C.M.

2014-01-01

Background Challenging behaviour of clients influences emotional wellbeing of staff; this in turn affects levels of staff engagement and avoidance within interactions with clients. The main goal of this study was to investigate to what extent levels of staff engagement and staff avoidance are

An experimental study of client-side Spotify peering behaviour

OpenAIRE

Ellis, M.; Strowes, S.; Perkins, C.

2011-01-01

Spotify is a popular music-streaming service which has seen widespread use across Europe. While Spotify’s server-side behaviour has previously been studied, little is known about the client-side behaviour. In this paper, we describe an experimental study where we collect packet headers for Spotify traffic over multiple 24-hour time frames at a client host. Two distinct types of behaviour are observed, when tracks are being downloaded, and when the client is only serving requests from other pe...

Patent Medicine VendorsAND#8217; Clients: Medicine Use Behaviour

Directory of Open Access Journals (Sweden)

Asa Auta

2012-12-01

Full Text Available AIM: To investigate some medicine use behaviour of Patent Medicine Vendors’ (PMVs clients including self medication practice and medication sharing behaviour. METHOD: A descriptive, cross-sectional survey was conducted in July 2011, on 361 undergraduate students of the University of Jos, Nigeria who visited PMVs within a month preceding the study. A pretested questionnaire was administered to participating students. Participants responded to questions on demography, and medicine use behaviour. Data were entered into the Statistical Package for Social Sciences (SPSS version 16 to generate descriptive statistics which were represented in percentages. RESULTS: The results showed that majority of the respondents (91.7% visited the PMVs for self-medication with the common classes of medicines procured by PMVs clients including analgesics (38.4%, antimalarials (22.2% and nutrition/blood preparations (14.1%. About 78.5% of the medicines sold to PMVs clients were in their original package and only 45.9% of clients reported checking the expiry date of their procured medicine prior to use. Medication sharing behaviour was common (60.2% among respondents. Although most respondents (70.2% said they had read a medicine information leaflet in the past, majority of them depended on unreliable sources such as friends/relatives (23.2%, media (10.8% and the internet (9.9% for medicine information. CONCLUSION: The study therefore demonstrated that PMV clients are those on self-medication practices and medication sharing behaviour is high among them. [TAF Prev Med Bull 2012; 11(6.000: 681-686

The impact of staff and service user gender on staff responses towards adults with intellectual disabilities who display aggressive behaviour.

Science.gov (United States)

Kleinberg, I; Scior, K

2014-02-01

The impact of staff and service user gender on responses of staff in intellectual disability (ID) services is poorly understood. The present study set out to assess the role of gender in influencing staff emotions, attributions and behavioural intentions in response to aggression displayed by adults with ID. A new scale measuring staff behavioural intentions was developed. A two × two (staff gender × service user gender) between subjects design was used to compare the responses of day and residential support staff to physical aggression by a hypothetical service user. In response to a vignette depicting a service user with ID assaulting a member of staff, 160 respondents completed measures of affective responses, causal attributions and behavioural intentions while imagining themselves as the target of the service user's assault. Female participants reported feeling more fear/anxiety, more depression/anger and less confident/relaxed than male participants. The longer staff had worked with people with ID, the more likely they were to favour safety-focused behaviours. More confident female participants were less likely to favour safety-focused behaviours, but confidence had no effect on male participants' endorsement of these behaviours. Increased confidence in both was associated with lower agreement of safety-focused behaviours in relation to the female vignette, regardless of participant gender. The more control women believed the service user had over their behaviour, the more likely they were to choose safety-focused behaviours. Punitive behaviours were favoured more in response to the male rather than the female service user. Punitive behaviours were also favoured more by more junior staff and by participants who expected feeling more depressed/angry in response to the vignettes. Both staff and service user gender influenced staff responses to aggression, yet the latter played a smaller role than expected. The role of gender in staff-service user

Application of the transtheoretical model of behaviour change for identifying older clients' readiness for hearing rehabilitation during history-taking in audiology appointments.

Science.gov (United States)

Ekberg, Katie; Grenness, Caitlin; Hickson, Louise

2016-07-01

The transtheoretical model (TTM) of behaviour change focuses on clients' readiness for adopting new health behaviours. This study explores how clients' readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients' readiness has consequences for the rehabilitation decisions they make within the initial appointment. Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment. The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments. Clients' readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined). The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients' needs, attitudes, desires, and psychological readiness for action in order to optimize clients' hearing outcomes.

The future of veterinary communication: Partnership or persuasion? A qualitative investigation of veterinary communication in the pursuit of client behaviour change.

Directory of Open Access Journals (Sweden)

Alison M Bard

Full Text Available Client behaviour change is at the heart of veterinary practice, where promoting animal health and welfare is often synonymous with engaging clients in animal management practices. In the medical realm, extensive research points to the link between practitioner communication and patient behavioural outcomes, suggesting that the veterinary industry could benefit from a deeper understanding of veterinarian communication and its effects on client motivation. Whilst extensive studies have quantified language components typical of the veterinary consultation, the literature is lacking in-depth qualitative analysis in this context. The objective of this study was to address this deficit, and offer new critical insight into veterinary communication strategies in the pursuit of client behaviour change. Role-play interactions (n = 15 between UK cattle veterinarians and an actress experienced in medical and veterinary education were recorded, transcribed and analysed thematically. Analysis revealed that, overall, veterinarians tend to communicate in a directive style (minimal eliciting of client opinion, dominating the consultation agenda, prioritising instrumental support, reflecting a paternalistic role in the consultation interaction. Given this finding, recommendations for progress in the veterinary industry are made; namely, the integration of evidence-based medical communication methodologies into clinical training. Use of these types of methodologies may facilitate the adoption of more mutualistic, relationship-centred communication in veterinary practice, supporting core psychological elements of client motivation and resultant behaviour change.

Conversational synchronization in naturally occurring settings: A recurrence-based analysis of gaze directions and speech rhythms of staff and clients with intellectual disability

NARCIS (Netherlands)

Reuzel, E.; Embregts, P.J.C.M.; Bosman, A.M.T.; Cox, R.; van Nieuwenhuijzen, M.; Jahoda, A.

2013-01-01

Past research has shown that rapport and cooperation between individuals is related to the level of nonverbal synchrony they achieve in their interactions. This study investigates the extent to which staff and clients with mild to borderline intellectual disability achieve interactional synchrony in

Conversational synchronization in naturally occurring settings : A recurrence-based analysis of gaze directions and speech rhythms of staff and clients with intellectual disability

NARCIS (Netherlands)

Reuzel, E.; Embregts, P.J.C.M.; Bosman, A.M.T.; Cox, R.; van den Nieuwenhuijzen, M.C.A.; Jahoda, A.

2013-01-01

Past research has shown that rapport and cooperation between individuals is related to the level of nonverbal synchrony they achieve in their interactions. This study investigates the extent to which staff and clients with mild to borderline intellectual disability achieve interactional synchrony in

Conversational Synchronization in Naturally Occurring Settings : A Recurrence-Based Analysis of Gaze Directions and Speech Rhythms of Staff and Clients with Intellectual Disability

NARCIS (Netherlands)

Reuzel, E.; Embregts, Petri J. C. M.; Bosman, A. M. T.; Cox, Ralf; van Nieuwenhuijzen, M.; Jahoda, A.

2013-01-01

Past research has shown that rapport and cooperation between individuals is related to the level of nonverbal synchrony they achieve in their interactions. This study investigates the extent to which staff and clients with mild to borderline intellectual disability achieve interactional synchrony in

Conversational Synchronization in Naturally Occurring Settings: A Recurrence-Based Analysis of Gaze Directions and Speech Rhythms of Staff and Clients with Intellectual Disability

NARCIS (Netherlands)

Reuzel, E.A.A.; Embregts, P.J.C.M.; Bosman, A.M.T.; Cox, R.F.A.; Nieuwenhuijzen, M. van; Jahoda, A.

2013-01-01

Past research has shown that rapport and cooperation between individuals is related to the level of nonverbal synchrony they achieve in their interactions. This study investigates the extent to which staff and clients with mild to borderline intellectual disability achieve interactional synchrony in

Attitudes and behaviours of maternal health care providers in interactions with clients: a systematic review.

Science.gov (United States)

Mannava, P; Durrant, K; Fisher, J; Chersich, M; Luchters, S

2015-08-15

High maternal mortality and morbidity persist, in large part due to inadequate access to timely and quality health care. Attitudes and behaviours of maternal health care providers (MHCPs) influence health care seeking and quality of care. Five electronic databases were searched for studies from January 1990 to December 2014. Included studies report on types or impacts of MHCP attitudes and behaviours towards their clients, or the factors influencing these attitudes and behaviours. Attitudes and behaviours mentioned in relation to HIV infection, and studies of health providers outside the formal health system, such as traditional birth attendants, were excluded. Of 967 titles and 412 abstracts screened, 125 full-text papers were reviewed and 81 included. Around two-thirds used qualitative methods and over half studied public-sector facilities. Most studies were in Africa (n = 55), followed by Asia and the Pacific (n = 17). Fifty-eight studies covered only negative attitudes or behaviours, with a minority describing positive provider behaviours, such as being caring, respectful, sympathetic and helpful. Negative attitudes and behaviours commonly entailed verbal abuse (n = 45), rudeness such as ignoring or ridiculing patients (n = 35), or neglect (n = 32). Studies also documented physical abuse towards women, absenteeism or unavailability of providers, corruption, lack of regard for privacy, poor communication, unwillingness to accommodate traditional practices, and authoritarian or frightening attitudes. These behaviours were influenced by provider workload, patients' attitudes and behaviours, provider beliefs and prejudices, and feelings of superiority among MHCPs. Overall, negative attitudes and behaviours undermined health care seeking and affected patient well-being. The review documented a broad range of negative MHCP attitudes and behaviours affecting patient well-being, satisfaction with care and care seeking. Reported negative patient

Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

Science.gov (United States)

Garner, Bryan R.; Hunter, Brooke D.; Modisette, Kathryn C.; Ihnes, Pamela C.; Godley, Susan H.

2011-01-01

High staff turnover has been described as a problem for the substance use disorder treatment field. This assertion is based primarily on the assumption that staff turnover adversely impacts treatment delivery and effectiveness. This assumption, however, has not been empirically tested. In this study, we computed annualized rates of turnover for treatment staff (n=249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. Additionally, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. PMID:22154040

Clients' knowledge, perception and satisfaction with quality of ...

African Journals Online (AJOL)

Clients' knowledge, perception and satisfaction with quality of maternal health care services at the primary health care level in Nnewi, Nigeria. ... Furthermore cost, local language used, staff attitude and interaction with clients was acceptable and may be the reason for high level of satisfaction reported. Key words: Clients' ...

Nursing staffs' emotional well-being and caring behaviours.

Science.gov (United States)

Chana, Navtej; Kennedy, Paul; Chessell, Zoë J

2015-10-01

To examine the relationships between structural factors (work stressors), individual factors (demographics and the personal resources of resilience and social support) and transactional factors (appraisals and coping), and nursing staffs' levels of burnout, psychological distress and caring behaviours. A further aim was to examine the relationships between nursing staffs' levels of burnout and psychological distress and their caring behaviours. Burnout and psychological distress levels have been found to be high in National Health Service nursing staff and furthermore this emotional distress has been found to affect patient care. In a National Health Service striving to provide high-quality patient-centred care, it is essential that factors affecting nursing staffs' well-being and their caring behaviours are examined. A cross-sectional correlation-based survey design. A sample of 102 nursing staff from an Acute National Health Service Trust were recruited in 2010. Participants completed the questionnaires: Nursing Stress Scale, Social Support Questionnaire-Short Form, Connor and Davidson Resilience Scale-2, Occupational Coping Self-Efficacy Scale for Nurses, PsychNurse Scale, Maslach Burnout Inventory, The Hospital Anxiety and Depression Scale and Caring Behaviours Inventory-revised. Due to the nonparametric nature of part of the data, Spearman's Rho correlations were used for analysis. Demographics were not found to be regularly correlated with nursing staffs' burnout, psychological distress or caring behaviours. Work stressors, coping strategies and self-efficacy were found to be significantly correlated with nursing staffs' burnout and psychological distress. Caring behaviours were also correlated with coping strategies and self-efficacy. Importantly, correlations were found between caring behaviours and nursing staffs' burnout and psychological distress. It is extremely important that the emotional well-being of nursing staff is supported, both for them, and

Challenging behaviour: an action plan for education and training.

Science.gov (United States)

Farrell, Gerald A; Salmon, Peter

Nurses and other health care staff frequently encounter a range of aggressive and other 'challenging behaviours' at work from clients and colleagues. In response to staff concerns, an abundance of state and national policies are now available but it is left up to individual employers to decide how best to implement them at a local level. In this paper we offer an education and training model which is conceptually sound, practical in application, and suitable for health care staff at different levels in the organisation. The importance of understanding challenging behaviour from an interactional perspective, and the educational principles on which training should be founded, are discussed. Finally, the cost of training and the need for program evaluation are considered.

Can Brief Workshop Interventions Change Care Staff Understanding of Challenging Behaviours?

Science.gov (United States)

Dowey, Alan; Toogood, Sandy; Hastings, Richard P.; Nash, Susie

2007-01-01

Background: The working culture surrounding challenging behaviour may have a strong effect on staff behaviour. As a first step to influencing staff talk about challenging behaviour, the aim of the present study was to explore whether a 1-day training workshop could have an effect on staff causal explanations. Methods: Fifty-four front line staff,…

The Client Company Marginally Utilises the Knowledge of Highly Skilled Temporary Staff

Science.gov (United States)

Augustsson, Gunnar

2016-01-01

This study is based on the presumption that there is often an underuse of temporary staff in client companies (CC) with highly skilled professionals. The study combines theories of the flexible organisation and a sociocultural perspective on learning within the framework of an inter-organisational context. The data are based partly on 17…

Quantitative and qualitative processes of change during staff-coaching sessions : An exploratory study

NARCIS (Netherlands)

van Oorsouw, W.M.W.J.; Embregts, P.J.C.M.; Bosman, A.M.T.

2013-01-01

Staff training is one of the interventions that managers can embed in their organizations to help staff improve their professional competences related to challenging behaviour of clients with intellectual disabilities. Individual coaching adds learning opportunities that are feasible but difficult

Quantitative and qualitative processes of change during staff-coaching sessions: An exploratory study

NARCIS (Netherlands)

Oorsouw, W.M.W.J. van; Embregts, P.J.C.M.; Bosman, A.M.T.

2013-01-01

Staff training is one of the interventions that managers can embed in their organizations to help staff improve their professional competences related to challenging behaviour of clients with intellectual disabilities. Individual coaching adds learning opportunities that are feasible but difficult

GenExp: an interactive web-based genomic DAS client with client-side data rendering.

Directory of Open Access Journals (Sweden)

Bernat Gel Moreno

Full Text Available BACKGROUND: The Distributed Annotation System (DAS offers a standard protocol for sharing and integrating annotations on biological sequences. There are more than 1000 DAS sources available and the number is steadily increasing. Clients are an essential part of the DAS system and integrate data from several independent sources in order to create a useful representation to the user. While web-based DAS clients exist, most of them do not have direct interaction capabilities such as dragging and zooming with the mouse. RESULTS: Here we present GenExp, a web based and fully interactive visual DAS client. GenExp is a genome oriented DAS client capable of creating informative representations of genomic data zooming out from base level to complete chromosomes. It proposes a novel approach to genomic data rendering and uses the latest HTML5 web technologies to create the data representation inside the client browser. Thanks to client-side rendering most position changes do not need a network request to the server and so responses to zooming and panning are almost immediate. In GenExp it is possible to explore the genome intuitively moving it with the mouse just like geographical map applications. Additionally, in GenExp it is possible to have more than one data viewer at the same time and to save the current state of the application to revisit it later on. CONCLUSIONS: GenExp is a new interactive web-based client for DAS and addresses some of the short-comings of the existing clients. It uses client-side data rendering techniques resulting in easier genome browsing and exploration. GenExp is open source under the GPL license and it is freely available at http://gralggen.lsi.upc.edu/recerca/genexp.

Mutual construction and reconstruction in client-consultant interaction

DEFF Research Database (Denmark)

Smith, Irene Skovgaard

Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...... presented in the paper illustrates how consultancy projects evolve through processes of negotiation over whose interpretation should count and who should be in control. In the process, client actors with different posi-tions and interests play an active role in creating what become valid and what ideas...

A comparative study on managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012.

Science.gov (United States)

Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaz

2014-03-01

Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. The results showed the necessity of health services managers' planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients.

Efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in Reducing Bullying Behaviour among In-School Adolescents in Ilorin, Nigeria

Science.gov (United States)

Alabi, Yahaya Lasiele; Lami, Mustapha Mulikat

2015-01-01

Bullying behaviour refers to repeated negative behaviour displayed by one or more person (s) with the intention of hurting the feeling, personality and power of the victim. The objective of this study therefore was to find out the efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in reducing bullying behaviour among in-school…

A clinical reasoning model focused on clients' behaviour change with reference to physiotherapists: its multiphase development and validation.

Science.gov (United States)

Elvén, Maria; Hochwälder, Jacek; Dean, Elizabeth; Söderlund, Anne

2015-05-01

A biopsychosocial approach and behaviour change strategies have long been proposed to serve as a basis for addressing current multifaceted health problems. This emphasis has implications for clinical reasoning of health professionals. This study's aim was to develop and validate a conceptual model to guide physiotherapists' clinical reasoning focused on clients' behaviour change. Phase 1 consisted of the exploration of existing research and the research team's experiences and knowledge. Phases 2a and 2b consisted of validation and refinement of the model based on input from physiotherapy students in two focus groups (n = 5 per group) and from experts in behavioural medicine (n = 9). Phase 1 generated theoretical and evidence bases for the first version of a model. Phases 2a and 2b established the validity and value of the model. The final model described clinical reasoning focused on clients' behaviour change as a cognitive, reflective, collaborative and iterative process with multiple interrelated levels that included input from the client and physiotherapist, a functional behavioural analysis of the activity-related target behaviour and the selection of strategies for behaviour change. This unique model, theory- and evidence-informed, has been developed to help physiotherapists to apply clinical reasoning systematically in the process of behaviour change with their clients.

Quantitative and Qualitative Processes of Change during Staff-Coaching Sessions: An Exploratory Study

Science.gov (United States)

van Oorsouw, Wietske M. W. J.; Embregts, Petri J. C. M.; Bosman, Anna M. T.

2013-01-01

Staff training is one of the interventions that managers can embed in their organizations to help staff improve their professional competences related to challenging behaviour of clients with intellectual disabilities. Individual coaching adds learning opportunities that are feasible but difficult to achieve in an in-service setting. In the…

Report on Provider-Client Interaction From 68 Methadone Maintenance Clinics in China.

Science.gov (United States)

Li, Li; Comulada, W Scott; Lin, Chunqing; Lan, Chiao-Wen; Cao, Xiaobin; Wu, Zunyou

2017-11-01

Provider-client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider-client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in the survey. Linear mixed effects regression models were performed to identify factors associated with provider-client interaction. It was observed that negative attitude toward drug users was associated with lower level of provider-client interaction and less time spent with each client. Other factors associated with lower level of interaction included being female, being younger, being a nurse, and fewer years in medical field. Higher provider-client interaction was associated with provider reported job satisfaction. The findings of this study call for a need to address provider negative attitudes that can impact provider-client interaction and the effectiveness of MMT. Future intervention efforts targeting MMT providers should be tailored by gender, provider type, and medical experiences.

Efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in Reducing Bullying Behaviour among in-School Adolescents in Ilorin, Nigeria

Directory of Open Access Journals (Sweden)

Yahaya Lasiele Alabi

2015-01-01

Full Text Available Bullying behaviour refers to repeated negative behaviour displayed by one or more person (s with the intention of hurting the feeling, personality and power of the victim. The objective of this study therefore was to find out the efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in reducing bullying behaviour among in-school adolescents in Ilorin, Nigeria. The study adopted the quasi-experimental research method using a 3×2 factorial design made up of three (3 row groups (two experimental and one control. Stratified random sampling technique was used to select three secondary schools on the basis of location to prevent experimental contamination. Self-report questionnaire was used to purposively select the participants. The primary dependent variable was bullying behaviour and respondents with high score on bullying items and low scores on victimisation items were selected to participate in the treatment. The findings revealed a significant reduction in the bullying behaviour of the in-school adolescents exposed to experimental treatments; Client-Centred Therapy (CCT produced significant reduction in the bullying behaviour among the in-school adolescents, and Rational-Emotive Behaviour Therapy (REBT produced significant reduction in the bullying behaviour of the in-school adolescents. It was recommended that CCT and REBT procedures should be employed in modifying bullying behaviours.

Factors Relating to Staff Attributions of Control over Challenging Behaviour

Science.gov (United States)

Dilworth, Jennifer A.; Phillips, Neil; Rose, John

2011-01-01

Background: Previous research has suggested that severity of intellectual disability (ID) and topography of behaviour may influence staff causal attributions regarding challenging behaviour. Subsequently, these causal attributions may influence helping behaviours. This study investigated the relationship between attributions of control over…

Request queues for interactive clients in a shared file system of a parallel computing system

Science.gov (United States)

Bent, John M.; Faibish, Sorin

2015-08-18

Interactive requests are processed from users of log-in nodes. A metadata server node is provided for use in a file system shared by one or more interactive nodes and one or more batch nodes. The interactive nodes comprise interactive clients to execute interactive tasks and the batch nodes execute batch jobs for one or more batch clients. The metadata server node comprises a virtual machine monitor; an interactive client proxy to store metadata requests from the interactive clients in an interactive client queue; a batch client proxy to store metadata requests from the batch clients in a batch client queue; and a metadata server to store the metadata requests from the interactive client queue and the batch client queue in a metadata queue based on an allocation of resources by the virtual machine monitor. The metadata requests can be prioritized, for example, based on one or more of a predefined policy and predefined rules.

Negotiating behavioural change: therapists' proposal turns in Cognitive Behavioural Therapy.

Science.gov (United States)

Ekberg, Katie; Lecouteur, Amanda

2012-01-01

Cognitive behavioural therapy (CBT) is an internationally recognised method for treating depression. However, many of the techniques involved in CBT are accomplished within the therapy interaction in diverse ways, and with varying consequences for the trajectory of therapy session. This paper uses conversation analysis to examine some standard ways in which therapists propose suggestions for behavioural change to clients attending CBT sessions for depression in Australia. Therapists' proposal turns displayed their subordinate epistemic authority over the matter at hand, and emphasised a high degree of optionality on behalf of the client in accepting their suggestions. This practice was routinely accomplished via three standard proposal turns: (1) hedged recommendations; (2) interrogatives; and (3) information-giving. These proposal turns will be examined in relation to the negotiation of behavioural change, and the implications for CBT interactions between therapist and client will be discussed.

Interactive Effects of Counselor-Client Similarity and Client Self-Esteem on Termination Type and Number of Sessions.

Science.gov (United States)

Berry, G. William; Sipps, Gary J.

1991-01-01

Examined effects of client self-esteem as measured by Rosenberg Self-Esteem Scale and client-counselor similarity as determined by Myers-Briggs Type Indicator (MBTI) on number of sessions and type of termination (unilateral or mutual) for 55 clients and 9 counselors at university counseling center. Self-esteem interacted significantly with…

HIV prevalence, attitudes and behaviour in clients of a confidential HIV testing and counselling centre in Uganda.

Science.gov (United States)

Müller, O; Barugahare, L; Schwartländer, B; Byaruhanga, E; Kataaha, P; Kyeyune, D; Heckmann, W; Ankrah, M

1992-08-01

To describe clients, operation and impact of an African public HIV testing and counselling centre. Analysis of samples from clients attending the AIDS Information Centre (AIC) in Kampala, Uganda in early 1991. HIV-1-positive and HIV-negative consecutive clients (250 of each), 86 consecutive couples, and 200 consecutive clients who were HIV-negative in 1990 and were attending for their repeat test. HIV seroprevalence rates, attitudes, behaviour and behaviour change. HIV-1 prevalence was 28% overall, 24% in men and 35% in women. Reasons for taking the HIV test were a planned marriage or a new relationship (27%; 84% in couples), to plan for the future (35%), distrust of sexual partner (14%) and illness or disease/death (not HIV-specific) of partner (20%). The majority of the reported intentions in response to a positive or a negative HIV test result were positive, demonstrating the ability to cope with this information. Of repeat clients, two (1%) had become HIV-1-positive. The majority of repeat clients reported one sexual partner only (67%) or sexual abstinence (25%). Compared with pre-test information from AIC clients attending for the first time, repeat clients reported casual sexual contacts less often (6 versus 25%) and, of those, the majority used condoms. Our study demonstrates the demand for and the feasibility of confidential HIV testing and counseling services in Uganda, and illustrates the value of these services in achieving behaviour changes. Such services should be considered an additional approach for the reduction of HIV transmission in Africa, especially in areas with high HIV seroprevalence rates.

Health behaviour information provided to clients during midwife-led prenatal booking visits: Findings from video analyses.

NARCIS (Netherlands)

Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.R.; Brug, J.; Hutton, E.K.

2017-01-01

OBJECTIVE: to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. DESIGN: quantitative video

Health behaviour information provided to clients during midwife-led prenatal booking visits : Findings from video analyses

NARCIS (Netherlands)

Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.R.; Brug, J.; Hutton, E.K.

2017-01-01

Objective to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. Design quantitative video

Health behaviour information provided to clients during midwife-led prenatal booking visits: findings from video analyses.

NARCIS (Netherlands)

Baron, R.; Martin, L.; Gitsels-van der Wal, J.T.; Noordman, J.; Heymans, M.W.; Spelten, E.; Brug, J.; Hutton, E.K.

2017-01-01

Objective: to quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided. Design: quantitative video

Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.

Science.gov (United States)

Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M

2017-09-01

Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.

Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences.

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Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa

2018-02-15

A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.

Working with Clients Who Engage in Self-Harming Behaviour: Experiences of a Group of Counsellors

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Fox, Claudine

2011-01-01

This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed…

Cognitive Behavioural Therapy from the Perspective of Clients with Mild Intellectual Disabilities: A Qualitative Investigation of Process Issues

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Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.

2013-01-01

Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…

Smoking Behaviors and Attitudes Among Clients and Staff at New York Addiction Treatment Programs Following a Smoking Ban: Findings After 5 Years.

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Pagano, Anna; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma; Soto-Nevarez, Arturo; Brown, Lawrence S; Delucchi, Kevin L

2016-05-01

Addiction treatment clients are more likely to die of tobacco-related diseases than of alcohol or illicit drug-related causes. We aimed to assess smoking behavior, and smoking-related attitudes and services, in New York addiction treatment programs before a statewide smoking ban in treatment facilities was implemented (2008), 1 year (2009) and 5 years after implementation (2013). We conducted surveys at each time point with clients (N = 329, 341, and 353, respectively) and staff (N = 202, 203, and 166, respectively) from five residential and two methadone maintenance programs in New York State. At each data collection wave, questionnaires measured smoking behavior as well as smoking-related knowledge, attitudes, and experiences with tobacco cessation services as part of addiction treatment. Staff smoking prevalence decreased from 35.2% in 2008 to 21.8% in 2013 (P = .005) while client smoking prevalence over the same period was unchanged (68.1% vs. 66.0%, P = .564). Among clients who smoked, mean cigarettes per day decreased from 13.7 (SD = 8.38) to 10.2 (SD = 4.44; P attitudes and cessation services received; and for staff self-efficacy and cessation services provided. In residential programs, scores for most items decreased (became less positive) in 2009 followed by a partial rebound in 2013. Methadone program scores tended to rise (become more positive) throughout the study period. Staff and clients may respond differentially to tobacco-free policies depending on type of treatment program, and this finding may help to inform the implementation of tobacco-free policies in other statewide addiction treatment systems. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

Directory of Open Access Journals (Sweden)

Hj.Indirawaty

2015-08-01

Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

Attentional Processes in Interactions between People with Profound Intellectual and Multiple Disabilities and Direct Support Staff

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Ine, Hostyn; Heleen, Neerinckx; Bea, Maes

2011-01-01

Few studies have examined joint attention in interactions with persons with profound intellectual and multiple disabilities (PIMD), despite its important role in high-quality interaction. The purpose of this study is to describe the attention-directing behaviours of persons with PIMD and their direct support staff and the attention episodes…

Choosing Staff Members Reduces Time in Mechanical Restraint Due to Self-Injurious Behaviour and Requesting Restraint

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Jensen, Craig C.; Lydersen, Tore; Johnson, Paul R.; Weiss, Shannon R.; Marconi, Michael R.; Cleave, Mary L.; Weber, Patricia

2012-01-01

Background: Using mechanical restraints to protect a person who engaged in dangerous self-injury was decreased by manipulation of an establishing operation involving the client choosing the staff person who would work with her. Materials and Methods: The client was a 28-year-old woman diagnosed with autism, bipolar disorder, static cerebral…

Clients' knowledge, perception and satisfaction with quality of ...

African Journals Online (AJOL)

2014-04-14

Apr 14, 2014 ... Furthermore cost, local language used, staff attitude and interaction with clients was acceptable and may be the .... skilled attendants; q = the complementary probability of. P (1 ‑ p) that ... Anticipating a response rate of 90%, an adjustment of the ... questionnaires were distributed, completely filled and were.

Physical Attractiveness: Interactive Effects of Counselor and Client on Counseling Processes.

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Vargas, Alice M.; Borkowski, John G.

1983-01-01

Assessed how the physical attractiveness of counselors and clients interacted to build rapport in two experiments involving college students (N=128 and N=64). Results showed the counselor's physical attractiveness had a major impact on her perceived effectiveness and the client's expectation of success irrespective of the client's attractiveness…

Emotional intelligence, emotions, and feelings of support staff working with clients with intellectual disabilities and challenging behavior: an exploratory study.

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Zijlmans, Linda J M; Embregts, Petri J C M; Bosman, Anna M T

2013-11-01

Working with clients who show challenging behavior can be emotionally demanding and stressful for support staff, because this behavior may cause a range of negative emotional reactions and feelings. These reactions are of negative influence on staff wellbeing and behavior. Research has focused on negative emotions of staff. However, a distinction between emotions and feelings has never been made in the research field of intellectual disabilities. Negative emotions and feelings may be regulated by emotional intelligence, a psychological construct that takes into account personal style and individual differences. The purpose of this study was to explore the relationship between emotional intelligence on the one hand and emotions and feelings on the other. Participants were 207 support staff serving clients with moderate to borderline intellectual disabilities and challenging behavior. Emotional intelligence, emotions, and feelings were measured with questionnaires. The results show that emotional intelligence, emotions, and feelings are related. However, found relationships were weak. Most significant relations were found between feelings and stress management and adaptation elements of emotional intelligence. Because the explored variables can change over time they call for a longitudinal research approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations with staff during clinical placement: A qualitative study.

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McCloughen, Andrea; Foster, Kim

2017-04-20

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

Staff-family relationships in nursing home care: a typology of challenging behaviours.

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Bauer, Michael

2007-09-01

Aim.  This paper draws on data from a study which investigated how Australian nursing home staff constructed staff-family relationships. Background.  Working with the family in aged care to provide the best care possible is consistent with modern nursing philosophy which espouses holistic care. The quality and enjoyment of the experience however, is frequently fraught with problems and challenges for both the staff and the family involved. Design.  A qualitative constructivist design as described by Guba and Lincoln [Fourth Generation Evaluation. Sage Publications, London.] was used. Method.  Thirty paid caregivers drawn from eight nursing homes were interviewed about their experiences of working with residents' families. A constant comparative method of data analysis was used to arrive at the findings. Results.  This paper reports on seven themes under the category of 'unacceptable behaviours'. These themes describe a range of attitudes and behaviours exhibited by families which staff members found undesirable. Conclusions.  Staff members found a number of family behaviours challenging. Nursing home staff perceives the family as subordinate to their needs and want to retain control of the work environment. Relevance to clinical practice.  Nursing home staff need to move away from custodial models of care focused on 'getting the work done' and develop more family friendly work practices that are inclusive of the needs of the family and view them as equal partners in care.

Sexual behaviours of clients of sex workers reported within phone calls at HIV/AIDS/STIs Italian Helpline

Directory of Open Access Journals (Sweden)

Ilaria Mulieri

2013-06-01

Full Text Available BACKGROUND: Clients of sex workers represent a relevant target for interventions aimed at the prevention of HIV and sexually transmitted infections (STIs. Within prevention strategies, the AIDS and sexually transmitted infections helpline (Telefono Verde AIDS/ IST, TVA-IST of National Institute of Health in Italy has provided, since 1987, specific information and counselling interventions. AIM: The present study reports data on anagraphical characteristics and behaviours of clients of sex workers, anonymously reported at TVA-IST in the period 1987-2010. DISCUSSION: Among 95 149 phone calls (14% of the total considered 99.5% came from males, over 80% aged under 37 years and prevalently from Northern Italy. Among sexual behaviours, unprotected sexual intercourses were reported in the 26% of the calls. Subjects under 27 years reported a higher frequency of unprotected anal intercourse, while they used protection with oral and vaginal intercourses in a greater extent than older ones. Due to differential behaviours within clients of sex workers, specific informative strategies for this targeted population should adequately consider age-related differences.

The behaviours that dementia care home staff in South Africa find challenging: An exploratory study.

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van Wyk, Adele; Manthorpe, Jill; Clark, Charlotte

2017-10-01

Background Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion This exploratory study identified care home workers' desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents' distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents' distressed behaviour. Training should be developed in South Africa to promote good practice.

The transtheoretical model and strategies of European fitness professionals to support clients in changing health-related behaviour: A survey study

NARCIS (Netherlands)

Middelkamp, P.J.C.; Wolfhagen, P.; Steenbergen, B.

2015-01-01

Introduction: The transtheoretical model of behaviour change (TTM) is often used to understand and predict changes in health related behaviour, for example exercise behaviour and eating behaviour. Fitness professionals like personal trainers typically service and support clients in improving

Predicting Change in Emotional and Behavioural Problems during Inpatient Treatment in Clients with Mild Intellectual Disability

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Tenneij, Nienke; Didden, Robert; Koot, Hans M.

2011-01-01

Background: Little is known about client characteristics that are related to outcome during inpatient treatment of adults with mild intellectual disability (ID) and severe behavioural problems. Method: We explored variables that were related to a change in behavioural problems in 87 individuals with mild ID during inpatient treatment in facilities…

The Competitive Advantage: Client Service.

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Leffel, Linda G.; DeBord, Karen B.

The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…

Dynamics of the HIV epidemic in southern China: sexual and drug-using behaviours among female sex workers and male clients in Yunnan.

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Xu, J J; Smith, M K; Chu, J; Ding, G W; Chang, D F; Sharp, G B; Qian, H Z; Lu, L; Bi, A M; Wang, N

2012-09-01

To examine the HIV/sexually transmitted infection (STI)-related risk behaviours among community-based female sex workers (FSWs) and their clients in Yunnan Province, China, we performed a cross-sectional study of 705 FSWs and 100 male clients. We found that HIV seroprevalence among FSWs was 13.0% and the most prevalent STI was herpes simplex virus type 2 (HSV-2) (71.1%), followed by Chlamydia trachomatis (18.1%) and syphilis (8.8%). The 20% of FSWs who reported injection drug use also reported needle-sharing behaviours in the last three months. Drug-using FSWs had substantially higher HIV and HSV-2 prevalence, serviced more clients and had a longer history of sex work than non-using FSWs. In total, 57.0% of male clients did not consistently use condoms with FSWs, 2.0% reported illicit drug use and 17.0% had STI symptoms in the last year. The dual risk behaviours of drug-using FSWs and clients place them at greater risk of HIV infection. Intervention programmes must adopt comprehensive methods.

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

OpenAIRE

Hj.Indirawaty; Syamsuddin AB

2015-01-01

ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing re...

Staff perceptions of challenging parent-staff interactions and beneficial strategies in the Neonatal Intensive Care Unit.

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Friedman, Joshua; Friedman, Susan Hatters; Collin, Marc; Martin, Richard J

2018-01-01

To characterise neonatal intensive care unit (NICU) staff perceptions regarding factors which may lead to more challenging staff-parent interactions, and beneficial strategies for working with families with whom such interactions occur. A survey of 168 physician and nursing staff at two NICUs in American teaching hospitals inquired about their perceptions of challenging parent-staff interactions and situations in which such interactions were likely to occur. From a medical perspective, staff perceptions of challenging interactions were noted when infants had recent decompensation, high medical complexity, malformations or long duration of stay in the NICU. From a psychological/social perspective, a high likelihood of challenging interactions was noted with parents who were suspicious, interfere with equipment, or parents who hover in the NICU, express paranoid or delusional thoughts, repeat questions, perceive the staff as inaccessible, are managing addictions, or who require child protective services involvement. Frequent family meetings, grieving opportunities, education of parents, social work referrals, clearly defined rules, partnering in daily care and support groups were perceived as the most beneficial strategies for improving difficult interactions. This study delineates what staff perceive as challenging interactions and provides support for an educational and interventional role that incorporates mental health professionals. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Exploring Lawyer-Client Interaction: A Qualitative Study of Positive Lawyer Characteristics.

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Elbers, Nieke A; van Wees, Kiliaan A P C; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

2012-03-01

Personal injury victims involved in compensation processes have a worse recovery than those not involved in compensation processes. One predictor for worse recovery is lawyer engagement. As some people argue that this negative relation between lawyer engagement and recovery may be explained by lawyers' attitude and communications to clients, it seems important to investigate lawyer-client interaction. Although procedural justice and therapeutic jurisprudence had previously discussed aspects relevant for lawyer-client interaction, the client's perspective has been rather ignored and only few empirical studies have been conducted. In this qualitative study, 21 traffic accident victims were interviewed about their experiences with their lawyer. Five desirable characteristics for lawyers were identified: communication, empathy, decisiveness, independence, and expertise. Communication and empathy corresponded with aspects already discussed in literature, whereas decisiveness, independence and expertise had been addressed only marginally. Further qualitative and quantitative research is necessary to establish preferable lawyer characteristics and to investigate what would improve the well-being of personal injury victims during the claims settlement process.

Negative Emotional Reactions to Challenging Behaviour and Staff Burnout: Two Replication Studies

Science.gov (United States)

Rose, David; Horne, Sharon; Rose, John L.; Hastings, Richard P.

2004-01-01

Background: Hastings, R. P. ["American Journal on Mental Retardation" (2002) Vol. 107, pp. 455-467] hypothesized that staff negative emotional reactions to challenging behaviour might accumulate over time to affect staff well-being. Only one previous study (Mitchell, G.& Hastings, R. P. ["American Journal on Mental…

The Relationship between Reciprocity and the Emotional and Behavioural Responses of Staff

Science.gov (United States)

Thomas, Cathryn; Rose, John

2010-01-01

Background: The current study examines a model relating to the concept of reciprocity and burnout in staff, incorporating previous research findings based upon Weiner's (1980, 1986) cognitive-emotional model linking emotions, optimism and helping behaviour, with the aim of testing the model. Materials: Staff working in community homes within the…

Training Teaching Staff to Facilitate Spontaneous Communication in Children with Autism: Adult Interactive Style Intervention (AISI)

Science.gov (United States)

Kossyvaki, Lila; Jones, Glenys; Guldberg, Karen

2016-01-01

Previous research has demonstrated that the way adults interact with children with autism can have a great impact on their spontaneous communication. However, to date, few studies have focused on modifying adults' behaviour and even fewer have been conducted in school settings which actively involve teaching staff in designing the intervention.…

Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions.

Science.gov (United States)

Kelly, Peter J; Leung, Joanne; Deane, Frank P; Lyons, Geoffrey C B

2016-11-01

Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. The sample consisted of 220 substance-dependent individuals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regression examined the predictors of further treatment attendance. The full model accounted for 21% of the variance in treatment attendance, with attitude and Implementation Intentions contributing significantly to the prediction. Findings from the present study would suggest that assisting clients to develop a specific treatment plan, as well as helping clients to build positive perceptions about subsequent treatment, will promote greater attendance at further treatment following detoxification. [Kelly PJ, Leung J, Deane FP, Lyons GCB. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions. Drug Alcohol Rev 2016;35:678-685]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Training staff to promote self-management in people with intellectual disabilities.

Science.gov (United States)

Sandjojo, Janice; Zedlitz, Aglaia M E E; Gebhardt, Winifred A; Hoekman, Joop; Dusseldorp, Elise; den Haan, Jeanet A; Evers, Andrea W M

2018-02-26

People with intellectual disabilities have increasing difficulties managing their daily affairs. This study examined the effectiveness of a staff training, which teaches staff to promote self-management in people with intellectual disabilities. Effectiveness was assessed with questionnaires addressing clients' (n = 26) independence and self-reliance, support needs and challenging behaviour, using a pre-posttest control group design. Additionally, focus groups were conducted with trained staff members 6 months after the training. In the long term, the intervention group showed a significant increase in independence and self-reliance, in contrast to the comparison group. No effect was found on support needs and challenging behaviour. Trained staff members reported limited benefits of the training, but had noticed changes in their attitude and method of working afterwards. Further self-management research is required to investigate how independence and self-reliance can be promoted more effectively in this population. Future trainings should carefully consider their content, format, and implementation. © 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.

Constructive conflict and staff consensus in substance abuse treatment.

Science.gov (United States)

Melnick, Gerald; Wexler, Harry K; Chaple, Michael; Cleland, Charles M

2009-03-01

Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.

Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis

NARCIS (Netherlands)

Hazelhof, T.J.G.M.; Schoonhoven, L.; Gaal, B.G. van; Koopmans, R.T.C.M.; Gerritsen, D.L.

2016-01-01

AIM: Provide insight into the concept of stress in the context of challenging behaviour of nursing home residents with dementia and its causes and consequences. BACKGROUND: Challenging behaviour is frequent in residents with dementia, but consequences for nursing staff are unclear. INTRODUCTION:

Evaluating a staff training program on the interaction between staff and people with intellectual disability and challenging behaviour : An observational study

NARCIS (Netherlands)

Embregts, P.J.C.M.; Zijlmans, L.; Gerits, L.; Bosman, A.M.T.

2018-01-01

Background: The aim of this study was to evaluate the effects of a training program focusing on improvement of emotional intelligence (EI) and support staffs’ awareness of their behaviour towards people with an intellectual disability based on interactional patterns. The support provided regarding

Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

Science.gov (United States)

Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

2015-03-01

Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for

Social exchange as a framework for client-nurse interaction during public health nursing maternal-child home visits.

Science.gov (United States)

Byrd, Mary E

2006-01-01

The purpose of this paper was to develop a nursing-focused use of social exchange theory within the context of maternal-child home visiting. The nature of social exchange theory, its application to client-nurse interaction, and its fit with an existing data set from a field research investigation were examined. Resources exchanged between the nurse and clients were categorized and compared across the patterns of home visiting, nursing strategies based on exchange notions were identified, and variations in exchange were linked with client outcomes. The nurse provided resources within the categories of information, status, service, and goods. Clients provided time, access to the home, space within the home to conduct the visit, opportunities to observe maternal-child interaction, access to the infant, and information. The ease and breadth of resource exchange varied across the patterns of home visiting. The social exchange perspective was useful in categorizing resources, specifying and uncovering new resource categories, understanding nursing strategies to initiate and maintain the client-nurse relationship, and linking client-nurse interactive phenomena with client outcomes. Social exchange theory is potentially useful for understanding client-nurse interaction in the context of maternal-child home visits.

Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires.

Science.gov (United States)

Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

2014-01-01

Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

45 CFR 1608.7 - Attorney-client relationship.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Attorney-client relationship. 1608.7 Section 1608... PROHIBITED POLITICAL ACTIVITIES § 1608.7 Attorney-client relationship. Nothing in this part is intended to prohibit an attorney or staff attorney from providing any form of legal assistance to an eligible client...

Evaluating the effectiveness of a healthy lifestyle clinician in addressing the chronic disease risk behaviours of community mental health clients: study protocol for a randomised controlled trial.

Science.gov (United States)

Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wye, Paula; Clancy, Richard; Castle, David; Wutzke, Sonia; Rissel, Chris; Wilson, Andrew; McCombie, Paul; Murphy, Fionna; Bowman, Jenny

2017-06-15

People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia. This protocol describes a randomised controlled trial that aims to assess the effectiveness of allocating a clinician within a community mental health service to the specific role of providing assessment, advice and referral for clients' chronic disease risk behaviours. Approximately 540 clients of one community mental health service will be randomised to receive either usual care for chronic disease risks provided in routine consultations or usual care plus an additional face-to-face consultation and follow-up telephone call with a 'healthy lifestyle clinician'. The clinician will assess clients' chronic disease risk behaviours, provide advice to change behaviours, and refer at-risk clients to free telephone coaching services (New South Wales (NSW) Quitline and NSW Get Healthy Information and Coaching Service) for specialist behaviour change care. The primary outcomes, regarding referral to and client uptake of the telephone services, will be obtained from the respective services. Telephone interviews of clients at baseline and at 1 and 6 months post baseline follow-ups will assess secondary outcomes: receipt of any assessment, advice and referral from the mental health service; satisfaction with the receipt of such care; satisfaction with the receipt of any care provided by the telephone services; interest and confidence in and perceived importance of changing risk behaviours; and risk behaviour status. This study will add

Staff attributions towards men with intellectual disability who have a history of sexual offending and challenging behaviour

OpenAIRE

Mackinlay, L.; Langdon, Peter E.

2009-01-01

Background Staff working within secure services for people with intellectual disabilities (ID) are likely to work with sexual offenders, but very little attention has been paid to how they think about this sexual offending behaviour.\\ud \\ud \\ud Method Forty-eight staff working within secure services for people with ID were recruited and completed the Attribution Style Questionnaire in relation to the sexual offending behaviour and challenging behaviour of men with mild ID. Attributions toward...

The ties that bind? Social networks of nursing staff and staff’s behaviour towards residents with dementia.

NARCIS (Netherlands)

Beek, A.P.A. van; Wagner, C.; Frijters, D.H.M.; Ribbe, M.W.; Groenewegen, P.P.

2013-01-01

This study investigated social networks of nursing staff and staff's behaviour towards residents with dementia. We focused on two types of networks: communication networks among staff, and networks between nursing staff and relatives/acquaintances of residents. Data was collected in 37 long-term

Seeking what matters: determinants of clients' satisfaction in obstetric care services in Pakistan.

Science.gov (United States)

Ali, Moazzam; Qazi, Muhammad Suleman; Seuc, Armando

2014-01-01

Aim of this study was to determine the dimensions of the service quality in the public hospitals and evaluate the determinants of client satisfaction in obstetric health in the context of Pakistan. The present research evaluates the application of an integrated client satisfaction model that draws mainly from the original SERVQUAL framework in obstetric health services. We conducted a cross-sectional study, in four public district hospitals in Pakistan, enrolling 1101 clients attending obstetric health care services. Measures of service quality and determinants of client satisfaction were factor-analysed and multiple regression analysis was used to test the hypothesis. The client satisfaction increased significantly with increases in respondent's age, number of children, number of visits and with decrease in educational status. Factor analysis revealed five service quality dimensions; and multiple regression analysis showed that all five dimensions of service quality in obstetric care were significant in explaining client satisfaction. The most powerful predictor for client satisfaction was provider communication with clients, followed by responsiveness and discipline. Interventions aimed at improving client provider interaction would not only advance the clinical provision of services, butwould also result in greater patient satisfaction with the services provided, leading to higher levels of facility utilization and continuity of care. Better client provider interaction can be accomplished at hospital's level through focused training of all cadre of service providers sensitizing them on clients' needs. Results also showed that the proposed framework is a valid and flexible instrument in assessing and monitoring service quality and enabling staff to identify where improvements are needed, from the clients' perspective.

The impact of prison staff responses on self-harming behaviours: prisoners' perspectives.

Science.gov (United States)

Marzano, Lisa; Ciclitira, Karen; Adler, Joanna

2012-03-01

To further understanding of how health and correctional staff responses to self-harming behaviours influence prisoners and their subsequent actions. Participant-centred, qualitative methods were used to explore the complex and under-researched perspectives of self-harming male prisoners. Semi-structured interviews were conducted with 20 adult male prisoners who had engaged in repetitive, non-suicidal self-harm during their current prison sentence, or considered doing so. The interviews were analyzed drawing on principles of thematic analysis and discourse analysis. With some exceptions, prison officers, nurses, and doctors are portrayed by prisoners as being ill-prepared to deal with repetitive self-harm, often displaying actively hostile attitudes and behaviours. These findings underscore the need for appropriate training, support and supervision for staff working with self-harming prisoners. ©2011 The British Psychological Society.

Gardening with Huntington's disease clients--creating a programme of winter activities.

Science.gov (United States)

Spring, Josephine Anne; Baker, Mark; Dauya, Loreane; Ewemade, Ivie; Marsh, Nicola; Patel, Prina; Scott, Adrienne; Stoy, Nicholas; Turner, Hannah; Viera, Marc; Will, Diana

2011-01-01

A programme of garden-related indoor activities was developed to sustain a gardening group for people with mid to late stage Huntington's disease during the winter. The activities were devised by the horticulturist, working empirically, involving the services occupational therapist, physiotherapist, occupational therapy art technician, computer room, recreation and leisure staff. The programme was strongly supported by the nursing and care staff. Feedback on the effectiveness of the activities was sought from the clients, team members and unit staff. The clients' interest in gardening was sustained by a multidisciplinary programme of indoor growing and using plant products in creative activities, computing and group projects. The clients enjoyed all activities except one that they said lacked contact with plants. The inexpensive programme of activities enabled creativity and self-expression, stimulated social contact and helped with therapeutic goals of the clients. In addition, it engaged the multi-disciplinary team and the unit staff, was practical and enhanced the environment.

Can retail banking clients' attrition be managed?

Directory of Open Access Journals (Sweden)

Agaliotis Konstantinos

2015-01-01

Full Text Available The rurrο_e of all banks across the universe is to satisfy their clients' necessities. One of the predominant impacts of the last few years' financial crisis in Europe was the way in which customers interact with their banks. The theory of 'main bank' is not any more the case as clients' trust toward banks fades away together with their loyalty. Nowadays, it is necessary for banks to segment their clientele data base, and target the most profitable clients. The retention strategy of each financial institution becomes more and more important as the value of each retained customer is disproportional to the cost of acquiring a new one. The main findings of the subject retail banking clients' retention policy analysis prove that clients of different lifetime value have different propensity to defect. At the same time, the ability of a bank to retain a potential defector does not depend directly on satisfying the defection reason. Many of the various bank counter offers which do not directly satisfy the reason that a client refers to as the 'defection' one, are enough in order to retain a client. Equally important to the identification of clients' behavioural patterns is the use of the subject findings on behalf of the retail oriented banks in order to predict accurately the cost of future defection, as well as, to incorporate one more measurable parameter in their credit risk scorecards i.e. the intention to increase credit exposure.

Opening the Black Box of Cognitive-Behavioural Case Management in Clients with Ultra-High Risk for Psychosis

NARCIS (Netherlands)

Hartmann, Jessica A.; McGorry, Patrick D.; Schmidt, Stefanie J.; Amminger, G. Paul; Yuen, Hok Pan; Markulev, Connie; Berger, Gregor E.; Chen, Eric Y. H.; de Haan, Lieuwe; Hickie, Ian B.; Lavoie, Suzie; McHugh, Meredith J.; Mossaheb, Nilufar; Nieman, Dorien H.; Nordentoft, Merete; Riecher-Rössler, Anita; Schäfer, Miriam R.; Schlögelhofer, Monika; Smesny, Stefan; Thompson, Andrew; Verma, Swapna Kamal; Yung, Alison R.; Nelson, Barnaby

2017-01-01

Background: Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT and the

Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients.

Science.gov (United States)

Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo

2018-04-25

Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. © 2018 Nordic College of Caring Science.

A theory led narrative review of one-to-one health interventions: the influence of attachment style and client-provider relationship on client adherence.

Science.gov (United States)

Nanjappa, S; Chambers, S; Marcenes, W; Richards, D; Freeman, R

2014-10-01

A theory-led narrative approach was used to unpack the complexities of the factors that enable successful client adherence following one-to-one health interventions. Understanding this could prepare the provider to anticipate different adherence behaviours by clients, allowing them to tailor their interventions to increase the likelihood of adherence. The review was done in two stages. A theoretical formulation was proposed to explore factors which influence the effectiveness of one-to-one interventions to result in client adherence. The second stage tested this theory using a narrative synthesis approach. Eleven studies across the health care arena were included in the synthesis and explored the interplay between client attachment style, client-provider interaction and client adherence with health interventions. It emerged that adherence results substantially because of the relationship that the client has with the provider, which is amplified or diminished by the client's own attachment style. This occurs because the client's attachment style shapes how they perceive and behave in relationships with the health-care providers, who become the 'secure base' from which the client accepts, assimilates and adheres with the recommended health intervention. The pathway from one-to-one interventions to adherence is explained using moderated mediation and mediated moderation models. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Impact of Intervention to Improve Nursing Home Resident-Staff Interactions and Engagement.

Science.gov (United States)

Hartmann, Christine W; Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Allen, Rebecca S; Zhao, Shibei; Wewiorski, Nancy J; Sullivan, Jennifer L; Dillon, Kristen; Clark, Valerie; Berlowitz, Dan R; Snow, Andrea Lynn

2018-04-30

For nursing home residents, positive interactions with staff and engagement in daily life contribute meaningfully to quality of life. We sought to improve these aspects of person-centered care in an opportunistic snowball sample of six Veterans Health Administration nursing homes (e.g., Community Living Centers-CLCs) using an intervention that targeted staff behavior change, focusing on improving interactions between residents and staff and thereby ultimately aiming to improve resident engagement. We grounded this mixed-methods study in the Capability, Opportunity, Motivation, Behavior (COM-B) model of behavior change. We implemented the intervention by (a) using a set of evidence-based practices for implementing quality improvement and (b) combining primarily CLC-based staff facilitation with some researcher-led facilitation. Validated resident and staff surveys and structured observations collected pre and post intervention, as well as semi-structured staff interviews conducted post intervention, helped assess intervention success. Sixty-two CLC residents and 308 staff members responded to the surveys. Researchers conducted 1,490 discrete observations. Intervention implementation was associated with increased staff communication with residents during the provision of direct care and decreased negative staff interactions with residents. In the 66 interviews, staff consistently credited the intervention with helping them (a) develop awareness of the importance of identifying opportunities for engagement and (b) act to improve the quality of interactions between residents and staff. The intervention proved feasible and influenced staff to make simple enhancements to their behaviors that improved resident-staff interactions and staff-assessed resident engagement.

Opening the Black Box of Cognitive-Behavioural Case Management in Clients with Ultra-High Risk for Psychosis

DEFF Research Database (Denmark)

Hartmann, Jessica A.; McGorry, Patrick D.; Schmidt, Stefanie J.

2017-01-01

Background: Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT and the se...

Attitudes of Nursing Facilities' Staff Toward Pharmacy Students' Interaction with its Residents.

Science.gov (United States)

Adkins, Donna; Gavaza, Paul; Deel, Sharon

2017-06-01

All Appalachian College of Pharmacy second-year students undertake the longitudinal geriatric early pharmacy practice experiences (EPPE) 2 course, which involves interacting with geriatric residents in two nursing facilities over two semesters. The study investigated the nursing staff's perceptions about the rotation and the pharmacy students' interaction with nursing facility residents. Cross-sectional study. Academic setting. 63 nursing facility staff. A 10-item attitude survey administered to nursing staff. Nursing staff attitude toward pharmacy students' interaction with geriatric residents during the course. Sixty-three responses were received (84% response rate). Most respondents were female (95.2%), who occasionally interacted with pharmacy students (54.8%) and had worked at the facilities for an average of 6.8 years (standard deviation [SD] = 6.7) years. Staff reported that pharmacy students practiced interacting with geriatric residents and nursing facility staff, learned about different medications taken by residents as well as their life as a nursing facility resident. In addition, the student visits improved the mood of residents and staff's understanding of medicines, among others. Staff suggested that students spend more time with their residents in the facility as well as ask more questions of staff. The nursing facility staff generally had favorable attitudes about pharmacy students' visits in their nursing facility. Nursing facility staff noted that the geriatric rotation was a great learning experience for the pharmacy students.

Client Centred Desing

DEFF Research Database (Denmark)

Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

2008-01-01

In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

Client experiences of motivational interviewing: An interpersonal process recall study.

Science.gov (United States)

Jones, Sarah A; Latchford, Gary; Tober, Gillian

2016-03-01

To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse. A qualitative study using grounded theory. Interviews with nine clients were conducted using interpersonal process recall (IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour. These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship. Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. © 2015 The British Psychological Society.

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.

Science.gov (United States)

Klein, Britt; Clinnick, Lisa; Chesler, Jessica; Stranieri, Andrew; Bignold, Adam; Dazeley, Richard; McLaren, Suzanne; Lauder, Sue; Balasubramanian, Venki

2018-01-01

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.

Coping with Challenging Behaviours of Children with Autism: Effectiveness of Brief Training Workshop for Frontline Staff in Special Education Settings

Science.gov (United States)

Ling, C. Y. M.; Mak, W. W. S.

2012-01-01

Background: The present study examined the effectiveness of three staff training elements: psychoeducation (PE) on autism, introduction of functional behavioural analysis (FBA) and emotional management (EM), on the reaction of challenging behaviours for frontline staff towards children with autism in Hong Kong special education settings. Methods:…

[Effects of an intensive therapy program for behaviorally disordered mentally handicapped patients on staff personnel in residential care].

Science.gov (United States)

Elbing, U; Rohmann, U H

1994-03-01

This study evaluates the effects of an intensive therapy program designed for mentally handicapped persons with severely disturbed or autistic behavior on their staff personal which had an active role in the program. The staff members rated their professional competence, quality of interaction with the client, team culture and work satisfaction before and after being engaged in the program, with additional ratings of their personal aims at the beginning of the program. Three sets of data were obtained with the program being conducted three times in a row. The testings of the related as well as the independent samples show differentiated program effects. The main effect is an increase of the professional competence and quality of interaction, especially by the qualified staff members. Trainees put emphasis on the development of their personal relationship with the client. The results are discussed in terms of the impact of learning processes specific to the roles of the staff members and motivational factors on learning and therapy outcome, along with institutional conditions influencing successful learning. Thus the program facilitates the professional and interpersonal learning process of staff members in a specific way with success as well as with limitations.

Coaching in style: A sequential analysis of interpersonal styles in coach-client interactions

NARCIS (Netherlands)

Ianiro, P.M.; Lehmann-Willenbrock, N.K.; Kauffeld, S.

2015-01-01

Purpose: Despite calls for studying interaction processes in coaching, little is known about the link between coach–client interactions and coaching success. In particular, interpersonal behavior in coaching remains unexplored, although it is considered highly relevant to social relationships and

Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities.

Science.gov (United States)

van Wijk, Evalina; Traut, Annalene; Julie, Hester

2014-08-14

Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment. The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.

The Impact of Organizational Stress and Burnout on Client Engagement

Science.gov (United States)

Landrum, Brittany; Knight, Danica K.; Flynn, Patrick M.

2011-01-01

This paper explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices that impact client engagement (Broome, Flynn, Knight, & Simpson, 2007). The current study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the U.S. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, while engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress, but was not related to participation. Two additional organizational measures – workload and influence – moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed. PMID:22154029

Does Self-Image Matter? Client's Self-Image, Behaviour and Evaluation of a Career Counselling Session: An Exploratory Study

Science.gov (United States)

Schedin, Gunnar; Armelius, Kerstin

2008-01-01

This exploratory study addresses differences in self-image as a client characteristic in career counselling by using the Structural Analysis of Social Behaviour (Benjamin, L., "Journal of Consulting and Clinical Psychology," 64(6), 1203-1212, 1996; Benjamin, L., "Journal of Personality Assessment," 66(2), 248-266, 1996) and an adaptation…

Using HL7 in hospital staff assignments.

Science.gov (United States)

Unluturk, Mehmet S

2014-02-01

Hospital staff assignments are the instructions that allocate the hospital staff members to the hospital beds. Currently, hospital administrators make the assignments without accessing the information regarding the occupancy of the hospital beds and the acuity of the patient. As a result, administrators cannot distinguish between occupied and unoccupied beds, and may therefore assign staff to unoccupied beds. This gives rise to uneven and inefficient staff assignments. In this paper, the hospital admission-discharge-transfer (ADT) system is employed both as a data source and an assignment device to create staff assignments. When the patient data is newly added or modified, the ADT system updates the assignment software client with the relevant data. Based on the relevant data, the assignment software client is able to construct staff assignments in a more efficient way. © 2013 Elsevier Ltd. All rights reserved.

Speaking for the Client

DEFF Research Database (Denmark)

Mik-Meyer, Nanna; Silverman, D.

. Nonetheless staff often assume that their clients were at the centre of the encounter, even when there is little indication that they understand the Danish language spoken. In order to analyze and explain dilemmas like these, we draw on symbolic interactionism and conversation analysis, placing linguistic...

Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities

Directory of Open Access Journals (Sweden)

Evalina van Wijk

2014-08-01

Objectives: The aim of the study was to describe patients’ perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. Research design: A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Method: Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch’s descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Results: Analysis of the data indicates two central categories in the factors contributing to patients’ aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. Conclusion: From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.

Staff Judgements of Responsibility for the Challenging Behaviour of Adults with Intellectual Disabilities

Science.gov (United States)

Dagnan, D.; Cairns, M.

2005-01-01

This study examines the importance of staff judgements of responsibility for challenging behaviour in predicting their emotional and intended helping responses. Sixty-two carers completed questionnaires rating attributions of internality, stability and controllability, emotions of sympathy and anger, judgements of responsibility for the…

Knowledge sharing behaviour among non-academic staff in higher learning institutes: The role of trust and perceived risk

Directory of Open Access Journals (Sweden)

Muhammad Sabbir Rahman

2018-03-01

Full Text Available The purpose of the paper is to analyse knowledge sharing behaviour among non-academic staff of higher learning institutions. This research focuses on the mediation impact of perceived risk on trust and knowledge sharing behaviour. The research also proposes actions that can be taken by higher learning institutions to enhance trust among the staff in order to create a knowledge sharing environment at the workplace. This research applied confirmatory factor analysis and Structural Equation Modeling (SEM to evaluate the proposed measurement model and proved the research hypotheses. The findings from the research show that perceived risk plays a strong mediating role between trust and knowledge sharing behaviour among the non-academic staff of higher learning institutions. The SEM analysis also confirmed that the research model shows a good fit. This research highlights issues concerning knowledge sharing practices among non-academic staff and provides some recommendations to the managers to address these issues. The researchers agreed that more research needs to be done in this area as there are aspects that are yet to be explored. The findings of this research serve to add to the literature on knowledge sharing focussing on non-academic staff of higher learning institutions.

Development of a Nutrition Education Intervention for Food Bank Clients.

Science.gov (United States)

Dave, Jayna M; Thompson, Deborah I; Svendsen-Sanchez, Ann; McNeill, Lorna Haughton; Jibaja-Weiss, Maria

2017-03-01

The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtaining service from the Houston Food Bank (HFB). Participants were HFB and pantry staff and clients. Interview data were coded and analyzed using grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Data were used to tailor the curriculum to the target population. Six HFB staff, 49 pantry staff from 17 pantries, and 54 clients from 10 pantries participated in interviews and focus groups and completed questionnaires. The participants provided opinion on the current nutrition education provided via the food bank and made suggestions on strategies for development of an intervention. Their feedback was used to develop the six-session intervention curriculum to be delivered over 6 months. This research provides evidence that it is critical for members of the target audience be included in formative research to develop behavior change programs that are relevant and appealing and target their needs and interests.

Substance abusers' personality disorders and staff members' emotional reactions

Directory of Open Access Journals (Sweden)

Hesse Morten

2008-04-01

Full Text Available Abstract Background Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions. Methods Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations. Results Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.

"I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service.

Science.gov (United States)

Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Breen, Courtney

2017-12-06

The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential

Staying in the Here-and-Now: A Pilot Study on the Use of Dialectical Behaviour Therapy Group Skills Training for Forensic Clients with Intellectual Disability

Science.gov (United States)

Sakdalan, J. A.; Shaw, J.; Collier, V.

2010-01-01

Background: Dialectic behaviour therapy (DBT) has been widely used with individuals diagnosed with borderline personality disorder who exhibit severe emotional and behavioural dysregulation. There is a paucity of research in assessing the effectiveness of DBT with forensic clients with intellectual disability (ID). Methods: This pilot study aims…

Interactive Relationship between Job Involvement, Job Satisfaction, Organisational Citizenship Behaviour, and Organizational Commitment in Nigerian Universities

OpenAIRE

B.M. Nwibere

2014-01-01

The study examined the interactive relationship between job involvement, job satisfaction, organisational commitment citizenship behaviour (OCB) and organisational commitment among employees of Nigerian universities. The sample for the study consisted of two hundred and ten academic members of staff (210) from five (5) Federal Government owned universities in the Niger Delta Region of Nigeria. The study utilized both quantitative data (questionnaire) and qualitative data (interview). The Mult...

Chaperone-client complexes: A dynamic liaison

Science.gov (United States)

Hiller, Sebastian; Burmann, Björn M.

2018-04-01

Living cells contain molecular chaperones that are organized in intricate networks to surveil protein homeostasis by avoiding polypeptide misfolding, aggregation, and the generation of toxic species. In addition, cellular chaperones also fulfill a multitude of alternative functionalities: transport of clients towards a target location, help them fold, unfold misfolded species, resolve aggregates, or deliver clients towards proteolysis machineries. Until recently, the only available source of atomic resolution information for virtually all chaperones were crystal structures of their client-free, apo-forms. These structures were unable to explain details of the functional mechanisms underlying chaperone-client interactions. The difficulties to crystallize chaperones in complexes with clients arise from their highly dynamic nature, making solution NMR spectroscopy the method of choice for their study. With the advent of advanced solution NMR techniques, in the past few years a substantial number of structural and functional studies on chaperone-client complexes have been resolved, allowing unique insight into the chaperone-client interaction. This review summarizes the recent insights provided by advanced high-resolution NMR-spectroscopy to understand chaperone-client interaction mechanisms at the atomic scale.

Role Stressors, Engagement and Work Behaviours: A Study of Higher Education Professional Staff

Science.gov (United States)

Curran, Tara M.; Prottas, David J.

2017-01-01

The study used data provided by 349 professional staff employees from 17 different US higher education institutions to assess aspects of their working conditions that could influence their own work engagement and the work-related behaviours of their colleagues. Relationships among three role stressors (role ambiguity, role conflict and role…

Developing Teaching Assistants' Skills in Positive Behaviour Management: An Application of Video Interaction Guidance in a Secondary School

Science.gov (United States)

Hayes, Ben; Richardson, Sally; Hindle, Sarah; Grayson, Katy

2011-01-01

This paper reports an action research project in a school in the UK designed to investigate the impact of a brief Video Interaction Guidance (VIG) intervention in promoting skills of non-teaching staff in positive behaviour management. A summary of the literature in relation to VIG is provided before describing the project and data collected. Ten…

Understanding the innovation adoption process of construction clients, Clients driving Innovation

NARCIS (Netherlands)

Hartmann, Andreas; Dewulf, Geert P.M.R.; Reymen, Isabelle; Adams, L.; Guest, K.

2006-01-01

Although the role of clients in stimulating construction innovation seems to be controversial, little has been known about their innovation adoption behaviour. This paper presents first results of an ongoing research project the aim of which is to shed more light on the adoption processes of

Perceptions and expectations of regular support meetings between staff and people with an intellectual disability

NARCIS (Netherlands)

Reuzel, E.A.A.; Embregts, P.J.C.M.; Bosman, A.; van de Nieuwenhuizen, M.; Jahoda, A.

2017-01-01

Background Client-centred models of care emphasise the importance of collaborative working between staff and clients with an intellectual disability (ID). How people with an ID perceive the nature of their engagement with staff is relatively unknown. This study investigated the perceptions of staff

TERAPI RUMATAN METADONE: KETANGGAPAN PASIEN, SIKAP STAFF DAN PENERIMAAN MASYARAKAT

Directory of Open Access Journals (Sweden)

Siti Isfandari

2012-11-01

Full Text Available To minimize impact of injection drug use on HIV/AIDS transmission, known as Harm Reduction, a longitudinal study on methadone maintenance substitution (MMS trial was conducted in Drug Dependence Hospital, Jakarta in November 2003 and Sanglah Hospital, Denpasar in Januury 2004. Respondents of the study were 58 methadone clients From Jakarta and 22 from Denpasar, as well as 11 RSKO's staffs and seven staffs from Sanglah Hospital. Data were collected by questionnaires, interviews and focus group discussion in the third and sixth month from the client admission. In addition to minimize HIV/AIDS transmission, other benefit of the program is to increase productivity and social participation of the MMS participants. Applying the WHO responsiveness concept for health service performance, we measured the performance of MMS. Both In the first three and six month, patients had positif responsiveness with total and component average score not less than 30. But there was no significant change comparing responsiveness in the third and sixth month. Among the components of responsiveness, information and communication received most positif evaluation from patients, while regulation received the lowest evaluation. Generally, all patients support the MMS program. Staffs of MMS had neutral attitude toward the program, try their best to perform their job and learn to understand more on their clients world. The conclusionis that MMS indeed provide positive impact to the clients, and further understanding from staffs toward their clients is necessary for better communication with the clients.

Staff attributions of the causes of challenging behaviour in children and adults with profound intellectual and multiple disabilities

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Poppes, P.; van der Putten, A.A.J.; ten Brug, A.; Vlaskamp, C.

A study has shown that staff do not generally perceive challenging behaviour in people with profound intellectual and multiple disabilities (PIMD) as being of serious consequence. In this study we aimed to gain a better understanding of the causal explanations that direct care and support staff give

Anxiety in mammography: mammographers' and clients' perspectives

International Nuclear Information System (INIS)

Galletta, S.; Joel, N.; Maguire, R.; Weaver, K.; Poulos, A.

2003-01-01

The aim of this study was to identify causes of anxiety experienced by mammographers and clients during mammography and strategies to decrease the anxiety generated by the mammographic procedure. Two questionnaires were distributed: one to mammographers in public and private centres within NSW, the other to women (clients) who have experienced mammography. Mammographers' and clients' rankings of causes of clients' anxiety demonstrated many similarities indicating the mammographers' acknowledgement of factors contributing to client anxiety. Thematic analysis provided important qualitative data concerning anxiety experienced by both mammographers and clients and the influence of mammographer and client behaviour on that anxiety. The results of this study have provided important new knowledge for mammographic practice and mammography education. By understanding the causes of anxiety experienced by clients, mammographers can provide an informed, empathetic approach to the mammographic process. By acknowledging factors which increase their own anxiety mammographers can reduce the impact of this on themselves and on their clients. Copyright (2003) Australian Institute of Radiography

Spiritual needs in health care settings: a qualitative meta-synthesis of clients' perspectives.

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Hodge, David R; Horvath, Violet E

2011-10-01

Spiritual needs often emerge in the context of receiving health or behavioral health services. Yet, despite the prevalence and salience of spiritual needs in service provision, clients often report their spiritual needs are inadequately addressed. In light of research suggesting that most social workers have received minimal training in identifying spiritual needs, this study uses a qualitative meta-synthesis (N=11 studies) to identify and describe clients'perceptions of their spiritual needs in health care settings. The results revealed six interrelated themes: (1) meaning, purpose, and hope; (2) relationship with God; (3) spiritual practices; (4) religious obligations; (5) interpersonal connection; and (6) professional staff interactions. The implications of the findings are discussed as they intersect social work practice and education.

Sex workers clients in Italy: results of a phone survey on HIV risk behaviour and perception

Directory of Open Access Journals (Sweden)

Ilaria Mulieri

2014-12-01

Full Text Available INTRODUCTION: Sex workers (SW clients represent a bridge population for HIV transmission from high risk to low risk general population. MATERIALS AND METHODS: A cross-sectional anonymous telephone survey was carried out at the AIDS and Sexually Transmitted Infections Helpline of National Institute of Health in Italy. The questionnaire was proposed on a voluntary basis to a sample of 119 subjects from helpline users. RESULTS: The 119 participants were all males, aged between 19 and 59 years and mostly accessed female prostitutes. Vaginal intercourses with SW were more frequently reported, followed by passive oral, active oral sex and active anal intercourses. Cumulatively, 86.6% and 84.6% of vaginal and anal intercourses were respectively reported as regularly protected by condom. DISCUSSION: The telephone interview allowed an eased access, a high response rate and a standardised evaluation of questions CONCLUSIONS: It is necessary a constant monitoring of the characteristics, behaviour, risk perception and testing of SW clients in Italian and other populations.

Staff perceptions of borderline personality disorder and recovery: A Q-sort method approach.

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Dean, Rebecca; Siddiqui, Sara; Beesley, Frank; Fox, John; Berry, Katherine

2018-04-16

This study was the first to explore how staff that work with people diagnosed with borderline personality disorder (BPD) perceive recovery in this client group. These views are important because of the crucial role that staff play in the care of people with BPD, and the challenges that staff experience with these clients. A Q methodology design was used, containing 58 statements about recovery. Twenty-nine mental health staff sorted recovery statements according to perceived importance to recovery in BPD. There were two different viewpoints about recovery in BPD. A medically oriented group viewed coping with symptoms and behaviours specific to BPD as being most important to recovery, whereas participants who were more well-being oriented viewed achieving overall well-being that was universally valued regardless of diagnosis as more important. Both groups reported that engaging in socially valued activities such as work and education was not an important aspect of recovery and that people with BPD could be considered to have recovered despite continued impairments in everyday functioning. Staff perceptions of recovery in BPD can differ, which poses risks for consistent team working, a particularly important issue in this client group due to the relational difficulties associated with the diagnosis. Multidisciplinary teams working with people diagnosed with BPD therefore need to find a forum to promote a shared understanding of each patient's needs and support plans. We advocate that team formulation is a promising approach to achieve more consistent ways of working within teams. Findings Multidisciplinary teams working with people with borderline personality disorder should use team formulations to create a shared understanding of individual patient's needs and goals for recovery, so they can deliver a consistent approach to care. Recovery questionnaires should be used to develop an understanding of a patient's individual recovery goals. Limitations Opportunity

An Abstract Interaction Concept for Designing Interaction Behaviour of Service Compositions

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Dirgahayu, T.; Quartel, Dick; van Sinderen, Marten J.; Mertins, Kai; Ruggaber, Rainer; Popplewell, Keith; Xu, Xiaofei

2008-01-01

In a service composition, interaction behaviour specifies an information exchange protocol that must be complied with in order to guarantee interoperability between services. Interaction behaviour can be designed using a top-down design approach utilising high abstraction levels to control its

Field-based generation and social validation managers and staff competencies for small community residences.

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Thousand, J S; Burchard, S N; Hasazi, J E

1986-01-01

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.

Needs of Persons with Severe Intellectual Disabilities: A Q-Methodological Study of Clients with Severe Behavioural Disorders and Severe Intellectual Disabilities

Science.gov (United States)

Kreuger, Linda; van Exel, Job; Nieboer, Anna

2008-01-01

Background: A demand-oriented approach is becoming increasingly important in care provision. The purpose of this study was to identify the primary needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. Materials and Methods: We used the theory of Social Production Function and Maslow's hierarchy of needs to…

Guidance for nuclear medicine staff on radiopharmaceuticals drug interaction

International Nuclear Information System (INIS)

Santos-Oliveira, Ralph

2009-01-01

Numerous drug interactions related to radiopharmaceuticals take place every day in hospitals many of which are not reported or detected. Information concerning this kind of reaction is not abundant, and nuclear medicine staff are usually overwhelmed by this information. To better understand this type of reaction, and to help nuclear medicine staff deal with it, a review of the literature was conducted. The results show that almost all of radiopharmaceuticals marketed around the world present drug interactions with a large variety of compounds. This suggests that a logical framework to make decisions based on reviews incorporating adverse reactions must be created. The review also showed that researchers undertaking a review of literature, or even a systematic review that incorporates drug interactions, must understand the rationale for the suggested methods and be able to implement them in their review. Additionally, a global effort should be made to report as many cases of drug interaction with radiopharmaceuticals as possible. With this, a complete picture of drug interactions with radiopharmaceuticals can be drawn. (author)

How organisational behaviours and human factors can positively impact contractors to nuclear power plants

International Nuclear Information System (INIS)

Arnaldos Gonzalez, A.; Walker-Sutton, J.; Shannon, M.; Mendoza Garcia, J.

2012-01-01

Organisational behaviours have a significant impact on individual and group behaviours but are frequently ignored during the design, planning and scheduling of work or when conducting an investigation of events. Why should it matter? It is important to calculate the personal and organisational impact and cost of those elements which contribute to organisational safety. We look at two nuclear contractor organisations (one in Spain and one in the UK) that are actively making a positive difference to their behaviours in a commercial nuclear environment. They are creating a better business environment for their staff, and a robust business differentiator for future work with their clients. We consider what the cost and impact is of the changes they have made to their organisational behaviours.

Relational interaction in occupational therapy: Conversation analysis of positive feedback.

Science.gov (United States)

Weiste, Elina

2018-01-01

The therapeutic relationship is an important factor for good therapy outcomes. The primary mediator of a beneficial therapy relationship is clinician-client interaction. However, few studies identify the observable interactional attributes of good quality relational interactions, e.g. offering the client positive feedback. The present paper aims to expand current understanding of relational interaction by analyzing the real-time interactional practices therapists use for offering positive feedback, an important value in occupational therapy. The analysis is based on the conversation analysis of 15 video-recorded occupational therapy encounters in psychiatric outpatient clinics. Two types of positive feedback were identified. In aligning feedback, therapists encouraged and complimented clients' positive perspectives on their own achievements in adopting certain behaviour, encouraging and supporting their progress. In redirecting feedback, therapists shifted the perspective from clients' negative experiences to their positive experiences. This shift was interactionally successful if they laid the foundation for the shift in perspective and attuned their expressions to the clients' emotional states. Occupational therapists routinely provide their clients with positive feedback. Awareness of the interactional attributes related to positive feedback is critically important for successful relational interaction.

The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital.

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Bloor, R N; Meeson, L; Crome, I B

2006-04-01

The UK Department of Health required that by April 2001, all NHS bodies would have implemented a smoking policy. It has been suggested that the best demonstration a hospital can make of its commitment to health is to ban smoking on its premises. This paper reports on an evaluation of the effectiveness of a non-smoking policy in a newly opened NHS psychiatric hospital. Questionnaires were sent to all 156 nursing staff in a psychiatric hospital to assess the effectiveness of the policy in terms of staff smoking behaviour, attitudes to the restriction and compliance with the policy. Of the 156 questionnaires distributed, 92 (58%) were returned; smokers, former smokers and those who have never smoked were quite evenly represented at 34.78%, 34.78% and 30.43%, respectively. Of eight critical success factors for the policy, only one, staff not smoking in Trust public areas, had been achieved. A non-smoking policy was generally accepted as necessary by nursing staff working in a mental health setting. Staff felt that the policy was not effective in motivating smoking nurses to stop and that insufficient support was given to these nurses. The study highlights the importance of introducing staff support systems as an integral part of smoking policies and the role of counterintuitive behaviour in the effectiveness of smoking policy introduction in healthcare settings.

The Effect of Diagnostic Label on Care Staff's Perceptions of Cause of Challenging Behaviour in Individuals with Learning Disabilities

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Gifford, Clive; Knott, Fiona

2016-01-01

Background: This study investigated whether care staff's causal attributions and emotional reactions to the challenging behaviour displayed by service users were influenced by the service user's diagnostic label. Materials and Method: One hundred and twenty care staff were randomly allocated to one of three conditions. Participants viewed a video…

Interpersonal relations between health care workers and young clients: barriers to accessing sexual and reproductive health care.

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Alli, Farzana; Maharaj, Pranitha; Vawda, Mohammed Yacoob

2013-02-01

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level.

Clients' satisfaction with HIV treatment services in Bamenda, Cameroon: a cross-sectional study.

Science.gov (United States)

Wung, Buh Amos; Peter, Nde Fon; Atashili, Julius

2016-07-19

Clients have explicit desires or requests for services when visiting hospitals; inadequate discovery of their needs may result in dissatisfaction. Patient satisfaction influences retention in HIV care, adherence to HAART and serves as determinant to HIV suppression. This study's objectives were to quantify clients' satisfaction with HIV services in Bamenda and determine relationship between satisfaction and clients' socio-demographic/structural characteristics. A cross-sectional study was conducted on HIV-positive patients followed-up, on treatment and who consulted in the Bamenda Regional Hospital treatment centre between July and August 2014. Participants consent was sought and data collected on client's level of satisfaction to staff-patient-communication, staff attitudes, privacy and confidentiality and staffing and amenities situations in the hospital. Data was collected using a structured questionnaire interviewer-administered by investigator and trained health personnel. Collected data was analyzed using Epi Info version 3.5.4 and clients' satisfaction measured using frequencies and percentages. A total of 384 participants took part in this study and their median age was 37 years (IQR: 29-46). Two hundred and seventy-four (71.4 %) participants were females. Overall satisfaction with HIV services was 91.2 % and participants reported less satisfaction with overall staffing and amenities situation of the centre (3.6 %). In the multivariate analysis, only being female, employed and perceiving high number of nurses working at the treatment centre remained significant predictors of overall satisfaction with HIV services. A high proportion of participants expressed satisfaction with HIV services. However, some dissatisfaction is masked in this high satisfaction level. This dissatisfaction underscores need to improve staff attitudes, staff-patient-communication, employ more staff and build better patient facilities. Future studies need to focus on assessing long

Toward Healthy Family Breathing: client survey

National Research Council Canada - National Science Library

Kaloti, Jiti; Naylor, P.J

1997-01-01

.... A secondary purpose was to measure clients behaviours and attitudes to add to the knowledge about how different types of perinatal workers can best assist pregnant and parenting women who smoke...

Combinations of Injunctions and Personality Types Determining Forms of Self-Destructive Behaviour in Alcohol-Dependent Clients: Findings of a Russian Observational Study

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Dmitri Shustov

2016-07-01

Full Text Available This observational study, conducted 2009-2012 with 190 male out-patient clients diagnosed with alcohol dependence and receiving psychotherapeutic treatment in Ryazan, Russia, investigated whether the patterns of self-destructive behaviours exhibited by the subjects were linked to their Personality Types and which combinations of injunctions were reflected in their main personality traits. Self-destructive behaviour was measured according to the 7 Alcoholic Self-Destructiveness Dimensions (ASD (Shustov 2005; data on alcohol abuse and preferred ASD were gathered through semi-structured interview; personality patterns and psychosocial functioning were assessed by means of clinical observation, semi-structured interview, the Personality Diagnostic Questionnaire: Version 4+ (Hyler, 1994 (Russian version and ICD-10 criteria except for Narcissistic Disorder diagnosed according to DSM-IV; 12 injunctions were assessed with The Drego Injunction Scale (Drego, 1994 (Russian version. When correlations were analysed, it was found that injunctions had a significant impact on the hamartic alcoholic script of the out-patient alcohol-dependent clients on the following continuum: Don’t Be, Don’t Think, Don’t Be a Child, Don’t Trust, Don’t Feel, Don’t Grow Up; client personality types had direct relationship with specific injunction patterns. Personality Types mediated the Alcoholic Self-Destructiveness Dimensions: the Classical Suicidal Dimension being associated with Borderline personality traits; Antisocial with the Antisocial personality; and Professional with the Narcissistic Personality.

Analysing change in music therapy interactions of children with communication difficulties.

Science.gov (United States)

Spiro, Neta; Himberg, Tommi

2016-05-05

Music therapy has been found to improve communicative behaviours and joint attention in children with autism, but it is unclear what in the music therapy sessions drives those changes. We developed an annotation protocol and tools to accumulate large datasets of music therapy, for analysis of interaction dynamics. Analysis of video recordings of improvisational music therapy sessions focused on simple, unambiguous individual and shared behaviours: movement and facing behaviours, rhythmic activity and musical structures and the relationships between them. To test the feasibility of the protocol, early and late sessions of five client-therapist pairs were annotated and analysed to track changes in behaviours. To assess the reliability and validity of the protocol, inter-rater reliability of the annotation tiers was calculated, and the therapists provided feedback about the relevance of the analyses and results. This small-scale study suggests that there are both similarities and differences in the profiles of client-therapist sessions. For example, all therapists faced the clients most of the time, while the clients did not face back so often. Conversely, only two pairs had an increase in regular pulse from early to late sessions. More broadly, similarity across pairs at a general level is complemented by variation in the details. This perhaps goes some way to reconciling client- and context-specificity on one hand and generalizability on the other. Behavioural characteristics seem to influence each other. For instance, shared rhythmic pulse alternated with mutual facing and the occurrence of shared pulse was found to relate to the musical structure. These observations point towards a framework for looking at change in music therapy that focuses on networks of variables or broader categories. The results suggest that even when starting with simple behaviours, we can trace aspects of interaction and change in music therapy, which are seen as relevant by therapists. �

Assessing User Perceptions of Staff Training Requirements in the Substance Use Workforce: A Review of the Literature

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Wylie, Leon W. J.

2010-01-01

Although the potential range of the workforce that may positively interact with substance users is large, and takes in all who may have to deal with substance use issues in some way, the literature mainly focuses on user views of specialist substance use or health and social care staff. With client-centred care a key policy of modern service…

Factors Associated with the Intention of Registered Dietitians to Discuss Nutrigenetics with their Patients/Clients.

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Bouchard-Mercier, Annie; Desroches, Sophie; Robitaille, Julie; Vohl, Marie-Claude

2016-12-01

The objective of this study was to investigate factors affecting the intention of Registered Dietitians (RDs) to discuss nutrigenetics with their patients/clients. A survey based on the theory of planned behaviour (TPB; attitude, subjective norm, and perceived behavioural control) was developed and sent by email to RD members of the Ordre professionnel des diététistes du Québec. Multiple regression analyses were performed to examine the determinants of intention and behaviour. A total of 141 RDs completed the questionnaire (5.8% response rate). On a scale from -2 to 2 (from strongly disagree to strongly agree), the intention of discussing nutrigenetics with patients/clients was neutral (mean of -0.07 ± 0.92). The TPB construct of attitude was the most strongly associated with intention (β = 0.66, P nutrigenetics with their patients/clients in the last 3 months. Only perceived behavioural control contributed to explain the behaviour (β = 0.17, P nutrigenetics with their patients/clients were determined. This knowledge will help inform the design of future educational content about nutrigenetics.

Identifying Successful Learners from Interaction Behaviour

Science.gov (United States)

McCuaig, Judi; Baldwin, Julia

2012-01-01

The interaction behaviours of successful, high-achieving learners when using a Learning Management System (LMS) are different than the behaviours of learners who are having more difficulty mastering the course material. This paper explores the idea that conventional Learning Management Systems can exploit data mining techniques to predict the…

Clients of sex workers in Switzerland: it makes sense to counsel and propose rapid test for HIV on the street, a preliminary report.

Science.gov (United States)

Diserens, Esther-Amélie; Bodenmann, Patrick; N'Garambe, Chantal; Ansermet-Pagot, Anne; Vannotti, Marco; Masserey, Eric; Cavassini, Matthias

2010-03-19

Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby. Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic. We intercepted 144 men, 112 (77.8%) agreed to be interviewed. Among them, 50 (46.6%) had never been tested for HIV. A total of 31 (27.7%) rapid HIV tests were performed, 16 (51.6%) in clients who had not previously been tested. None were reactive. Initially, 19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing. This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate. This setting seems particularly appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour.

Investigating Burnout and Psychological Well-Being of Staff Working with People with Intellectual Disabilities and Challenging Behaviour: The Role of Personality

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Chung, Man Cheung; Harding, Carly

2009-01-01

Background: The present research extended previous research by broadening the dimensions of personality traits, and focusing on burnout and psychological well-being among staff working with people with intellectual disabilities and challenging behaviour. Methods: This is a cross-sectional survey in which 103 staff completed questionnaires…

The impact of worker values on client outcomes within a drug treatment service.

Science.gov (United States)

Phillips, Rosie; Bourne, Humphrey

2008-02-01

Little attention has been paid to understanding the impact of values, attributes and characteristics of drugs workers on therapeutic relationships and treatment outcomes. Interaction of values with other variables is considered to be of importance since values play a role in determining attitudes and behaviours. This exploratory study investigates the impact of drug workers' personal values on client outcomes within a drug treatment service. Eight drug workers and 58 clients were recruited at a UK charity working with problematic drug users who are also socially excluded. Drug workers completed a validated questionnaire to elicit their personal values. Client outcomes were assessed using the Christo Inventory for Substance Misuse Services. The relationship between client outcomes and worker values were analysed using Spearman's rank test of association. Drug workers prioritising stimulation, self-direction and hedonism value types experienced more positive client outcomes compared with those prioritising security, conformity, benevolence, tradition and universalism types. The value types associated with positive outcomes fall within Schwartz's 'openness to change' superordinate dimension, whereas those related to more negative outcomes fall within the 'conservation' dimension. The study suggests that drug workers' personal values may have a significant impact upon client outcomes in the treatment of substance misuse. Reasons for this finding are explored, as are limitations of this study and suggestions for future research.

HIV, sexually transmitted infections and sexual behaviour of male clients of female sex workers in Andhra Pradesh, Tamil Nadu and Maharashtra, India: results of a cross-sectional survey.

Science.gov (United States)

Subramanian, Thilakavathi; Gupte, Mohan D; Paranjape, Ramesh S; Brahmam, Ginnela N V; Ramakrishnan, Lakshmi; Adhikary, Rajatashuvra; Kangusamy, Boopathi; Thomas, Beena E; Kallam, Srinivasan; Girish, C P K

2008-12-01

To characterize and describe patterns of HIV, sexually transmitted infections (STI) and sexual behaviour of male clients of female sex workers (FSW). A cross-sectional study was conducted among 4821 clients of FSW from 12 districts in three states in India: Andhra Pradesh, Maharashtra and Tamil Nadu. A structured questionnaire was administered to elicit demographic characteristics and sexual behavioural patterns. Blood and urine samples were tested for HIV, syphilis and herpes simplex type 2 serology, gonococcal and chlamydial infection. The median age of clients surveyed was 30 years; 57% were married and 64% had a steady sexual partner; 61% had sex with more than one FSW and 39% had four or more sexual encounters in the past month. The prevalence of HIV ranged from 2.0% to 10.9%, syphilis ranged from 3.1% to 10.1%; gonorrhoea and chlamydia ranged between 0% and 4.5%. Clients older than 30 years [odds ratio (OR) 1.65; 95% confidence interval (CI) 1.33-2.05] and having a different mix of commercial and non-commercial partners (OR 1.56; 95% CI 1.25-1.96) had a higher volume of sex acts with FSW. Inconsistent condom use with FSW was significantly associated with older clients (OR 4.2; 95% CI 3.33-5.29), illiteracy (OR 1.39; 95% CI 1.14-1.69), age sex (OR 1.83; 95% CI 1.24-2.70) and having different FSW partners in the past month (OR 1.64; 95% CI 1.23-2.18). Clients of FSW studied here constitute a significant bridge group for HIV and other STI, because of their high volume of different sexual partners and very low consistent condom use. HIV prevention programmes need to address male clients.

Parent-child interaction therapy for preschool children with disruptive behaviour problems in the Netherlands.

Science.gov (United States)

Abrahamse, Mariëlle E; Junger, Marianne; Chavannes, E Lidewei; Coelman, Frederique J G; Boer, Frits; Lindauer, Ramón J L

2012-06-13

Persistent high levels of aggressive, oppositional and impulsive behaviours, in the early lives of children, are significant risk factors for adolescent and adult antisocial behaviour and criminal activity. If the disruptive behavioural problems of young children could be prevented or significantly reduced at an early age, the trajectory of these behavioural problems leading to adolescent delinquency and adult antisocial behaviour could be corrected. Parent-Child Interaction Therapy (PCIT) is a short-term, evidence-based, training intervention for parents dealing with preschool children, who exhibit behavioural problems. Recently, PCIT was implemented in a Dutch community mental health setting. This present study aims to examine the short-term effects of PCIT on reducing the frequency of disruptive behaviour in young children. This study is based on the data of 37 referred families. Whereby the results of which are derived from an analysis of parent reports of the Eyberg Child Behavior Inventory (ECBI), obtained during each therapeutic session. Furthermore, demographic information, extracted from client files, was also utilized. However, it must be noted that eleven families (27.5%) dropped out of treatment before the treatment protocol was completed. To investigate the development of disruptive behaviour, a non-clinical comparison group was recruited from primary schools (N = 59). The results of this study indicate that PCIT significantly reduces disruptive behaviour in children. Large effect sizes were found for both fathers and mothers reported problems (d = 1.88, d = 1.99, respectively), which is similar to American outcome studies. At post treatment, no differences were found concerning the frequency of behavioural problems of children who completed treatment and those who participated in the non-clinical comparison group. The findings of this study suggest that PCIT is potentially an effective intervention strategy for young children and their

Parent–child interaction therapy for preschool children with disruptive behaviour problems in the Netherlands

Directory of Open Access Journals (Sweden)

Abrahamse Mariëlle E

2012-06-01

Full Text Available Abstract Background Persistent high levels of aggressive, oppositional and impulsive behaviours, in the early lives of children, are significant risk factors for adolescent and adult antisocial behaviour and criminal activity. If the disruptive behavioural problems of young children could be prevented or significantly reduced at an early age, the trajectory of these behavioural problems leading to adolescent delinquency and adult antisocial behaviour could be corrected. Parent–Child Interaction Therapy (PCIT is a short-term, evidence-based, training intervention for parents dealing with preschool children, who exhibit behavioural problems. Recently, PCIT was implemented in a Dutch community mental health setting. This present study aims to examine the short-term effects of PCIT on reducing the frequency of disruptive behaviour in young children. Methods This study is based on the data of 37 referred families. Whereby the results of which are derived from an analysis of parent reports of the Eyberg Child Behavior Inventory (ECBI, obtained during each therapeutic session. Furthermore, demographic information, extracted from client files, was also utilized. However, it must be noted that eleven families (27.5% dropped out of treatment before the treatment protocol was completed. To investigate the development of disruptive behaviour, a non-clinical comparison group was recruited from primary schools (N = 59. Results The results of this study indicate that PCIT significantly reduces disruptive behaviour in children. Large effect sizes were found for both fathers and mothers reported problems (d = 1.88, d = 1.99, respectively, which is similar to American outcome studies. At post treatment, no differences were found concerning the frequency of behavioural problems of children who completed treatment and those who participated in the non-clinical comparison group. Conclusion The findings of this study suggest that PCIT is potentially an

Positive behaviour support training for staff for treating challenging behaviour in people with intellectual disabilities: a cluster RCT.

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Hassiotis, Angela; Poppe, Michaela; Strydom, Andre; Vickerstaff, Victoria; Hall, Ian; Crabtree, Jason; Omar, Rumana; King, Michael; Hunter, Rachael; Bosco, Alessandro; Biswas, Asit; Ratti, Victoria; Blickwedel, Jessica; Cooper, Vivien; Howie, William; Crawford, Mike

2018-03-01

Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID). To evaluate whether or not such training is clinically effective in reducing challenging behaviour in routine care. The study also included longer-term follow-up (approximately 36 months). A multicentre, single-blind, two-arm, parallel-cluster randomised controlled trial. The unit of randomisation was the community ID service using an independent web-based randomisation system and random permuted blocks on a 1 : 1 allocation stratified by a staff-to-patient ratio for each cluster. Community ID services in England. Adults (aged > 18 years) across the range of ID with challenging behaviour [≥ 15 Aberrant Behaviour Checklist - Community total score (ABC-C T )]. Manual-assisted face-to-face PBS training to therapists and treatment as usual (TAU) compared with TAU only in the control arm. Carer-reported changes in challenging behaviour as measured by the ABC-C T over 12 months. Secondary outcomes included psychopathology, community participation, family and paid carer burden, family carer psychopathology, costs of care and quality-adjusted life-years (QALYs). Data on main outcome, service use and health-related quality of life were collected for the 36-month follow-up. A total of 246 participants were recruited from 23 teams, of whom 109 were in the intervention arm (11 teams) and 137 were in the control arm (12 teams). The difference in ABC-C T between the intervention and control arms [mean difference -2.14, 95% confidence interval (CI) -8.79 to 4.51; p  = 0.528] was not statistically significant. No treatment effects were found for any of the secondary outcomes. The mean cost per participant in the intervention arm was £1201. Over 12 months, there was a difference in QALYs of 0.076 in favour of the intervention (95% CI 0.011 to 0.140 QALYs) and a 60% chance that the

[Affective behavioural responses by dogs to tactile human-dog interactions].

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Kuhne, Franziska; Hössler, Johanna C; Struwe, Rainer

2012-01-01

The communication of dogs is based on complex, subtle body postures and facial expressions. Some social interaction between dogs includes physical contact. Humans generally use both verbal and tactile signals to communicate with dogs. Hence, interaction between humans and dogs might lead to conflicts because the behavioural responses of dogs to human-dog interaction may be misinterpreted and wrongly assessed. The behavioural responses of dogs to tactile human-dog interactions and human gestures are the focus of this study. The participating dogs (n = 47) were privately owned pets.They were of varying breed and gender.The test consisted of nine randomised test sequences (e. g. petting the dog's head or chest). A test sequence was performed for a period of 30 seconds. The inter-trial interval was set at 60 seconds and the test-retest interval was set at 10 minutes. The frequency and duration of the dogs'behavioural responses were recorded using INTERACT. To examine the behavioural responses of the dogs, a two-way analysis of variance within the linear mixed models procedure of IBM SPSS Statistics 19 was conducted. A significant influence of the test-sequenc order on the dogs' behaviour could be analysed for appeasement gestures (F8,137 = 2.42; p = 0.018), redirected behaviour (F8,161 = 6.31; p = 0.012) and socio-positive behaviour (F8,148 = 6.28; p = 0.012). The behavioural responses of the dogs, which were considered as displacement activities (F8,109 = 2.5; p = 0.014) differed significantly among the test sequences. The response of the dogs, measured as gestures of appeasement, redirected behaviours, and displacement activities, was most obvious during petting around the head and near the paws.The results of this study conspicuously indicate that dogs respond to tactile human-dog interactions with gestures of appeasement and displacement activities. Redirected behaviours, socio-positive behaviours as well displacement activities are behavioural responses which dogs

A Measure of Staff Burnout among Health Professionals.

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Jones, John W.

Staff burnout among health professionals refers to a syndrome of physical and emotional exhaustion involving the development of negative job attitudes, a poor professional self-concept, and a loss of empathic concern for clients. The Staff Burnout Scale for Health Professionals (SBS-HP) is a 20-item inventory assessing cognitive, affective,…

Writing about stress: the impact of a stress-management programme on staff accounts of dealing with stress.

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van Oorsouw, Wietske M W J; Embregts, Petri J C M; Bosman, Anna M T; Jahoda, Andrew

2014-05-01

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.

Assessment of ART centres in India: client perspectives.

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Sogarwal, Ruchi; Bachani, Damodar

2009-05-01

Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

Improving the Quality of Staff and Participant Interaction in an Acquired Brain Injury Organization

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Guercio, John M.; Dixon, Mark R.

2010-01-01

Weekly observations of direct-care staff in a facility for persons with brain injury yielded less than optimal interactional style with facility residents. Following an observational baseline, staff were asked to self-rate a 15-min video sample of their interaction behavior with participants on their unit. They were then asked to compare their…

Robust client/server shared state interactions of collaborative process with system crash and network failures

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Wang, Lei; Wombacher, Andreas; Ferreira Pires, Luis; van Sinderen, Marten J.; Chi, Chihung

With the possibility of system crashes and network failures, the design of robust client/server interactions for collaborative process execution is a challenge. If a business process changes state, it sends messages to relevant processes to inform about this change. However, server crashes and

Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units.

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Zwijsen, S A; Gerritsen, D L; Eefsting, J A; Smalbrugge, M; Hertogh, C M P M; Pot, A M

2015-01-01

Caring for people with dementia in dementia special care units is a demanding job. Challenging behaviour is one of the factors influencing the job satisfaction and burnout of care staff. A care programme for the challenging behaviour of nursing home residents with dementia might, next to diminishing the challenging behaviour of residents, improve job satisfaction and reduce the care staff's feelings of burnout. To determine the effects of a care programme for the challenging behaviour of nursing home residents with dementia on the burnout, job satisfaction and job demands of care staff. The care programme was implemented according to a stepped wedge design in which care units were randomly divided over five groups with different time points of starting with implementation. 17 Dutch dementia special care units. Care staff members of the 17 units. The care programme consists of an education package and of various structured assessment tools that guide professionals through the multidisciplinary detection, analysis, treatment and evaluation of treatment of challenging behaviour. Burnout, job satisfaction and job demands were measured before implementation, halfway through the implementation process and after all the care units had implemented the care programme. Burnout was measured with the Dutch version of the Maslach burnout inventory (UBOS-C, three subscales); job satisfaction and job demands were measured with subscales of the Leiden Quality of Work Questionnaire. Mixed model analyses were used to determine effects. Care staff could not be blinded for the intervention. Of the 1441 questionnaires, 645 were returned (response 45%, 318 control measurements, 327 intervention measurements) by 380 unique care staff members. Significant effects were found on job satisfaction (0.93, 95% CI 0.48-1.38). On the other outcomes, no significant changes in the scores were found. Positive effects of using the Grip on Challenging behaviour care programme were found on job

Region specific changes in nonapeptide levels during client fish interactions with allopatric and sympatric cleaner fish.

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Soares, Marta C; Cardoso, Sónia C; Mazzei, Renata; André, Gonçalo I; Morais, Marta; Gozdowska, Magdalena; Kalamarz-Kubiak, Hanna; Kulczykowska, Ewa

2017-01-01

Social relationships are crucially dependent on individual ability to learn and remember ecologically relevant cues. However, the way animals recognize cues before engaging in any social interaction and how their response is regulated by brain neuromodulators remains unclear. We examined the putative involvement of arginine vasotocin (AVT) and isotocin (IT), acting at different brain regions, during fish decision-making in the context of cooperation, by trying to identify how fish distinguish and recognize the value of other social partners or species. We hypothesized that the behavioural responses of cleaner fish clients to different social contexts would be underlain by changes in brain AVT and IT levels. We have found that changes in AVT at the level of forebrain and optic tectum are linked with a response to allopatric cleaners (novel or unfamiliar stimuli) while those at cerebellum are associated with the willingness to be cleaned (in response to sympatric cleaners). On the other hand, higher brain IT levels that were solely found in the diencephalon, also in response to allopatric cleaners. Our results are the first to implicate these nonapeptides, AVT in particular, in the assessment of social cues which enable fish to engage in mutualistic activities.

ENTREPRENEURSHIP: INFLUENCE OF ENTREPRENEURSHIP TRAINING COURSES ON ENTREPRENEURIAL BEHAVIOUR OF THE STAFF IN OFFICES OF YOUTH AND SPORTS IN YAZD PROVINCE

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Nooshin Benar

2013-08-01

Full Text Available The main objective of this study was to analyze the entrepreneurial behaviour of the staff of Offices of Youth and Sports in Yazd province and the influence of entrepreneurial training courses on their behaviour. The population under study were all the staff, a total number of 101 persons, of nine (9 Offices of Youth and Sports in Yazd province. The population for pre-testing was equal to the actual population of the study. In terms of methodology it was a descriptive study and in terms of purpose an applicable one. Instrument for data gathering was a survey questionnaire prepared by the researcher and the validity of which was examined by the professors of the university and approved based on their suggestions and views. It consisted of 55 questions in order to measure and evaluate behavioural characteristics of entrepreneurs (Balanced Risk-taking, Locus of Control, Mental Health, Challenge Seeking, Success Seeking or need for achievement, Dreaming or fantasizing, Activism or pro-active, and Ambiguity Tolerance. The stability of the questionnaire was tested and measured byCronbach Alpha Coefficient which was alfa=0.87. The gathered data were analysed using descriptive statistical methods (Mean, Standard Deviation, Charts/Figures and deductive (non-parametric methods (Kolmogorov-Smirnov test, Friedman, Mann-Whitney U, Spearman and Pearson.The results showed that there is a significant and positive relationship between activism, dreaming and risk taking characteristics with challenge seeking; and between achievement seeking, mental health and ambiguity tolerance with locus of control characteristic. On the other hand, ranking the characteristics of entrepreneurial behaviour of staff demonstrated that the highest ranking belongs to dreaming and mental health and the lowest ranking belongs to activism and locus of control. Overall, there is a significant relationship between entrepreneurial behaviour and entrepreneurial training. Based on these

Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey.

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Cooper, Claudia; Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill

2018-01-01

There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening "at least sometimes" in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052-1.349). Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.

Quantity and quality of interaction between staff and older patients in UK hospital wards: A descriptive study.

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Barker, Hannah Ruth; Griffiths, Peter; Mesa-Eguiagaray, Ines; Pickering, Ruth; Gould, Lisa; Bridges, Jackie

2016-10-01

The quality of staff-patient interactions underpins the overall quality of patient experience and can affect other important outcomes. However no studies have been identified that comprehensively explore both the quality and quantity of interactions in general hospital settings. To quantify and characterise the quality of staff-patient interactions and to identify factors associated with negative interaction ratings. Data were gathered at two acute English NHS hospitals between March and April 2015. Six wards for adult patients participated including medicine for older people (n=4), urology (n=1) and orthopaedics (n=1). Eligible patients on participating wards were randomly selected for observation. Staff-patient interactions were observed using the Quality of Interactions Schedule. 120h of care were observed with each 2h observation session determined from a balanced random schedule (Monday-Friday, 08:00-22:00h). Multilevel logistic regression models were used to determine factors associated with negative interactions. 1554 interactions involving 133 patients were observed. The median length of interaction was 36s with a mean of 6 interactions per patient per hour. Seventy three percent of interactions were categorized as positive, 17% neutral and 10% negative. Forty percent of patients had at least one negative interaction (95% confidence interval 32% to 49%). Interactions initiated by the patient (adjusted Odds Ratio [OR] 5.30), one way communication (adjusted OR 10.70), involving two or more staff (adjusted OR 5.86 for 2 staff, 6.46 for 3+ staff), having a higher total number of interactions (adjusted OR 1.09 per unit increase), and specific types of interaction content were associated with increased odds of negative interaction (pinteraction was associated with increased odds of negative interaction in a reduced model. There was no significant association with gender, age or cognitive impairment. There was substantially more variation at ward level (variance

A "client perspective" helps improve services.

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1998-01-01

Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

Staff behavior toward children and adolescents in a residential facility: A self-report questionnaire

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Huitink, C.; Embregts, P.J.C.M.; Veerman, J.W.; Verhoeven, L.T.W.

2011-01-01

The purpose of the present study was to examine psychometric properties of the Staff Behavior toward Clients questionnaire (SBC), a self-report measure for care staff working with children and adolescents with mild to borderline intellectual disabilities in residential care. Ninetynine care staff

Design and Build: Views from some Major Public Clients in Hong Kong

Directory of Open Access Journals (Sweden)

Albert P C Chan

2001-09-01

Full Text Available This paper presents the views of clients in public sector on design and build(D&B procurement method. Specifically, their reasons of adopting D&B and refusing to adopt it were explored. Data were collected through face-to-face interviews with ten senior staff from four major public organisations in Hong Kong. The findings indicate that public clients held different views on D&B methods based on different grounds. Apart from functional requirements such as project completion time, cost certainty, etc., internal resources and political force would also influence client's adoption of D&B method in the public sector.

PATRON-CLIENT RELATIONSHIP PADA MASYARAKAT MADURA

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Mohammad Hefni

2012-03-01

Full Text Available Abstrac This article traces patron-client relationship of Madurese both from socio-historical point of view and its contemporary progress. As an imbalance social-exchange relationship, in terms of patron-client relationship, second side (client much highly depends upon the first side (patron. This had been experienced in Madurese social history during the native governmental period of time. The government was classified into two major classes; ruler class (patron and farmer class (client. The former is fully in authority to take control either economic or politic potencies, however, the later transacts labors to the first side. Both side is connected by a bribe (upeti systems—percaton, apanage and daleman. In current progress this relationship becomes more acquaintance, it covers economic and politic relationship. The success of Trunojoyo, the king of Sumenep's inherit, against the Mataram domination had been supported by Madurese people that had previously tightened to the system. Today,  patron-client relationship in Madura is reflected in the relationship between the head of village, as the owner of percaton,  and the staff as well as people, as the percaton manager. The other is well-described in the relationship of ship owner and pandega (fisher in fishing. Once the relationship is set up, it directs to diadik relation, a two in one relation which is more personal and long lasting one. Kata-kata kunci Patron-klien, percaton, apanage, panembahan, rakyat, daleman, kepala desa, juragan, pandega, dan diadik.

Client evaluation of a specialist inpatient parent-infant psychiatric service.

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Nair, Revi; Bilszta, Justin; Salam, Nilam; Shafira, Nadia; Buist, Anne

2010-12-01

The aim of this paper was to collect feedback on a specialist parent-infant psychiatric service in terms of client satisfaction with inpatient treatment, and the impact on health outcomes of providing written information about available support options in the community following discharge. Women (n = 37) from consecutive admissions between January 2006 and December 2007 were contacted by telephone and administered a service quality evaluation questionnaire. Women were happy with the quality of inpatient care provided but suggested areas of improvement included continuity of staff during the inpatient stay and better communication between inpatient and outpatient services post-discharge. At discharge, women were not confident with their ability in coping with motherhood but confidence with parenting skills increased post-discharge. Use of recommended post-discharge community support and/or health services was poor. As adherence with discharge recommendations was less than ideal, greater involvement of primary/community health care professionals, and active participation of clients and carers, in discharge planning is required. Increased emphasis on the practical skills of motherhood as well as opportunities to develop the mother-infant relationship may assist mothers in gaining confidence to interact with their baby and pick up infant cues.

Integrating Attachment Theory to Support a Client Coming to Terms with Infidelity

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Claire, Carolyn A.

2010-01-01

Finding it difficult to overcome the emotional distress experienced when considering her husband's infidelity, a client seeks counselling support. The client's goal was to learn about herself and to use the experience as an opportunity for self transformation. The case study utilizes Attachment Theory and Cognitive Behavioural Therapy to help the…

Motorboat noise disrupts co-operative interspecific interactions.

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Nedelec, Sophie L; Mills, Suzanne C; Radford, Andrew N; Beldade, Ricardo; Simpson, Stephen D; Nedelec, Brendan; Côté, Isabelle M

2017-08-01

Human-made noise is contributing increasingly to ocean soundscapes. Its physical, physiological and behavioural effects on marine organisms are potentially widespread, but our understanding remains largely limited to intraspecific impacts. Here, we examine how motorboats affect an interspecific cleaning mutualism critical for coral reef fish health, abundance and diversity. We conducted in situ observations of cleaning interactions between bluestreak cleaner wrasses (Labroides dimidiatus) and their fish clients before, during and after repeated, standardised approaches with motorboats. Cleaners inspected clients for longer and were significantly less cooperative during exposure to boat noise, and while motorboat disturbance appeared to have little effect on client behaviour, as evidenced by consistency of visit rates, clientele composition, and use of cleaning incitation signals, clients did not retaliate as expected (i.e., by chasing) in response to increased cheating by cleaners. Our results are consistent with the idea of cognitive impairments due to distraction by both parties. Alternatively, cleaners might be taking advantage of distracted clients to reduce their service quality. To more fully understand the importance of these findings for conservation and management, further studies should elucidate whether the efficacy of ectoparasite removal by cleaners is affected and explore the potential for habituation to boat noise in busy areas.

Trust and Work Place Spirituality on Knowledge Sharing Behaviour: Perspective from Non-Academic Staff of Higher Learning Institutions

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Rahman, Muhammad Sabbir; Osmangani, Aahad M; Daud, Nuraihan Mat; Chowdhury, Abdul Hannan; Hassan, Hasliza

2015-01-01

Purpose: This empirical research aims to add value in the existing research on knowledge sharing, investigate the antecedents of knowledge-sharing behaviour by embedding trust and workplace spirituality variable on non-academic staff from higher learning institution in Malaysia. The role of trust, perceived risk and workplace spirituality towards…

Who cares for involuntary clients?

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Soliman, Soheil; Pollack, Harold A; Alexander, Jeffrey A

2009-01-01

The objectives of this study were to compare characteristics of outpatient substance abuse treatment (OSAT) units that serve high proportions of involuntary clients (ICs) with those that serve a low percentage of such clients. The authors analyze unit-level 1995-2005 data from the National Drug Abuse Treatment System Survey (NDATSS). Approximately 1/6 of OSAT units draw the dominant majority of their clients from involuntary referrals. OSAT units that treat a high proportion of ICs are less likely to be accredited by professional organizations, have fewer treatment staff with advanced degrees, and have shorter average treatment duration than do OSAT units that serve few ICs. OSAT units that serve ICs are more likely to offer legal and domestic violence services but are less likely to offer mental health services or aftercare. OSAT units that serve ICs are less likely to be hospital-affiliated than are other units. Clients at such facilities are more likely to be convicted of driving while intoxicated (DWI), are younger, are less likely to have received prior treatment, are more likely to remain abstinent after treatment, but are more likely to be remanded back to courts. The authors conclude that ICs are an important market niche in OSAT care. DWI is by far the most common offense reported in units that specialize in ICs. Aside from legal and domestic violence services, units with a high proportion of ICs appear to offer somewhat less intensive and professionalized services than do other facilities; however, clients at these units are more likely to be abstinent at the end of treatment and but more likely to be remanded back to the courts.

Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study.

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Hessler, J B; Schäufele, M; Hendlmeier, I; Junge, M N; Leonhardt, S; Weber, J; Bickel, H

2018-06-01

Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses. Overall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups. BPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as

Evaluation of a liaison librarian program: client and liaison perspectives.

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Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae

2006-10-01

This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

'We're in the sandwich': Aged care staff members' negotiation of constraints and the role of the organisation in enacting and supporting an ethic of care.

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Petriwskyj, Andrea; Gibson, Alexandra; Webby, Glenys

2015-12-01

Aged care staff are often seen as holding power in care relationships, particularly in client engagement. Such a perception, however, may limit our understanding and analysis of the dynamics and politics within care spaces. This paper uses interview and focus group data from both staff and clients of an Australian aged care provider to identify the positions given to, and taken up by, staff in client engagement. Focusing on one of these positions, in which staff are seen as managing and negotiating constraints, the paper uses an ethic of care lens to examine the context in which engagement - and this position taking - occurs. Findings reflect the importance of the organisational and systemic context to the practice of care ethics and the potential vulnerability and disempowerment of care giving staff. Implications for the support of staff in client engagement and the role of care organisations beyond structures and processes to an active participant in an ethic of care are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Four different types of client attitudes towards purchasing spectacles in optometric practice

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Fylan, Fiona; Grunfeld, Elizabeth A; Turvey, Andrew; Desallais, Jacques

2005-01-01

Abstract Background  Unmet expectations are a major cause of client dissatisfaction, yet very little is known about the expectations and health values that clients in optometry practice hold about having an eye examination and purchasing spectacles. This study identified different attitudes and behaviours held by presbyope clients in optometric practices. Method  A total of 158 presbyope clients, recruited from 14 practices, completed a questionnaire which was developed from the theory of planned behaviour. The questionnaire examined attitudes towards spectacles and visiting the optician, motivation to visit the optician, perceptions of barriers to attending the opticians, information requirements, and preferences for shared decision‐making. Responses were analysed using principal components analysis. Results and Conclusions  Four factors were identified, which were labelled style, vision, avoiding and seeking. Style is concerned with the importance of appearing fashionable or stylish, and desiring approval from others. Vision relates to clients’ attitudes towards obtaining clear vision and to maintaining healthy eyesight. Avoiding describes the perceived difficulties associated with visiting the optician and purchasing new spectacles. Seeking corresponds to the desire for information on the technical details of lenses. Practitioners could use these characteristics to tailor information to meet the needs and address the expectations of individual clients. This may make the information provided more personally relevant, and could enhance client satisfaction. PMID:15713167

Difficult relationships--interactions between family members and staff in long-term care.

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Norris, S

2000-01-01

Staff of long-term care facilities and family members have a common responsibility to ensure the best course of treatment and everyday care for residents who often cannot speak for themselves. Understanding the difference between instrumental and preservative care, and who the proper agent is to provide care in each category will not only improve staff/family interactions, but residential care in general. The Resident Enrichment and Activity Program improves the family/staff relationship obliquely by involving family in social activities; the Family Involvement in Care program, and the Patterns in Caregiving program directly target the relationship and involve the facility's administration to effect policy change.

Women-focused treatment agencies and process improvement: Strategies to increase client engagement

Science.gov (United States)

Wisdom, Jennifer P.; Hoffman, Kim; Rechberger, Elke; Seim, Kay; Owens, Betta

2009-01-01

Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement. PMID:20046914

Comparing the Obvious: Interactional characteristics of staff in acute mental health nursing and forensic psychiatric nursing

DEFF Research Database (Denmark)

Gildberg, Frederik Alkier; Bradley, Stephen K.; Hounsgaard, Lise

2013-01-01

This article reports on and compares two separate studies of the interactional characteristics of forensic mental health staff and acute mental health staff as they interact with inpatients, respectively. Both studies were conducted using participant observation, along with informal and formal...... interviews. Findings show that both acute and forensic mental health nursing practice is characterized by two overriding themes; ‘trust and relationship-enabling care’ and ‘behavior and perception-corrective care.’ The comparison of the two studies shows no major differences in the characteristics of staff...

My Therapist is a Student? The Impact of Therapist Experience and Client Severity on Cognitive Behavioural Therapy Outcomes for People with Anxiety Disorders.

Science.gov (United States)

Mason, Liam; Grey, Nick; Veale, David

2016-03-01

Allocation of trainee therapist cases is often performed based on intuition and clinical circumstances, with lack of empirical evidence on the role of severity of presenting problem. This has the potential to be anxiety-provoking for supervisors, trainees and service users themselves. To determine how therapist experience interacts with symptom severity in predicting client outcomes. An intention-to-treat analysis of annual outcome data for primary and secondary care clients seen by a specialist anxiety disorders service. 196 clients were stratified into mild, moderate and baseline severe symptoms of anxiety (GAD-7) and depression (PHQ-9). We measured percentage change on these measures, as well as number of sessions and therapy dropout. We also examined rates of reliable and clinically significant change on disorder-specific measures. We hypothesized that qualified therapists would achieve better outcomes than trainees, particularly for severe presentations. Overall, outcomes were comparable between trainee and qualified therapists on all measures, and trainees additionally utilized fewer therapy sessions. There was however an interaction between anxiety severity (GAD-7) and therapist group, such that severely anxious clients achieved greater symptom improvement with qualified as compared to trainee therapists. Further, for trainee but not qualified therapists, baseline anxiety was negatively associated with rate of reliable and clinically significant change on disorder-specific measures. These findings indicate generally favourable outcomes for trainee therapists delivering manualized treatments for anxiety disorders. They additionally suggest that trainee therapists may benefit from additional support when working with clients that present with severe anxiety.

The impact of staff training on staff outcomes in dementia care: a systematic review.

Science.gov (United States)

Spector, Aimee; Revolta, Catherine; Orrell, Martin

2016-11-01

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.

Magnetic behaviour of interacting antiferromagnetic nanoparticles

International Nuclear Information System (INIS)

Markovich, V; Jung, G; Gorodetsky, G; Puzniak, R; Wisniewski, A; Skourski, Y; Mogilyanski, D

2012-01-01

Magnetic properties of interacting La 0.2 Ca 0.8 MnO 3 nanoparticles have been investigated. The field-induced transition from antiferromagnetic (AFM) to ferromagnetic (FM) state in the La 0.2 Ca 0.8 MnO 3 bulk has been observed at exceptionally high magnetic fields. For large particles, the field-induced transition widens while magnetization progressively decreases. In small particles the transition is almost fully suppressed. The thermoremanence and isothermoremanence curves constitute fingerprints of irreversible magnetization originating from nanoparticle shells. We have ascribed the magnetic behaviour of nanoparticles to a core-shell scenario with two main magnetic contributions; one attributed to the formation of a collective state formed by FM clusters in frustrated coordination at the surfaces of interacting AFM nanoparticles and the other associated with inner core behaviour as a two-dimensional diluted antiferromagnet. (paper)

Rules of Engagement: Toward an Analysis of Staff Responses to Challenging Behavior.

Science.gov (United States)

Hastings, Richard P.; Remington, Bob

1994-01-01

This article reviews literature on the responses of direct care staff to challenging behaviors of individuals with mental retardation. The paper constructs a behavior analytic description of the functions of care staff behavior in relation to their clients' challenging behaviors, draws a distinction between contingency-shaped and rule-governed…

Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

Science.gov (United States)

1992-01-01

In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

Violence in Al-Zahra Hospital from the Viewpoint of Administrative Support Staff: A Qualitative Study

Directory of Open Access Journals (Sweden)

Mahmoud Keyvanara

2015-10-01

Conclusion: Considering the high prevalence of violence in hospitals and its adverse effects on the societies, organizations and individuals, necessary measures must be taken to diminish the occurrence of this problem, some of which include: increasing insurance coverage, changing physical structure of hospitals to increase security, limiting the entrance of individuals, making administrative processes more transparent, culture-making about terms of visiting and patient companionship, holding workshops on violence and proper relationship with patients and families and using experienced staff to interact with clients.

Preventing and managing challenging behaviour.

Science.gov (United States)

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Latent interaction effects in the theory of planned behaviour applied to quitting smoking.

Science.gov (United States)

Hukkelberg, Silje Sommer; Hagtvet, Knut A; Kovac, Velibor Bobo

2014-02-01

This study applies three latent interaction models in the theory of planned behaviour (TPB; Ajzen, 1988, Attitudes, personality, and behavior. Homewood, IL: Dorsey Press; Ajzen, 1991, Organ. Behav. Hum. Decis. Process., 50, 179) to quitting smoking: (1) attitude × perceived behavioural control on intention; (2) subjective norms (SN) × attitude on intention; and (3) perceived behavioural control × intention on quitting behaviour. The data derive from a longitudinal Internet survey of 939 smokers aged 15-74 over a period of 4 months. Latent interaction effects were estimated using the double-mean-centred unconstrained approach (Lin et al., 2010, Struct. Equ. Modeling, 17, 374) in LISREL. Attitude × SN and attitude × perceived behavioural control both showed a significant interaction effect on intention. No significant interaction effect was found for perceived behavioural control × intention on quitting. The latent interaction approach is a useful method for investigating specific conditions between TPB components in the context of quitting behaviour. Theoretical and practical implications of the results are discussed. © 2013 The British Psychological Society.

Experimental Blind Quantum Computing for a Classical Client

Science.gov (United States)

Huang, He-Liang; Zhao, Qi; Ma, Xiongfeng; Liu, Chang; Su, Zu-En; Wang, Xi-Lin; Li, Li; Liu, Nai-Le; Sanders, Barry C.; Lu, Chao-Yang; Pan, Jian-Wei

2017-08-01

To date, blind quantum computing demonstrations require clients to have weak quantum devices. Here we implement a proof-of-principle experiment for completely classical clients. Via classically interacting with two quantum servers that share entanglement, the client accomplishes the task of having the number 15 factorized by servers who are denied information about the computation itself. This concealment is accompanied by a verification protocol that tests servers' honesty and correctness. Our demonstration shows the feasibility of completely classical clients and thus is a key milestone towards secure cloud quantum computing.

Experimental Blind Quantum Computing for a Classical Client.

Science.gov (United States)

Huang, He-Liang; Zhao, Qi; Ma, Xiongfeng; Liu, Chang; Su, Zu-En; Wang, Xi-Lin; Li, Li; Liu, Nai-Le; Sanders, Barry C; Lu, Chao-Yang; Pan, Jian-Wei

2017-08-04

To date, blind quantum computing demonstrations require clients to have weak quantum devices. Here we implement a proof-of-principle experiment for completely classical clients. Via classically interacting with two quantum servers that share entanglement, the client accomplishes the task of having the number 15 factorized by servers who are denied information about the computation itself. This concealment is accompanied by a verification protocol that tests servers' honesty and correctness. Our demonstration shows the feasibility of completely classical clients and thus is a key milestone towards secure cloud quantum computing.

Cleaner shrimp use a rocking dance to advertise cleaning service to clients.

Science.gov (United States)

Becker, Justine H A; Curtis, Lynda M; Grutter, Alexandra S

2005-04-26

Signals transmit information to receivers about sender attributes, increase the fitness of both parties, and are selected for in cooperative interactions between species to reduce conflict [1, 2]. Marine cleaning interactions are known for stereotyped behaviors [3-6] that likely serve as signals. For example, "dancing" and "tactile dancing" in cleaner fish may serve to advertise cleaning services to client fish [7] and manipulate client behavior [8], respectively. Cleaner shrimp clean fish [9], yet are cryptic in comparison to cleaner fish. Signals, therefore, are likely essential for cleaner shrimp to attract clients. Here, we show that the yellow-beaked cleaner shrimp [10] Urocaridella sp. c [11] uses a stereotypical side-to-side movement, or "rocking dance," while approaching potential client fish in the water column. This dance was followed by a cleaning interaction with the client 100% of the time. Hungry cleaner shrimp, which are more willing to clean than satiated ones [12], spent more time rocking and in closer proximity to clients Cephalopholis cyanostigma than satiated ones, and when given a choice, clients preferred hungry, rocking shrimp. The rocking dance therefore influenced client behavior and, thus, appears to function as a signal to advertise the presence of cleaner shrimp to potential clients.

Risk assessment by client and case manager for shared decision making in outpatient forensic psychiatry

NARCIS (Netherlands)

van den Brink, Rob H. S.; Troquete, Nadine A. C.; Beintema, Harry; Mulder, Tamara; van Os, Titus W. D. P.; Schoevers, Robert A.; Wiersma, Durk

2015-01-01

Background: In outpatient forensic psychiatry, assessment of re-offending risk and treatment needs by case managers may be hampered by an incomplete view of client functioning. The client's appreciation of his own problem behaviour is not systematically used for these purposes. The current study

Effectiveness of the ‘Who’s Challenging Who’ support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial

OpenAIRE

Randell, Elizabeth; Hastings, Richard P.; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary

2017-01-01

Background Findings suggest approximately one in six people with intellectual disability engage in ‘challenging behaviours’, which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. ‘Who’s ...

Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units

NARCIS (Netherlands)

Zwijsen, S.A.; Gerritsen, D.L.; Eefsting, J.A.; Smalbrugge, M.; Hertogh, C.M.P.M.; Pot, A.M.

2015-01-01

Background: Caring for people with dementia in dementia special care units is a demanding job. Challenging behaviour is one of the factors influencing the job satisfaction and burnout of care staff. A care programme for the challenging behaviour of nursing home residents with dementia might, next to

Coming to grips with challenging behaviour: a cluster randomised controlled trial on the effects of a new care programme for challenging behaviour on burnout, job satisfaction and job demands of care staff on dementia special care units

NARCIS (Netherlands)

Zwijsen, S.A.; Gerritsen, D.L.; Eefsting, J.A.; Smalbrugge, M.; Hertogh, C.M.; Pot, A.M.

2015-01-01

BACKGROUND: Caring for people with dementia in dementia special care units is a demanding job. Challenging behaviour is one of the factors influencing the job satisfaction and burnout of care staff. A care programme for the challenging behaviour of nursing home residents with dementia might, next to

Effectiveness of the 'Who's Challenging Who' support staff training intervention to improve attitudes and empathy towards adults with intellectual disability and challenging behaviours: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Randell, Elizabeth; Hastings, Richard P; McNamara, Rachel; Knight, Roseanna; Gillespie, David; Taylor, Zachary

2017-10-05

Findings suggest approximately one in six people with intellectual disability engage in 'challenging behaviours', which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. 'Who's Challenging Who?' (WCW) training is designed to emphasise the role of staff in residential settings as a challenge also to people with intellectual disability. The course is delivered jointly by a trainer with intellectual disability who has been labelled as having challenging behaviour, along with a trainer without intellectual disability. This is a cluster randomised two-arm trial of WCW training versus a waiting list control. Overall, 118 residential settings will be recruited and randomised on a 1:1 ratio. Within each setting, two members of staff will be invited to take part in the trial. Participants will complete assessments at baseline and at 6 and 20 weeks. WCW is a half day initial training course with some follow-on coaching to ensure implementation. The primary outcome is changes in staff empathy towards people with challenging behaviour. Secondary outcomes at the staff level include confidence, attitudes and work-related well-being. Secondary outcomes at the residential setting level include recorded incidents of aggressive challenging behaviour, and use of any restrictive practices. If the results of the cluster randomised trial are positive, we will disseminate the findings widely and make all training manuals and materials freely available for anyone in intellectual disability services (and beyond) to use. Our training approach may have wider implications in other areas of social care. It may also provide a generally applicable model for how to train people with

Nursing staff intentions towards managing deteriorating health in nursing homes: A convergent parallel mixed-methods study using the theory of planned behaviour.

Science.gov (United States)

O'Neill, Barbara J; Dwyer, Trudy; Reid-Searl, Kerry; Parkinson, Lynne

2018-03-01

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

Interactive client side data visualization with d3.js

Science.gov (United States)

Rodzianko, A.; Versteeg, R.; Johnson, D. V.; Soltanian, M. R.; Versteeg, O. J.; Girouard, M.

2015-12-01

Geoscience data associated with near surface research and operational sites is increasingly voluminous and heterogeneous (both in terms of providers and data types - e.g. geochemical, hydrological, geophysical, modeling data, of varying spatiotemporal characteristics). Such data allows scientists to investigate fundamental hydrological and geochemical processes relevant to agriculture, water resources and climate change. For scientists to easily share, model and interpret such data requires novel tools with capabilities for interactive data visualization. Under sponsorship of the US Department of Energy, Subsurface Insights is developing the Predictive Assimilative Framework (PAF): a cloud based subsurface monitoring platform which can manage, process and visualize large heterogeneous datasets. Over the last year we transitioned our visualization method from a server side approach (in which images and animations were generated using Jfreechart and Visit) to a client side one that utilizes the D3 Javascript library. Datasets are retrieved using web service calls to the server, returned as JSON objects and visualized within the browser. Users can interactively explore primary and secondary datasets from various field locations. Our current capabilities include interactive data contouring and heterogeneous time series data visualization. While this approach is very powerful and not necessarily unique, special attention needs to be paid to latency and responsiveness issues as well as to issues as cross browser code compatibility so that users have an identical, fluid and frustration-free experience across different computational platforms. We gratefully acknowledge support from the US Department of Energy under SBIR Award DOE DE-SC0009732, the use of data from the Lawrence Berkeley National Laboratory (LBNL) Sustainable Systems SFA Rifle field site and collaboration with LBNL SFA scientists.

Perceptions of service quality by clients and contact-personnel in the ...

African Journals Online (AJOL)

2013-05-03

May 3, 2013 ... Given the focus of banks on bank–client relationships, service quality is .... satisfaction was found to have a favourable impact on behavioural ...... Service Management and Marketing: A Customer Relationship Management.

Understanding the usage of the Helioviewer Project clients and services

Science.gov (United States)

Ireland, J.; Zahniy, S.; Mueller, D.; Nicula, B.; Verstringe, F.; Bourgoignie, B.; Buchlin, E.; Alingery, P.

2017-12-01

The Helioviewer Project enables visual exploration of the Sun and the inner heliosphere for everyone, everywhere via intuitive interfaces and novel technology. The project mainly develops two clients, helioviewer.org and JHelioviewer, and the server-side capabilities accessed via those clients. Images from many different ground and space-based sources are currently available from multiple servers. Solar and heliospheric feature and event information, magnetic field extrapolations and important time-series can also be browsed and visualized using Helioviewer Project clients. Users of the Helioviewer Project have made over two million movies and many millions of screenshots since detailed (and anonymous) logging of Helioviewer Project usage was implemented in February 2011. These usage logs are analyzed to give a detailed breakdown on user interaction with solar and heliospheric data via Helioviewer Project clients and services. We present summary statistics on how our users are using our clients and services, which data they are interested in, and how they choose to interact with different data sources. At the poster presentation we will also be soliciting ideas from the community to improve our clients and services.

Symptoms of burnout among staff of direct service care

OpenAIRE

ZICHOVÁ, Eliška

2017-01-01

This dissertation was focused on burnout syndrome among the staff of direct service care. The degree of burnout was estimated using Copenhagen Burnout Inventory questionnaire which was completed by the respondents from six Prague homes for seniors. The burnout incidence in this group was 30-45 %, whereas it was only 18-32 % among Czech Army employees who were studied for comparison. The staff of direct service care had significantly higher degree of personal, work-related, client-related and ...

Teaching Women with Intellectual Disabilities to Identify and Report Inappropriate Staff-to-Resident Interactions

Science.gov (United States)

Bollman, Jessica R.; Davis, Paula K.

2009-01-01

This study examined the effectiveness of behavioral skills training in teaching 2 adult women with mild intellectual disabilities to report inappropriate staff-to-resident interactions. The reporting skill included making a self-advocacy response, walking away, and reporting the interaction. Participants' performance was measured during baseline,…

Inelastic behaviour of collagen networks in cell–matrix interactions and mechanosensation

Science.gov (United States)

Mohammadi, Hamid; Arora, Pamma D.; Simmons, Craig A.; Janmey, Paul A.; McCulloch, Christopher A.

2015-01-01

The mechanical properties of extracellular matrix proteins strongly influence cell-induced tension in the matrix, which in turn influences cell function. Despite progress on the impact of elastic behaviour of matrix proteins on cell–matrix interactions, little is known about the influence of inelastic behaviour, especially at the large and slow deformations that characterize cell-induced matrix remodelling. We found that collagen matrices exhibit deformation rate-dependent behaviour, which leads to a transition from pronounced elastic behaviour at fast deformations to substantially inelastic behaviour at slow deformations (1 μm min−1, similar to cell-mediated deformation). With slow deformations, the inelastic behaviour of floating gels was sensitive to collagen concentration, whereas attached gels exhibited similar inelastic behaviour independent of collagen concentration. The presence of an underlying rigid support had a similar effect on cell–matrix interactions: cell-induced deformation and remodelling were similar on 1 or 3 mg ml−1 attached collagen gels while deformations were two- to fourfold smaller in floating gels of high compared with low collagen concentration. In cross-linked collagen matrices, which did not exhibit inelastic behaviour, cells did not respond to the presence of the underlying rigid foundation. These data indicate that at the slow rates of collagen compaction generated by fibroblasts, the inelastic responses of collagen gels, which are influenced by collagen concentration and the presence of an underlying rigid foundation, are important determinants of cell–matrix interactions and mechanosensation. PMID:25392399

Evidence of probabilistic behaviour in protein interaction networks

Directory of Open Access Journals (Sweden)

Reifman Jaques

2008-01-01

Full Text Available Abstract Background Data from high-throughput experiments of protein-protein interactions are commonly used to probe the nature of biological organization and extract functional relationships between sets of proteins. What has not been appreciated is that the underlying mechanisms involved in assembling these networks may exhibit considerable probabilistic behaviour. Results We find that the probability of an interaction between two proteins is generally proportional to the numerical product of their individual interacting partners, or degrees. The degree-weighted behaviour is manifested throughout the protein-protein interaction networks studied here, except for the high-degree, or hub, interaction areas. However, we find that the probabilities of interaction between the hubs are still high. Further evidence is provided by path length analyses, which show that these hubs are separated by very few links. Conclusion The results suggest that protein-protein interaction networks incorporate probabilistic elements that lead to scale-rich hierarchical architectures. These observations seem to be at odds with a biologically-guided organization. One interpretation of the findings is that we are witnessing the ability of proteins to indiscriminately bind rather than the protein-protein interactions that are actually utilized by the cell in biological processes. Therefore, the topological study of a degree-weighted network requires a more refined methodology to extract biological information about pathways, modules, or other inferred relationships among proteins.

Client Mobile Software Design Principles for Mobile Learning Systems

Directory of Open Access Journals (Sweden)

Qing Tan

2009-01-01

Full Text Available In a client-server mobile learning system, client mobile software must run on the mobile phone to acquire, package, and send student’s interaction data via the mobile communications network to the connected mobile application server. The server will receive and process the client data in order to offer appropriate content and learning activities. To develop the mobile learning systems there are a number of very important issues that must be addressed. Mobile phones have scarce computing resources. They consist of heterogeneous devices and use various mobile operating systems, they have limitations with their user/device interaction capabilities, high data communications cost, and must provide for device mobility and portability. In this paper we propose five principles for designing Client mobile learning software. A location-based adaptive mobile learning system is presented as a proof of concept to demonstrate the applicability of these design principles.

Veterinarians' perceptions of behaviour support in small-animal practice.

Science.gov (United States)

Roshier, A L; McBride, E A

2013-03-09

Veterinarians are professionals considered to be at the forefront of animal welfare, including behaviour medicine. However, concerns raised, both within the profession and without, highlight that the support offered is not optimal, due to deficiencies in veterinary training, which focuses on physical aspects and overlooks psychological aspects. This preliminary study explored the experiences and perceptions of six veterinarians (three male, three female, age range: 23-55 years) in two UK small-animal practices. Seventeen annual booster consultations were videoed and conversations thematically analysed for welfare topics discussed. Both veterinarians and clients completed questionnaires to gather demographic information and perspectives. All veterinarians recognised behaviour as a component of their caseload, and acknowledged that clients expected them to provide behaviour support. Veterinarians varied in their experiences of and confidence in providing behaviour support. Five felt unable to meet client expectations; four did not feel their training had prepared them sufficiently. Only one provided dedicated behaviour consultations, the others referred cases. All provided suggestions for behaviour skills needed for new veterinary graduates. The study has afforded an insight into the experiences of a small opportunistic sample of veterinarians. The data indicated important limitations regarding time available in general consultations to discuss behaviour concerns, and practitioner knowledge and skill in detection, anamnesis, assessment and provision of appropriate behaviour information. Suggestions for veterinary training in behaviour are provided.

HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry.

Science.gov (United States)

Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Atik; Merry, Maria Silvia

2018-02-15

Background: The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

Investigating the factors that affect the communication of death-related bad news to people with intellectual disabilities by staff in residential and supported living services: An interview study.

Science.gov (United States)

Tuffrey-Wijne, I; Rose, T

2017-08-01

Most staff working in intellectual disability services will be confronted with people with intellectual disabilities who need support around death, dying and bereavement. Previous studies suggest that intellectual disability staff tend to protect clients from knowing about death and avoid communication about death. The aims of this study were to gain further insight into the individual, organisational and contextual factors that affect the communication of death-related bad news to people with intellectual disabilities by intellectual disability staff and to develop guidelines for services to enable appropriate communication with clients about death and dying. Semi-structured interviews were held with 20 social care staff working in intellectual disability residential or supported living services in London, who had supported a client affected by death-related bad news in the past 6 months. Staff found supporting people with intellectual disabilities around death and dying extremely difficult and tended to avoid communication about death. The following factors had a particularly strong influence on staff practice around communicating death-related bad news: fear and distress around death; life and work experience; and organisational culture. Staff attitudes to death communication had a stronger influence than their client's level of cognitive or communicative abilities. Managers were important role models. Service managers should ensure not only that all their staff receive training in death, loss and communication but also that staff are enabled to reflect on their practice, through emotional support, supervision and team discussions. Future work should focus on the development and testing of strategies to enable intellectual disability staff to support their clients in the areas of dying, death and bereavement. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Utility of the theory of planned behavior to predict nursing staff blood pressure monitoring behaviours.

Science.gov (United States)

Nelson, Joan M; Cook, Paul F; Ingram, Jennifer C

2014-02-01

perceived control of the behaviour by nursing staff. © 2013 Blackwell Publishing Ltd.

Sign and Symptom and Ability to Control Violent Behaviour with Music Therapy and Rational Emotive Cognitive Behaviour Therapy

Directory of Open Access Journals (Sweden)

Heri Setiawan

2015-10-01

Full Text Available Introduction: Prevalence of violence is highly occur in mental disorders clients at psychiatric hospitals. The impact is injure to others. This research aims to examine the effectiveness of music therapy and RECBT to sign and symptom and ability to control violent behaviour. Methods: Quasi-experimental research design with a sample of 64 respondents. Result: The study found a decrease symptoms of violent behaviour, ability to control violent behavior include relaxation, change negative thingking, irational belief, and negative behavior have increased significantly than the clients that did not receiving therapy. Discussion: Music therapy and RECBT is recommended as a therapeutic nursing at the client’s violent behaviour. Key Word: violent, sign and simptom, ability, music therapy, RECBT

Guidance for nuclear medicine staff on radiopharmaceuticals drug interaction

Directory of Open Access Journals (Sweden)

Ralph Santos-Oliveira

2009-12-01

Full Text Available Numerous drug interactions related to radiopharmaceuticals take place every day in hospitals many of which are not reported or detected. Information concerning this kind of reaction is not abundant, and nuclear medicine staff are usually overwhelmed by this information. To better understand this type of reaction, and to help nuclear medicine staff deal with it, a review of the literature was conducted. The results show that almost all of radiopharmaceuticals marketed around the world present drug interactions with a large variety of compounds. This suggests that a logical framework to make decisions based on reviews incorporating adverse reactions must be created. The review also showed that researchers undertaking a review of literature, or even a systematic review that incorporates drug interactions, must understand the rationale for the suggested methods and be able to implement them in their review. Additionally, a global effort should be made to report as many cases of drug interaction with radiopharmaceuticals as possible. With this, a complete picture of drug interactions with radiopharmaceuticals can be drawn.Diversos casos de interações medicamentosas com radiofármacos ocorrem diariamente na rotina hospitalar, contudo muitos deles não são notificados ou mesmo percebidos. Informações a respeito desse tipo de reação não é abundante e os profissionais da medicina nuclear muitas vezes estão assoberbados por essas informações. De modo a entender esse tipo de reação e auxiliar a medicina nuclear a lidar com essa situação uma revisão da literatura foi realizada. Os resultados mostraram que a totalidade dos radiofármacos comercializados no mundo apresentam interação medicamentosa com uma enorme variedade de outros medicamentos. Dessa forma sugere-se que revisões sobre radiofármacos inclua um capítulo sobre efeitos adversos. Além disso, um esforço mundial para notificar efeitos adversos deve ser realizado, pois somente

An Initial Evaluation of Direct Care Staff Resilience Workshops in Intellectual Disabilities Services

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Ingham, Barry; Riley, Jenny; Nevin, Helen; Evans, Gemma; Gair, Elodie

2013-01-01

The emotional responses to challenging behaviour of direct care staff who support people with intellectual disabilities is thought to be an important mediating factor within the stress experienced by staff and a potential maintaining factor in challenging behaviour. A brief workshop to improve direct care staff resilience was developed and…

Communicative competence and psychological aspects when interacting with client in tourism

OpenAIRE

BITTER N.V.; KOLUPANOVA I.A.; ZHIDKOVA I.V.

2015-01-01

The article deals with the role of psychological preparation of specialists in service and tourism to building relationships with clients of travel agencies. Attention is paid to what is importantin psychological preparation of the expert assigned to the speech skill, because the possession of speech skills influences the formation of the motives and interests of the client, speed, completeness and the strength of assimilation of advertising materials, economy, recall; accuracy, consistency a...

Empathy from the client's perspective: A grounded theory analysis.

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MacFarlane, Peter; Anderson, Timothy; McClintock, Andrew S

2017-03-01

Although empathy is one of most robust predictors of client outcome, there is little consensus about how best to conceptualize this construct. The aim of the present research was to investigate clients' perceptions and in-session experiences of empathy. Semi-structured, video-assisted interpersonal process recall interviews were used to collect data from nine clients receiving individual psychotherapy at a university psychology clinic. Grounded theory analysis yielded a model consisting of three clusters: (1) relational context of empathy (i.e., personal relationship and professional relationship), (2) types of empathy (i.e., psychotherapists' cognitive empathy, psychotherapists' emotional empathy, and client attunement to psychotherapist), and (3) utility of empathy (i.e., process-related benefits and client-related benefits). These results suggest that empathy is a multi-dimensional, interactional process that affects-and is affected by-the broader relationship between client and psychotherapist.

Multiple Codes, Multiple Impressions: An Analysis of Doctor-Client Encounters in Nigeria

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Odebunmi, Akin

2013-01-01

Existing studies on doctor-client interactions have largely focused on monolingual encounters and the interactional effects and functions of the languages used in the communication between doctors and their clients. They have neither, to a large extent, examined the several codes employed in single encounters and their pragmatic roles nor given…

Exploring the impact of music concerts in promoting well-being in dementia care.

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Shibazaki, Kagari; Marshall, Nigel A

2017-05-01

This study explores the specific effects of live music concerts on the clients with dementia, their families and nursing staff/caregivers. Researchers attended 22 concerts in care facilities in England and Japan. Interviews were carried out with clients with dementia, nursing staff and family members. Observations were also carried out before, during and after the concerts. All observations were recorded in field notes. The effect of the concerts in both countries was seen to be beneficial to all clients and nursing staff, whether or not they attended the concert. Interviews with clients with mild to mid-stage dementia noted increased levels of cooperation, interaction and conversation. Those with more advanced forms of dementia exhibited decreased levels of agitation and anti-social behaviour. Staff members reported increased levels of care, cooperation and opportunities for assessment. Family members noted an increase in the levels of well-being in their partner/parent as well as in themselves. The study also suggested that the knowledge of musical components, an awareness of the rules of music and specific musical preferences appear to remain well beyond the time when other cognitive skills and abilities have disappeared. This initial study provided some further indication in terms of the uses of music as a non-pharmacological intervention for those living with all stages of dementia. These included opportunities for assessment of physical abilities as well as facilitating an increasing level of care.

Food Safety Education Using an Interactive Multimedia Kiosk in a WIC Setting: Correlates of Client Satisfaction and Practical Issues

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Trepka, Mary Jo; Newman, Frederick L.; Huffman, Fatma G.; Dixon, Zisca

2010-01-01

Objective: To assess acceptability of food safety education delivered by interactive multimedia (IMM) in a Supplemental Nutrition Program for Women, Infants and Children Program (WIC) clinic. Methods: Female clients or caregivers (n = 176) completed the food-handling survey; then an IMM food safety education program on a computer kiosk.…

Communicative Interaction among Local Editorial Staff Members: Current Situation and the Ways of its Improving

Directory of Open Access Journals (Sweden)

Mariya V. Korotitskaya

2017-06-01

Full Text Available Communication between management and employees is very important in organizations. However, communication problems might be more felt in any media organization as a whole and in the local media staff in particular. It’s obvious that news workers have everyday communicative interaction with different newsmakers. The article deals with the study and analysis of the communicative interaction between the local editorial creative staff members. Internal and external organizational understanding data are considered. It is determined that the level of organizational communication development influences the local editorial success and employees’ performance. Mutual understanding as the basic criterion of effective communication has several forms. The subject of our study is organizational understanding, that is, a special type of editorial staff relationship which is limited by the boundaries of the organization and is essential for its successful functioning and development. The analysis of empirical data allowed to identify the main problematic aspects and to work out the recommendations for vertical and horizontal communication development.

Adolescents Who Self-Harm: Professional Staff Knowledge, Attitudes and Training Needs

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Timson, Debbie; Priest, Helena; Clark-Carter, David

2012-01-01

This study aimed to investigate professional staff attitudes and knowledge about adolescents who engage in self-harming behaviour and to identify training needs. Previous research has suggested that medical and health care staff perceptions may reinforce the stigma associated with such behaviour and therefore jeopardise the effectiveness of…

Making participation accessible for vulnerable clients

Directory of Open Access Journals (Sweden)

Louis Anthony Iaquinto

2016-07-01

Full Text Available Despite forty years of research, community sector service providers still find operationalising participation in their practice confusing and difficult.  This paper presents the results of a preliminary study that begins to question why this is so and what can be done about it?  The study examines the meaning and importance of participation determined by a review of the academic literature, by soliciting feedback from a range of stakeholders in community sector organisations, including service users with complex barriers to participation, staff, and board members.  The participants’ perspectives, views and experience of participation were obtained through the use of semi-structured interviews.  The data generated a number of telling examples of the impact organisational culture has on service delivery and how the values of the leadership shape the organization, as well as illustrations of the principles that underpin participation expressed from the standpoints of the three participant groups.  Study findings underscore the critical importance for service providers to consider their culture and its influences.   Keywords: organisational culture, vulnerable clients, client participation

Impact of practice leadership management style on staff experience in services for people with intellectual disability and challenging behaviour: A further examination and partial replication.

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Deveau, Roy; McGill, Peter

2016-09-01

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.

Screening for depression: integrating training into the professional development programme for low vision rehabilitation staff.

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Rees, Gwyneth; Holloway, Edith E; Craig, Graeme; Hepi, Niky; Coad, Samantha; Keeffe, Jill E; Lamoureux, Ecosse L

2012-12-01

To describe the integration of depression screening training into the professional development programme for low vision rehabilitation staff and report on staff evaluation of this training. Pre-post intervention study, in a single population of low vision rehabilitation staff. Three hundred and thirty-six staff from Australia's largest low vision rehabilitation organization, Vision Australia. Staff completed the depression screening and referral training as part of a wider professional development programme. A pre-post-training questionnaire was administered to all staff. Descriptive and non-parametric statistics were used to determine differences in self-reported knowledge, confidence, barriers to recognition and management of depression between baseline and post training. One hundred and seventy-two participants completed both questionnaires. Following training, participants reported an increased knowledge of depression, were more likely to respond to depression in their clients and reported to be more confident in managing depression (P training incorporating more active and 'hands-on' sessions are likely to be required. This training is a promising first step in integrating a depression screening tool into low vision rehabilitation practice. Further work is needed to determine the barriers and facilitators to implementation in practice and to assess clients' acceptability and outcomes. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

Compulsive buying: a cognitive-behavioural model.

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Kellett, Stephen; Bolton, Jessica V

2009-01-01

Compulsive buying (CB) has only relatively recently become a topic of interest for researchers and clinicians alike. This hiatus means that (unlike other impulse control disorders) there is currently little theoretical guidance for clinicians attempting to intervene with CB clients and no established model for researchers to evaluate, distil and refine. The current paper summarizes and organizes the main extant identified factors in the CB literature into four distinct phases: (1) antecedents; (2) internal/external triggers; (3) the act of buying; and finally, (4) post-purchase. The relationships and interactions between the identified phases are then hypothesized, within the proposed cognitive-behavioural model. The model distinguishes the key cognitive, affective and behavioural factors within each phase and identifies how CB can become self-reinforcing over time. The over-arching treatment implication is that CB can be re-conceptualized as chronic and repetitive failure in self-regulation efforts, and that psychological interventions can accommodate this in attempting to facilitate change. A successful case example is provided of a 'co-dependent compulsive buyer' using the model, with psychometric evaluation of key aspects of CB and mental health at assessment, termination and 6-month follow-up. The research and clinical implications of the proposed model are discussed, alongside identified short-comings and the need for psychological services to respond appropriately to CB clients seeking help.

The insecure psychotherapy base: Using client and therapist attachment styles to understand the early alliance.

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Marmarosh, Cheri L; Kivlighan, Dennis M; Bieri, Kathryn; LaFauci Schutt, Jean M; Barone, Carrie; Choi, Jaehwa

2014-09-01

The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A physician role typology: colleague and client dependence in an HMO.

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Barr, J K; Steinberg, M K

1985-01-01

This paper reports on physicians' role definitions in one prepaid group practice, a health maintenance organization (HMO). Colleague and client dependence are reviewed and analyzed as separable dimensions of physician role definitions. Data are derived from documents, interviews, and staff questionnaires collected in 1979-1980. The evidence reported suggests widespread colleague dependence in the HMO. Physicians consulted with one another about patient care and engaged in informal referral and review, developing practice standards; and some of these physicians relied on colleagues for handling their patient visits when needed. In relation to their patients, some physicians viewed themselves as bureaucratic officials relatively dependent on client approval in carrying out their health care activities, while others saw themselves as trusted medical experts in a setting free of nonmedical constraints in patient care. The relationship of organizational structure to these different role definitions is discussed. Classifying these HMO physicians according to a fourfold typology of professional dependence shows that most are Organizational Physicians (Type I), who are both colleague and client dependent. Collegial Physicians (Type II) are colleague dependent and, at the same time, do not perceive clients as demanding. Implications for quality of care and physician satisfaction and turnover are considered.

Knowledge, attitudes, beliefs and behaviour intentions for three bowel management practices in intensive care: effects of a targeted protocol implementation for nursing and medical staff.

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Knowles, Serena; Lam, Lawrence T; McInnes, Elizabeth; Elliott, Doug; Hardy, Jennifer; Middleton, Sandy

2015-01-01

Bowel management protocols have the potential to minimize complications for critically ill patients. Targeted implementation can increase the uptake of protocols by clinicians into practice. The theory of planned behaviour offers a framework in which to investigate clinicians' intention to perform the behaviour of interest. This study aimed to evaluate the effect of implementing a bowel management protocol on intensive care nursing and medical staffs' knowledge, attitude, subjective norms, perceived behavioural control, behaviour intentions, role perceptions and past behaviours in relation to three bowel management practices. A descriptive before and after survey using a self-administered questionnaire sent to nursing and medical staff working within three intensive care units before and after implementation of our bowel management protocol (pre: May - June 2008; post: Feb - May 2009). Participants had significantly higher knowledge scores post-implementation of our protocol (pre mean score 17.6; post mean score 19.3; p = 0.004). Post-implementation there was a significant increase in: self-reported past behaviour (pre mean score 5.38; post mean score 7.11; p = 0.002) and subjective norms scores (pre mean score 3.62; post mean score 4.18; p = 0.016) for bowel assessment; and behaviour intention (pre mean score 5.22; post mean score 5.65; p = 0.048) for administration of enema. This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care. Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change. Despite an increase in clinicians' knowledge scores, our implementation strategy did not, however, significantly change clinician behaviour intentions for all three bowel management practices. Further research is

A Review of Behavioural Gerontology and Dementia Related Interventions

Directory of Open Access Journals (Sweden)

Josling, Megan

2015-12-01

Full Text Available Behavioural Gerontology is concerned with the interaction of the aging individual and their environment. One aspect of behavioural gerontology has focussed on the use of behaviourist methods to improve the functioning and quality of life of individuals with dementia. Positive reinforcement techniques have shown to have an effect on dementia related behavioural excesses (wandering, disruptive vocalisations, behavioural deficits (incontinence, self feeding and mood changes (depression. One of the major concerns of using reinforcement techniques in the case of dementia is maintenance of the behavioural changes with the continual implementation of the intervention. Research has indicated that individuals with dementia meet behavioural extinction criteria at an advanced rate in comparison with individuals without dementia. Thus for a behavioural change to be successfully maintained it requires diligence on the part of the caregiver and/or nursing home staff. In the case of dementia care centres and nursing homes, when using behavioural interventions to modify the behavioural symptoms of dementia, there needs to be a considerable overlap between Behavioural Gerontology and Organisational Behavioural Management to ensure the successful maintenance of behavioural change.

What's So Hard about Staff Development? A Study in Face-to-Face Interaction. Occasional Paper No. 14.

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Anang, Arlene; Florio-Ruane, Susan

Staff development carried out within a conference format is multidimensional, ambiguous, potentially face-threatening, and complex. It is dependent upon the interactional work that takes place during face-to-face negotiations. The skills and knowledge of the staff developer cannot be shared with a teacher in a vacuum, but are dependent upon the…

Serving up the self: Role identity and burnout in client service environments

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Carly Steyn

2015-12-01

Full Text Available Orientation: Whilst the limited investigations into the relationship between identity and burnout have made an important contribution to our understanding of the development of burnout, further research is required to gain a deeper understanding of how the processes associated with the construction and enactment of a specific identity could contribute to burnout amongst client service employees. Research purpose: The purpose of this research was to explore whether levels of burnout amongst client service employees are associated with the manner in which they define and enact the client service role identity. Motivation for the study: The negative effects of burnout amongst client service employees can be particularly devastating for client service organisations. A deeper understanding of the causes of burnout amongst client service employees is therefore essential if we wish to reduce the significant costs associated with burnout in this environment. Research approach, design and method: The research strategy comprised a qualitative design consisting of semi-structured interviews. Main findings: The results of the study indicate that the role identities of higher burnout client service employees differ from the role identities of lower burnout client service employees. Lower burnout employees view the client relationship as a partnership and experience a high level of self-verification when dealing with their clients. Higher burnout employees, on the other hand, describe themselves as subordinate to the client and exhibit strong feelings of defeat and failure when interacting with their clients. Practical implications/managerial implications: The study shows that if client service organisations wish to reduce the detrimental effects of burnout in the workplace, they need to pay careful attention to the way in which their client service employees perceive themselves in relation to the client. Since client service employees construct role

Modifier le cadre participatif pour résoudre un problème client : exemples d’ajustement opéré par les professionnels dans les interactions en centre d’appels

Directory of Open Access Journals (Sweden)

Colón De Carvajal Isabel

2012-07-01

Full Text Available Si, dans les interactions de service en centre d’appels, la conversation principale est celle engagée entre l’appelant et l’appelé, une multitude d’autres interactions caractérise le travail des opérateurs. Cet article présente une étude linguistique sur les interactions entre les opérateurs du centre d’appels LocBike, qui propose l’accès à des vélos en libre service dans une grande ville française, et les clients, qui empruntent ces vélos et appellent le centre en cas de problèmes. Ces interactions ont la particularité d’être menées autour d’objets technologiques, afin d’interagir avec le client et traiter son dossier. L’accès à cet environnement d’interactions téléphoniques médiées par ordinateur permet d’analyser la résolution du problème client du point de vue de l’opérateur, et d’observer que ce travail se réalise parfois en collaboration avec son collègue co-présent dans son environnement immédiat. Les professionnels opèrent alors des ajustements par rapport au dispositif de communication, ou s’ajustent eux-mêmes à ce dispositif, pendant l’interaction principale avec le client, ce qui tend à modifier le cadre participatif. L’objectif de notre travail est d’analyser les pratiques des professionnels lors de modifications du cadre participatif, et ce, dans le but de résoudre un problème client. A travers des exemples de collaboration, nous étudierons les formes d’ajustement que les professionnels mettent en place par rapport au dispositif de communication, modifiant ainsi temporairement le cadre participatif.

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 4. September 2010

International Nuclear Information System (INIS)

2010-09-01

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from September 6 to September 18, 2010 by the LH2 institute. For the 1504 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 5. September 2011

International Nuclear Information System (INIS)

2011-09-01

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from September 12 to September 23, 2011 by the LH2 institute. For the 1500 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 3. September 2009

International Nuclear Information System (INIS)

2009-09-01

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out in September 2009 by the LH2 institute. For the 1500 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 2. December 2008

International Nuclear Information System (INIS)

2008-12-01

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from November 10 to November 20, 2008 by the LH2 institute. For the 1502 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

From traditional cognitive-behavioural therapy to acceptance and commitment therapy for chronic pain: a mixed-methods study of staff experiences of change.

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Barker, Estelle; McCracken, Lance M

2014-08-01

Health care organizations, both large and small, frequently undergo processes of change. In fact, if health care organizations are to improve over time, they must change; this includes pain services. The purpose of the present study was to examine a process of change in treatment model within a specialty interdisciplinary pain service in the UK. This change entailed a switch from traditional cognitive-behavioural therapy to a form of cognitive-behavioural therapy called acceptance and commitment therapy. An anonymous online survey, including qualitative and quantitative components, was carried out approximately 15 months after the initial introduction of the new treatment model and methods. Fourteen out of 16 current clinical staff responded to the survey. Three themes emerged in qualitative analyses: positive engagement in change; uncertainty and discomfort; and group cohesion versus discord. Quantitative results from closed questions showed a pattern of uncertainty about the superiority of one model over the other, combined with more positive views on progress reflected, and the experience of personal benefits, from adopting the new model. The psychological flexibility model, the model behind acceptance and commitment therapy, may clarify both processes in patient behaviour and processes of staff experience and skilful treatment delivery. This integration of processes on both sides of treatment delivery may be a strength of acceptance and commitment therapy.

Modelling engagement in dementia through behaviour. Contribution for socially interactive robotics.

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Perugia, Giulia; Diaz Doladeras, Marta; Mallofre, Andreu Catala; Rauterberg, Matthias; Barakova, Emilia

2017-07-01

In this paper, we present a novel tool to measure engagement in people with dementia playing board games and interacting with a social robot, Pleo. We carried out two studies to reach a comprehensive inventory of behaviours accounting for engagement in dementia. The first one is an exploratory study aimed at modelling engagement in cognitive board games. The second one is a longitudinal study to investigate how people with dementia express engagement in cognitive games and in interactions with social robots. We adopted a technique coming from Ethology to mould behaviour, the ethogram. Ethogram is founded on low level behaviours, and allows hierarchical structuring. Herein, we present preliminary results consisting in the description of two ethograms and in their structuring obtained through thematic analysis. Such results show that an underlying structure of engagement exists across activities, and that different activities trigger different behavioural displays of engagement that adhere to such a structure.

Public debt managers' behaviour interactions with macro policies

NARCIS (Netherlands)

Hoogduin, Lex; Öztürk, Bahar; Wierts, Peter

2011-01-01

We investigate the evolution of public debt management, the policy behaviour of debt managers, and the interaction of debt management with financial stability and monetary policy. The main focus is on the euro area. Empirical estimations of a debt management reaction function indicate that the share

Interpersonal processes and self-injury: a qualitative study using Bricolage.

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Rayner, G; Warne, T

2016-02-01

Literature on self-injury has recognized the impact on the relationship between clients and staff. There is an absence of a detailed account of interpersonal processes surrounding self-injury. A Bricolage qualitative research approach was carried out in the United Kingdom that explored the interpersonal processes surrounding self-injury. Three pairs of clients and staff were interviewed about an incident of self-injury. The interviews were thematically analysed and then synthesized producing a deeper exploration of the relationship between the client and staff. An interpersonal trigger followed by anger and shame, resulted in self-injury to 'numb' these experiences. Self-injury is conceptualized as a safety behaviour to avoid shame and anger and then as a maintenance cycle that traps the client in a reinforcing and rejecting relationship. Staff interviewed were able to reflect with the clients and help them reframe these experiences. Mental Health Nurses can work with clients to understand their own interpersonal cycles of self-injury. They can then reflect on their own roles in this process and avoid reinforcing the clients' negative beliefs. WHAT THE STUDY ADDS TO INTERNATIONAL EVIDENCE: This is the first international paper to explore the interconnection between the client and a professional helper in their lived experiences of self-injury. © 2015 John Wiley & Sons Ltd.

Achieving success in intervention studies: an analysis of variable staff engagement across three midwifery settings.

Science.gov (United States)

Henderson, Amanda; Schoonbeek, Sue; Ossenberg, Christine; Caddick, Alison; Wing, Diane; Capell, Lorna; Gould, Karen

2014-06-01

To critically analyse the success of staff's behaviour changes in the practice setting. Facilitators were employed to initiate and facilitate a four-step process (optimism, overcoming obstacles, oversight and reinforcing outcomes) that fostered development of behaviours consistent with learning in everyday practice. Many studies seek to engage staff in workplace behaviour improvement. The success of such studies is highly variable. Little is known about the work of the facilitator in ensuring success. Understanding the contextual factors that contribute to effective facilitation of workplace improvement is essential to ensure best use of resources. Mixed methods Facilitators employed a four-step process - optimism, overcoming obstacles, oversight and reinforcing outcomes - to stage behaviour change implementation. The analysis of staff engagement in behaviour changes was assessed through weekly observation of workplaces, informal discussions with staff and facilitator diaries. The impact of behaviour change was informed through pre- and postsurveys on staff's perception across three midwifery sites. Surveys measured (1) midwives' perception of support for their role in facilitating learning (Support Instrument for Nurses Facilitating the Learning of Others) and (2) development of a learning culture in midwifery practice settings (Clinical Learning Organisational Culture Survey). Midwives across three sites completed the presurvey (n = 216) and postsurvey (n = 90). Impact varied according to the degree that facilitators were able to progress teams through four stages necessary for change (OOORO). Statistically significant results were apparent in two subscales important for supporting staff, namely teamwork and acknowledgement; in the two areas, facilitators worked through 'obstacles' and coached staff in performing the desired behaviours and rewarded them for their success. Elements of the learning culture also statistically improved in one site. Findings suggest

The ARAC client system: network-based access to ARAC

International Nuclear Information System (INIS)

Leach, M J; Sumikawa, D; Webster, C

1999-01-01

The ARAC Client System allows users (such as emergency managers and first responders) with commonly available desktop and laptop computers to utilize the central ARAC system over the Internet or any other communications link using Internet protocols. Providing cost-effective fast access to the central ARAC system greatly expands the availability of the ARAC capability. The ARAC Client system consists of (1) local client applications running on the remote user's computer, and (2) ''site servers'' that provide secure access to selected central ARAC system capabilities and run on a scalable number of dedicated workstations residing at the central facility. The remote client applications allow users to describe a real or potential them-bio event, electronically sends this information to the central ARAC system which performs model calculations, and quickly receive and visualize the resulting graphical products. The site servers will support simultaneous access to ARAC capabilities by multiple users. The ARAC Client system is based on object-oriented client/server and distributed computing technologies using CORBA and Java, and consists of a large number of interacting components

Perceptions of success in performance-based procurement: Differences between clients and contractors

NARCIS (Netherlands)

van Duren, J.M.A.; Doree, Andries G.; Voordijk, Johannes T.

2015-01-01

Purpose – The purpose of this study is to analyse, from the perspective of agency theory, differences between client and contractor in their perceptions of changes in uncertainty and in inclination to opportunistic behaviour while using a performance-based procurement procedure. In agency theory,

MPEG-4 interactive image transmission on mobile thin clients

Science.gov (United States)

Joveski, B.; Mitrea, M.; Pr"teux, F.

2010-05-01

The main issue in this paper is to deploy a compressing algorithm for heterogeneous content (text, graphics, image and video) with low-complex decoding. Such an algorithm will be involved in the remote display core problem for mobile thin clients: it allows the graphical content, computed on a remote server, to be displayer on the user's thin terminal, even when the network constraints (bandwidth, errors) are very strict. The paper is structured into three parts. First, a client-server architecture is presented. On the server side, the graphical content is parsed, converted and binary encoded into the MPEG 4 (BiFS, LASeR) format. This content is further streamed to the terminal, where it is played into a simple MPEG player. Secondly, this architecture is considered as a test bed for MPEG 4 performance assessment for various types of content (image, graphics, text). The quantitative results were focussed on bandwidth requirements and quality of experience. Finally, the conclusions are structured as a reference benchmarking of the MPEG (BiFS, LASeR) and outside (VNC) mobile remote display potential solutions.

The relationship between clinician turnover and adolescent treatment outcomes: An examination from the client perspective

Science.gov (United States)

Garner, Bryan R.; Funk, Rodney R.; Hunter, Brooke D.

2012-01-01

The turnover of substance use disorder (SUD) treatment staff has been assumed to adversely impact treatment effectiveness, yet only limited research has empirically examined this assumption. Representing an extension of prior organizational-level analyses of the impact of staff turnover on client outcomes, this study examined the impact of SUD clinician turnover on adolescent treatment outcomes using a client perspective. Multilevel regression analysis did reveal that relative to those adolescents who did not experience clinician turnover, adolescents who experienced both direct and indirect clinician turnover reported a significantly higher percentage of days using alcohol or drugs at 6-month follow-up. However, clinician turnover was not found to have significant associations (negative or positive) with the other five treatment outcomes examined (e.g., substance-related problems, involvement in illegal activity). Thus, consistent with our prior findings, the current study provides additional evidence that turnover of SUD clinicians is not necessarily associated with adverse treatment outcomes. PMID:23083980

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 3. September 2009; L'ouverture des marches de l'electricite et du gaz naturel pour les clients residentiels. Barometre annuel - vague 3. Septembre 2009

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-09-15

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out in September 2009 by the LH2 institute. For the 1500 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

Care Staff Intentions to Support Adults with an Intellectual Disability to Engage in Physical Activity: An Application of the Theory of Planned Behaviour

Science.gov (United States)

Martin, Emma; McKenzie, Karen; Newman, Emily; Bowden, Keith; Morris, Paul Graham

2011-01-01

Researchers suggest that people with an intellectual disability (ID) undertake less physical activity than the general population and many rely, to some extent, on others to help them to access activities. The Theory of Planned Behaviour (TPB) model was previously found to significantly predict the intention of care staff to facilitate a healthy…

Randomized controlled trial to determine the effectiveness of an interactive multimedia food safety education program for clients of the special supplemental nutrition program for women, infants, and children.

Science.gov (United States)

Trepka, Mary Jo; Newman, Frederick L; Davila, Evelyn P; Matthew, Karen J; Dixon, Zisca; Huffman, Fatma G

2008-06-01

Pregnant women and the very young are among those most susceptible to foodborne infections and at high risk of a severe outcome from foodborne infections. To determine if interactive multimedia is a more effective method than pamphlets for delivering food safety education to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clients. A randomized controlled trial of WIC clients was conducted. Self-reported food safety practices were compared between pre- and postintervention questionnaires completed >or=2 months after the intervention. Pregnant WIC clients or female caregivers (usually mothers) of WIC clients who were 18 years of age or older and able to speak and read English were recruited from an inner-city WIC clinic. Participants were randomized to receive food safety pamphlets or complete an interactive multimedia food safety education program on a computer kiosk. Change from pre- to postintervention food safety scores. A mean food safety score was determined for each participant for the pre- and postintervention questionnaires. The scores were used in a two-group repeated measures analysis of variance. Of the 394 participants, 255 (64.7%) completed the postintervention questionnaire. Satisfaction with the program was high especially among those with no education beyond high school. When considering a repeated measures analysis of variance model with the two fixed between-subject effects of group and age, a larger improvement in score in the interactive multimedia group than in the pamphlet group (P=0.005) was found, but the size of the group effect was small (partial eta(2)=0.033). Women aged 35 years or older in the interactive multimedia group had the largest increase in score. The interactive multimedia was well-accepted and resulted in improved self-reported food safety practices, suggesting that interactive multimedia is an effective option for food safety education in WIC clinics.

Empowering staff and clients: comparing preferences for management models by the professional degrees held by organization administrators.

Science.gov (United States)

Hardina, Donna; Montana, Salvador

2011-07-01

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 engage in management activities that focused on empowering staffthan in activities intended to increase client involvement in the political process or organizational decision making. However, when the responses of participants with MSW degrees were compared with those of non-social workers, findings indicate that social workers are more likely to engage in workplace activities that facilitate the political empowerment of clients.

How do incentives lead to deception in advisor-client interactions? Explicit and implicit strategies of self-interested deception.

Science.gov (United States)

Mackinger, Barbara; Jonas, Eva

2012-01-01

When confronted with important questions we like to rely on the advice of experts. However, uncertainty can occur regarding advisors' motivation to pursue self-interest and deceive the client. This can especially occur when the advisor has the possibility to receive an incentive by recommending a certain alternative. We investigated how the possibility to pursue self-interest led to explicit strategic behavior (bias in recommendation and transfer of information) and to implicit strategic behavior (bias in information processing: evaluation and memory). In Study 1 explicit strategic behavior could be identified: self-interested advisors recommended more often the self-serving alternative and transferred more self-interested biased information to their client compared to the advisor without specific interest. Also deception through implicit strategic behavior was identified: self-interested advisors biased the evaluation of information less in favor of the client compared to the control group. Self-interested advisors also remembered conflicting information regarding their self-interest worse compared to advisors without self-interest. In Study 2 beside self-interest we assessed accountability which interacted with self-interest and increased the bias: when accountability was high advisor's self-interest led to higher explicit strategic behavior (less transfer of conflicting information), and to higher implicit strategic behavior (devaluated and remembered less conflicting information). Both studies identified implicit strategic behavior as mediator which can explain the relation between self-interest and explicit strategic behavior. Results of both studies suggest that self-interested advisors use explicit and implicit strategic behavior to receive an incentive. Thus, advisors do not only consciously inform their clients "self-interested," but they are influenced unconsciously by biased information processing - a tendency which even increased with high

Montessori-based training makes a difference for home health workers & their clients.

Science.gov (United States)

Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

2003-01-01

Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

Design and Implementation of High Interaction Client Honeypot for Drive-by-Download Attacks

Science.gov (United States)

Akiyama, Mitsuaki; Iwamura, Makoto; Kawakoya, Yuhei; Aoki, Kazufumi; Itoh, Mitsutaka

Nowadays, the number of web-browser targeted attacks that lead users to adversaries' web sites and exploit web browser vulnerabilities is increasing, and a clarification of their methods and countermeasures is urgently needed. In this paper, we introduce the design and implementation of a new client honeypot for drive-by-download attacks that has the capacity to detect and investigate a variety of malicious web sites. On the basis of the problems of existing client honeypots, we enumerate the requirements of a client honeypot: 1) detection accuracy and variety, 2) collection variety, 3) performance efficiency, and 4) safety and stability. We improve our system with regard to these requirements. The key features of our developed system are stepwise detection focusing on exploit phases, multiple crawler processing, tracking of malware distribution networks, and malware infection prevention. Our evaluation of our developed system in a laboratory experiment and field experiment indicated that its detection variety and crawling performance are higher than those of existing client honeypots. In addition, our system is able to collect information for countermeasures and is secure and stable for continuous operation. We conclude that our system can investigate malicious web sites comprehensively and support countermeasures.

A component analysis of positive behaviour support plans.

Science.gov (United States)

McClean, Brian; Grey, Ian

2012-09-01

Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness. Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up. There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions. Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour.

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

Science.gov (United States)

Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

Rogers' interviews with Gloria and Kathy revisited: A micro-analysis of the client-therapist interaction.

OpenAIRE

Takens, R.J.

2005-01-01

In order to illustrate the use of the Processing Modes Scales of Sachse (1990a) two prototypical interviews of Rogers, respectively with Gloria and Kathy, were analyzed. It was hypothesized that Rogers would offer his clients high levels of 'processing proposals', and that, as a consequence, his clients would show high levels of processing, too. Indeed, Rogers' processing proposals were much deeper than normally found, as were the processing modes by the two clients involved. It also turned o...

How social factors and behavioural strategies affect feeding and social interaction patterns in pigs.

Science.gov (United States)

Boumans, Iris J M M; de Boer, Imke J M; Hofstede, Gert Jan; Bokkers, Eddie A M

2018-04-26

Animals living in groups compete for food resources and face food conflicts. These conflicts are affected by social factors (e.g. competition level) and behavioural strategies (e.g. avoidance). This study aimed to deepen our understanding of the complex interactions between social factors and behavioural strategies affecting feeding and social interaction patterns in animals. We focused on group-housed growing pigs, Sus scrofa, which typically face conflicts around the feeder, and of which patterns in various competitive environments (i.e. pig:feeder ratio) have been documented soundly. An agent-based model was developed to explore how interactions among social factors and behavioural strategies can affect various feeding and social interaction patterns differently under competitive situations. Model results show that pig and diet characteristics interact with group size and affect daily feeding patterns (e.g. feed intake and feeding time) and conflicts around the feeder. The level of competition can cause a turning point in feeding and social interaction patterns. Beyond a certain point of competition, meal-based (e.g. meal frequency) and social interaction patterns (e.g. displacements) are determined mainly by behavioural strategies. The average daily feeding time can be used to predict the group size at which this turning point occurs. Under the model's assumptions, social facilitation was relatively unimportant in the causation of behavioural patterns in pigs. To validate our model, simulated patterns were compared with empirical patterns in conventionally housed pigs. Similarities between empirical and model patterns support the model results. Our model can be used as a tool in further research for studying the effects of social factors and group dynamics on individual variation in feeding and social interaction patterns in pigs, as well as in other animal species. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of illness and hip fracture perceptions on coping strategies of elderly rehabilitation clients

Directory of Open Access Journals (Sweden)

Tone Brejc

2006-12-01

Full Text Available The objective of this pilot study was to evaluate, using Leventhal's self-regulatory model of illness perceptions, the effects of subjective representations of health and hip fracture on coping strategies in a sample of 52 clients more than 65 years old at the beginning of intensive hospital rehabilitation programme. The results revealed that rehabilitation clients suffering from hip fracture preserved their sense of good general and mental health. Negative representation of hip fracture was related only to perception of temporary decline in physical activity and not to perception of other personal, social and economic consequences neither to perception of their controllability. Perception of poor physical competence influenced the use of less preferred coping strategies of behavioural, mental and alcohol/drug based disengagement, and denial. Rehabilitation clients preferred those cognitive-behavioural and emotional strategies which confirmed their perception of self-efficiency and confidence in therapeutic assistance.Strategies were thus selected according to active and planned endeavour to cope, and were based on acceptance, turning to religion, focusing and venting emotions, and seeking instrumental and social support. The study confirmed the hypothesis that negative representation of hip fracture and poor sense of physical competence had a restraining effect on the use of coping strategies. There was no evidence that coping strategies of hip fracture in elderly rehabilitation clients created a specific pattern, depending on the perception of its consequences and the appraisal of possibility to regain health control. The validity of the findings is limited by a relatively small and selected sample of cognitive intact and motivated older rehabilitation clients, use of specific, non-standardised instruments, and a cross-sectional approach.

Client Perspective

International Nuclear Information System (INIS)

Cohen, M.; Oleksiak, T.A.

1991-01-01

Training Sections can best serve the needs of their clients by encouraging them to recognize that self-determination and overall training program ownership are the key ingredients of a successful program. In a support role, Training Sections should provide excellent lesson plans and instructors, good record keeping, and feedback vehicles. Most importantly, Training Sections should communicate closely with their clients and provide maximum flexibility to support overall client responsibilities

Interpersonal Interactions in Instrumental Lessons: Teacher/Student Verbal and Non-Verbal Behaviours

Science.gov (United States)

Zhukov, Katie

2013-01-01

This study examined verbal and non-verbal teacher/student interpersonal interactions in higher education instrumental music lessons. Twenty-four lessons were videotaped and teacher/student behaviours were analysed using a researcher-designed instrument. The findings indicate predominance of student and teacher joke among the verbal behaviours with…

Designing interaction behaviour in service-oriented enterprise application integration

NARCIS (Netherlands)

Dirgahayu, T.; Quartel, Dick; van Sinderen, Marten J.

In this paper we present an approach for designing interaction behaviour in service-oriented enterprise application integration. The approach enables business analysts to actively participate in the design of an integration solution. In this way, we expect that the solution meets its integration

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 5. September 2011; L'ouverture des marches de l'electricite et du gaz naturel pour les clients residentiels. Barometre annuel - vague 5. Septembre 2011

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-09-15

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from September 12 to September 23, 2011 by the LH2 institute. For the 1500 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 4. September 2010; L'ouverture des marches de l'electricite et du gaz naturel pour les clients residentiels. Barometre annuel - vague 4. Septembre 2010

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-09-15

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from September 6 to September 18, 2010 by the LH2 institute. For the 1504 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

The opening of electricity and natural gas markets to residential clients. Yearly barometer - run 2. December 2008; L'ouverture des marches de l'electricite et du gaz naturel pour les clients residentiels. Barometre annuel - vague 2. Decembre 2008

Energy Technology Data Exchange (ETDEWEB)

NONE

2008-12-15

The opening of energy markets to competition became effective to individuals ('residential clients') on July 1, 2007 with the possibility to freely choose their energy supplier. This opening of energy markets to residential clients started 3 years after the opening to professionals (July 1, 2004). The Commission of energy regulation (CRE) and the national energy Ombudsman have set in place in 2007 a quantitative yearly survey ('barometer') addressed to residential clients in order to collect statistical data about the behaviour of these clients with regards to the opening of markets to competition. This document deals with the results of the fourth run of this survey carried out from November 10 to November 20, 2008 by the LH2 institute. For the 1502 households investigated, LH2 has questioned the person in charge of the energy bills management. The barometer aimed at answering the following questions: - what is the level of knowledge and information of residential clients about markets opening and the existing regulation? - What perception of this opening do they have? (pros/cons, advantages/drawbacks); - what behaviour do they have in front of the opening of markets to competition? (approach with respect to information needs, knowledge about the offer, intention to change supplier, brakes/motivations in entering the open market). (J.S.)

Offender and/or client? Fuzzy institutional identities in prison-based drug treatment in Denmark

DEFF Research Database (Denmark)

Nielsen, Bjarke; Kolind, Torsten

2016-01-01

The last 20 years has witnessed a rise in prison-based drug treatment in Nordic countries. This increase has challenged the prominence of the punitive prison, and created changes in the roles of both clients and staff. This article explores the development of two institutional inmate identities......: the offender and the client, which have occurred as a consequence of this shift in prison policy. However, in their institutional narratives and daily practice both prison officers and counsellors often fluctuate when addressing inmates as offenders and/or clients. This fluctuation creates a “fuzzy” dynamic....... These institutional identities are characterized, on the one hand, by inmates being dealt with by counsellors as ‘real people' and ‘equals’, but simultaneously counsellors are resorting to the control opportunities allowed by the prison authorities such as urine tests and the use of isolation cells. On the other hand...

Incidence, types and characteristics of aggressive behaviour in treatment facilities for adults with mild intellectual disability and severe challenging behaviour

NARCIS (Netherlands)

Tenneij, N.H.; Koot, H.M.

2008-01-01

Background: Inpatient aggression in treatment facilities for persons with intellectual disability (ID) can have aversive consequences, for co-clients and staff, but also for the aggressors themselves. To manage and eventually prevent inpatient aggressive incidents, more knowledge about their types

Patients subject to high levels of coercion: staff's understanding.

Science.gov (United States)

Bowers, Len; Wright, Steve; Stewart, Duncan

2014-05-01

Measures to keep staff and patients safe (containment) frequently involve coercion. A small proportion of patients is subject to a large proportion of containment use. To reduce the use of containment, we need a better understanding of the circumstances in which it is used and the understandings of patients and staff. Two sweeps were made of all the wards, spread over four hospital sites, in one large London mental health organization to identify patients who had been subject to high levels of containment in the previous two weeks. Data were then extracted from their case notes about their past history, current problem behaviours, and how they were understood by the patients involved and the staff. Nurses and consultant psychiatrists were interviewed to supplement the information from the case records. Twenty-six heterogeneous patients were identified, with many ages, genders, diagnoses, and psychiatric specialities represented. The main problem behaviours giving rise to containment use were violence and self-harm. The roots of the problem behaviours were to be found in severe psychiatric symptoms, cognitive difficulties, personality traits, and the implementation of the internal structure of the ward by staff. Staff's range and depth of understandings was limited and did not include functional analysis, defence mechanisms, specific cognitive assessment, and other potential frameworks. There is a need for more in-depth assessment and understanding of patients' problems, which may lead to additional ways to reduce containment use.

The Effect of Client Attachment Style and Counselor Functioning on Career Exploration

Science.gov (United States)

littman-Ovadia, Hadassah

2008-01-01

This longitudinal research investigated the interactive effect of social attachment style and perceived-counselor behavior on exploratory behavior exhibited by clients during and after career counseling. Results from 96 clients in career counseling indicated that social confidence and comfort, and the perception that the counselor had created…

Is the amount of exposure to aggressive challenging behaviour related to staff work-related well-being in intellectual disability services? Evidence from a clustered research design.

Science.gov (United States)

Flynn, Samantha; Hastings, Richard P; Gillespie, David; McNamara, Rachel; Randell, Elizabeth

2018-04-17

Previous research has demonstrated an association between aggressive challenging behaviour (CB) and reductions in work-related well-being for intellectual disability (ID) support staff. Much of this research has used subjective measures of CB. To examine whether exposure to aggressive CB is associated with reduced work-related well-being in staff working in ID residential settings across the UK. A cross-sectional analysis was undertaken as part of a randomised trial; 186 staff from 100 settings completed questionnaires on their CB self-efficacy, empathy, positive work motivation, and burnout. Objective measures of aggressive CB in the preceding 16 weeks were collected from each setting. There was little association between staff exposure to aggressive CB and work-related well-being. Clustering effects were found for emotional exhaustion and positive work motivation, suggesting these variables are more likely to be influenced by the environment in which staff work. The level of clustering may be key to understanding how to support staff working in ID residential settings, and should be explored further. Longitudinal data, and studies including a comparison of staff working in ID services without aggressive CB exposure are needed to fully understand any association between aggressive CB and staff well-being. Copyright © 2018 Elsevier Ltd. All rights reserved.

How do incentives lead to deception in advisors-client interactions? Explicit and implicit strategies of self-interested deception.

Directory of Open Access Journals (Sweden)

Barbara eMackinger

2012-12-01

Full Text Available When confronted with important questions we like to rely on the advice of experts. However, uncertainty can occur regarding advisors’ motivation to pursue self-interest and deceive the client. This can especially occur when the advisor has the possibility to receive an incentive by recommending a certain alternative. We investigated how the possibility to pursue self-interest led to explicit strategic behavior (bias in recommendation and transfer of information and to implicit strategic behavior (bias in information processing: evaluation and memory. In Study 1 explicit strategic behavior could be identified: Self-interested advisors recommended more often the self-serving alternative and transferred more self-interested biased information to their client compared to the advisor without specific interest. Also deception through implicit strategic behavior was identified: Self-interested advisors biased the evaluation of information less in favor of the client compared to the control group. Self-interested advisors also remembered conflicting information regarding their self-interest worse compared to advisors without self-interest. In Study 2 beside self-interest we assessed accountability which interacted with self-interest and increased the bias: When accountability was high advisor’s self-interest led to higher explicit strategic behavior (less transfer of conflicting information, and to higher implicit strategic behavior (devaluated and remembered less conflicting information. Both studies identified implicit strategic behavior as mediator which can explain the relation between self-interest and explicit strategic behavior. Results of both studies suggest that self-interested advisors use explicit and implicit strategic behavior to receive an incentive. Thus, advisors do not only consciously inform their clients self-interested, but they are influenced unconsciously by biased information processing—a tendency which even increased with

How Do Incentives Lead to Deception in Advisor–Client Interactions? Explicit and Implicit Strategies of Self-Interested Deception

Science.gov (United States)

Mackinger, Barbara; Jonas, Eva

2012-01-01

When confronted with important questions we like to rely on the advice of experts. However, uncertainty can occur regarding advisors’ motivation to pursue self-interest and deceive the client. This can especially occur when the advisor has the possibility to receive an incentive by recommending a certain alternative. We investigated how the possibility to pursue self-interest led to explicit strategic behavior (bias in recommendation and transfer of information) and to implicit strategic behavior (bias in information processing: evaluation and memory). In Study 1 explicit strategic behavior could be identified: self-interested advisors recommended more often the self-serving alternative and transferred more self-interested biased information to their client compared to the advisor without specific interest. Also deception through implicit strategic behavior was identified: self-interested advisors biased the evaluation of information less in favor of the client compared to the control group. Self-interested advisors also remembered conflicting information regarding their self-interest worse compared to advisors without self-interest. In Study 2 beside self-interest we assessed accountability which interacted with self-interest and increased the bias: when accountability was high advisor’s self-interest led to higher explicit strategic behavior (less transfer of conflicting information), and to higher implicit strategic behavior (devaluated and remembered less conflicting information). Both studies identified implicit strategic behavior as mediator which can explain the relation between self-interest and explicit strategic behavior. Results of both studies suggest that self-interested advisors use explicit and implicit strategic behavior to receive an incentive. Thus, advisors do not only consciously inform their clients “self-interested,” but they are influenced unconsciously by biased information processing – a tendency which even increased with high

University life and pandemic influenza: Attitudes and intended behaviour of staff and students towards pandemic (H1N1 2009

Directory of Open Access Journals (Sweden)

MacIntyre C Raina

2010-03-01

Full Text Available Abstract Background In a pandemic young adults are more likely to be infected, increasing the potential for Universities to be explosive disease outbreak centres. Outbreak management is essential to reduce the impact in both the institution and the surrounding community. Through the use of an online survey, we aimed to measure the perceptions and responses of staff and students towards pandemic (H1N1 2009 at a major university in Sydney, Australia. Methods The survey was available online from 29 June to 30 September 2009. The sample included academic staff, general staff and students of the University. Results A total of 2882 surveys were completed. Nearly all respondents (99.6%, 2870/2882 were aware of the Australian pandemic situation and 64.2% (1851/2882 reported either "no anxiety" or "disinterest." Asian-born respondents were significantly (p Conclusions Responses to a pandemic are subject to change in its pre-, early and mid-outbreak stages. Lessons for these institutions in preparation for a second wave and future disease outbreaks include the need to promote positive public health behaviours amongst young people and students.

Rational emotive behaviour therapy: distinctive features

OpenAIRE

Dryden, Windy

2008-01-01

Rational emotive behaviour therapy (REBT) encourages the client to focus on their emotional problems in order to understand, challenge and change the irrational beliefs that underpin these problems. REBT can help clients to strengthen conviction in their alternative rational beliefs by acting in ways that are consistent with them and thus encourage a healthier outlook.\\ud \\ud This accessible and direct guide introduces the reader to REBT while indicating how it is different from other approac...

Training to raise staff awareness about safeguarding children.

Science.gov (United States)

Fleming, Jane

2015-04-01

To improve outcomes for children and young people health organisations are required to train all staff in children's safeguarding. This creates difficulties for large complex organisations where most staff provide services to the adult population. Heart of England NHS Foundation Trust is a large acute and community trust that had difficulties in engaging staff in children's safeguarding training. Compliance rates for clinical staff who were trained in children's safeguarding were low and needed to be addressed. This article sets out why safeguarding training is important for all staff and how the trust achieved staff engagement and improved compliance rates. To evaluate, maintain and develop safeguarding knowledge, understanding, skills, attitude and behaviour further resources are planned to allow access to learning resources in a variety of formats.

ALARM, a life saving training program for inpatient mental health care staff. Tallinn, Estland (27-30 augustus 2014) : Oral presentation European Symposium on Suicide and Suicidal Behaviour

NARCIS (Netherlands)

Nienke Kool

2014-01-01

Oral presentation European Symposium on Suicide and Suicidal Behaviour. Titel: ALARM, a life saving training program for inpatient mental health care staff. Tallinn, Estland (27-30 augustus 2014) Introduction Despite precautions, suicide does happen. Sometimes patients are found while attempting

3-Form Cosmology: Phantom Behaviour, Singularities and Interactions

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João Morais

2017-03-01

Full Text Available The latest cosmological observations by the Planck collaboration (and combined with others are compatible with a phantom-like behaviour ( w < − 1 for the dark energy equation of state that drives the current acceleration of the Universe. With this mindset, we look into models where dark energy is described by a 3-form field minimally coupled to gravity. When compared to a scalar field, these models have the advantage of more naturally accommodating a cosmological-constant and phantom-like behaviours. We show how the latter happens for a fairly general class of positive-valued potentials, and through a dynamical system approach, we find that in such cases the 3-form field leads the Universe into a Little Sibling of the Big Rip singular event into the future. In this work, we explore the possibility of avoiding such singularity via an interaction in the dark sector between cold dark matter and the 3-form field. For the kind of interactions considered, we deduce a condition for replacing the LSBR by a late time de Sitter phase. For specific examples of interactions that meet this condition, we look for distinctive imprints in the statefinder hierarchy { S 3 ( 1 ; S 4 ( 1 } , { S 3 ( 1 ; S 5 ( 1 } , and in the growth rate of matter, ϵ ( z , through the composite null diagnostic (CND.

Comparison of veterinary health services expectations and perceptions between oncologic pet owners, non-oncologic pet owners and veterinary staff using the SERVQUAL methodology.

Science.gov (United States)

Gregório, Hugo; Santos, Patricia; Pires, Isabel; Prada, Justina; Queiroga, Felisbina Luísa

2016-11-01

Client satisfaction gained great importance in health care as a measurement of service quality. One of the most popular methods to evaluate client satisfaction is the SERVQUAL inquiry which measures service quality by evaluating client expectations and services towards a service in five dimensions: Tangibles, Empathy, Assurance, Reliability and Responsiveness. In order to evaluate if owners of pets with cancer constitute a distinctive group from the general pet owner population and if these differences were perceived by the hospital staff we applied a SERVQUAL questionnaire to 51 owners of pet with cancer, 68 owners from the general pet population and 14 staff members. Owners of oncologic pets had different expectations of an ideal service granting importance to Assurance questions (6.75 vs 6.5, p= 0.045) while showing unmet needs in Reliability and Empathy dimensions. Veterinarians failed to understand these specificities and over evaluated characteristics of Tangible dimension (6.75 vs 6.25, p=0.027). Owners of pet with cancer seem to constitute a specific subpopulation with special needs and veterinary staff should invest resources towards Assurance instead of privileging tangible aspects of veterinary services. By aligning professionals expectations with those of pet owners veterinarians can achieve better client satisfaction, improved compliance and stronger doctor-owner relationships.

Interactions between dopamine and oxytocin in the control of sexual behaviour.

Science.gov (United States)

Baskerville, Tracey A; Douglas, Alison J

2008-01-01

Dopamine and oxytocin are two key neuromodulators involved in reproductive behaviours, such as mating and maternal care. Much evidence underlies their separate roles in such behaviours, but particularly in sexual behaviour. It is generally believed that central dopaminergic and oxytocinergic systems work together to regulate the expression of penile erection, but relatively little is known regarding how they interact. Thus, this review aims to discuss neuroanatomical proof, neuromodulator secretory profiles in the hypothalamus and behavioural pharmacological evidence which support a dopamine-oxytocin link in three hypothalamic nuclei that have been implicated in sexual behaviour, namely the medial preoptic nucleus, supraoptic nucleus and paraventricular nucleus (PVN). We also aim to provide an overview of potential dopamine-mediated transduction pathways that occur within these nuclei and are correlated with the exhibition of penile erection. The PVN provides the most convincing evidence for a dopamine-oxytocin link and it is becoming increasingly apparent that parvocellular oxytocinergic neurons in the PVN, in part, mediate the effects of dopamine to elicit penile erection. However, while we show that oxytocin neurons express dopamine receptors, other evidence on whether dopaminergic activation of PVN oxytocin cells involves a direct and/or indirect mechanism is inconclusive and further evidence is required to establish whether the two systems interact synergistically or sequentially in the regulation of penile erection.

Working alliance, real relationship, session quality, and client improvement in psychodynamic psychotherapy: A longitudinal actor partner interdependence model.

Science.gov (United States)

Kivlighan, Dennis M; Hill, Clara E; Gelso, Charles J; Baumann, Ellen

2016-03-01

We used the Actor Partner Interdependence Model (APIM; Kashy & Kenny, 2000) to examine the dyadic associations of 74 clients and 23 therapists in their evaluations of working alliance, real relationship, session quality, and client improvement over time in ongoing psychodynamic or interpersonal psychotherapy. There were significant actor effects for both therapists and clients, with the participant's own ratings of working alliance and real relationship independently predicting their own evaluations of session quality. There were significant client partner effects, with clients' working alliance and real relationship independently predicting their therapists' evaluations of session quality. The client partner real relationship effect was stronger in later sessions than in earlier sessions. Therapists' real relationship ratings (partner effect) were a stronger predictor of clients' session quality ratings in later sessions than in earlier sessions. Therapists' working alliance ratings (partner effect) were a stronger predictor of clients' session quality ratings when clients made greater improvement than when clients made lesser improvement. For clients' session outcome ratings, there were complex three-way interactions, such that both Client real relationship and working alliance interacted with client improvement and time in treatment to predict clients' session quality. These findings strongly suggest both individual and partner effects when clients and therapists evaluate psychotherapy process and outcome. Implications for research and practice are discussed. (c) 2016 APA, all rights reserved).

Predicting retail banking consumer behaviour using statistics

Directory of Open Access Journals (Sweden)

Konstantinos Agaliotis

2015-04-01

Full Text Available The рurрοѕe οf any eсοnοmiс-based aсtivitу is the creation of needs. As the financial activities are not an exception to this rule, understanding clients’ necessities and their satisfaction is of primary concern for all financial institutions. Being conversant with the exact details that constitute client behaviour and the processes that lead to particular decisions, has become an advantage for financial institutions investing resources in it. Finally, it will not only pay off by satisfying the clients’ needs, but it will also secure a long-standing loyalty and relationships with them. As all relationships, the one between the client and the bank requires support and mutual understanding. Given the Serbian retail banking market, we may conclude the following: firstly, there is still potential for doing business in this filed; secondly, the particular segments of customers would accept new products; and thirdly, banks have to focus on the highest ranking clients concerning their credit worthiness. As regards the client behaviour over different product offerings, we can conclude that cash loans and credit card holders are not price sensitive, and that subsequently, the existing holders intend to increase their credit exposure.

Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

Science.gov (United States)

Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L; Raue, Patrick J

2015-01-01

The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.

Staff members' perceptions of an animal-assisted activity.

Science.gov (United States)

Bibbo, Jessica

2013-07-01

To examine the perceptions of staff members toward the implementation of an animal-assisted activity (AAA) in an outpatient regional cancer center. Quasi-experimental, post-test design. An adult outpatient regional cancer center in northern California. 34 facility staff members. Self-report questionnaire following four weeks of AAA visitation. Visits took place three times a week for a total of 12 visits. Perceptions of the AAA. Previous perceptions toward AAA influenced the perceptions of the visitation's efficacy. Direct and indirect interaction with the visiting AAA teams was positively associated with perceptions of the AAA. A disagreement occurred that the AAA had caused extra stress or work for staff. Enjoyment of interacting with the dog handler was not significantly different from interacting with the dog; however, it was more positively correlated to acceptance of the AAA. The study provided evidence that the AAA was generally accepted by staff members. Individual staff members' perceptions of dogs and AAAs can influence their receptivity to AAA interventions. Interaction with AAA teams should be voluntary and available for patients and staff members. AAA may be introduced into facilities without creating the perception of extra stress or work for staff members. Providing staff the opportunity to interact with visiting AAA teams may be beneficial for the success of such programs. The human handler in AAA teams may play a vital role in the staff acceptance of such programs.

On the systematic behaviour of the intermittency-induces in nuclear interactions

International Nuclear Information System (INIS)

Adamovich, M.I.; Aggarwal, M.M.; Alexandrov, Y.A.; Andreeva, N.P.; Anson, Z.V.; Arora, R.; Avetyan, F.A.; Badyal, S.K.; Basova, E.; Bhalla, K.B.; Bhasin, A.; Bhatia, V.S.; Bogdanov, V.G.; Bubnov, V.I.; Burnett, T.H.; Cai, X.; Chasnikov, I.Y.; Chernova, L.P.; Chernyavski, M.M.; Dressel, B.; Eligbaeva, G.Z.; Eremenko, L.E.; Friedlander, E.M.; Gaitinov, A.S.; Ganssauge, E.R.; Garpman, S.; Gerassimov, S.G.; Grote, J.; Gulamov, K.G.; Gupta, S.K.; Gupta, V.; Heckman, H.H.; Huang, H.; Jakobsson, B.; Judek, B.; Kachroo, S.; Kadyrov, F.G.; Kalyachkina, G.S.; Kanygina, E.K.; Karabova, M.; Kaul, G.L.; Kaur, M.; Kharlamov, S.P.; Koss, T.; Krasnov, S.A.; Kumar, V.; Lal, P.; Larionova, V.G.; Lepetan, V.N.; Lindstrom, P.J.; Liu, L.S.; Lokanathan, S.; Lord, J.; Lukicheva, N.S.; Luo, S.B.; Mangotra, L.K.; Marutyan, N.A.; Maslennikova, N.V.; Mittra, I.S.; Mookerjee, S.; Mueller, C.; Nasrulaeva, H.; Nasyrov, S.H.; Navotny, V.S.; Orlova, G.I.; Otterlund, I.; Palsania, H.S.; Peresadko, N.G.; Petrov, N.V.; Plyushchev, V.A.; Qian, W.Y.; Raniwala, R.; Raniwala, S.; Rao, N.K.; Rappoport, V.M.; Rhee, J.T.; Saidkhanov, N.; Salmanova, N.A.; Sarkisova, L.G.; Sarkisyan, V.R.; Schulz, W.; Shabratova, G.S.; Shakhova, T.I.; Singh, B.; Skelding, D.; Soederstroem, K.; Solovjeva, Z.I.; Stenlund, E.; Strausz, S.C.; Sun, J.F.; Svechnikova, L.N.; Tolstov, K.D.; Tretyakova, M.I.; Trofimova, T.P.; Tuleeva, U.; Vokal, S.; Wang, H.Q.; Weng, Z.Q.; Wilkes, R.J.; Xu, G.F.; Zhang, D.H.; Zheng, P.Y.; Zhochova, S.I.; Zhou, D.C.; Zhou, J.C.

1991-01-01

The non-statistical fluctuations observed in nuclear interactions, as described by the intermittency-indices from scaled factorial moment analyses, are found to follow a systematic behaviour. The heaviest systems studied, i.e. interactions with sulfur projectiles, are found to have fluctuations which are larger than expected from simple scaling rules. (orig.)

On the systematic behaviour of the intermittency-induces in nuclear interactions

Energy Technology Data Exchange (ETDEWEB)

Adamovich, M I; Aggarwal, M M; Alexandrov, Y A; Andreeva, N P; Anson, Z V; Arora, R; Avetyan, F A; Badyal, S K; Basova, E; Bhalla, K B; Bhasin, A; Bhatia, V S; Bogdanov, V G; Bubnov, V I; Burnett, T H; Cai, X; Chasnikov, I Y; Chernova, L P; Chernyavski, M M; Dressel, B; Eligbaeva, G Z; Eremenko, L E; Friedlander, E M; Gaitinov, A S; Ganssauge, E R; Garpman, S; Gerassimov, S G; Grote, J; Gulamov, K G; Gupta, S K; Gupta, V; Heckman, H H; Huang, H; Jakobsson, B; Judek, B; Kachroo, S; Kadyrov, F G; Kalyachkina, G S; Kanygina, E K; Karabova, M; Kaul, G L; Kaur, M; Kharlamov, S P; Koss, T; Krasnov, S A; Kumar, V; Lal, P; Larionova, V G; Lepetan, V N; Lindstrom, P J; Liu, L S; Lokanathan, S; Lord, J; Lukicheva, N S; Luo, S B; Mangotra, L K; Marutyan, N A; Maslennikova, N V; Mittra, I S; Mookerjee, S; Mueller, C; Nasrulaeva, H; Nasyrov, S H; Navotny, V S; Orlova, G I; Otterlund, I; Palsania, H S; Peresadko, N G; Petrov, N V; EMU01 Collaboration

1991-07-18

The non-statistical fluctuations observed in nuclear interactions, as described by the intermittency-indices from scaled factorial moment analyses, are found to follow a systematic behaviour. The heaviest systems studied, i.e. interactions with sulfur projectiles, are found to have fluctuations which are larger than expected from simple scaling rules. (orig.).

Concept mapping to improve team work, team learning and care of the person with dementia and behavioural and psychological symptoms.

Science.gov (United States)

Aberdeen, Suzanne M; Byrne, Graeme

2018-04-01

The incidence of behavioural and psychological symptoms of dementia in residential aged care facilities is high. Effective team work and knowledgeable staff are cited as important facilitators of appropriate care responses to clients with these symptoms, but to achieve this within a resource-poor workplace can be challenging. In the study reported in this paper, concept mapping was trialled to enhance multifocal person-centred assessment and care planning as well as team learning. The outcomes of team concept mapping were evaluated using a quasi-experimental design with pre- and post-testing in 11 selected Australian residential aged care facilities , including two control residential aged care facilities , over a nine-month period. It was demonstrated that use of concept mapping improved team function, measured as effectiveness of care planning, as well as enhancing learning, with increased knowledge of dementia care even amongst staff who were not directly involved with the process. It is suggested that these results may be generalizable to other countries and care settings.

Irrational Career Decision-Making: Connecting Behavioural Economics and Career Development

Science.gov (United States)

Redekopp, Dave E.

2017-01-01

Very frequently, students and clients do not do what they say they will do. Decisions and plans made in counselling sessions are often not enacted. The career development field may be better able to address the chasm between rational decisions and actual behaviour by applying the findings of behavioural economics. Behavioural economics research is…

HIV Clients as Agents for Prevention: A Social Network Solution

Directory of Open Access Journals (Sweden)

Sarah Ssali

2012-01-01

Full Text Available HIV prevention efforts to date have not explored the potential for persons living with HIV to act as change agents for prevention behaviour in their social networks. Using egocentric social network analysis, this study examined the prevalence and social network correlates of prevention advocacy behaviours (discussing HIV in general; encouraging abstinence or condom use, HIV testing, and seeking HIV care enacted by 39 HIV clients in Uganda. Participants engaged in each prevention advocacy behaviour with roughly 50–70% of the members in their network. The strongest determinant of engaging in prevention advocacy with more of one’s network members was having a greater proportion of network members who knew one’s HIV seropositive status, as this was associated with three of the four advocacy behaviours. These findings highlight the potential for PLHA to be key change agents for HIV prevention within their networks and the importance of HIV disclosure in facilitating prevention advocacy.

What role can avatars play in e-mental health interventions? Exploring new models of client-therapist interaction.

Directory of Open Access Journals (Sweden)

Imogen C Rehm

2016-11-01

Full Text Available In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and amongst peers. Avatars are digital self-representations which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified: (1 in the formation of online peer support communities; (2 replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3 using avatar technology to facilitate or augment face-to-face treatment; (4 as part of serious games, and (5 communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement: (1 facilitating the development of a virtual therapeutic alliance; (2 reducing communication barriers; (3 promoting treatment-seeking through anonymity; (4 promoting expression and exploration of client identity, and (5 enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

What Role Can Avatars Play in e-Mental Health Interventions? Exploring New Models of Client-Therapist Interaction.

Science.gov (United States)

Rehm, Imogen C; Foenander, Emily; Wallace, Klaire; Abbott, Jo-Anne M; Kyrios, Michael; Thomas, Neil

2016-01-01

In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and among peers. Avatars are digital self-representations, which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified (1) in the formation of online peer support communities; (2) replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3) using avatar technology to facilitate or augment face-to-face treatment; (4) as part of serious games; and (5) communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement by (1) facilitating the development of a virtual therapeutic alliance; (2) reducing communication barriers; (3) promoting treatment-seeking through anonymity; (4) promoting expression and exploration of client identity; and (5) enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

Emotional congruence between clients and therapists and its effect on treatment outcome.

Science.gov (United States)

Atzil-Slonim, Dana; Bar-Kalifa, Eran; Fisher, Hadar; Peri, Tuvia; Lutz, Wolfgang; Rubel, Julian; Rafaeli, Eshkol

2018-01-01

The present study aimed to (a) explore 2 indices of emotional congruence-temporal similarity and directional discrepancy-between clients' and therapists' ratings of their emotions as they cofluctuate session-by-session; and (b) examine whether client/therapist emotional congruence predicts clients' symptom relief and improved functioning. The sample comprised 109 clients treated by 62 therapists in a university setting. Clients and therapists self-reported their negative (NE) and positive emotions (PE) after each session. Symptom severity and functioning level were assessed at the beginning of each session using the clients' self-reports. To assess emotional congruence, an adaptation of West and Kenny's (2011) Truth and Bias model was applied. To examine the consequences of emotional congruence, polynomial regression, and response surface analyses were conducted (Edwards & Parry, 1993). Clients and therapists were temporally similar in both PE and NE. Therapists experienced less intense PE on average, but did not experience more or less intense NE than their clients. Those therapists who experienced more intense NE than their clients were more temporally similar in their emotions to their clients. Therapist/client incongruence in both PE and NE predicted poorer next-session symptomatology; incongruence in PE was also associated with lower client next-session functioning. Session-level symptoms were better when therapists experienced more intense emotions (both PE and NE) than their clients. The findings highlight the importance of recognizing the dynamic nature of emotions in client-therapist interactions and the contribution of session-by-session emotional dynamics to outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Towards culturally competent health care: language use of bilingual staff.

Science.gov (United States)

Johnson, M; Noble, C; Matthews, C; Aguilar, N

1998-01-01

The presence of diverse language skills within health staff provides opportunities to better meet the needs of a multicultural population. A cross-sectional survey of all staff within the South Western Sydney Area Health Service was undertaken to compare language skills with population needs and examine the context of language use. Thirty-one per cent of staff (n = 964) were bilingual or multilingual, with the predominant languages spoken being Tagalog (Filipino), Cantonese, Hindi, Spanish, Vietnamese and Italian. Thirty-seven per cent of bilingual staff used their language skills at least weekly, predominantly in situations of simple conversation and giving directions. Bilingual staff are a valuable resource for the organisation and the presence of a similar overall proportion of bilingual and bicultural staff may engender tolerance and adaptability in providing care to a diverse population. However, supply does not directly match community demand. This mismatch will continue unless recruitment is focused towards identified language groups. The high proportion of staff who rarely used their language skills (37%) may be due to lack of opportunity or limited need, and suggests that further research needs to examine service models that locate bilingual workers close to client need. This study takes a crucial first step towards realising equitable and culturally appropriate care utilising the principles of productive diversity.

Men with elevated testosterone levels show more affiliative behaviours during interactions with women

Science.gov (United States)

van der Meij, Leander; Almela, Mercedes; Buunk, Abraham P.; Fawcett, Tim W.; Salvador, Alicia

2012-01-01

Testosterone (T) is thought to play a key role in male–male competition and courtship in many vertebrates, but its precise effects are unclear. We explored whether courtship behaviour in humans is modulated and preceded by changes in T. Pairs of healthy male students first competed in a non-physical contest in which their T levels became elevated. Each participant then had a short, informal interaction with either an unfamiliar man or woman. The sex of the stimulus person did not affect the participants' behaviour overall. However, in interactions with women, those men who had experienced a greater T increase during the contest subsequently showed more interest in the woman, engaged in more self-presentation, smiled more and made more eye contact. No such effects were seen in interactions with other men. This is the first study to provide direct evidence that elevating T during male–male competition is followed by increased affiliative behaviour towards women. PMID:21632627

Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

Science.gov (United States)

Worku, Mesfin; Loha, Eskindir

2017-06-27

Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

The diversity of travel behaviour: Motives and social interactions in leisure time activities

OpenAIRE

Stauffacher, Michael; Schlich, Robert; Axhausen, Kay W.; Scholz, Roland W.

2005-01-01

Influencing travel behaviour towards a more sustainable form has long been the subject of lively discussion. Whilst some claim that urban form can influence mobility patterns, others stress personal characteristics. Still, psychological factors like personal need and motives (e.g., social interaction, recreation, variety seeking and curiosity) are also relevant, especially for the highly individualistic behaviour of leisure travel, but have been largely neglected in travel behaviour studies. ...

Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

Directory of Open Access Journals (Sweden)

Robert Kaba Alhassan

Full Text Available Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps.To evaluate the effect of SCE interventions on health worker motivation and experiences with clients.The study is a cluster randomized trial involving health workers in private (n = 38 and public (n = 26 primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72% were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation.Intrinsic (non-financial work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were

Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

Science.gov (United States)

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2016-01-01

Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked

Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial

Science.gov (United States)

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

2016-01-01

Background Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. Purpose To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. Methods The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Results Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while

Regulation of catalytic behaviour of hydrolases through interactions with functionalized carbon-based nanomaterials

International Nuclear Information System (INIS)

Pavlidis, Ioannis V.; Vorhaben, Torge; Gournis, Dimitrios; Papadopoulos, George K.; Bornscheuer, Uwe T.; Stamatis, Haralambos

2012-01-01

The interaction of enzymes with carbon-based nanomaterials (CBNs) is crucial for the function of biomolecules and therefore for the design and development of effective nanobiocatalytic systems. In this study, the effect of functionalized CBNs, such as graphene oxide (GO) and multi-wall carbon nanotubes (CNTs), on the catalytic behaviour of various hydrolases of biotechnological interest was monitored and the interactions between CBNs and proteins were investigated. The enzyme–nanomaterial interactions significantly affect the catalytic behaviour of enzymes, resulting in an increase up to 60 % of the catalytic efficiency of lipases and a decrease up to 30 % of the esterase. Moreover, the use of CNTs and GO derivatives, especially those that are amine-functionalized, led to increased thermal stability of most the hydrolases tested. Fluorescence and circular dichroism studies indicated that the altered catalytic behaviour of enzymes in the presence of CBNs arises from specific enzyme–nanomaterial interactions, which can lead to significant conformational changes. In the case of lipases, the conformational changes led to a more active and rigid structure, while in the case of esterases this led to destabilization and unfolding. Kinetic and spectroscopic studies indicated that the extent of the interactions between CBNs and hydrolases can be mainly controlled by the functionalization of nanomaterials than by their geometry.

Regulation of catalytic behaviour of hydrolases through interactions with functionalized carbon-based nanomaterials

Energy Technology Data Exchange (ETDEWEB)

Pavlidis, Ioannis V. [University of Ioannina, Laboratory of Biotechnology, Department of Biological Applications and Technologies (Greece); Vorhaben, Torge [Institute of Biochemistry, Greifswald University, Department of Biotechnology and Enzyme Catalysis (Germany); Gournis, Dimitrios [University of Ioannina, Department of Materials Science and Engineering (Greece); Papadopoulos, George K. [Epirus Institute of Technology, Laboratory of Biochemistry and Biophysics, Faculty of Agricultural Technology (Greece); Bornscheuer, Uwe T. [Institute of Biochemistry, Greifswald University, Department of Biotechnology and Enzyme Catalysis (Germany); Stamatis, Haralambos, E-mail: hstamati@cc.uoi.gr [University of Ioannina, Laboratory of Biotechnology, Department of Biological Applications and Technologies (Greece)

2012-05-15

The interaction of enzymes with carbon-based nanomaterials (CBNs) is crucial for the function of biomolecules and therefore for the design and development of effective nanobiocatalytic systems. In this study, the effect of functionalized CBNs, such as graphene oxide (GO) and multi-wall carbon nanotubes (CNTs), on the catalytic behaviour of various hydrolases of biotechnological interest was monitored and the interactions between CBNs and proteins were investigated. The enzyme-nanomaterial interactions significantly affect the catalytic behaviour of enzymes, resulting in an increase up to 60 % of the catalytic efficiency of lipases and a decrease up to 30 % of the esterase. Moreover, the use of CNTs and GO derivatives, especially those that are amine-functionalized, led to increased thermal stability of most the hydrolases tested. Fluorescence and circular dichroism studies indicated that the altered catalytic behaviour of enzymes in the presence of CBNs arises from specific enzyme-nanomaterial interactions, which can lead to significant conformational changes. In the case of lipases, the conformational changes led to a more active and rigid structure, while in the case of esterases this led to destabilization and unfolding. Kinetic and spectroscopic studies indicated that the extent of the interactions between CBNs and hydrolases can be mainly controlled by the functionalization of nanomaterials than by their geometry.

Client satisfaction in a faith-based health network: findings from a survey in Uganda.

Science.gov (United States)

Shumba, Constance Sibongile; Kabali, Kenneth; Miyonga, Jonathan; Mugadu, Jairus; Lakidi, Luke; Kerchan, Patrick; Tumwesigye, Tonny

2017-09-01

Client satisfaction surveys are important in evaluating quality of the healthcare processes and contribute to health service improvements by assisting health program managers to develop appropriate strategies. The goal of this study was to assess clients' level of satisfaction with services provided by private-not-for-profit member health facilities affiliated to Uganda Protestant Medical Bureau. This was a cross-sectional descriptive study using an interviewer-administered questionnaire conducted in 254/278 (91%) of UPMB member health facilities between 27th April and 14th July 2014 among 927 clients. The tool measured ten dimensions of the care-seeking experience namely; health facility access; waiting time; health providers; support staff; rights; payments; facilities and environment; consent; confidentiality; and the overall care seeking experience. Logistic regression was utilised for multivariate analysis. Overall client satisfaction was found to be high within the UPMB network (84.2%). Most of the client satisfaction dimensions were rated above 70% except payments and rights. There was evidence of association with marital status; single/never married were 3.05 times more likely to be dissatisfied compared to widowed. Clients attending HCIII were less likely to be dissatisfied compared to those attending HCII (OR=0.51, 95% CI: 0.25-1.05). Post-secondary education (OR=1.79; 95% CI 1.01-3.17), being formally employed (OR=2.78, 95% CI: 0.91-8.48) or unemployed (OR=3.34, 95% CI: 1.00-11.17), attendance at a hospital (OR=2.15, 95% CI: 1.36- 3.41) were also associated with high dissatisfaction levels with payments. This study found a high level of satisfaction with services in the UPMB network but recorded low client satisfaction with the dimensions of rights and payments. Health workers should take time to explain rights and entitlement as well as charges levied to clients.

Emergence of global scaling behaviour in the coupled Earth-atmosphere interaction

OpenAIRE

Fallah, Bijan; Saberi, Abbas Ali; Sodoudi, Sahar

2016-01-01

Scale invariance property in the global geometry of Earth may lead to a coupled interactive behaviour between various components of the climate system. One of the most interesting correlations exists between spatial statistics of the global topography and the temperature on Earth. Here we show that the power-law behaviour observed in the Earth topography via different approaches, resembles a scaling law in the global spatial distribution of independent atmospheric parameters. We report on obs...

Believing versus interacting: Behavioural and neural mechanisms underlying interpersonal coordination

DEFF Research Database (Denmark)

Konvalinka, Ivana; Bauer, Markus; Kilner, James

When two people engage in a bidirectional interaction with each other, they use both bottom-up sensorimotor mechanisms such as monitoring and adapting to the behaviour of the other, as well as top-down cognitive processes, modulating their beliefs and allowing them to make decisions. Most research...... in joint action has investigated only one of these mechanisms at a time – low-level processes underlying joint coordination, or high-level cognitive mechanisms that give insight into how people think about another. In real interactions, interplay between these two mechanisms modulates how we interact...

E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care.

Science.gov (United States)

Nilsson, Annika; Andrén, Marianne; Engström, Maria

2014-04-18

The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives. The interactive assessments were useful in assessing staff members' practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point.

E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care

Science.gov (United States)

2014-01-01

Background The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care. Methods Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education. Results Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives. Conclusion The interactive assessments were useful in assessing staff members’ practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point. PMID:24742168

Noninstructional Staff Perceptions of the College Climate

Science.gov (United States)

Duggan, Molly H.

2008-01-01

This study explored staff perception of organizational climate, including the impact of gender on staff interactions with faculty and students and staff perceptions of workplace satisfaction within the community college. The overarching research question guiding this study was, What are noninstructional staff perceptions of the community college…

Chronic disease health risk behaviours amongst people with a mental illness.

Science.gov (United States)

Bartlem, Kate M; Bowman, Jennifer A; Bailey, Jacqueline M; Freund, Megan; Wye, Paula M; Lecathelinais, Christophe; McElwaine, Kathleen M; Campbell, Elizabeth M; Gillham, Karen E; Wiggers, John H

2015-08-01

Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/. © The

Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study.

Science.gov (United States)

Shaw, Souradet Y; Deering, Kathleen N; Reza-Paul, Sushena; Isac, Shajy; Ramesh, Banadakoppa M; Washington, Reynold; Moses, Stephen; Blanchard, James F

2011-12-29

Studies have demonstrated the significance of commercial sex work in the ongoing transmission of HIV and other sexually transmitted infections (STIs) in India. Clients of female sex workers (FSWs) are thought to be an important bridging population for HIV/STIs. However, there is a lack of information on basic characteristics of sex work clients. This study sought to describe the prevalence of HIV and other STIs, as well as examine the determinants of these pathogens among a sample of clients in south India. Data were from a cross-sectional biological and behavioural survey of FSW clients from six districts in Karnataka State, India. The prevalence of HIV, syphilis, herpes simplex virus type 2 (HSV-2), chlamydia (CT) and gonorrhoea (NG) among clients was examined. Multivariable logistic regression models were used to analyse the socio-demographic, sexual behaviour and sex-work related characteristics related to the prevalence of each pathogen. Sampling weights and appropriate survey methods were utilized in regression models to account for complex sampling design. The total sample size was 2,745. The average age of clients was 30.4 (SE:0.3). Across the total sample, the prevalence of HIV, HSV-2, syphilis and CT/NG was 5.6%, 28.4%, 3.6% and 2.2%, respectively. The prevalence of HIV/STIs varied substantially across districts, reaching statistical significance for HIV (plodges were at increased risk for CT/NG (AOR: 6.3; 95%CI: 1.9-20.6, p=.03). Examining co-infections, clients with HSV-2 infections were at substantially higher risk of being HIV-positive (AOR: 10.4; 95%CI: 6.1-17.7, p<.0001). This study fills in important gaps in knowledge regarding clients in southern India. The strong association between HIV and HSV-2 infections highlights the complications in designing effective prevention, intervention and management programs of this well-hidden population.

The Behavioural Phenotype of Smith-Magenis Syndrome: Evidence for a Gene-Environment Interaction

Science.gov (United States)

Taylor, L.; Oliver, C.

2008-01-01

Background: Behaviour problems and a preference for adult contact are reported to be prominent in the phenotype of Smith-Magenis syndrome. In this study we examined the relationship between social interactions and self-injurious and aggressive/disruptive behaviour in Smith-Magenis syndrome to explore potential operant reinforcement of problem…

Human agency beliefs influence behaviour during virtual social interactions.

Science.gov (United States)

Caruana, Nathan; Spirou, Dean; Brock, Jon

2017-01-01

In recent years, with the emergence of relatively inexpensive and accessible virtual reality technologies, it is now possible to deliver compelling and realistic simulations of human-to-human interaction. Neuroimaging studies have shown that, when participants believe they are interacting via a virtual interface with another human agent, they show different patterns of brain activity compared to when they know that their virtual partner is computer-controlled. The suggestion is that users adopt an "intentional stance" by attributing mental states to their virtual partner. However, it remains unclear how beliefs in the agency of a virtual partner influence participants' behaviour and subjective experience of the interaction. We investigated this issue in the context of a cooperative "joint attention" game in which participants interacted via an eye tracker with a virtual onscreen partner, directing each other's eye gaze to different screen locations. Half of the participants were correctly informed that their partner was controlled by a computer algorithm ("Computer" condition). The other half were misled into believing that the virtual character was controlled by a second participant in another room ("Human" condition). Those in the "Human" condition were slower to make eye contact with their partner and more likely to try and guide their partner before they had established mutual eye contact than participants in the "Computer" condition. They also responded more rapidly when their partner was guiding them, although the same effect was also found for a control condition in which they responded to an arrow cue. Results confirm the influence of human agency beliefs on behaviour in this virtual social interaction context. They further suggest that researchers and developers attempting to simulate social interactions should consider the impact of agency beliefs on user experience in other social contexts, and their effect on the achievement of the application's goals.

Human agency beliefs influence behaviour during virtual social interactions

Directory of Open Access Journals (Sweden)

Nathan Caruana

2017-09-01

Full Text Available In recent years, with the emergence of relatively inexpensive and accessible virtual reality technologies, it is now possible to deliver compelling and realistic simulations of human-to-human interaction. Neuroimaging studies have shown that, when participants believe they are interacting via a virtual interface with another human agent, they show different patterns of brain activity compared to when they know that their virtual partner is computer-controlled. The suggestion is that users adopt an “intentional stance” by attributing mental states to their virtual partner. However, it remains unclear how beliefs in the agency of a virtual partner influence participants’ behaviour and subjective experience of the interaction. We investigated this issue in the context of a cooperative “joint attention” game in which participants interacted via an eye tracker with a virtual onscreen partner, directing each other’s eye gaze to different screen locations. Half of the participants were correctly informed that their partner was controlled by a computer algorithm (“Computer” condition. The other half were misled into believing that the virtual character was controlled by a second participant in another room (“Human” condition. Those in the “Human” condition were slower to make eye contact with their partner and more likely to try and guide their partner before they had established mutual eye contact than participants in the “Computer” condition. They also responded more rapidly when their partner was guiding them, although the same effect was also found for a control condition in which they responded to an arrow cue. Results confirm the influence of human agency beliefs on behaviour in this virtual social interaction context. They further suggest that researchers and developers attempting to simulate social interactions should consider the impact of agency beliefs on user experience in other social contexts, and their effect

A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: a unique opportunity for reaching the disadvantaged

Directory of Open Access Journals (Sweden)

Paul Christine

2011-10-01

Full Text Available Abstract Background Social and community service organisations (SCSOs are non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals. SCSOs hold considerable potential for providing smoking cessation support to disadvantaged smokers. This study aimed to establish the prevalence of smoking, interest in quitting and interest in receiving cessation support amongst clients accessing SCSOs. Methods Clients seeking financial or material assistance from three SCSOs in NSW, Australia, between February and October 2010 were invited to complete a 60-item general health touch screen computer survey. This included questions about smoking status, past quit attempts and interest in receiving support to quit smoking from SCSO staff. Results A total of 552 clients were approached to participate during the study period, of which 383 provided consent and completed the survey (69% consent rate. Daily smoking was reported by 53.5% of participants. Occasional smoking (non-daily smoking was reported by a further 7.9% of participants. Most participants had tried to quit smoking in the past (77% and had made an average of two quit attempts (SD = 3.2 lasting longer than 24 hours in the previous 12 months. More than half of all participants (52.8% reported that they would like help from SCSO staff to quit smoking. For those interested in receiving help, the preferred types of help were access to free NRT (77%, cash rewards (52% and non-cash rewards (47% for quitting, and to receive support and encouragement from SCSO staff to quit (45%. Conclusions Smoking rates among clients accessing SCSO are substantially higher than the general population rate of 15.1%. A substantial proportion of clients are interested in quitting and want support from the SCSO to do so.

Prevalence of HIV and sexually transmitted infections among clients of female sex workers in Karnataka, India: a cross-sectional study

Directory of Open Access Journals (Sweden)

Shaw Souradet Y

2011-12-01

Full Text Available Abstract Background Studies have demonstrated the significance of commercial sex work in the ongoing transmission of HIV and other sexually transmitted infections (STIs in India. Clients of female sex workers (FSWs are thought to be an important bridging population for HIV/STIs. However, there is a lack of information on basic characteristics of sex work clients. This study sought to describe the prevalence of HIV and other STIs, as well as examine the determinants of these pathogens among a sample of clients in south India. Methods Data were from a cross-sectional biological and behavioural survey of FSW clients from six districts in Karnataka State, India. The prevalence of HIV, syphilis, herpes simplex virus type 2 (HSV-2, chlamydia (CT and gonorrhoea (NG among clients was examined. Multivariable logistic regression models were used to analyse the socio-demographic, sexual behaviour and sex-work related characteristics related to the prevalence of each pathogen. Sampling weights and appropriate survey methods were utilized in regression models to account for complex sampling design. Results The total sample size was 2,745. The average age of clients was 30.4 (SE:0.3. Across the total sample, the prevalence of HIV, HSV-2, syphilis and CT/NG was 5.6%, 28.4%, 3.6% and 2.2%, respectively. The prevalence of HIV/STIs varied substantially across districts, reaching statistical significance for HIV (p Conclusions This study fills in important gaps in knowledge regarding clients in southern India. The strong association between HIV and HSV-2 infections highlights the complications in designing effective prevention, intervention and management programs of this well-hidden population.

Youth Justice staff attitudes towards screening for self-harm.

Science.gov (United States)

Knowles, Sarah E; Townsend, Ellen; Anderson, Martin P

2012-09-01

Young offenders are recognised as a high-risk group for suicidal behaviour. It is essential that the screening used to identify those at risk and refer them to mental health services is effective, especially in community settings where service utilisation is low. Staff attitudes towards screening for suicide and self-harm are likely to influence how a young offender engages with the screening process. Our study is the first to explore community youth justice staff attitudes towards, and perceptions of, screening for self-harmful behaviour. Eight semi-structured interviews were conducted at an English Youth Offending Team in June 2006 with staff who had used the suicide screening tool with young offenders. Data were analysed using Interpretative Phenomenological Analysis. Staff attitudes towards working within the screening system varied along two dimensions. The first 'active/passive' dimension related to perceived confidence in dealing with self-harm. The second 'positive/negative' dimension related to perceptions of the benefits of screening and the effectiveness of mental health provision for young offenders. Results indicate that barriers to effective screening must be tackled at both individual and organisational levels. The model of attitudes presented here could be used to increase understanding of how staff can be supported to engage effectively with the screening system. © 2012 Blackwell Publishing Ltd.

Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff.

Science.gov (United States)

Gjersing, Linn R; Butler, Tony; Caplehorn, John R M; Belcher, Josephine M; Matthews, Richard

2007-09-01

Justice Health NSW has one of the most extensive prison-based methadone programmes in the world. We examine prison health staff attitudes towards methadone treatment and compare these with community methadone staff. A cross-sectional survey of 202 staff employed by Justice Health New South Wales was undertaken in 2003. Results. The mean scores on the various sub-scales were: abstinence-orientation (AO) 2.9 (95% CI 2.8 - 3.0); disapproval of drug use (DDU) 3.3 (95% CI 3.2 - 3.4); knowledge (Know) 2.7 (95% CI 2.4 - 2.9); and toxicity 4.6 (95% CI 4.2 - 5.0). Both the AO and DDU score were correlated negatively with the Know score (r = -0.37 and r = -0.13, respectively). Prison health staff had higher AO (2.9 vs. 2.6, p US community methadone staff about the toxicity of methadone (4.6 vs. 0.0, p prison health staff attitudes to methadone treatment. Correctional health staff tend to be more abstinence-orientated, more likely to disapprove of drug use, and less knowledgeable about the risks and benefits of methadone than Australian community methadone staff. The findings have important implications for training health staff working in the prison environment with regard to client retention on methadone treatment.

Theoretical Explanations of Environmental Motivations and Expectations of Clients on Green Building Demand and Investment

International Nuclear Information System (INIS)

Joachim, Onuoha Iheanyichukwu; Kamarudin, Norhaya; Aliagha, Godwin Uche; Ufere, Kalu Joseph

2015-01-01

In building industry, green demand and investment creates a positive footprint on the environment. However, these environmental opportunities have not been adequately harnessed and explored by Clients of green building apparently because of poor understanding of the motivating drivers and benefits accruing from green building demand and investment. The decision to demand for or invest in green building is influenced by certain environmental motivating drivers and expectations which have not been fully examined by researchers and not well understood by stakeholders. Based on the Theory of Planned Behaviour (TPB) and Theory of Value Belief Norm (VBN) explanations, this study focused on the Clients, purchasers and users' motivations and intentions to go for green building. Based on the reviewed theories, we hypothesized that environmental motivations and expectations for green building demand and investment are embedded in the environmental quest for protection of eco-system and bio-diversity, improvement of water and air quality, reduction of solid waste, conservation of natural resources, reduction of societal costs of landfill creation and maintenance, minimization of site impact and reduction emission to air and enhanced energy efficiency. However, the predictive validity of these propositions depends on the client's beliefs, values, social pressure, and perceived behavioural control

An exploration of bullying behaviours in nursing: a review of the literature.

Science.gov (United States)

Wilson, Janet Lynn

This article explores bullying behaviours in nursing in the UK and other countries, why bullying happens, and suggests actions to prevent or combat it. Bullying involves intentional and repeated psychological violence, humiliating and isolating staff from colleagues. Current literature reports that 20-25% of nursing staff experience bullying behaviour. The main perpetrators are nurses in a senior position to those being bullied and colleagues who are established staff members. Those likely to be bullied are students and new staff members. Bullying can cause distress and depression, with up to 25% of those bullied leaving their jobs or the profession, and have an impact on patient care. Factors contributing to bullying are hierarchical management and employees not feeling empowered. Silence and inaction by managers and colleagues allows this behaviour to continue. A zero-tolerance policy and the addressing of this behaviour clearly and promptly by managers should be instigated. Staff being bullied should be supported by colleagues.

Client-Oriented Approach: Forming the System of Management of the Bank Relations with Clients

Directory of Open Access Journals (Sweden)

Zavadska Diana V.

2015-03-01

Full Text Available The aim of the article is to develop the theoretical principles of forming the bank relations with clients as part of the client-oriented strategy implementation. As a result of the conducted research there has been presented the definition of client-orientation, mechanism and system of management. The system of management of the bank relations with clients, the purpose and objectives of its formation have been substantiated. The hierarchy of subjects of forming and managing the process of the bank relations with client has been presented. The ways of implementing in practice the functions of the mechanism of managing relations with clients have been revealed. It has been proved that for implementation of the client-oriented approach the banking institution should have a comprehensive view of its clients’ behavior, which detailed understanding will allow for a more accurate segmentation and building individualized partnership relations. Implementing the principle of totality of client relationships level and comprehensive knowledge, development of employee behavior techniques and special techniques for working with the most valuable clients, the use of analytics and forecasting tools will provide targeting of marketing campaigns and lead to minimization of additional costs, satisfaction of every client, loyalty, increase in the market share, growth of sales volume, increase in profits of the banking institution.

Structure of the TPR domain of AIP: lack of client protein interaction with the C-terminal α-7 helix of the TPR domain of AIP is sufficient for pituitary adenoma predisposition.

Directory of Open Access Journals (Sweden)

Rhodri M L Morgan

Full Text Available Mutations of the aryl hydrocarbon receptor interacting protein (AIP have been associated with familial isolated pituitary adenomas predisposing to young-onset acromegaly and gigantism. The precise tumorigenic mechanism is not well understood as AIP interacts with a large number of independent proteins as well as three chaperone systems, HSP90, HSP70 and TOMM20. We have determined the structure of the TPR domain of AIP at high resolution, which has allowed a detailed analysis of how disease-associated mutations impact on the structural integrity of the TPR domain. A subset of C-terminal α-7 helix (Cα-7h mutations, R304* (nonsense mutation, R304Q, Q307* and R325Q, a known site for AhR and PDE4A5 client-protein interaction, occur beyond those that interact with the conserved MEEVD and EDDVE sequences of HSP90 and TOMM20. These C-terminal AIP mutations appear to only disrupt client-protein binding to the Cα-7h, while chaperone binding remains unaffected, suggesting that failure of client-protein interaction with the Cα-7h is sufficient to predispose to pituitary adenoma. We have also identified a molecular switch in the AIP TPR-domain that allows recognition of both the conserved HSP90 motif, MEEVD, and the equivalent sequence (EDDVE of TOMM20.

La contrainte client

Directory of Open Access Journals (Sweden)

Guillaume Tiffon

2011-04-01

Full Text Available Cet article montre que le contact client a beau être ambivalent, dans la mesure où il est à la fois source de contrainte et de reconnaissance, dans certains cas, comme celui des caissières, il constitue avant tout une contrainte, en ce que les clients contrôlent le travail qui s’opère « sous leurs yeux », tandis que, dans d’autres cas, comme celui des kinésithérapeutes, il contribue avant tout à donner du sens au travail et, par là, à susciter l’engagement des travailleurs. L’article souligne ainsi combien la contrainte client revêt des modalités différentes selon la configuration, spatiale et temporelle, dans laquelle se déroule la relation de service, et le différentiel de compétences entre les protagonistes engagés dans cette relation.The client constraint. A comparative analysis of cashiers and physiotherapistsThis article shows that despite the ambivalence of client contact, insofar as it is both a source of constraint and recognition, in some cases, as the ones of cashiers, it isprimarily a constraint: clients control the work that takes place “before their eyes”, whereas in other cases – as in the ones of physiotherapists – it contributes to give meaning to work and, thereby, to arouse the commitment of workers. The article highlights how the client constraint takes on different forms depending on thespatial and temporal configuration where the service relation runs, and the skills differential between the protagonists involved in this relation.El apremio de los clientes. Análisis comparativo entre las cajeras de supermercado y los kinesiterapeutasEn este artículo se demuestra que aunque el contacto con los clientes puede ser percibido como agradable, en realidad en la mayoría de los casos el cliente es percibido como un peso puesto que estos « controlan » visualmente el trabajo de las cajeras mientras que en otras profesiones como es el caso de los kinesiterapeutas la presencia del paciente

Male nurses' experiences of providing intimate care for women clients.

Science.gov (United States)

Inoue, Madoka; Chapman, Rose; Wynaden, Dianne

2006-09-01

This paper reports a study of male nurses' experiences of providing intimate care for women clients. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

Transient Behaviour of Interacting Extractive System

International Nuclear Information System (INIS)

El-Bialy, S.H.; Elsherbiny, A.E.

2000-01-01

The aim of this study is to investigate the dynamic behaviour of mixer-settler extractive system, which represents an interacting one. When a stimulus single is introduced to aqueous feed; the response of the aqueous phase of the first stage is considered as stimulus signals to both organic phase in the same stage and the aqueous phase of the second one. The response of the last phase represents-in turn- stimulus signals to both organic phase in the same stage and the aqueous phase in the next one. Mathematical model was derived for a system consisting of two stages in the cascade. The model assumed a continuous stirred tank reactor (CSTR) for mixer zone and variable holdups and flow rates of both aqueous and organic phases during operation. Non-linear equilibrium was considered. The obtained model-being non-linear- was linearized and Laplace transformation method was used to solve the model. The system constants are those corresponding to extraction of uranyl nitrate from 3 N nitric acid solution using Tbp dissolved in kerosene at 30% of the former. Stimulus-response test was carried out on the model by considering a step increase in solute concentration in aqueous feed stream. The system behaviour was tested at different values of operating parameters. First order behaviour for the first stage was observed and higher order for the rest of the system. A general relation for the difference in the power of the denominator and numerator of the transfer function of the i th stage was concluded for aqueous phase. The study showed that the system overdamp over the practical range of chosen parameters as explained from the values of transfer function roots

Nurses' behavioural intentions towards self-poisoning patients: a theory of reasoned action, comparison of attitudes and subjective norms as predictive variables.

Science.gov (United States)

McKinlay, A; Couston, M; Cowan, S

2001-04-01

The incidence of self-poisoning is on the increase. Most patients who self-poison are dealt with initially in the general hospital. Therefore, the type and quality of care self-poisoning patients receive will depend, in part, on how they are viewed by nursing staff within the general hospital setting. A knowledge and understanding of the attitudes held by nurses towards self-poisoning patients is therefore important to those involved in the planning and delivery of care towards this client group. Previous studies have examined health care professionals' attitudes towards people who self-poison. Usually, however, these have not focused specifically on nurses' attitudes, and they have ignored the relationship between the attitudes expressed by staff and their intentions to engage in subsequent caring behaviour of one sort or another. It is hence unclear how the findings of such studies are relevant or applicable to nursing policy and practice. The present study aims to address these limitations using a methodology informed by the theory of reasoned action. The study aims to separate out the distinctive roles played by nurses' own attitudes, and the social pressures represented by other people's attitudes, in determining the types of caring behaviour in which nurses intend to engage when dealing with self-poisoning patients. The study adopts a questionnaire-based approach incorporating two specially designed vignettes. The results show that nurses' own attitudes, and what they believe about the attitudes of others, predict their behavioural intentions towards self-poisoning patients. The study also shows that nurses with a more positive orientation towards self-poisoning patients differ in behavioural and normative beliefs from nurses who have a less positive orientation. The implications for future attempts to explore the relationship between nurses' attitudes and subsequent caring behaviour are considered, along with implications for nursing policy and practice.

CERN Staff Association supports the personnel of WIPO

CERN Multimedia

Staff Association

2017-01-01

For over two years already, the Director General of WIPO has been attacking the WIPO Staff Council: firing the Staff Association President, intimidating staff delegates as well as the personnel, organising an election for his own council to replace the legitimately elected Staff Council, etc. 25.01.2017 - CERN Staff Association The behaviour of the Director General of WIPO is absolutely intolerable and contrary to the rules, principles and agreements applicable in international organisations. It is also in clear contradiction with the fundamental rights and especially the freedom of speech and expression, even more so within an Association whose legitimacy cannot be unilaterally challenged. fi On Wednesday 25 January 2017, in response to a call for participation by FICSA (Federation of International Civil Servants’ Associations – www.FICSA.org) and CCISUA (Coordinating Committee for International Staff Unions and Associations – www.ccisua.org), several delegations of Geneva-ba...

Consumer-providers of care for adult clients of statutory mental health services.

Science.gov (United States)

Pitt, Veronica; Lowe, Dianne; Hill, Sophie; Prictor, Megan; Hetrick, Sarah E; Ryan, Rebecca; Berends, Lynda

2013-03-28

the same outcome to provide a summary estimate of the effect across studies. We describe findings for each outcome in the text of the review with considerations of the potential impact of bias and the clinical importance of results, with input from a clinical expert. We included 11 randomised controlled trials involving 2796 people. The quality of these studies was moderate to low, with most of the studies at unclear risk of bias in terms of random sequence generation and allocation concealment, and high risk of bias for blinded outcome assessment and selective outcome reporting.Five trials involving 581 people compared consumer-providers to professionals in similar roles within mental health services (case management roles (4 trials), facilitating group therapy (1 trial)). There were no significant differences in client quality of life (mean difference (MD) -0.30, 95% confidence interval (CI) -0.80 to 0.20); depression (data not pooled), general mental health symptoms (standardised mean difference (SMD) -0.24, 95% CI -0.52 to 0.05); client satisfaction with treatment (SMD -0.22, 95% CI -0.69 to 0.25), client or professional ratings of client-manager relationship; use of mental health services, hospital admissions and length of stay; or attrition (risk ratio 0.80, 95% CI 0.58 to 1.09) between mental health teams involving consumer-providers or professional staff in similar roles.There was a small reduction in crisis and emergency service use for clients receiving care involving consumer-providers (SMD -0.34 (95%CI -0.60 to -0.07). Past or present consumers who provided mental health services did so differently than professionals; they spent more time face-to-face with clients, and less time in the office, on the telephone, with clients' friends and family, or at provider agencies.Six trials involving 2215 people compared mental health services with or without the addition of consumer-providers. There were no significant differences in psychosocial outcomes (quality of

The Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual Disabilities

Science.gov (United States)

Sterkenburg, P. S.; Janssen, C. G. C.; Schuengel, C.

2008-01-01

Background: A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method: Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded…

The Design and Development of Staff Wellbeing Initiatives: Staff Stressors, Burnout and Emotional Exhaustion at Children and Young People's Mental Health in Australia.

Science.gov (United States)

Coates, Dominiek D; Howe, Deborah

2015-11-01

Mental health work presents problems for staff over and above those encountered in other organisations, including other areas of healthcare. Healthcare workers, in particular mental health workers, have poorer job satisfaction and higher job burnout and turnover compared with established norms for other occupational groups. To make sense of why healthcare workers experience high levels of burnout, a strong body of literature points to the emotionally demanding nature of people-work. The negative effects of mental health work on employee health can be mitigated by the provision of appropriate job resources and wellbeing initiatives. As to develop initiatives that appropriately target staff sources of stress and needs, it is important to engage staff in this process. As such, Children and Young People's Mental Health (CYPMH) and headspace Gosford, in Australia, New South Wales (NSW), developed a survey to identify how staff experience and manage the emotional demands of mental health work, what they identify as key stressors and which initiatives they would like to see implemented. Fifty-five staff (response rate of 73 %) completed the survey, and the results suggest that while staff find the work emotionally demanding, they do not appear to be emotionally exhausted and report administrative rather than client issues as their primary concerns. While a strong body of literature identifies the management of emotions in the workplace as a significant cause of stress, organisational stressors such as working in a bureaucratic environment are also important to understanding staff wellbeing.

Controlled Study of the Impact on Child Behaviour Problems of Intensive Interaction for Children with ASD

Science.gov (United States)

Tee, Abi; Reed, Phil

2017-01-01

Pupils with autism spectrum disorder (ASD) received 6 months of intensive interaction or treatment as usual. They were assessed for behaviour problems at the start and end of the period, and changes were related to child and parent factors. Intensive interaction did not offer any greater advantages to child behaviour than treatment as usual.…

Parental and Staff Perceptions of Individual Programming Teams: Collaboration in and beyond the Conference.

Science.gov (United States)

Hermary, Martin E.; Rempel, Judith

1990-01-01

Questionnaires were completed by 103 staff and 76 parents of clients of a day training and residential agency for persons with mental handicaps. Although, in general, respondents felt part of their respective teams, differences of opinion arose with respect to team cohesiveness, and comprehensibility and participatory equality at conferences.…

Exercise self-identity: interactions with social comparison and exercise behaviour

NARCIS (Netherlands)

Verkooijen, K.T.; de Bruijn, G.J.

2013-01-01

Possible interactions among exercise self-identity, social comparison and exercise behaviour were explored in a sample of 417 undergraduate students (Mean age = 21.5, SD = 3.0; 73% female). Two models were examined using self-report data; (1) a mediation model which proposed an association between

Exercise self-identity: interactions with social comparison and exercise behaviour

NARCIS (Netherlands)

Verkooijen, K.T.; Bruijn, de G.J.

2013-01-01

Possible interactions among exercise self-identity, social comparison and exercise behaviour were explored in a sample of 417 undergraduate students (Mean age¿=¿21.5, SD¿=¿3.0; 73% female). Two models were examined using self-report data; (1) a mediation model which proposed an association between

The multidimensional behavioural hypervolumes of two interacting species predict their space use and survival.

Science.gov (United States)

Lichtenstein, James L L; Wright, Colin M; McEwen, Brendan; Pinter-Wollman, Noa; Pruitt, Jonathan N

2017-10-01

Individual animals differ consistently in their behaviour, thus impacting a wide variety of ecological outcomes. Recent advances in animal personality research have established the ecological importance of the multidimensional behavioural volume occupied by individuals and by multispecies communities. Here, we examine the degree to which the multidimensional behavioural volume of a group predicts the outcome of both intra- and interspecific interactions. In particular, we test the hypothesis that a population of conspecifics will experience low intraspecific competition when the population occupies a large volume in behavioural space. We further hypothesize that populations of interacting species will exhibit greater interspecific competition when one or both species occupy large volumes in behavioural space. We evaluate these hypotheses by studying groups of katydids ( Scudderia nymphs) and froghoppers ( Philaenus spumarius ), which compete for food and space on their shared host plant, Solidago canadensis . We found that individuals in single-species groups of katydids positioned themselves closer to one another, suggesting reduced competition, when groups occupied a large behavioural volume. When both species were placed together, we found that the survival of froghoppers was greatest when both froghoppers and katydids occupied a small volume in behavioural space, particularly at high froghopper densities. These results suggest that groups that occupy large behavioural volumes can have low intraspecific competition but high interspecific competition. Thus, behavioural hypervolumes appear to have ecological consequences at both the level of the population and the community and may help to predict the intensity of competition both within and across species.

Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer.

Science.gov (United States)

Stoewen, Debbie L; Coe, Jason B; MacMartin, Clare; Stone, Elizabeth A; E Dewey, Catherine

2014-10-01

To describe the process aspects (communication) of the information expectations of clients accessing oncology care services at a tertiary referral center for dogs with life-limiting cancer. Qualitative analysis of data acquired during in-person single and dyadic interviews. 43 dog owners participating in 30 interviews. Independent in-person interviews were conducted with standardized open- and closed-ended questions from April to October 2009. Thematic analysis was performed on transcripts of the interview discussions. The participants expected information to be communicated in a forthright manner; in multiple formats; with understandable language; in an unrushed environment wherein staff took the time to listen, answer all questions, and repeat information when necessary; on a continuous basis, with 24-hour access to address questions or concerns; in a timely manner; with positivity; with compassion and empathy; with a nonjudgmental attitude; and through staff with whom they had established relationships. Results indicated that the manner in which information is communicated is vitally important to clients of dogs with life-limiting cancer in that it not only facilitates comprehension but also creates a humanistic environment from which clients derive the psychosocial support needed to successfully cope with their pet's condition.

Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital; Outcomes and ocular healthcare-seeking behaviours

Directory of Open Access Journals (Sweden)

Ruhi A. Khan

2017-03-01

Full Text Available Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA. Results: A total of 150 nurses participated in the study (response rate: 30.0%. The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%, 32 (21.3% and 10 (6.7% nurses, respectively. A total of 58 nurses (38.7% failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%. With regards to regular eye checkups, 77 participants (51.3% reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each. Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

Crack Growth Behaviour of P92 Steel Under Creep-fatigue Interaction Conditions

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JING Hong-yang

2017-05-01

Full Text Available Creep-fatigue interaction tests of P92 steel at 630℃ under stress-controlled were carried out, and the crack propagation behaviour of P92 steel was studied. The fracture mechanism of crack growth under creep-fatigue interaction and the transition points in a-N curves were analyzed based on the fracture morphology. The results show that the fracture of P92 steel under creep-fatigue interaction is creep ductile fracture and the (Ctavg parameter is employed to demonstrate the crack growth behaviour; in addition, the fracture morphology shows that the crack growth for P92 steel under creep-fatigue interaction is mainly caused by the nucleation and growth of the creep voids and micro-cracks. Furthermore, the transition point of a-lg(Ni/Nf curve corresponds to the turning point of initial crack growth changed into steady crack growth while the transition point of (da/dN-N curve exhibits the turning point of steady creep crack growth changed into the accelerated crack growth.

Self-reflection in cognitive behavioural therapy and supervision.

Science.gov (United States)

Prasko, Jan; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos; Vyskocilova, Jana

2012-12-01

Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the

Interactions between personality and institutions in cooperative behaviour in humans

Science.gov (United States)

Schroeder, K. B.; Nettle, D.; McElreath, R.

2015-01-01

Laboratory attempts to identify relationships between personality and cooperative behaviour in humans have generated inconsistent results. This may partially stem from different practices in psychology and economics laboratories, with both hypothetical players and incentives typical only in the former. Another possible cause is insufficient consideration of the contexts within which social dilemmas occur. Real social dilemmas are often governed by institutions that change the payoff structure via rewards and punishments. However, such ‘strong situations’ will not necessarily suppress the effects of personality. On the contrary, they may affect some personalities differentially. Extraversion and neuroticism, reflecting variation in reward and punishment sensitivity, should predict modification of cooperative behaviour following changes to the payoff structure. We investigate interactions between personality and a punishment situation via two versions of a public goods game. We find that, even in a strong situation, personality matters and, moreover, it is related to strategic shifts in cooperation. Extraversion is associated with a shift from free-riding to cooperation in the presence of punishment, agreeableness is associated with initially higher contributions regardless of game, and, contrary to our predictions, neuroticism is associated with lower contributions regardless of game. Results should lead to new hypotheses that relate variation in biological functioning to individual differences in cooperative behaviour and that consider three-way interactions among personality, institutional context and sociocultural background. PMID:26503684

Counselor Responsiveness to Client Religiousness.

Science.gov (United States)

Kelly, Eugene W., Jr.

1990-01-01

Presents eight categories of client attitudes toward religion and suggests opportunities for religiously oriented counselor responses. Uses four categories to describes how religion may be associated with specific client issues. Contends that an informed appreciation of clients' religiousness and the religious dimensions of many client issues can…

The effect of an attachment-based intervention on challenging behaviour: visually and severe intellectually impaired children

NARCIS (Netherlands)

Sterkenburg, P.S.; Janssen, C.G.C.; Schuengel, C.

2008-01-01

Background A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were

Education in geriatric medicine for community hospital staff.

LENUS (Irish Health Repository)

O'Hanlon, Shane

2010-12-01

Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

The Impact of Client Expertise, Client Gender and Auditor Gender on Auditors' Judgments

NARCIS (Netherlands)

A.H. Gold-Nöteberg (Anna); J.E. Hunton (James); M.I. Gomaa (Mohamed)

2006-01-01

textabstractThe purpose of the current study is to assess the extent to which auditors’ judgments are affected by client expertise, client gender and auditor gender. Prior audit research suggests that auditors place more weight on evidence received from clients who possess higher, relative to

Explaining human uniqueness: genome interactions with environment, behaviour and culture.

Science.gov (United States)

Varki, Ajit; Geschwind, Daniel H; Eichler, Evan E

2008-10-01

What makes us human? Specialists in each discipline respond through the lens of their own expertise. In fact, 'anthropogeny' (explaining the origin of humans) requires a transdisciplinary approach that eschews such barriers. Here we take a genomic and genetic perspective towards molecular variation, explore systems analysis of gene expression and discuss an organ-systems approach. Rejecting any 'genes versus environment' dichotomy, we then consider genome interactions with environment, behaviour and culture, finally speculating that aspects of human uniqueness arose because of a primate evolutionary trend towards increasing and irreversible dependence on learned behaviours and culture - perhaps relaxing allowable thresholds for large-scale genomic diversity.

Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

Science.gov (United States)

Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra

2016-01-01

This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; pcommunication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Emergency Department Staff Beliefs About Self-Harm: A Thematic Framework Analysis.

Science.gov (United States)

Koning, Kate Louise; McNaught, Angela; Tuffin, Keith

2017-11-03

To explore the beliefs and attitudes of emergency department staff about self-harm behaviour. Existing studies looking at views regarding self-harm rely solely on the information provided by medical and nursing staff using a questionnaire format. No studies currently consider ancillary staff members' beliefs about self-harm, even though they also work with these patients. A thematic framework analysis of interview transcripts was carried out. Individual semi-structured interviews were conducted from December 2015 to February 2016. Fifteen medical, nursing, and ancillary staff members from a large, tertiary emergency department participated. There were 5 major themes identified-causes of self-harm are multifactorial; beliefs about self-harm can change over time; emergency departments should only focus on the physical; self-harm occurs on a spectrum; and the system has failed. The results suggest participants felt ill-prepared and lacking in appropriate training to help patients that self-harm, and furthermore they have little faith in the mental health system. Staff beliefs and attitudes may change over time with exposure to patients who self-harm, possibly becoming more positive in response to a greater understanding of why the self-harm behaviour is occurring.

Social interactions of eating behaviour among high school students: a cellular automata approach

Science.gov (United States)

2012-01-01

Background Overweight and obesity in children and adolescents is a global epidemic posing problems for both developed and developing nations. The prevalence is particularly alarming in developed nations, such as the United States, where approximately one in three school-aged adolescents (ages 12-19) are overweight or obese. Evidence suggests that weight gain in school-aged adolescents is related to energy imbalance exacerbated by the negative aspects of the school food environment, such as presence of unhealthy food choices. While a well-established connection exists between the food environment, presently there is a lack of studies investigating the impact of the social environment and associated interactions of school-age adolescents. This paper uses a mathematical modelling approach to explore how social interactions among high school adolescents can affect their eating behaviour and food choice. Methods In this paper we use a Cellular Automata (CA) modelling approach to explore how social interactions among school-age adolescents can affect eating behaviour, and food choice. Our CA model integrates social influences and transition rules to simulate the way individuals would interact in a social community (e.g., school cafeteria). To replicate these social interactions, we chose the Moore neighbourhood which allows all neighbours (eights cells in a two-dimensional square lattice) to influence the central cell. Our assumption is that individuals belong to any of four states; Bring Healthy, Bring Unhealthy, Purchase Healthy, and Purchase Unhealthy, and will influence each other according to parameter settings and transition rules. Simulations were run to explore how the different states interact under varying parameter settings. Results This study, through simulations, illustrates that students will change their eating behaviour from unhealthy to healthy as a result of positive social and environmental influences. In general, there is one common characteristic of

Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

Science.gov (United States)

von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

2017-09-10

Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

Client Proteins and Small Molecule Inhibitors Display Distinct Binding Preferences for Constitutive and Stress-Induced HSP90 Isoforms and Their Conformationally Restricted Mutants.

Directory of Open Access Journals (Sweden)

Thomas L Prince

Full Text Available The two cytosolic/nuclear isoforms of the molecular chaperone HSP90, stress-inducible HSP90α and constitutively expressed HSP90β, fold, assemble and maintain the three-dimensional structure of numerous client proteins. Because many HSP90 clients are important in cancer, several HSP90 inhibitors have been evaluated in the clinic. However, little is known concerning possible unique isoform or conformational preferences of either individual HSP90 clients or inhibitors. In this report, we compare the relative interaction strength of both HSP90α and HSP90β with the transcription factors HSF1 and HIF1α, the kinases ERBB2 and MET, the E3-ubiquitin ligases KEAP1 and RHOBTB2, and the HSP90 inhibitors geldanamycin and ganetespib. We observed unexpected differences in relative client and drug preferences for the two HSP90 isoforms, with HSP90α binding each client protein with greater apparent affinity compared to HSP90β, while HSP90β bound each inhibitor with greater relative interaction strength compared to HSP90α. Stable HSP90 interaction was associated with reduced client activity. Using a defined set of HSP90 conformational mutants, we found that some clients interact strongly with a single, ATP-stabilized HSP90 conformation, only transiently populated during the dynamic HSP90 chaperone cycle, while other clients interact equally with multiple HSP90 conformations. These data suggest different functional requirements among HSP90 clientele that, for some clients, are likely to be ATP-independent. Lastly, the two inhibitors examined, although sharing the same binding site, were differentially able to access distinct HSP90 conformational states.

The object of your affection: how commitment, leadership and justice influence workplace behaviours in health care.

Science.gov (United States)

Perreira, Tyrone A; Berta, Whitney

2016-03-01

This paper describes the development of a coherent framework that develops nursing knowledge and guides research in workplace behaviours, work performance, and the factors that influence behaviours and performance. Work performance is dependent upon behaviours that are related to one's commitment towards their workplace and leadership interactions. The influence of these concepts on work outcomes has been established in disparate studies, but their precedence in terms of influencing workers' behaviours, is not well understood. A scientific realism approach is applied, where theory and current research in the field of organisational behaviour and work motivation are drawn upon to identify validated constructs and explain their relationships. An augmented framework is produced, incorporating concepts of relevance to work motivation and work attitudes. Propositions, predicated on research evidence, are offered. Conclusions A novel comprehensive framework is developed, extending the range of behaviours important to workers and the organisation. Focusing on targets for which nurses are affectively committed can prove useful to managers. The developed framework can be informative to managers by increasing awareness of the relationships between concepts, such that they are mindful of these constructs while interacting with staff. © 2015 John Wiley & Sons Ltd.

The Effect of an Attachment-Based Behaviour Therapy for Children with Visual and Severe Intellectual Disabilities. [Article

NARCIS (Netherlands)

Sterkenburg, P S; Janssen, C G C; Schuengel, C

2008-01-01

Background: A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour., Method: Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were

Pupil and Staff Perceptions of Rewards at a Pupil Referral Unit

Science.gov (United States)

Capstick, Joanna

2005-01-01

The present study investigated the perceptions of both pupils and staff at a pupil referral unit (PRU) towards the reward system currently in use. The main aims were to establish whether teachers and pupils perceived the same rewards as effective, to determine whether staff and pupils perceived that rewards changed behaviour, and finally whether…

Outsource the Clients Management? A Study about the Impact of the Facilities Management Activity Outsourcing in the Satisfaction of Organizational Clients

Directory of Open Access Journals (Sweden)

Hellio Calian Martins

2014-04-01

Full Text Available Satisfaction is the subject of several studies because of the managerial implications related to customer loyalty and business sustainability. This study aims to assess the satisfaction of organizational clients of Shopping Centers (SC with the technical and environmental services that provide the necessary conditions for the retail practice denominated facilities management (FM. FM involves a wide range of services to retailers to ensure normal operation (HR and finance management, real estate and Legal advice, IT repairs .... The services can be managed and/or performed by internal or external staff. FM activities are quite subject to contractual and environmental problems. Although most of the time they are invisible to consumers attending the SC, when they are poorly performed, the effects can be devastating, causing dissatisfaction among consumers and retailers. Data collected at two big SC in Rio de Janeiro were statistically analyzed. Results show evidence that this management option has significant relevance in customer satisfaction and there is also evidence that the shopkeeper satisfaction is lower when the FM is outsourced. This work aims to contribute to retail management, specifically SC management, by analyzing the satisfaction of organizational clients with services of FM and may provide more information for better decision making.

Beauty from the beast: Avoiding errors in responding to client questions.

Science.gov (United States)

Waehler, Charles A; Grandy, Natalie M

2016-09-01

Those rare moments when clients ask direct questions of their therapists likely represent a point when they are particularly open to new considerations, thereby representing an opportunity for substantial therapeutic gains. However, clinical errors abound in this area because clients' questions often engender apprehension in therapists, causing therapists to respond with too little or too much information or shutting down the discussion prematurely. These response types can damage the therapeutic relationship, the psychotherapy process, or both. We explore the nature of these clinical errors in response to client questions by providing examples from our own clinical work, suggesting potential reasons why clinicians may not make optimal use of client questions, and discussing how the mixed psychological literature further complicates the issue. We also present four guidelines designed to help therapists, trainers, and supervisors respond constructively to clinical questions in order to create constructive interactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Client-Centeredness of Family Planning Services in a Resource ...

African Journals Online (AJOL)

RESULTS: The average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, ...

Client-centeredness of Finnish and Estonian nursing students and the support from nursing education to develop it. Students' self-evaluation.

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Kalam-Salminen, Ly; Valkonen, Marjo-Riitta; Aro, Ilme; Routasalo, Pirkko

2013-10-01

The purpose of this comparative study is to describe the differences between Finnish and Estonian students evaluations about their client-centeredness and educational support they received to develop it. Client-centeredness has many positive effects on the quality and effectiveness of care. However, some deficiencies have been identified in the client-centeredness of nursing staff. Research on the subject has been limited, and we lack knowledge of graduating students' competence in client-centeredness and the support of their education to develop it. The sample consisted of 390 undergraduate nursing students, 195 from Finland and 195 from Estonia. The data were collected in 2009 using the structured five-point scale questionnaire. The questionnaire was designed to measure students' client-centeredness and the educational support they received from nursing education. The data were analyzed by the PASW Statistics 18-programme using descriptive statistics, Kolmogorov-Smirnov test and Mann-Whitney U-test. Predominantly, students in both countries evaluated their level of client-centeredness high. The Estonian students generally evaluated their client-centeredness higher compared to the Finnish students. The same applied to support provided by nursing education. The greatest differences were related to education and particularly theoretical teaching. In Estonia, students' client-centeredness manifested itself more in politeness and willingness to serve clients, whereas respecting the clients' values was emphasized in Finland. Students' requisites, referred here as knowledge, skills and abilities to implement client-centered nursing, for client-centeredness had deficiencies, and the support from education was also the weakest regarding these aspects. In future, education on development of nursing activities, acquisition of knowledge and services provided by health care as well as legislation should be enhanced, since these areas proved the most difficult for the students

Tools assessing nurse manager behaviours and RN job satisfaction: a review of the literature.

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Feather, Rebecca

2015-09-01

To determine the state of the science in relation to registered nurse (RN) perceptions of nurse manager behaviours that influence registered nurse job satisfaction. Nurse managers have been related by research to the job satisfaction of their staff. However, little is known about how nurses perceive the behaviours of nurse managers as influencing their job satisfaction. A literature search was conducted to identify journal articles that included studies involving instruments of nurse manager behaviours and staff nurse job satisfaction levels. The literature shows a lack of consistency in the definitions of job satisfaction, instrumentation for measurement and conclusions that identify specific management behaviours effective for high levels of job satisfaction of RNs related to staff nurse perceptions. Studies include important aspects of what shapes a healthy work environment for nurses, but no single study identified specific nurse manager behaviours based solely on the perceptions of staff nurses and their job satisfaction. The perceptions of staff nurses are important for hospital administrators and nurse managers in order to know how to improve satisfaction and reduce turnover. Instruments developed based on manager beliefs may not provide data needed to influence a change in management behaviours that results in improved job satisfaction. © 2014 John Wiley & Sons Ltd.

Client-Oriented Approach: Forming the System of Management of the Bank Relations with Clients

OpenAIRE

Zavadska Diana V.

2015-01-01

The aim of the article is to develop the theoretical principles of forming the bank relations with clients as part of the client-oriented strategy implementation. As a result of the conducted research there has been presented the definition of client-orientation, mechanism and system of management. The system of management of the bank relations with clients, the purpose and objectives of its formation have been substantiated. The hierarchy of subjects of forming and managing the process...

Counselors' attachment anxiety and avoidance and the congruence in clients' and therapists' working alliance ratings.

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Kivlighan, Dennis M; Marmarosh, Cheri L

2018-07-01

To determine how counselors' attachment anxiety and avoidance related to congruence between counselors' and clients' Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients' WA ratings predicting counselors' WA ratings. Directional bias was defined as the difference in level between counselors' and clients' WA ratings. Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. As hypothesized counselors' WA ratings were significantly and positively related to clients' WA ratings. Also as hypothesized, counselors' WA ratings were significantly lower than their clients' WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors' attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Counselors' attachment anxiety is realted to their ability to accurately percieve their clients' WA.

Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour.

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Frielink, Noud; Embregts, Petri

2013-12-01

Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients. We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes. The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty. Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.

Advancing the recovery orientation of hospital care through staff engagement with former clients of inpatient units.

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Kidd, Sean A; McKenzie, Kwame; Collins, April; Clark, Carrie; Costa, Lucy; Mihalakakos, George; Paterson, Jane

2014-02-01

This study was undertaken to assess the impact of consumer narratives on the recovery orientation and job satisfaction of service providers on inpatient wards that focus on the treatment of schizophrenia. It was developed to address the paucity of literature and service development tools that address advancing the recovery model of care in inpatient contexts. A mixed-methods design was used. Six inpatient units in a large urban psychiatric facility were paired on the basis of characteristic length of stay, and one unit from each pair was assigned to the intervention. The intervention was a series of talks (N=58) to inpatient staff by 12 former patients; the talks were provided approximately biweekly between May 2011 and May 2012. Self-report measures completed by staff before and after the intervention assessed knowledge and attitudes regarding the recovery model, the delivery of recovery-oriented care at a unit level, and job satisfaction. In addition, focus groups for unit staff and individual interviews with the speakers were conducted after the speaker series had ended. The hypothesis that the speaker series would have an impact on the attitudes and knowledge of staff with respect to the recovery model was supported. This finding was evident from both quantitative and qualitative data. No impact was observed for recovery orientation of care at the unit level or for job satisfaction. Although this engagement strategy demonstrated an impact, more substantial change in inpatient practices likely requires a broader set of strategies that address skill levels and accountability.

HIV in Kenya: Sexual behaviour and quality of care of sexually transmitted diseases

NARCIS (Netherlands)

H.A.C.M. Voeten (Hélène)

2006-01-01

textabstractThis thesis describes three important determinants of HIV spread in Kenya: 1. Sexual behaviour of female sex workers, their clients, and young adults 2. Health care seeking behaviour for sexually transmitted diseases (STD) 3. Quality of STD care in the public and private health

Open client/server computing and middleware

CERN Document Server

Simon, Alan R

2014-01-01

Open Client/Server Computing and Middleware provides a tutorial-oriented overview of open client/server development environments and how client/server computing is being done.This book analyzes an in-depth set of case studies about two different open client/server development environments-Microsoft Windows and UNIX, describing the architectures, various product components, and how these environments interrelate. Topics include the open systems and client/server computing, next-generation client/server architectures, principles of middleware, and overview of ProtoGen+. The ViewPaint environment

Negative Symptoms and Avoidance of Social Interaction: A Study of Non-Verbal Behaviour.

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Worswick, Elizabeth; Dimic, Sara; Wildgrube, Christiane; Priebe, Stefan

2018-01-01

Non-verbal behaviour is fundamental to social interaction. Patients with schizophrenia display an expressivity deficit of non-verbal behaviour, exhibiting behaviour that differs from both healthy subjects and patients with different psychiatric diagnoses. The present study aimed to explore the association between non-verbal behaviour and symptom domains, overcoming methodological shortcomings of previous studies. Standardised interviews with 63 outpatients diagnosed with schizophrenia were videotaped. Symptoms were assessed using the Clinical Assessment Interview for Negative Symptoms (CAINS), the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale. Independent raters later analysed the videos for non-verbal behaviour, using a modified version of the Ethological Coding System for Interviews (ECSI). Patients with a higher level of negative symptoms displayed significantly fewer prosocial (e.g., nodding and smiling), gesture, and displacement behaviours (e.g., fumbling), but significantly more flight behaviours (e.g., looking away, freezing). No gender differences were found, and these associations held true when adjusted for antipsychotic medication dosage. Negative symptoms are associated with both a lower level of actively engaging non-verbal behaviour and an increased active avoidance of social contact. Future research should aim to identify the mechanisms behind flight behaviour, with implications for the development of treatments to improve social functioning. © 2017 S. Karger AG, Basel.

Training Staff Serving Clients with Intellectual Disabilities: A Meta-Analysis of Aspects Determining Effectiveness

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van Oorsouw, Wietske M. W. J.; Embregts, Petri J. C. M.; Bosman, Anna M. T.; Jahoda, Andrew

2009-01-01

The last decades have seen increased emphasis on the quality of training for direct-care staff serving people with intellectual disabilities. Nevertheless, it is unclear what the key aspects of effective training are. Therefore, the aim of the present meta-analysis was to establish the ingredients (i.e., goals, format, and techniques) for staff…

SIGN LANGUAGE: HOW THE NURSING STAFF INTERACTS TO TAKE CARE OF DEAF PATIENTS?

Directory of Open Access Journals (Sweden)

Wiliam César alves Machado

2013-06-01

Full Text Available Objetivo: Identificar como profissionais da equipe de enfermagem de um hospital universitário interagem para cuidar de seus clientes surdos, considerando-se fundamental o domínio da Língua de Sinais Brasileira (Libras para planejamento da assistência de enfermagem prestada a esta clientela. Método: Pesquisa descritiva, exploratória, com abordagem quanti-qualitativa, realizada no segundo semestre de 2011 com 37 profissionais da equipe de enfermagem de hospital universitário da rede federal de ensino localizado na cidade do Rio de Janeiro. Os elementos quantitativos foram analisados a luz da estatística descritiva, elucidando o perfil sociodemográfico dos sujeitos (sexo, idade, faixa etária, categoria profissional, tempo de atuação profissional e domínio de Libras, enquanto os dados qualitativos foram extraídos das informações referentes à interação ao cuidar de clientes surdos foram analisadas a luz da técnica de análise de conteúdo.  Resultados: Nenhum profissional da equipe domina Libras e 21 (57% informaram nunca ter prestado cuidados a clientes surdos. Das estratégias de comunicação utilizadas pelos 16 (43% dos profissionais de enfermagem que já prestaram cuidados aos clientes surdos destacaram-se: 12 (46,15% referências ao uso da mímica; 4 (15,38% menções ao uso da leitura labial; 8 (30,77% referências ao uso da escrita; 1 (3,85% referência ao uso do desenho; e 1 (3,85% menção à ajuda de intérprete para se comunicar com clientes surdos quando lhes prestaram cuidados de enfermagem. Conclusão: Conclui-se que é preciso a tomada de providências efetivas para que profissionais de enfermagem se comuniquem adequadamente com os clientes surdos, a começar pela oferta regular de disciplinas específicas em todos os cursos e programas de ensino, habilitando os estudantes e, consequentemente, as futuras gerações para que possam planejar a assistência e prestar cuidados dignos a essas pessoas. Descritores

Relabelling behaviour : The effects of psycho-education on the perceived severity and causes of challenging behaviour in people with profound intellectual and multiple disabilities

NARCIS (Netherlands)

Poppes, P.; Putten, van der Annette; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.

2016-01-01

BackgroundPrevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the

Evaluation of Fourth-Year Veterinary Students' Client Communication Skills: Recommendations for Scaffolded Instruction and Practice.

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Stevens, Brenda J; Kedrowicz, April A

Effective client communication is important for success in veterinary practice. The purpose of this project was to describe one approach to communication training and explore fourth-year veterinary students' communication skills through an evaluation of their interactions with clients during a general practice rotation. Two raters coded 20 random videotaped interactions simultaneously to assess students' communication, including their ability to initiate the session, incorporate open-ended questions, listen reflectively, express empathy, incorporate appropriate nonverbal communication, and attend to organization and sequencing. We provide baseline data that will guide future instruction in client communication. Results showed that students' communication skills require development. Half of the students sampled excelled at open-ended inquiry (n=10), and 40% (n=8) excelled at nonverbal communication. Students needed improvement on greeting clients by name and introducing themselves and their role (n=15), reflective listening (n=18), empathy (n=17), and organization and sequencing (n=18). These findings suggest that more focused instruction and practice is necessary in maintaining an organized structure, reflective listening, and empathy to create a relationship-centered approach to care.

Improving communication between staff and disabled children in hospital wards: testing the feasibility of a training intervention developed through intervention mapping.

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Gumm, Rebecca; Thomas, Eleanor; Lloyd, Claire; Hambly, Helen; Tomlinson, Richard; Logan, Stuart; Morris, Christopher

2017-01-01

To develop and test the feasibility of a novel parent-inspired training intervention for hospital ward staff to improve communication with disabled children when inpatients. Training content and delivery strategies were informed by the iterative process of Intervention Mapping and developed in collaboration with parents of disabled children. UK University Hospital children's ward. 80 medical, nursing, allied health professionals, clerical and housekeeping staff on a children's ward. Themes identified in previous qualitative research formed the basis of the training. Learning objectives included prioritising communication, cultivating empathy, improving knowledge and developing confidence. Participant feedback was used to refine content and delivery. Intervention documentation adheres to the Template for Intervention Description and Replication checklist. Highlighting mandated National Health Service policies and involving the hospital Patient and Carer Experience Group facilitated management support for the training. Eighty staff participated in one of four 1-hour sessions. A paediatric registrar and nurse delivered sessions to mixed groups of staff. General feedback was very positive. The intervention, fully documented in a manual, includes videos of parent carers discussing hospital experiences, interactive tasks, small group discussion, personal reflection and intention planning. Generic and local resources were provided. It was feasible to deliver this new communication training to hospital ward staff and it was positively received. Early feedback was encouraging and indicates a commitment to behaviour change. Further piloting is required to establish the transferability of the intervention to other hospitals, followed by consideration of downstream markers to evaluate the effects on disabled children's inpatient experience. Organisational and cultural change is required to support individual behaviour change.

Client attachment security predicts alliance in a randomized controlled trial of two psychotherapies for bulimia nervosa

DEFF Research Database (Denmark)

Folke, Sofie; Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig Bernt

2016-01-01

interaction whereby dismissing clients would develop weaker alliances in psychoanalytic psychotherapy and preoccupied clients would develop weaker alliances in cognitive-behavioral therapy. Conclusions: As the first study to examine client attachment and therapeutic alliance using observer-based instruments......Objective: This study investigated the relation between clients’ attachment patterns and the therapeutic alliance in two psychotherapies for bulimia nervosa. Method: Data derive from a randomized clinical trial comparing cognitive-behavioral therapy and psychoanalytic psychotherapy for bulimia...... to be a significant (p = .007) predictor of alliance levels at the three measured time points, with clients higher on attachment security developing stronger alliances with their therapists in both treatments as compared to clients higher on attachment insecurity. No evidence was found to support a hypothesized...

Working in clients' homes: the impact on the mental health and well-being of visiting home care workers.

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Denton, Margaret A; Zeytinoğlu, Işk Urla; Davies, Sharon

2002-01-01

The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.

A Comparison of the Interactive Play Behaviours between Children with Albinism and Their Siblings and Children without Albinism and Their Non-Albino Siblings

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Javangwe, Gwatirera; Mukondyo, Rachel Z.

2012-01-01

The study explored the nature of the interactive play behaviours of children with albinism and children without albinism and compared the interactive behaviours of both children with albinism and children without albinism. Naturalistic observations were conducted during periods of free play, using the interactive play behaviour checklist aided by…

Internet-Based Interventions for Addictive Behaviours: A Systematic Review.

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Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M

2016-12-01

Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.

From inter-specific behavioural interactions to species distribution patterns along gradients of habitat heterogeneity.

Science.gov (United States)

Laiolo, Paola

2013-01-01

The strength of the behavioural processes associated with competitor coexistence may vary when different physical environments, and their biotic communities, come into contact, although empirical evidence of how interference varies across gradients of environmental complexity is still scarce in vertebrates. Here, I analyse how behavioural interactions and habitat selection regulate the local distribution of steppeland larks (Alaudidae) in a gradient from simple to heterogeneous agricultural landscapes in Spain, using crested lark Galerida cristata and Thekla lark G. theklae as study models. Galerida larks significantly partitioned by habitat but frequently co-occurred in heterogeneous environments. Irrespective of habitat divergence, however, the local densities of the two larks were negatively correlated, and the mechanisms beyond this pattern were investigated by means of playback experiments. When simulating the intrusion of the congener by broadcasting the species territorial calls, both larks responded with an aggressive response as intense with respect to warning and approach behaviour as when responding to the intrusion of a conspecific. However, birds promptly responded to playbacks only when congener territories were nearby, a phenomenon that points to learning as the mechanisms through which individuals finely tune their aggressive responses to the local competition levels. Heterospecifics occurred in closer proximity in diverse agro-ecosystems, possibly because of more abundant or diverse resources, and here engage in antagonistic interactions. The drop of species diversity associated with agricultural homogenisation is therefore likely to also bring about the disappearance of the behavioural repertoires associated with species interactions.

Beliefs about medicines and self-reported adherence among pharmacy clients.

Science.gov (United States)

Mårdby, Ann-Charlotte; Akerlind, Ingemar; Jörgensen, Tove

2007-12-01

To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.

Mining Staff Assignment Rules from Event-Based Data

NARCIS (Netherlands)

Ly, Linh Thao; Rinderle, Stefanie; Dadam, Peter; Reichert, Manfred; Bussler, Christoph J.; Haller, Armin

2006-01-01

Process mining offers methods and techniques for capturing process behaviour from log data of past process executions. Although many promising approaches on mining the control flow have been published, no attempt has been made to mine the staff assignment situation of business processes. In this

Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives.

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Iqbal, Maha; Velan, Gary M; O'Sullivan, Anthony J; Balasooriya, Chinthaka

2016-08-22

Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

Interaction effects in the theory of planned behaviour: Predicting fruit and vegetable consumption in three prospective cohorts.

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Kothe, Emily J; Mullan, Barbara A

2015-09-01

The theory of planned behaviour (TPB) has been criticized for not including interactions between major constructs thought to underlie behaviour. This study investigated the application of the TPB to the prediction of fruit and vegetable consumption across three prospective cohorts. The primary aim of the study was to investigate whether interactions between major constructs in the theory would increase the ability of the model to predict intention to consume fruit and vegetables (i.e., attitude × perceived behavioural control [PBC], subjective norm × PBC, subjective norm × attitude) and self-reported fruit and vegetable intake (i.e., PBC × intention). Secondary data analysis from three cohorts: One predictive study (cohort 1) and two intervention studies (cohorts 2 and 3). Participants completed a TPB measure at baseline and a measure of fruit and vegetable intake at 1 week (cohort 1; n = 90) or 1 month (cohorts 2 and 3; n = 296). Attitude moderated the impact of PBC on intention. PBC moderated the impact of intention on behaviour at 1 week but not 1 month. The variance accounted for by the interactions was small. However, the presence of interactions between constructs within the TPB demonstrates a need to consider interactions between variables within the TPB in both theoretical and applied research using the model. © 2014 The British Psychological Society.

Job Satisfaction Of Hospital Nursing Staff

Directory of Open Access Journals (Sweden)

Charlotte Pietersen

2005-11-01

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.

Speech comprehension aided by multiple modalities: behavioural and neural interactions

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McGettigan, Carolyn; Faulkner, Andrew; Altarelli, Irene; Obleser, Jonas; Baverstock, Harriet; Scott, Sophie K.

2014-01-01

Speech comprehension is a complex human skill, the performance of which requires the perceiver to combine information from several sources – e.g. voice, face, gesture, linguistic context – to achieve an intelligible and interpretable percept. We describe a functional imaging investigation of how auditory, visual and linguistic information interact to facilitate comprehension. Our specific aims were to investigate the neural responses to these different information sources, alone and in interaction, and further to use behavioural speech comprehension scores to address sites of intelligibility-related activation in multifactorial speech comprehension. In fMRI, participants passively watched videos of spoken sentences, in which we varied Auditory Clarity (with noise-vocoding), Visual Clarity (with Gaussian blurring) and Linguistic Predictability. Main effects of enhanced signal with increased auditory and visual clarity were observed in overlapping regions of posterior STS. Two-way interactions of the factors (auditory × visual, auditory × predictability) in the neural data were observed outside temporal cortex, where positive signal change in response to clearer facial information and greater semantic predictability was greatest at intermediate levels of auditory clarity. Overall changes in stimulus intelligibility by condition (as determined using an independent behavioural experiment) were reflected in the neural data by increased activation predominantly in bilateral dorsolateral temporal cortex, as well as inferior frontal cortex and left fusiform gyrus. Specific investigation of intelligibility changes at intermediate auditory clarity revealed a set of regions, including posterior STS and fusiform gyrus, showing enhanced responses to both visual and linguistic information. Finally, an individual differences analysis showed that greater comprehension performance in the scanning participants (measured in a post-scan behavioural test) were associated with

Community ambulation: influences on therapists and clients reasoning and decision making.

Science.gov (United States)

Corrigan, Rosemary; McBurney, Helen

2008-01-01

Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

Prevalence and Predictors of Self-Reported Consistent Condom Usage among Male Clients of Female Sex Workers in Tamil Nadu, India

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Charles, Bimal; Sam, Asirvatham Edwin

2014-01-01

Clients of female sex workers (FSWs) possess a high potential of transmitting HIV and other sexually transmitted infections from high risk FSWs to the general population. Promotion of safer sex practices among the clients is essential to limit the spread of HIV/AIDS epidemic. The aim of this study is to estimate the prevalence of consistent condom use (CCU) among clients of FSWs and to assess the factors associated with CCU in Tamil Nadu. 146 male respondents were recruited from the hotspots who reportedly had sex with FSWs in exchange for cash at least once in the past one month. Data were analyzed using bivariate and multivariate methods. Overall, 48.6 and 0.8 percent clients consistently used condoms in the past 12 months with FSWs and regular partners, respectively. Logistic regression showed that factors such as education, peers' use of condoms, and alcohol consumption significantly influenced clients' CCU with FSWs. Strategies for safe sex-behaviour are needed among clients of FSWs in order to limit the spread of HIV/AIDS epidemic in the general population. The role of peer-educators in experience sharing and awareness generation must also be emphasized. PMID:26316978

Keeper-Animal Interactions: Differences between the Behaviour of Zoo Animals Affect Stockmanship.

Science.gov (United States)

Ward, Samantha J; Melfi, Vicky

2015-01-01

Stockmanship is a term used to describe the management of animals with a good stockperson someone who does this in a in a safe, effective, and low-stress manner for both the stock-keeper and animals involved. Although impacts of unfamiliar zoo visitors on animal behaviour have been extensively studied, the impact of stockmanship i.e familiar zoo keepers is a new area of research; which could reveal significant ramifications for zoo animal behaviour and welfare. It is likely that different relationships are formed dependant on the unique keeper-animal dyad (human-animal interaction, HAI). The aims of this study were to (1) investigate if unique keeper-animal dyads were formed in zoos, (2) determine whether keepers differed in their interactions towards animals regarding their attitude, animal knowledge and experience and (3) explore what factors affect keeper-animal dyads and ultimately influence animal behaviour and welfare. Eight black rhinoceros (Diceros bicornis), eleven Chapman's zebra (Equus burchellii), and twelve Sulawesi crested black macaques (Macaca nigra) were studied in 6 zoos across the UK and USA. Subtle cues and commands directed by keepers towards animals were identified. The animals latency to respond and the respective behavioural response (cue-response) was recorded per keeper-animal dyad (n = 93). A questionnaire was constructed following a five-point Likert Scale design to record keeper demographic information and assess the job satisfaction of keepers, their attitude towards the animals and their perceived relationship with them. There was a significant difference in the animals' latency to appropriately respond after cues and commands from different keepers, indicating unique keeper-animal dyads were formed. Stockmanship style was also different between keepers; two main components contributed equally towards this: "attitude towards the animals" and "knowledge and experience of the animals". In this novel study, data demonstrated unique dyads

Do client fees help or hurt?

Science.gov (United States)

Barnett, B

1998-01-01

This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

Examining client perceptions of partnership quality and the relationships between its dimensions in an IT outsourcing relationship

Directory of Open Access Journals (Sweden)

Michael Steven Lane

2011-03-01

Full Text Available This paper reports on an empirical study of the multidimensionality of partnership quality and the relationships between these dimensions. A two-phase survey was conducted for a range of organisations from different industry sectors to collect empirical data to test the validity and reliability of the measurement model for the multidimensionality of partnership quality. The measurement model for partnership quality was confirmed by the results of the data analyses. This research also aimed to identify the significant relationships between these dimensions using a second generation multivariate analysis technique—partial least squares(PLS. The findings from results of the data analyses show that inter-organisational trust, shared business understanding and to a lesser extent, functional and dysfunctional conflict between the client organisation and the outsourcing vendor in an IT outsourcing relationship are the key determinants of partnership quality. The key outcome of high partnership quality between the client organisation and the outsourcing vendor in an IT outsourcing relationship is mutual beneficial sharing of risks and benefits. Commitment is confirmed as a multidimensional construct of behaviour and temporal/continuance commitment but is not is influenced by the other dimensions of partnership quality. Trust and shared business understanding are the key drivers in the IT outsourcing relationship ensuring that the sharing of risks and benefits are realised and conflict is minimised leading to a high quality and ultimately successful partnership between the client organisation and the outsourcing vendor. Furthermore behavioural commitment to the contractual obligations of an IT outsourcing relationship sustains an ongoing temporal commitment to the partnership between the client organisation and the outsourcing vendor.

A 'Communication and Patient Safety' training programme for all healthcare staff: can it make a difference?

Science.gov (United States)

Lee, Peter; Allen, Kellie; Daly, Michael

2012-01-01

Communication breakdown is a factor contributing to most cases of patient harm, and this harm continues to occur at unacceptable levels. Responding to this evidence, the Metro South District of Queensland Health (Australia) has developed a communication skills training programme titled 'Communication and Patient Safety'. The three modules, each lasting 3½ h, cover both staff-to-patient and staff-to-staff communication issues, and an unusual feature is that clinical and non-clinical staff attend together. Following positive evaluation data from our initial pilot programme (involving 350 staff in a single hospital), the programme was expanded to all five hospitals in the district, and has now been completed by over 3000 staff. The results show that despite the significant time commitment, participants find the courses useful and relevant (Kirkpatrick level 1), they learn and retain new material (level 2), and they report changes in behaviour at individual, team and facility levels (level 3). Although it remains a challenge to obtain quantitative data showing that training such as this directly improves patient safety (level 4), our qualitative and informal feedback indicates that participants and their managers perceive clear improvements in the 'communication culture' after a workplace team has attended the courses. Improving 'communication for safety' in healthcare is a worldwide imperative, and other healthcare jurisdictions should be able to obtain similar results to ours if they develop and support interactive, non-didactic training in communication skills.

'I can actually talk to them now': qualitative results of an educational intervention for emergency nurses caring for clients who self-injure.

Science.gov (United States)

McAllister, Margaret; Moyle, Wendy; Billett, Stephen; Zimmer-Gembeck, Melanie

2009-10-01

This Australian study evaluated the effectiveness of a solution-focused education intervention in extending and improving emergency nursing responses to patients who present because of self-injury. Emergency nurses commonly report lack of training and feeling unskilled in managing people who present because of self-harm. Most educational interventions have provided content knowledge, yet rarely have they focused on conveying the value of health promotion strategies such as proactive skills and coping strategies. A mixed method pretest-posttest group design was used. Nurses (n = 36) were interviewed to examine differences in professional identity, awareness of self-injury and clinical reasoning. The qualitative results are presented in this paper and these showed improvements in knowledge and understanding of self-harm, self-belief in nurses' capacity to positively influence clients and the value of health promotion skills. The intervention produced a positive attitudinal shift towards clients and an expressed intention to act in ways that were more person-centred and change oriented. The solution-focused education intervention appears to show promise as an intervention for enabling nurses to value their unique contribution to providing a health service that is more proactive and health-promoting. Interactive education bringing psychosocial skills to technical nursing staff builds confidence, competence and more person-focused care.

Behavioural Insights into Benefits Claimants' Training

Science.gov (United States)

Gloster, Rosie; Buzzeo, Jonathan; Cox, Annette; Bertram, Christine; Tassinari, Arianna; Schmidtke, Kelly Ann; Vlaev, Ivo

2018-01-01

Purpose: The purpose of this paper is to explore the behavioural determinants of work-related benefits claimants' training behaviours and to suggest ways to improve claimants' compliance with training referrals. Design/methodology/approach: Qualitative interviews were conducted with 20 Jobcentre Plus staff and training providers, and 60 claimants.…

Relabelling Behaviour. The Effects of Psycho-Education on the Perceived Severity and Causes of Challenging Behaviour in People with Profound Intellectual and Multiple Disabilities

Science.gov (United States)

Poppes, P.; van der Putten, A.; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.

2016-01-01

Background: Prevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the person with PIMD and attribute challenging…

Grip on challenging behaviour: a multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol

NARCIS (Netherlands)

Zwijsen, S.A.; Smalbrugge, M.; Zuidema, S.U.; Koopmans, R.T.C.M.; Bosmans, J.E.; Tulder, M.W. van; Eefsting, J.A.; Gerritsen, D.L.; Pot, A.M.

2011-01-01

BACKGROUND: Behavioural problems are common in nursing home residents with dementia and they often are burdensome for both residents and nursing staff. In this study, the effectiveness and cost-effectiveness of a new care programme for managing behavioural problems will be evaluated. METHODS/DESIGN:

Grip on challenging behaviour: a multidisciplinary care programme for managing behavioural problems in nursing home residents with dementia. Study protocol

NARCIS (Netherlands)

Zwijsen, S.A.; Smalbrugge, M.; Zuidema, S.U.; Koopmans, R.T.C.M.; Bosmans, J.E.; van Tulder, M.W.; Eefsting, J.A.; Gerritsen, D.L.; Pot, A.M.

2011-01-01

Background: Behavioural problems are common in nursing home residents with dementia and they often are burdensome for both residents and nursing staff. In this study, the effectiveness and cost-effectiveness of a new care programme for managing behavioural problems will be evaluated. Methods/Design.

Organisational citizenship behaviour among railway employees in a ...

African Journals Online (AJOL)

This study investigated the effect of differences in age, education and tenure on organisational citizenship behaviour (OCB). The purposive sample comprised 839 permanently employed staff in a railway organisation in the Democratic Republic of Congo. Participants completed the Organisational Citizenship Behaviour ...

A Fire Safety Certification System for Board and Care Operators and Staff. SBIR Phase I: Final Report.

Science.gov (United States)

Walker, Bonnie L.

This report describes the development and pilot testing of a fire safety certification system for board and care operators and staff who serve clients with developmental disabilities. During Phase 1, training materials were developed, including a trainer's manual, a participant's coursebook a videotape, an audiotape, and a pre-/post test which was…

Team-client Relationships And Extreme Programming

Directory of Open Access Journals (Sweden)

John Karn

2008-01-01

Full Text Available This paper describes a study that examined the relationship between software engineering teams who adhered to the extreme programming (XP methodology and their project clients. The study involved observing teams working on projects for clients who had commissioned a piece of software to be used in the real world. Interviews were conducted during and at the end of the project to get client opinion on how the project had progressed. Of interest to the researchers were opinions on frequency of feedback, how the team captured requirements, whether or not the iterative approach of XP proved to be helpful, and the level of contextual and software engineering knowledge the client had at the start of the project. In theory, fidelity to XP should result in enhanced communication, reduce expectation gaps, and lead to greater client satisfaction. Our results suggest that this depends heavily on the communication skills of the team and of the client, the expectations of the client, and the nature of the project.

Impact of patient suicide on front-line staff in Ireland.

LENUS (Irish Health Repository)

Gaffney, Paul

2009-08-01

Research and anecdotal evidence suggests that coming to terms with the suicide of a patient can be extremely distressing for front-line professionals. Some research also suggests that exposure to such situations can undermine professionals\\' functioning and feelings of competence, cause them to question their professional standing and ultimately contribute to burnout. A survey of 447 front-line professionals\\' experiences of patient suicide was undertaken to further explore these issues. Thematic analysis of open-ended questionnaire items revealed that concerns for the bereaved family, feelings of responsibility for the death and having a close therapeutic relationship with the client are key factors that influence the adjustment and coping of a health professional in the aftermath of the death of a client by suicide. The results are discussed with a focus on the impact of suicide on front-line staff, the need for ongoing support and training and the development of specific post-suicide protocols.

Development and feasibility of smartphone application for cognitive-behavioural case management of individuals with early psychosis.

Science.gov (United States)

Kim, Sung-Wan; Lee, Ga-Young; Yu, Hye-Young; Jung, Eun-I; Lee, Ju-Yeon; Kim, Seon-Young; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

2017-05-18

This article describes the development of the smartphone application for cognitive-behavioural case management of young individuals with early psychosis and examines the acceptance and potential clinical benefits of this application through a pilot survey. Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (Heal Your Mind [HYM]) for cognitive-behavioural case management and symptom monitoring. The HYM application for clients includes 6 main modules including thought record, symptom record, daily life record, official notices, communication and scales. The key module is the "thought record" for self-directed cognitive-behavioural treatment. When the client writes and sends the self-cognitive-behavioural therapy sheet to the case manager, the latter receives a notification and can provide feedback in real time. We conducted a survey to investigate the acceptance and feasibility of this approach among young clients with early psychosis. A total of 24 clients with early psychosis participated in this survey. More than 80% of participants reported that it was easy to learn to use this application, and no one described this application as very complicated or reported that they needed a long time to learn how to use it. About 80% of participants were satisfied with this application, and 70% reported that they received help as a result of using this application. This study suggests that this smartphone application is useful for young individuals with early psychosis and that it may contribute to the development of both young customer- and case manager-friendly systems for this clinical population. © 2017 John Wiley & Sons Australia, Ltd.

Interactive Evolution of Complex Behaviours Through Skill Encapsulation

DEFF Research Database (Denmark)

González de Prado Salas, Pablo; Risi, Sebastian

2017-01-01

Human-based computation (HBC) is an emerging research area in which humans and machines collaborate to solve tasks that neither one can solve in isolation. In evolutionary computation, HBC is often realized through interactive evolutionary computation (IEC), in which a user guides evolution by it...... in evolutionary computation and, as the results in this paper show, IEC-ESP is able to solve complex control problems that are challenging for a traditional fitness-based approach.......Human-based computation (HBC) is an emerging research area in which humans and machines collaborate to solve tasks that neither one can solve in isolation. In evolutionary computation, HBC is often realized through interactive evolutionary computation (IEC), in which a user guides evolution...... by iteratively selecting the parents for the next generation. IEC has shown promise in a variety of different domains, but evolving more complex or hierarchically composed behaviours remains challenging with the traditional IEC approach. To overcome this challenge, this paper combines the recently introduced ESP...

Disentangling the relationships between staff nurses' workplace empowerment and job satisfaction.

Science.gov (United States)

Dahinten, V S; Lee, S E; MacPhee, M

2016-11-01

The primary aim of this study was to examine the relationships between structural empowerment, psychological empowerment and job satisfaction among staff nurses, after controlling for their leaders' use of empowering behaviours. Nurses' job satisfaction is a critical factor in health-care organisations because of its association with nurse turnover and quality of patient care. Nurses continue to report high levels of job dissatisfaction. Cross-sectional data for 1007 Canadian staff nurses were analysed using hierarchical multiple regression. Structural empowerment was the strongest independent predictor of job satisfaction, followed by leader empowering behaviours and psychological empowerment. After accounting for the effects of structural empowerment and leader empowering behaviours, the four dimensions of psychological empowerment showed only small independent effects on job satisfaction. Psychological empowerment did not mediate the effects of structural empowerment on job satisfaction. Nurses' job satisfaction is most influenced by their access to organisational empowerment structures. Leader empowering behaviours, structural empowerment, and psychological empowerment, operating together, enhance nurses' job satisfaction. Nurse leaders should use a variety of empowerment strategies that are important to nurses' job satisfaction and potentially to the quality of patient care and nurse turnover. © 2016 John Wiley & Sons Ltd.

When care situations evoke difficult emotions in nursing staff members: an ethnographic study in two Norwegian nursing homes.

Science.gov (United States)

Sandvoll, Anne Marie; Grov, Ellen Karine; Kristoffersen, Kjell; Hauge, Solveig

2015-01-01

Caring practice in nursing homes is a complex topic, especially the challenges of meeting the basic needs of residents when their behaviour evokes difficult emotions. Cognitive and physical changes related to aging and disability can contribute to behaviours considered to be unacceptable. For example, resident behaviours such as spitting, making a mess with food or grinding teeth are behaviours that most people do not want to see, hear or experience. The aim of this study was to gain a deeper understanding of how nursing home staff members deal with such behaviours in care situations. This article draws on ethnographic data to describe how nursing home staff members manage unpleasant resident behaviours. The study was based on two long-term units in two Norwegian public nursing homes. The Region's Medical Ethics Committee and the Norwegian Social Science Data Services granted approval. In total, 45 participants (37 nursing aides and eight nurses) agreed to participate in this study. Ten of the participants were interviewed at the end of the field study. This study indicates that nursing home staff members experience difficult emotions related to some residents' behaviours. However, they found these feelings difficult to express and rarely verbalized them openly. In addition, they were characterized by a strong obligation to help all residents, despite their own feelings. Therefore, it appears that an inner struggle occurs as a part of everyday practice. Despite these difficult emotions, nursing staff members believed that they needed to manage their responses and continued to offer good care to all residents. These findings extend our understanding of this unarticulated part of nursing home practice.

Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

Science.gov (United States)

2012-01-01

Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with

Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

Directory of Open Access Journals (Sweden)

McGilton Katherine S

2012-10-01

Full Text Available Abstract Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1 examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2 examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1 development of an individualized patient communication care plan; (2 a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3 a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to

Aboriginal-mainstream partnerships: exploring the challenges and enhancers of a collaborative service arrangement for Aboriginal clients with substance use issues

Directory of Open Access Journals (Sweden)

Taylor Kate P

2013-01-01

Full Text Available Abstract Background Partnerships between different health services are integral to addressing the complex health needs of vulnerable populations. In Australia, partnerships between Aboriginal1 community controlled and mainstream services can extend health care options and improve the cultural safety of services. However, although government funding supports such collaborations, many factors can cause these arrangements to be tenuous, impacting the quality of health care received. Research was undertaken to explore the challenges and enhancers of a government initiated service partnership between an Aboriginal Community Controlled alcohol and drug service and three mainstream alcohol rehabilitation and support services. Methods Sixteen staff including senior managers (n=5, clinical team leaders (n=5 and counsellors (n=6 from the four services were purposively recruited and interviewed. Interviews were semi-structured and explored staff experience of the partnership including the client intake and referral process, shared client care, inter-service communication and ways of working. Results & discussion Communication issues, partner unfamiliarity, ‘mainstreaming’ of Aboriginal funding, divergent views regarding staff competencies, client referral issues, staff turnover and different ways of working emerged as issues, emphasizing the challenges of working with a population with complex issues in a persistent climate of limited resourcing. Factors enhancing the partnership included adding a richness and diversity to treatment possibilities and opportunities to explore different, more culturally appropriate ways of working. Conclusion While the literature strongly advises partnerships be suitably mature before commencing service delivery, the reality of funding cycles may require partnerships become operational before relationships are adequately consolidated. Allowing sufficient time and funding for both the operation and relational aspects of a

Correlates of unprotected sex with male clients among female sex workers in 13 Mexican cities.

Science.gov (United States)

Semple, Shirley J; Pitpitan, Eileen V; Chavarin, Claudia V; Strathdee, Steffanie A; Mendoza, Doroteo V; Aarons, Gregory A; Patterson, Thomas L

2017-12-01

This study examined correlates of unprotected vaginal and anal sex (UVA) with male clients among female sex workers (FSWs). Baseline data were gathered from 1089 FSWs recruited from 13 cities across Mexico enrolled in an evidence-based sexual risk reduction intervention. We used generalised estimating equations (GEE) to predict total UVA while controlling for the nested structure of the data. Total UVA with clients in the past month was examined in relation to selected sociodemographic, substance-use, and micro- and macro-environmental factors. A greater number of UVA acts was associated with three micro-level environmental factors (i.e. never getting condoms for free, unaffordability of condoms, greater number of clients per month), and three macro-level environmental factors (i.e. lower health and higher education indices, greater population size of city). These findings suggest the development of social and structural approaches to HIV prevention for FSWs in Mexico, including modification of venue-based policies that pressure FSWs to maximise client volume, changes to the work environment that promote availability and affordability of condoms, and improved population health. Moreover, our findings call for the development of context-specific HIV interventions that take into account variations in the sexual risk behaviours and HIV risk environments of FSWs throughout Mexico.

Microsatellite polymorphisms associated with human behavioural and psychological phenotypes including a gene-environment interaction.

Science.gov (United States)

Bagshaw, Andrew T M; Horwood, L John; Fergusson, David M; Gemmell, Neil J; Kennedy, Martin A

2017-02-03

The genetic and environmental influences on human personality and behaviour are a complex matter of ongoing debate. Accumulating evidence indicates that short tandem repeats (STRs) in regulatory regions are good candidates to explain heritability not accessed by genome-wide association studies. We tested for associations between the genotypes of four selected repeats and 18 traits relating to personality, behaviour, cognitive ability and mental health in a well-studied longitudinal birth cohort (n = 458-589) using one way analysis of variance. The repeats were a highly conserved poly-AC microsatellite in the upstream promoter region of the T-box brain 1 (TBR1) gene and three previously studied STRs in the activating enhancer-binding protein 2-beta (AP2-β) and androgen receptor (AR) genes. Where significance was found we used multiple regression to assess the influence of confounding factors. Carriers of the shorter, most common, allele of the AR gene's GGN microsatellite polymorphism had fewer anxiety-related symptoms, which was consistent with previous studies, but in our study this was not significant following Bonferroni correction. No associations with two repeats in the AP2-β gene withstood this correction. A novel finding was that carriers of the minor allele of the TBR1 AC microsatellite were at higher risk of conduct problems in childhood at age 7-9 (p = 0.0007, which did pass Bonferroni correction). Including maternal smoking during pregnancy (MSDP) in models controlling for potentially confounding influences showed that an interaction between TBR1 genotype and MSDP was a significant predictor of conduct problems in childhood and adolescence (p behaviour up to age 25 years (p ≤ 0.02). This interaction remained significant after controlling for possible confounders including maternal age at birth, socio-economic status and education, and offspring birth weight. The potential functional importance of the TBR1 gene's promoter microsatellite

Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana

Directory of Open Access Journals (Sweden)

Jessica D. Rothstein

2016-01-01

Full Text Available Mobile phone applications may enhance the delivery of critical health services and the accuracy of health service data. Yet, the opinions and experiences of frontline health workers on using mobile apps to track pregnant and recently delivered women are underreported. This evaluation qualitatively assessed the feasibility, usability, and acceptability of a mobile Client Data App for maternal, neonatal, and child client data management by community health nurses (CHNs in rural Ghana. The mobile app enabled CHNs to enter, summarize, and query client data. It also sent visit reminders for clients and provided a mechanism to report level of care to district officers. Fourteen interviews and two focus groups with CHNs, midwives, and district health officers were conducted, coded, and thematically analyzed. Results indicated that the app was easily integrated into care, improved CHN productivity, and was acceptable due to its capacity to facilitate client follow-up, data reporting, and decision-making. However, the feasibility and usability of the app were hindered by high client volumes, staff shortages, and software and device challenges. Successful integration of mobile client data apps for frontline health workers in rural and resource-poor settings requires real-time monitoring, program investments, and targeted changes in human resources.

Parent-Child Interaction Therapy for Child Disruptive Behaviour Disorders: A Meta-Analysis

Science.gov (United States)

Ward, Michelle A.; Theule, Jennifer; Cheung, Kristene

2016-01-01

Background: Numerous studies have looked at the efficacy of Parent-Child Interaction Therapy (PCIT) for young children with externalizing behaviour problems. Objective: The present study compiled these results through a comprehensive review to provide greater clarity regarding the efficacy of this treatment. Methods: Using a random effects model,…

Dynamics of tactical behaviour in association football when manipulating players' space of interaction.

Directory of Open Access Journals (Sweden)

Angel Ric

Full Text Available The analysis of positional data in association football allows the spatial distribution of players during matches to be described in order to improve the understanding of tactical-related constraints on the behavioural dynamics of players. The aim of this study was to identify how players' spatial restrictions affected the exploratory tactical behaviour and constrained the perceptual-motor workspace of players in possession of the ball, as well as inter-player passing interactions. Nineteen professional outfield male players were divided into two teams of 10 and 9 players, respectively. The game was played under three spatial constraints: a players were not allowed to move out of their allocated zones, except for the player in possession of the ball; b players were allowed to move to an adjacent zone, and; c non-specific spatial constraints. Positional data was captured using a 5 Hz interpolated GPS tracking system and used to define the configuration states of players for each second in time. The configuration state comprised 37 categories derived from tactical actions, distance from the nearest opponent, distance from the target and movement speed. Notational analysis of players in possession of the ball allowed the mean time of ball possession and the probabilities of passing the ball between players to be calculated. The results revealed that the players' long-term exploratory behaviour decreased and their short-term exploration increased when restricting their space of interaction. Relaxing players' positional constraints seemed to increase the speed of ball flow dynamics. Allowing players to move to an adjacent sub-area increased the probabilities of interaction with the full-back during play build-up. The instability of the coordinative state defined by being free from opponents when players had the ball possession was an invariant feature under all three task constraints. By allowing players to move to adjacent sub-areas, the

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

Science.gov (United States)

Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

2017-11-01

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed

[Turnover of Non-medical Staff in Outpatient Oncology Practices: Is Building Social Capital a Solution?].

Science.gov (United States)

Gloede, T D; Ernstmann, N; Baumann, W; Groß, S E; Ansmann, L; Nitzsche, A; Neumann, M; Wirtz, M; Schmitz, S; Schulz-Nieswandt, F; Pfaff, H

2015-11-01

While a lot is known about potential and actual turnover of non-medical hospital staff, only few data exist for the outpatient setting. In addition, little is known about actual instruments which leaders can use to influence staff turnover in physician practices. In the literature, the social capital of an organisation, which means the amount of trust, common values and reciprocal behaviour in the organisation, has been discussed as a possible field of action. In the present study, staff turnover as perceived by outpatient haematologists and oncologists is presented and analysed as to whether social capital is associated with that staff turnover. In conclusion, measures to increase the social capital of a practice are presented. The present study is based on data gathered in a questionnaire-based survey with members of the Professional Organisation of -Office-Based Haematologists and Oncologists (N=551). The social capital of the practice was captured from the haematologists and oncologists using an existing and validated scale. To analyse the impact of the practice's social capital on staff turnover, as perceived by the physicians, bivariate correlations and linear regression analyses were calculated. In total, 152 haematologists and oncologists participated in the study which represents a response rate of 28%. In the regression analyses, social capital appears as a significant and strong predictor of staff turnover (beta=-0.34; pturnover although the underlying study design does not allow for drawing causal conclusions regarding this relationship. To create social capital in their practice, outpatient physicians may apply measures that facilitate social interaction among staff, foster trust and facilitate cooperation. Such measures may already be applied when hiring and training new staff, but also continuously when leading employees and when organising work tasks, e.g., by establishing regular team meetings. © Georg Thieme Verlag KG Stuttgart · New York.

Call center. Centrados en el cliente

OpenAIRE

Leal-Alonso-de-Castañeda, José Enrique

2003-01-01

La empresa actual ha de estar preparada para responder al Cliente tal y como éste espera, porque no se busca un cliente puntual, sino un cliente fiel. La globalización de la economía y del acceso a los mercados exige que la empresa sea capaz de atraer al cliente no sólo con un servicio de calidad, sino además con una atención de calidad. La implantación de un Call Center (Centro de Atención al Cliente, Centro de Atención de Llamadas) constituye por todo ello una estrategia de negocio qu...

Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada.

Science.gov (United States)

Chamberlain, Stephanie A; Gruneir, Andrea; Hoben, Matthias; Squires, Janet E; Cummings, Greta G; Estabrooks, Carole A

2017-06-01

Our study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care. We used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form. We found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy. This study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

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