Organizational Attributes of Practices Successful at a Disease Management Program

Objective: To assess the contribution of organizational factors to implementation of 3 asthma quality measures: enrollment in a disease management program, development of a written treatment plan, and prescription of severity-appropriate anti-inflammatory therapy. Study design: A total of 138 pediatric clinicians and 247 office staff in 13 urban clinics and 23 nonurban private practices completed questionnaires about their practice's organizational characteristics (eg, leadership, communication, perceived effectiveness, job satisfaction). Results: 94% of the clinicians and 92% of the office staff completed questionnaires. When adjusted for confounders, greater practice activity and perceived effectiveness in meeting family needs were associated with higher rates of enrollment in the Easy Breathing program, whereas higher scores for 3 organizational characteristics-communication timeliness, decision authority, and job satisfaction-were associated with both higher enrollment and a greater number of written treatment plans. None of the organizational characteristics was associated with greater use of anti-inflammatory therapy. Conclusions: Three organizational characteristics predicted 2 quality asthma measures: use of a disease management program and creation of a written asthma treatment plan. If these organizational characteristics were amenable to change, then our findings could help focus interventions in areas of effective and acceptable organizational change. © 2009 Mosby, Inc. All rights reserved.

Successful medical treatment of Acanthamoeba keratitis

Purpose: To describe the outcome of a series of Acanthamoeba keratitis treated with a similar regimen. Methods: All cases diagnosed with Acanthamoeba keratitis in a referral centre from June 1994 through June 1997 were included. Diagnosis of Acanthamoeba keratitis was based in clinical presentation and laboratory results. Positive laboratory identification of Acanthamoeba from corneal scraping or contact lens was required, unless the patient had very characteristic symptoms (severe pain) and signs of the infection, including perineural infiltrates. Initial intensive treatment included topical polyhexamethylene biguanide (PHMB) 0.02%, propamidine isothionate 0.1% and broad-spectrum antibiotics. The treatment was gradually tapered. After documented response to anti-acanthamoeba therapy, topical steroids were introduced; they were discontinued before cessation of the antiAcanthamoeba regimen. Results: Six males and four females, with a mean age of 30.0 ± 7.4 years were included in this study. All cases weared contact lenses. On presentation all cases had severe pain, and epitheliopathy was associated with stromal infiltrate in most (seven of ten) cases. Four patients had anterior uveitis. Perineural infiltrates were present in three cases and ring infiltrate in one patient. Anti-amoebic treatment was started 12.7 ± 7.2 days after beginning of symptoms. The clinical response to therapy was very satisfactory in all patients. Within two to three weeks all patients had remarkable lessening of pain and photophobia, and improvement of clinical signs. At two to three months, visual acuity had improved in all patients. Two patients required penetrating keratoplasty for visual rehabilitation. Conclusion: The use of PHMB and propamidine cured all cases of Acanthamoeba keratitis. Cautious introduction of steroids was associated with expedited resolution of inflammation and provided symptomatic relief.

Social Dance for Successful Aging:The Practice of Health, Happiness, and Social Inclusion Amongst Senior Citizens

This article presents findings from a qualitative study of social
dancing for successful aging amongst senior citizens in three locales:
in Blackpool (GB), around Belfast (NI), and in Sacramento (US). Social
dancers are found to navigate an intense space in society, one of
wellbeing accompanied by a beneficial sense of youthfulness. Besides
such renewal and self-actualisation, findings also attest to the perceived
social, psychological and health benefits of social dancing amongst senior
citizens. They also articulate three different social dancing practices:
social dance as tea dance (Sacramento), social dance as practice dance
(Blackpool), social dance as motility (Belfast and environs).

Successful but Unappealing: Fifteen Years of Workplace Partnership in Ireland:Special Issue: Partnership, Collaboration and Mutual Gains

This paper presents the first comprehensive review and assessment of Ireland's influential 15-year experiment with workplace partnership. The paper reviews the outcomes of workplace partnership and explains the limited adoption of partnership in the private and public sectors, drawing on the authors' experiences as participants in policy initiatives concerned with promoting partnership in the workplace. Although the promotion of partnership was to the fore in public policy between the late 1990s to the onset of the recession and successful outcomes were reported for the main stakeholders where partnerships were established, the paper explains why the concept nevertheless remained largely unappealing across the private and public sectors.

The role of personality and self-efficacy in the selection and retention of successful nursing students:a longitudinal study

Aim: This paper is a report of a study to examine the role of personality and self-efficacy in predicting academic performance and attrition in nursing students.

Background: Despite a considerable amount of research investigating attrition in nursing students and new nurses, concerns remain. This particular issue highlights the need for a more effective selection process whereby those selected are more likely to complete their preregistration programme successfully, and remain employed as Registered Nurses.

Method: A longitudinal design was adopted. A questionnaire, which included measures of personality and occupational and academic self-efficacy, was administered to 384 students early in the first year of the study. At the end of the programme, final marks and attrition rates were obtained from university records for a total of 350 students. The data were collected from 1999 to 2002.

Findings: Individuals who scored higher on a psychoticism scale were more likely to withdraw from the programme. Occupational self-efficacy was revealed to be a statistically significant predictor of final mark obtained, in that those with higher self-efficacy beliefs were more likely to achieve better final marks. Extraversion was also shown to negatively predict academic performance in that those with higher extraversion scores were more likely to achieve lower marks.

Conclusion: More research is needed to explore the attributes of successful nursing students and the potential contribution of psychological profiling to a more effective selection process.

Factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for dying patients – a realist evaluation

Objectives: The Liverpool Care Pathway for the dying patient (LCP) was designed to improve end-of-life care in generalist health care settings. Controversy has led to its withdrawal in some jurisdictions. The main objective of this research was to identify the influences that facilitated or hindered successful LCP implementation.

Method: An organisational case study using realist evaluation in one health and social care trust in Northern Ireland. Two rounds of semi-structured interviews were conducted with two policy makers and twenty two participants with experience and/or involvement in management of the LCP during 2011 and 2012.

Results: Key resource inputs included facilitation with a view to maintaining LCP ‘visibility’, reducing anxiety among nurses and increasing their confidence regarding the delivery of end-of-life care; and nurse and medical education designed to increase professional self-efficacy and reduce misuse and misunderstanding of the LCP. Key enabling contexts were consistent senior management support; ongoing education and training tailored to the needs of each professional group; and an organisational cultural change in the hospital setting that encompassed end-of-life care.

Conclusion: There is a need to appreciate the organizationally complex nature of intervening to improve end-of-life care. Successful implementation of evidence-based interventions for end-of-life care requires commitment to planning, training and ongoing review that takes account of different perspectives, institutional hierarchies and relationships and the educational needs of professional disciplines. There is a need also to recognise that medical consultants require particular support in their role as gatekeepers and as a lead communication channel with patients and their relatives.

Successful Food Safety Analysis

Dr Kevin Cooper of the Institute for Global Food Security at Queen’s University Belfast, Northern Ireland, spoke to Kate Mosford of The
Column about the importance of accuracy, reliability, and stability in food safety analysis and the role of ultrahigh-pressure liquid chromatography tandem mass spectrometry (UHPLC–MS–MS) in his research.

Successful translation of Academic Research into wider Economic Impact: University of Southampton, Distinguished Lecture

No abstract available

Successful balance training is associated with improved multisensory function in fall-prone older adults

Balance maintenance relies on a complex interplay between many different sensory modalities. Although optimal multisensory processing is thought to decline with ageing, inefficient integration is particularly associated with falls in older adults. We investigated whether improved balance control, following a novel balance training intervention, was associated with more efficient multisensory integration in older adults, particularly those who have fallen in the past. Specifically, 76 healthy and fall-prone older adults were allocated to either a balance training programme conducted over 5 weeks or to a passive control condition. Balance training involved a VR display in which the on-screen position of a target object was controlled by shifts in postural balance on a Wii balance board. Susceptibility to the sound-induced flash illusion, before and after the intervention (or control condition), was used as a measure of multisensory function. Whilst balance and postural control improved for all participants assigned to the Intervention group, improved functional balance was correlated with more efficient multisensory processing in the fall-prone older adults only. Our findings add to growing evidence suggesting important links between balance control and multisensory interactions in the ageing brain and have implications for the development of interventions designed to reduce the risk of falls.

Effects of Parasitism and Morphology on Squirrelpox Virus Seroprevalence in Grey Squirrels (Sciurus carolinensis)

Invasive species have been cited as major causes of population extinctions in several animal and plant classes worldwide. The North American grey squirrel (Sciurus carolinensis) has a major detrimental effect on native red squirrel (Sciurus vulgaris) populations across Britain and Ireland, in part because it can be a reservoir host for the deadly squirrelpox virus (SQPV). Whilst various researchers have investigated the epizootiology of SQPV disease in grey squirrels and have modelled the consequent effects on red squirrel populations, less work has examined morphological and physiological characteristics that might make individual grey squirrels more susceptible to contracting SQPV. The current study investigated the putative relationships between morphology, parasitism, and SQPV exposure in grey squirrels. We found geographical, sex, and morphological differences in SQPV seroprevalence. In particular, larger animals, those with wide zygomatic arch widths (ZAW), males with large testes, and individuals with concurrent nematode and/or coccidial infections had an increased seroprevalence of SQPV. In addition, males with larger spleens, particularly those with narrow ZAW, were more likely to be exposed to SQPV. Overall these results show that there is variation in SQPV seroprevalence in grey squirrels and that, consequently, certain individual, or populations of, grey squirrels might be more responsible for transmitting SQPV to native red squirrel populations.