An exploration of the importanceof emotional intelligence in midwifery

Background, Recognition of the importance of Emotional intelligence dates back as far as Aristotle (350BC). More recently the notion of emotional intelligence features in social psychology literature; it has also been embraced within personnel management and is now beginning to appear in nursing, medical and midwifery journals. Emotional intelligence involves possessing the capacity for motivation, creativity, the ability to operate at peak performance and the ability to persist in the face of setbacks and failures. Emotional intelligence refers to the ability to recognise our own feelings and those of others and it enables us to manage emotions effectively in ourselves and in our relationships. Midwives are constantly responding to change and challenges within maternity services. This paper examines how emotional intelligence can assist midwives in dealing with pressures which involve delivering the Government reforms, providing choice to women and facing current issues within the midwifery workforce. Midwives need emotional intelligence in order to express their feelings and recognize the feelings of others. Enhancing our relationships with colleagues and clients will ultimately impact on the quality of care delivered to women. Overall the aims of the paper are to create an awareness of the importance of emotional intelligence in practice and define emotional intelligence.

Private equity and entrepreneurial management in management buy-outs

Critics claim that short-term profit orientation and high deal price strategies of private equity (PE) firms can negatively affect the ability of management buyouts to initiate and sustain entrepreneurial management. This study investigates this claim by comparing effects of majority PE backed and other buy-outs at different levels of financial leverage on post buy-out increases in entrepreneurial management. We propose that PE can be used as an organizational refocusing device that simultaneously increases entrepreneurial and administrative management. We find that majority PE-backed buy-outs significantly increase entrepreneurial management practices. Furthermore, the increased financial leverage positively affects administrative management in management buy-outs. However, the effect of high financial leverage is larger for majority PE-backed buy-outs. These results support the notion that PE firms help buy-out companies develop ambidextrous organizational change: i.e. simultaneously develop entrepreneurial and administrative management practices. The findings have important implications for practitioners and policy makers.

Challenges of UK/Irish Contractors Regarding Material Management and Logistics in Confined Site Construction

The aim of this paper is to identify the various managerial issues encountered by UK/Irish contractors in the management of materials in confined urban construction sites. Through extensive literature review, detailed interviews, case studies, cognitive mapping, causal loop diagrams, questionnaire survey and documenting severity indices, a comprehensive insight into the materials management concerns within a confined construction site environment is envisaged and portrayed. The leading issues highlighted are: that contractors’ material spatial requirements exceed available space, it is difficult to coordinate the storage of materials in line with the programme, location of the site entrance makes delivery of materials particularly difficult, it is difficult to store materials on-site due to the lack of space, and difficult to coordinate the storage requirements of the various sub-contractors. With the continued development of confined urban centres and the increasing high cost of materials, any marginal savings made on-site would translate into significant monetary savings at project completion. Such savings would give developers a distinct competitive advantage in this challenging economic climate. As on-site management professionals successfully identify, acknowledge and counteract the numerous issues illustrated, the successful management of materials on a confined urban construction site becomes attainable.

High-volume haemofiltration for sepsis.

Background: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU). This is despite advances in the management of patients with severe sepsis and septic shock including early recognition, source control, timely and appropriate administration of antimicrobial agents, and goal directed haemodynamic, ventilatory and metabolic therapies. High-volume haemofiltration (HVHF) is a blood purification technique which may improve outcomes in critically ill patients with severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used to treat acute kidney injury (AKI) in critically ill patients in the ICU.

Objectives: This review assessed whether HVHF improves clinical outcome in adult critically ill patients with sepsis in an ICU setting.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2011, Issue 7); MEDLINE (1990 to August 2011), EMBASE (1990 to August 2011); LILACS (1982 to August 2011), Web of Science (1990 to August 2011), CINAHL (1982 to August 2011) and specific websites.

Selection criteria: We included randomized controlled trials (RCTs) and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration to standard or usual dialysis therapy; and RCTs and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration to no similar dialysis therapy. The studies involved adults in critical care units.

Data collection and analysis: Three review authors independently extracted data and assessed trial quality. We sought additional information as required from trialists.

Main results: We included three randomized trials involving 64 participants. Due to the small number of studies and participants, it was not possible to combine data or perform sub-group analyses. One trial reported ICU and 28-day mortality, one trial reported hospital mortality and in the third, the number of deaths stated did not match the quoted mortality rates. No trials reported length of stay in ICU or hospital and one reported organ dysfunction. No adverse events were reported. Overall, the included studies had a low risk of bias.

Authors' conclusions: There were no adverse effects of HVHF reported.There is insufficient evidence to recommend the use of HVHF in critically ill patients with severe sepsis and or septic shock except as interventions being investigated in the setting of a randomized clinical trial. These trials should be large, multi-centred and have clinically relevant outcome measures. Financial implications should also be assessed.

Steps to a better Belfast: physical activity assessment and promotion in primary care

BACKGROUND: Low physical activity (PA) levels which increase the risk of chronic disease are reported by two-thirds of the general UK population. Promotion of PA by primary healthcare professionals is advocated but more evidence is needed regarding effective ways of integrating this within everyday practice. This study aims to explore the feasibility of a randomised trial of a pedometer-based intervention, using step-count goals, recruiting patients from primary care. METHOD: Patients, aged 35-75, attending four practices in socioeconomically deprived areas, were invited to complete a General Practice PA Questionnaire during routine consultations. Health professionals invited 'inactive' individuals to a pedometer-based intervention and were randomly allocated to group 1 (prescribed a self-determined goal) or group 2 (prescribed a specific goal of 2500 steps/day above baseline). Both groups kept step-count diaries and received telephone follow-up at 1, 2, 6 and 11 weeks. Step counts were reassessed after 12 weeks. RESULTS: Of the 2154 patients attending, 192 questionnaires were completed (8.9%). Of these, 83 were classified as 'inactive'; 41(10 men; 31 women) completed baseline assessments, with the mean age of participants being 51 years. Mean baseline step counts were similar in group 1 (5685, SD 2945) and group 2 (6513, SD 3350). The mean increase in steps/day was greater in groups 1 than 2 ((2602, SD 1957) vs (748, SD 1997) p=0.005). CONCLUSIONS: A trial of a pedometer-based intervention using self-determined step counts appears feasible in primary care. Pedometers appear acceptable to women, particularly at a perimenopausal age, when it is important to engage in impact loading activities such as walking to maintain bone mineral density. An increase of 2500 steps/day is achievable for inactive patients, but the effectiveness of different approaches to realistic goal-setting warrants further study.

Healthcare professionals’ response to cachexia in advanced cancer: A qualitative study

Purpose/Objectives: To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer.

Research Approach: A qualitative approach based on symbolic interactionism.

Setting: A regional cancer center in a large teaching hospital in the United Kingdom.

Participants: 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer.

Methodologic Approach: Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection.

Findings: Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer.

Conclusions: Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals.

Interpretation: This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care.

Knowledge Translation: Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their families.

Management of myelofibrosis:a survey of current practice in the United Kingdom

To investigate the experience of clinicians in the management of patients with myelofibrosis, current treatment options and their utility.

Global talent management: exploring talent identification in the multinational enterprise

In recent decades, interest in talent management has continued to grow among practitioners, consultants and academics. Conceptual development and subsequent empirical analysis has been limited and struggled to keep pace with the plethora of management consultancy reports in the area. More recently, global talent management has come to the fore due to the increasing importance and challenges multinational enterprises (MNEs) face in satisfying their talent demands. This paper analyses the operationalisation of the talent identification stage in global talent management. In so doing, we find that the use of talent pool segmentation is becoming a popular means of identifying and managing talent. However, MNEs face a number of challenges in ensuring that it is an effective system.

Management of Hyperphosphataemia in Chronic Kidney Disease:Summary of National Institute for Health and Clinical Excellence (NICE) Guideline

Bone disease and ectopic calcification are the two main consequences of hyperphosphataemia of chronic kidney disease (CKD). Observational studies have demonstrated that hyperphosphataemia in CKD is associated with increased mortality. Furthermore, the use of phosphate binders in dialysis patients is associated with significantly lower mortality. The UK Renal Registry data show significant underachievement of phosphate targets in dialysis patients. It is believed to be due to wide variation in how management interventions are used. The National Institute for Health and Clinical Excellence (NICE) has developed a guideline on the management of hyperphosphataemia in CKD. This is based on the evidence currently available using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. This review outlines the recommendations including research recommendations and discusses methodology, rationale and challenges faced in developing this guideline and the health economic model used to assess the cost-effectiveness of different phosphate binders. © 2013 S. Karger AG, Basel.

Motion Management for Radical Radiotherapy in Non-small Cell Lung Cancer

Intrafraction tumour motion is an issue that is of increased interest in the era of image-guided radiotherapy. It is particularly relevant for non-small cell lung cancer, for which a number of recent developments are in use to aid with motion management in the delivery of radical radiotherapy. The ability to deliver hypofractionated ablative doses, such as in stereotactic radiotherapy, has been aided by improvements in the ability to analyse tumour motion and amend treatment delivery. In addition, accounting for tumour motion can enable dose escalation to occur by reducing the normal tissue being irradiated by virtue of a reduction in target volumes. Motion management for lung tumours incorporates five key components: imaging, breath-hold techniques, abdominal compression, respiratory tracking and respiratory gating. These will be described, together with the relevant benefits and associated complexities. Many studies have described improved dosimetric coverage and reduced normal tissue complication probability rates when using motion management techniques. Despite the widespread uptake of many of these techniques, there is a paucity of literature reporting improved outcome in overall survival and local control for patients whenever motion management techniques are used. This overview will review the extent of lung tumour motion, ways in which motion is detected and summarise the key methods used in motion management.

Re-challenge chemotherapy with gemcitabine plus carboplatin in patients with non-small cell lung cancer

Despite recent improvements to current therapies and the emergence of novel agents to manage advanced non-small cell lung cancer (NSCLC), the patients' overall survival remains poor. Re-challenging with first-line chemotherapy upon relapse is common in the management of small cell lung cancer but is not well reported for advanced NSCLC. NSCLC relapse has been attributed to acquired drug resistance, but the repopulation of sensitive clones may also play a role, in which case re-challenge may be appropriate. Here, we report the results of re-challenge with gemcitabine plus carboplatin in 22 patients from a single institution who had previously received gemcitabine plus platinum in the first-line setting and had either partial response or a progression-free interval of longer than 6 months. In this retrospective study, the charts of patients who underwent second-line chemotherapy for NSCLC in our cancer center between January 2005 and April 2010 were reviewed. All the patients who received a combination of gemcitabine and carboplatin for re-challenge were included in the study. These patients were offered second-line treatment on confirmation of clear radiological disease progression. The overall response rate was 15% and disease control rate was 75%. The median survival time was 10.4 months, with 46% of patients alive at 1 year. These results suggest that re-challenge chemotherapy should be considered in selected patients with radiological partial response or a progression-free survival of longer than 6 months to the initial therapy.

Collaborative evolution: the context surrounding the formation and the effectiveness of a school partnership in a divided community in Northern Ireland

This paper examines an initiative promoting collaboration between schools located in a city setting in Northern Ireland, which is broadly divided along ethnic and political lines. The schools involved, like the vast majority of schools in Northern Ireland, educate Protestant and Catholic children separately. This presents particular challenges for school collaboration as it implies the establishment of new, connected relationships in an education system, which is historically and contemporaneously more characterised by division. Since 2007, the schools in this study have been involved in an education initiative which promotes cross-sectoral shared learning in core areas of the curriculum with a view to promoting school improvement; the additional, indirect goal is also about improving community relations. However, over this period, the relationship between the institutions has deepened, leading schools to examine how they can sustain partnership and evolve collaborative practice. This paper explores how the partnership has evolved and assesses its effectiveness as a collaborative enterprise. The paper concludes by demonstrating how effective collaboration between schools in Northern Ireland mitigates the potentially negative impacts of educating children separately, but also how effective models of school collaboration are capable of providing enhanced learning opportunities for pupils and are also capable of developing the communities in which they are located.

The Oxford Handbook of Conflict Management in Organizations

New ways of managing conflict are increasingly important features of work and employment in organizations. In the book the world's leading scholars in the field examine a range of innovative alternative dispute resolution (ADR) practices, drawing on international research and scholarship and covering both case studies of major exemplars and developments in countries in different parts of the global economy. Developments in the management of individual and collective conflict at work are addressed, as are innovations in both unionized and non-union organizations and in the private and public sectors.

New practices for managing conflict in organizations are set in the context of trends in workplace conflict and perspectives on how conflict should be understood and addressed. Part 1 examines the changing context of conflict management by addressing the main frameworks for understanding conflict management, the trend in conflict at work, developments in employment rights, and the influence of HRM on conflict management. Part 2 covers the main approaches to conflict management in organizations, addressing both conventional and alternative approaches to conflict resolution. Conventional grievance handling and third-party processes in conflict resolution are examined as well as the main ADR practices, including conflict management in non-union firms, the role of the organizational ombudsman, mediation, interest-based bargaining, line and supervisory management, and the concept of conflict management systems. Part 3 presents case studies of exemplars and innovators in the field, covering mediation in the US postal service, interest-based bargaining at Kaiser-Permanente, 'med-arb' in the New Zealand Police, and judicial mediation in UK employment tribunals. Part 4 covers international developments in conflict management in Germany, Japan, The United States, Australia, New Zealand, the United Kingdom and China.

This Handbook gives a comprehensive overview of this growing field, which has seen an huge increase in programmes of study in university business and law schools and in executive education programmes.

Lightweight Risk Management in Agile projects

Risk management in software engineering has become a recognized project management practice but it seems that not all companies are systematically applying it. At the same time, agile methods have become popular, partly because proponents claim that agile methods implicitly reduce risks due
to, for example, more frequent and earlier feedback, shorter periods of development time and easier prediction of cost. Therefore, there is a need to investigate how risk management can be usable in iterative and evolutionary software development processes. This paper investigates the gathering of empirical data on risk management from the project environment and presents
a novel approach to manage risk in agile projects. Our approach is based on a prototype tool, Agile Risk Tool (ART). This tool reduces human effort in risk management by using software agents to identify, assess and monitor risk, based on input and data collected from the project environment and by applying
some designated rules. As validation, groups of student project data were used to provide evidence of the efficacy of this approach. We demonstrate the approach and the feasibility of using a lightweight risk management tool to alert, assess and monitor risk with reduced human effort.