Norms and their relationship to behavior in worksite settings : an application of the Jackson Return Potential Model

To measure health norms and assess their influence on behavior among 2541 employees in 16 manufacturing worksites using an adapted Jackson's Return Potential Model (RPM). METHODS: Worksite-level norm intensity, crystallization, and normative power were calculated for several behaviors; linear regression analyses tested whether normative power was related to each health behavior. RESULTS: Norms about safe work practices and smoking were most intense; norms about safe work practices were most crystallized. Safe work practices and smoking held the highest normative power; healthy eating held the least normative power. Comparing norm characteristics across health behaviors leads to important leverage points for intervening to influence norms and improve worker health.

Another minority group: use of aged care day programs and community leisure services by older people with lifelong disability

Objective: This study examined the extent to which programs available to the general aged community are accessible to older people with lifelong disability. Method: Forty Victorian generic aged day activity and community leisure programs used by older people responded to a survey that sought information on the extent to which such services are used by older people with a lifelong disability. Results: More than half of these services are accessed by a small number of people with lifelong disability and overall there was a willingness to include this group in generic services. Barriers and solutions to successful generic service use were reported. Conclusions: The findings indicate that the issues for people with lifelong disability differ little from those of other minority groups. It is proposed that disability services have a role in brokering services for their older clients, and continued planning and collaboration between disability and aged services will benefit all older people.

Foreign aid, leisure-effort choice, and economic growth

Using an endogenous growth model, this paper examines the growth and welfare effects of foreign aid in the recipient economy. The emphasis is on the incentive factor of the effort-leisure choice. Besides financing public services, part of the aid is transferred to the public. This increases individual wealth, thereby providing less incentives to individuals for human capital acquisition, but with more leisure. Thus, foreign aid may not always help the growth and welfare of the economy. Taking this incentive factor into account, we further study the issue on aid allocation in achieving the highest levels of growth and welfare. Along the balanced growth path, aid allocation for welfare maximization is different from that under growth maximization.

Barriers and enablers affecting patient engagement in managing medications within specialty hospital settings

Background : Communication problems contribute enormously to medication errors and adverse events. Encouraging patient engagement can help to facilitate effective medication management.

Objectives : To examine barriers and enablers affecting how patients engage with managing their medications in specialty hospital settings.

Design : An exploratory qualitative design was used involving in-depth interviews with doctors, nurses, pharmacists, patients and family members.

Setting : An Australian public, metropolitan teaching hospital was the study site and five specialty hospital settings were used, including cardiac care, emergency care, intensive care, oncology care and perioperative care.

Results : In all, 21 health professionals, 11 patients and 12 family members participated in the study (n = 44). Barriers and enablers involved intrapersonal, interpersonal and environmental aspects, and differences in perceptions and experiences were found between the various settings. Health professionals had preconceived notions of what was appropriate behaviour in conveying information about medications. Many health professionals stated that they deliberately chose not to provide medication-related knowledge. Different barriers for patient engagement existed in various settings – in emergency care, patients could only stay for 4 h; in intensive care, medication changes regularly happened; in cardiac care, patients were discharged prematurely due to urgent need of beds; in oncology, there was lack of availability of oncology consultants; while in perioperative care, surgeons and anaesthetists were available just before surgery.

Conclusions : Complex barriers and enablers are associated with patient engagement in specialty clinical settings. By developing an understanding of these barriers and enablers, health professionals can help patients to understand and participate in their medication management.

Obesity prevention interventions in early childhood education and care settings with parental involvement: a systematic review

Partnering early childhood education and care (ECEC) and the home together may be more effective in combating obesogenic risk factors in preschool children. Thus, an evaluation of ECEC obesity prevention interventions with a parental component was conducted, exploring parental engagement and its effect on obesity and healthy lifestyle outcomes. A search revealed 15 peer-reviewed papers. Some studies demonstrated positive weight changes, and secondary outcomes of changes in physical activity and healthy eating were reported in most studies; study quality ranged from fair to good. Four findings were linked to weight changes: (1) when educational material is consistent across settings; (2) capacity building of parents; (3) parents encouraging their children to drink water and (4) parental satisfaction and participation. A partnership between parents and ECEC may be a powerful force in the prevention of paediatric obesity. A better understanding of collaborative parental engagement is needed.

Wound management in disaster settings

Background Few guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where resources and facilities are also often limited, and clear appropriate guidance is needed for early wound management. Methods We undertook a systematic review focusing on the nature of wounds in disaster situations, and the outcomes of wound management in recent disasters. We then presented the findings to an international consensus panel with a view to formulating a guideline for the initial management of wounds by first responders and subsequent healthcare personnel as they deploy. Results We included 62 studies in the review that described wound care challenges in a diverse range of disasters, and reported high rates of wound infection with multiple causative organisms. The panel defined a guideline in which the emphasis is on not closing wounds primarily but rather directing efforts toward cleaning, debridement, and dressing wounds in preparation for delayed primary closure, or further exploration and management by skilled surgeons. Conclusion Good wound care in disaster settings, as outlined in this article, can be achieved with relatively simple measures, and have important mortality and morbidity benefits. © 2014 Société Internationale de Chirurgie.

An analysis of tracking settings in blackberry 10 and windows phone 8 smartphones

The use of tracking settings in smartphones facilitates the provision of tailored services to users by allowing service providers access to unique identifiers stored on the smartphones. In this paper, we investigate the 'tracking off' settings on the Blackberry 10 and Windows Phone 8 platforms. To determine if they work as claimed, we set up a test bed suitable for both operating systems to capture traffic between the smartphone and external servers. We dynamically execute a set of similar Blackberry 10 and Windows Phone 8 applications, downloaded from their respective official markets. Our results indicate that even if users turn off tracking settings in their smartphones, some applications leak unique identifiers without their knowledge. © 2014 Springer International Publishing Switzerland.

Pharmacists' interprofessional communication about medications in specialty hospital settings

Effective communication between pharmacists, doctors, and nurses about patients' medications is particularly important in specialty hospital settings where high-risk medications are frequently used. This article describes the nature of communication about medications that occurs between pharmacists and other health professionals, including doctors and nurses, in specialty hospital settings. Semistructured interviews with, and participant observations of, pharmacists, nurses, and doctors were conducted in specialty settings of an Australian public, metropolitan teaching hospital. Twenty-one individuals working in the settings of emergency care, oncology care, intensive care, cardiothoracic care, and perioperative care were interviewed. In addition, participant observations of 56 individuals were conducted in emergency care, oncology care, intensive care, and cardiothoracic care. Detailed thematic analysis of the data was performed. Across all of the settings, pharmacy was less visible than medicine and nursing in terms of pharmacists' work performed, pharmacy documentation and resources, and pharmacists' physical visibility. Pharmacists, doctors, and nurses largely worked alongside one another rather than with each other. When collaboration occurred, the professional groups engaged in mostly reactive communication to accomplish specific medication tasks that needed completing. Interprofessional differences in attitudes toward medications and medication management communication behaviors were evident. Pharmacists need to engage in more proactive communication in order to reduce the risk of medication errors occurring.

Improving the accessibility of health services in urban and regional settings for indigenous people

Accessible health services are those that are physically available, affordable (economic accessibility), appropriate and acceptable. Health services can be inaccessible if providers do not acknowledge and respect cultural factors, physical barriers and economic barriers, or if the community is not aware of available services.There are many strategies for successfully improving Indigenous access to urban and regional health services. Individual service providers need to consult with their local community to identify the specific issues relating to their context and selectively adapt the strategies outlined in this report.

Community-associated methicillin-resistant Staphylococcus aureus transmission in households of infected cases : a pooled analysis of primary data from three studies across international settings

Diverse strain types of methicillin-resistant Staphylococcus aureus (MRSA) cause infections in community settings worldwide. To examine heterogeneity of spread within households and to identify common risk factors for household transmission across settings, primary data from studies conducted in New York (USA), Breda (The Netherlands), and Melbourne (Australia) were pooled. Following MRSA infection of the index patient, household members completed questionnaires and provided nasal swabs. Swabs positive for S. aureus were genotyped by spa sequencing. Poisson regression with robust error variance was used to estimate prevalence odds ratios for transmission of the clinical isolate to non-index household members. Great diversity of strain types existed across studies. Despite differences between studies, the index patient being colonized with the clinical isolate at the home visit (P < 0·01) and the percent of household members aged <18 years (P < 0·01) were independently associated with transmission. Targeted decolonization strategies could be used across geographical settings to limit household MRSA transmission.

An RCT to evaluate the utility of a clinical protocol for staff in the management of behavioral and psychological symptoms of dementia in residential aged-care settings

Objectives: Behavioral and psychological symptoms of dementia (BPSD) cause significant stress and distress to both aged-care residents and staff. This study evaluated a training program to assist staff to manage BPSD in residential care. Method: A randomised controlled trial (RCT) was employed. The study was included in the Australian and New Zealand Clinical Trial Register residential care facilities. Staff (n = 204) and residents (n = 187) were from 16 residential care facilities. Facilities were recruited and randomly assigned to four staff training conditions: (1) training in the use of a BPSD-structured clinical protocol, plus external clinical support, (2) a workshop on BPSD, plus external clinical support, (3) training in the use of the structured clinical protocol alone, and (4) care as usual. Staff and resident outcome measures were obtained pre-intervention, three months and six months post-intervention. The primary outcome was changes in BPSD, measured using the Cohen-Mansfield Agitation Inventory (CMAI) as well as frequency and duration of challenging behaviors. Secondary outcomes were changes in staff adjustment. Results: There were improvements in challenging behaviors for both intervention conditions that included training in the BPSD instrument, but these were not maintained in the condition without clinical support. The training/support condition resulted in sustained improvements in both staff and resident variables, whereas the other conditions only led to improvement in some of the measured variables. Conclusion: These results demonstrate the effectiveness of the BPSD protocol in reducing BPSD and improving staff self-efficacy and stress.

Cultural influence on peer relationships in early childhood settings

This paper presents a cultural perspective of young children’s peer relationships. Through reporting on a study of a group of Chinese immigrant children’s learning experiences with peers of the same cultural backgrounds in English dominant early childhood contexts, it reveals that the sharing of a similar cultural heritage may play an important role in the development of relationships for young children in diverse cultural learning communities. This paper is written from the perspectives of socioculture and culture theory. Central to my argument is the contextual dimension of culture. This dimension provides an explanatory structure for understanding immigrant children’s formation of home-culture oriented peer togetherness and peer culture within the paradigm of English dominant spheres. My position is to recognize that the children’s responses to peers are both subject to the influences of their home cultures, and the relationship between different cultures. The notion of cultural relationship is important in this paper, leading to the suggestion that early childhood settings should create an enabling and empowering sociocultural milieu that provides immigrant children with opportunities for intercultural ways of learning and development.