Developing and Integrating the Management of Elder Abuse in Primary Practice: A Case Study Using A Web-Based CME Course Format

Introduction: As the population in the United States continues to age, more attention in primary practice settings is now devoted toward managing the care of the elderly. The occurrence of elder abuse is a growing problem. It is a condition many professionals in primary care may be ill prepared with the knowledge or resources to identify and manage. [See PDF for complete abstract]

Patient satisfaction and nursing staff work satisfaction in an urban public teaching hospital

This study examined the level of patient satisfaction and nursing staff work satisfaction at an urban public hospital in the Southwestern United States. The primary objectives of this study were to determine: (1) the level of overall patient satisfaction and satisfaction with specific dimensions of hospital care; (2) the differences in patient satisfaction according to demographic characteristics (age, gender, ethnicity, and education completed) and predispositional factors (perceived health status, perceived level of pain, prior contact with the hospital, and hospital image) and the relative importance of each variable on patient satisfaction; (3) the level of overall work satisfaction and satisfaction with specific dimensions of work experienced by the medical/surgical nursing staff; (4) the differences in work satisfaction experienced by the nursing staff based on demographic variables (age, gender, ethnicity, and marital status) and professional factors (education completed, staff position, the number of years employed with the hospital, and number of years employed in nursing) and the relative importance of each variable on work satisfaction; and (5) to determine the effect of the nursing work milieu on patient and staff satisfaction.^ The study findings showed that patients experienced a moderate to low level of satisfaction with the dimensions of hospital care (admission process, daily care, information, nursing care, physician care, other hospital staff, living arrangements, and overall care). Of the eight dimensions of care, patients reported a relatively positive level of satisfaction (75 percent or better) with only one dimension: physician care. Ethnicity, perceived health status, and hospital image were significantly related to patient satisfaction. Hispanic patients, those who were in good health, and those who felt the hospital had a good image in their community were most satisfied with hospital care. Patients also reported areas of hospital care that needed the most improvement. Responses included: rude staff, better nursing care, and better communication.^ Findings from the nursing satisfaction survey indicated a low level of satisfaction with the dimensions of work (autonomy, pay, professional status, interaction, task requirements, and organizational policies). Only one dimension of work, professional status, received a mean satisfaction score in the positive range. Additionally, staff members were unanimously dissatisfied with their salaries. Frequently mentioned work-related problems reported by the staff included: staffing shortages, heavy patient loads. and excessive paperwork.^ The nursing milieu appeared to have had a significant effect on the satisfaction levels of patients nursing staff employees. The nursing staff were often short staffed, which increased the patient-to-nurse ratio. Consequently, patients did not receive the amount of attention and care they expected from the nursing staff. Crowded patient rooms allowed for little personal space and privacy. Dissatisfaction with living conditions served to influence patients' attitudes and satisfaction levels. These frustrations were often directed toward their primary caregivers, the nursing staff. Consequently, the nursing milieu appeared to directly affect and influence the satisfaction levels of both patients and staff. (Abstract shortened by UMI). ^

Learning processes in student teaching: Analyses from a study using learning diaries

The present study seeks to obtain deeper insight into the learning processes in practical training in primary teacher education in Upper Austria. Based on the offer-and-use model of instruction, 230 diary entries of 46 student teachers (28 students in their third semester, 18 students in their fifth semester) were analysed with legard to the learning topics, learning sourcesJ and Ìealning processes involved in practical training. The results show a variety of learning forms, ranging from the unreflective imitation of school mentors' practices to active knowledge construction. In addition, they illustrate that the available learning offers were suboptimally utilized by stuclent teachers who failed to work systernatically and continuously on their professional development.

Primary care at Swiss universities - current state and perspective

Background There is increasing evidence that a strong primary care is a cornerstone of an efficient health care system. But Switzerland is facing a shortage of primary care physicians (PCPs). This pushed the Federal Council of Switzerland to introduce a multifaceted political programme to strengthen the position of primary care, including its academic role. The aim of this paper is to provide a comprehensive overview of the situation of academic primary care at the five Swiss universities by the end of year 2012. Results Although primary care teaching activities have a long tradition at the five Swiss universities with activities starting in the beginning of the 1980ies; the academic institutes of primary care were only established in recent years (2005 – 2009). Only one of them has an established chair. Human and financial resources vary substantially. At all universities a broad variety of courses and lectures are offered, including teaching in private primary care practices with 1331 PCPs involved. Regarding research, differences among the institutes are tremendous, mainly caused by entirely different human resources and skills. Conclusion So far, the activities of the existing institutes at the Swiss Universities are mainly focused on teaching. However, for a complete academic institutionalization as well as an increased acceptance and attractiveness, more research activities are needed. In addition to an adequate basic funding of research positions, competitive research grants have to be created to establish a specialty-specific research culture.

Teaching practice recommendations: prevention and screening

The aim of this article is to provide guidance to family doctors on how to tutor students about effective screening and primary prevention. Family doctors know their patients and adapt national and international guidelines to their specific context, risk profile, sex and age as well as to the prevalence of the disorders under consideration. Three cases are presented to illustrate guideline use according to the level of evidence (for a 19-year-old man, a 60-year-old woman, and an 80-year-old man). A particular strength of family medicine is that doctors see their patients over the years. Thus they can progressively go through the various prevention strategies, screening, counselling and immunisation, accompanying their patients with precious advice for their health throughout their lifetime.

The Swiss National Registry for Primary Immunodeficiencies: report on the first 6 years' activity from 2008 to 2014

The Swiss National Registry for Primary Immunodeficiency Disorders (PID) was established in 2008, constituting a nationwide network of paediatric and adult departments involved in the care of patients with PID at university medical centres, affiliated teaching hospitals and medical institutions. The registry collects anonymized clinical and genetic information on PID patients and is set up within the framework of the European database for PID, run by the European Society of Immunodeficiency Diseases. To date, a total of 348 patients are registered in Switzerland, indicating an estimated minimal prevalence of 4·2 patients per 100 000 inhabitants. Distribution of different PID categories, age and gender are similar to the European cohort of currently 19 091 registered patients: 'predominantly antibody disorders' are the most common diseases observed (n = 217/348, 62%), followed by 'phagocytic disorders' (n = 31/348, 9%). As expected, 'predominantly antibody disorders' are more prevalent in adults than in children (78 versus 31%). Within this category, 'common variable immunodeficiency disorder' (CVID) is the most prevalent PID (n = 98/217, 45%), followed by 'other hypogammaglobulinaemias' (i.e. a group of non-classified hypogammaglobulinaemias) (n = 54/217, 25%). Among 'phagocytic disorders', 'chronic granulomatous disease' is the most prevalent PID (n = 27/31, 87%). The diagnostic delay between onset of symptoms and diagnosis is high, with a median of 6 years for CVID and more than 3 years for 'other hypogammaglobulinaemias'.

Primary school teacher’s noticing of students’ mathematical thinking in problem solving

Professional noticing of students’ mathematical thinking in problem solving involves the identification of noteworthy mathematical ideas of students’ mathematical thinking and its interpretation to make decisions in the teaching of mathematics. The goal of this study is to begin to characterize pre-service primary school teachers’ noticing of students’ mathematical thinking when students solve tasks that involve proportional and non-proportional reasoning. From the analysis of how pre-service primary school teachers notice students’ mathematical thinking, we have identified an initial framework with four levels of development. This framework indicates a possible trajectory in the development of primary teachers’ professional noticing.

Effects of Dialogic Reading in the Improvement of Reading Comprehension in Students of Primary Education

Reading is an essential factor for success at school that requires certain skills and strategies of great complexity rarely taught in schools. Verbalization of comprehension strategies can be considered an effective measure in learning to read. The purpose of this study was to analyze the effect of a program of teaching reading strategies implemented through interactive dialogic reading groups in the learning of reading comprehension. A quasi-experimental comparison with pretest and posttest design between groups was used. A sample of 355 participants aged between 8 and 9 years aged was used. The results weigh the potential value of the program and support the development of teaching models that integrate dialogic reading practices as they facilitate learning of reading comprehension.

The influence of an in-service programme on primary teachers conceptions about practical work

The purpose of this study was to investigate how an in-service programme influenced primary teachers’ conceptions about practical work. Ten elementary teachers participated in a Portuguese city in an one-year professional development programme, which aimed to promote the use of practical activities in classroom. Semi-structured interviews and classroom observations were both used to examine changes in teachers’ conceptions about science teaching and in their classroom pratices. Data also included written artefacts, such as teachers’ written reflections, lesson plans, activity sheets, assessment items and student work samples. Based on the analysis of the data, the changes in teachers’ conceptions were organized into four categories: student and learning, teacher and teaching, science teaching, and teaching context. Throughout their participation in the programme, teachers pointed out several constraints related to planning and implementing practical activities. Results indicate that most teachers were able to overcome their initial difficulties and progressively gained more confidence in using student-centered pratices. However, one year after the end of the programme, teachers reported that their actual practices did not changed significantly, particularly with regard to inquiry-based practical and collaborative activities, which remained absent or rare. Implications for professional development and further research are discussed.

Scaffolding and bilingual shared reading experiences: Promoting primary school students' learning and development

This paper explores the connections between scaffolding, second language learning and bilingual shared reading experiences. A socio- cultural theory of cognition underpins the investigation, which involved implementing a language and culture awareness program (LCAP) in a year 4 classroom and in the school community. Selected passages from observations are used to analyse the learning of three students, particularly in relation to languages other than English (LOTE). As these three case study students interacted in the classroom, at home and in the community, they co-constructed, appropriated and applied knowledge form one language to another. Through scaffolding, social spaces were constructed, where students learning and development were extended through a variety of activities that involved active participation, such as experimenting with language, asking questions and making suggestions. Extending these opportunities for student learning and development is considered in relation to creating teaching and learning environments that celebrate socio-cultural and linguistic diversity.

After hours medical ward duties in a teaching hospital

In many Australian hospitals a medical officer is available for urgent review of in-patients outside normal working hours. Current practice in nurse-initiated requests for medical officer involvement out of hours may adversely affect patient outcome as well as medical and nursing resource use at these times. Of 10 523 nurse-initiated requests for out-of-hours review recorded by medical officers at our hospital in 2002-2003, the most frequent reasons for the requests were medication review, IV fluid orders, IV resite, venesection and pathology review, none of which are related to acute changes in clinical condition. Requests for routine review of medication and fluid orders were found to be rarely essential and often inappropriate. Medical officer activity was highest before midnight and least after midnight, suggesting most requests are fulfilled in the evening. Several strategies to reduce inappropriate out-of-hours requests were identified. Routine tasks could be completed by primary treating unit staff before going off-duty. IV cannulation and venesection may be performed by appropriately trained phlebotomists or skilled advanced practice nursing staff. Meticulous ordering of 'as required' analgesia and night sedation would reduce unnecessary requests. Clinical protocols for nurse-initiated adjustment of drugs with variable dosing may also decrease inefficiencies. This would leave the ward cover medical officers more available for their primary function of urgent patient review.

Need for systematic synthetic phonics teaching within the early reading curriculum

Both the New Zealand Ministry of Education's Literacy Experts Group and the Australian National Inquiry into the Teaching of Literacy have recently acknowledged the centrality of systematic instruction in synthetic phonics to early reading instruction, but this conclusion remains contentious in some circles. This paper briefly summarises empirical research in basic psychology and evidence-based evaluation studies supporting the inclusion of systematic synthetic phonics instruction within the early reading curriculum, allowing practising psychologists to develop an informed opinion on this issue.