Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care

ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.

Model Configuration And Data Management In The Short-Term Water Information Forecasting Tools

The Short-term Water Information and Forecasting Tools (SWIFT) is a suite of tools for flood and short-term streamflow forecasting, consisting of a collection of hydrologic model components and utilities. Catchments are modeled using conceptual subareas and a node-link structure for channel routing. The tools comprise modules for calibration, model state updating, output error correction, ensemble runs and data assimilation. Given the combinatorial nature of the modelling experiments and the sub-daily time steps typically used for simulations, the volume of model configurations and time series data is substantial and its management is not trivial. SWIFT is currently used mostly for research purposes but has also been used operationally, with intersecting but significantly different requirements. Early versions of SWIFT used mostly ad-hoc text files handled via Fortran code, with limited use of netCDF for time series data. The configuration and data handling modules have since been redesigned. The model configuration now follows a design where the data model is decoupled from the on-disk persistence mechanism. For research purposes the preferred on-disk format is JSON, to leverage numerous software libraries in a variety of languages, while retaining the legacy option of custom tab-separated text formats when it is a preferred access arrangement for the researcher. By decoupling data model and data persistence, it is much easier to interchangeably use for instance relational databases to provide stricter provenance and audit trail capabilities in an operational flood forecasting context. For the time series data, given the volume and required throughput, text based formats are usually inadequate. A schema derived from CF conventions has been designed to efficiently handle time series for SWIFT.

Stage level measurement of information and communication technology in organizations

Na moderna Economia do Conhecimento, na Era do Big Data, entender corretamente o uso e a gestão da Tecnologia de Informação e Comunicação (TIC) tendo como base o campo acadêmico de estudos de Sistemas de Informação (SI), torna-se cada vez mais relevante e estratégico para as organizações que pretendem: permanecer em atividade, estar aptas para atender novas demandas (internas e externas) e enfrentar as complexas mudanças na competição de mercado. Esta pesquisa utiliza a teoria dos estágios de crescimento, fundamentada pelos estudos de Richard L. Nolan nos anos 70. A literatura acadêmica relacionada com modelos de estágios de crescimento e o contexto do campo de estudo de SI, fornecem as bases conceituais deste estudo. A pesquisa identifica um modelo com seus construtos relacionados aos estágios de crescimento das iniciativas da TIC/SI organizacional, partindo das variáveis de benchmark de segundo nível de Nolan, e propõe sua operacionalização com a criação e desenvolvimento de uma escala. De caráter exploratório e descritivo, a pesquisa traz contribuição teórica ao paradigma da teoria dos estágios de crescimento, adicionando um novo processo de crescimento em sua estrutura conceitual. Como resultado, é disponibilizado além de um instrumento de escala bilíngue (português e inglês), recomendações e regras para aplicação de um instrumento de pesquisa do tipo survey, na continuidade deste estudo. Como implicação geral desta pesquisa, é esperado que seu uso e aplicação ao mensurar a avaliação do nível de estágio da TIC/SI em organizações, possam auxiliar dois perfis de indivíduos: acadêmicos que estudam essa temática, assim como, profissionais que buscam respostas de suas ações práticas nas organizações onde trabalham.

Does absorptive capacity affect project performance? A study based on project management practices, organization learning, and knowledge

The literature has emphasized that absorptive capacity (AC) leads to performance, but in projects its influences still unclear. Additionally, the project success is not well understood by the literature, and AC can be an important mechanism to explain it. Therefore, the purpose of this study is to investigate the effect of absorptive capacity on project performance in the construction industry of São Paulo State. We study this influence through potential and realized absorptive capacity proposed by Zahra and George (2002). For achieving this goal, we use a combination of qualitative and quantitative research. The qualitative research is based on 15 interviews with project managers in different sectors to understand the main constructs and support the next quantitative phase. The content analysis was the technique used to analyze those interviews. In quantitative phase through a survey questionnaire, we collected 157 responses in the construction sector with project managers. The confirmatory factor analysis and hierarchical linear regression were the techniques used to assess the data. Our findings suggest that the realized absorptive capacity has a positive influence on performance, but potential absorptive capacity and the interactions effect have no influence on performance. Moreover, the planning and monitoring have a positive impact on budget and schedule, and customer satisfaction while risk coping capacity has a positive impact on business success. In academics terms, this research enables a better understanding of the importance of absorptive capacity in the construction industry and it confirms that knowledge application in processes and routines enhances performance. For management, the absorptive capacity enables the improvements of internal capabilities reflected in the increased project management efficiency. Indeed, when a company manages project practices efficiently it enhances business and project performance; however, it needs initially to improve its internal abilities to enrich processes and routines through relevant knowledge.

The Approach To The Administrative Mapping In Knowledge Management For Portugal Libraries

In the study of theoretical trends in Administration, the management of information follows the development of theories of Administration; constant-adaptations are suffered. Information Science as Museums, Archives and Libraries, understands and concerns itself with the changes wrought in these endeavour of the knowledge society as new forms of communication and integration. They interact in ways such as to maximize access to information and facilitate improvement on their structural environment. The research aims at identifies the requirements and specifications of an information system for knowledge management in the public's library enviromnent and proposes to achieve a pre-defined structure for the implementation of administration management. The research is conducted with public's library of the metropolian region of the North's Portugal. In the improvement of systems theoretical administrative trends become management decisions and result in the ultimate success of the organization.

The Brazilian Seismographic Integrated Systems (BRASIS): Infrastructure and data management

In geophysics and seismology, raw data need to be processed to generate useful information that can be turned into knowledge by researchers. The number of sensors that are acquiring raw data is increasing rapidly. Without good data management systems, more time can be spent in querying and preparing datasets for analyses than in acquiring raw data. Also, a lot of good quality data acquired at great effort can be lost forever if they are not correctly stored. Local and international cooperation will probably be reduced, and a lot of data will never become scientific knowledge. For this reason, the Seismological Laboratory of the Institute of Astronomy, Geophysics and Atmospheric Sciences at the University of São Paulo (IAG-USP) has concentrated fully on its data management system. This report describes the efforts of the IAG-USP to set up a seismology data management system to facilitate local and international cooperation. © 2011 by the Istituto Nazionale di Geofisica e Vulcanologia. All rights reserved.

Report of the information specialists expert meeting and context management workshop

Includes bibliography

Information and communication technologies for disaster risk management in the Caribbean

Includes bibliography.

Information and communication technology for disaster risk management in the Caribbean: subregional solutions to the challenge of limited human resource capacity

This document was adapted from a paper originally presented to the 8th Annual Caribbean Conference of Comprehensive Disaster Management, held in Montego Bay, Jamaica in December, 2013. It summarizes several activities that ECLAC has undertaken to assess the current state of information and communications technology (ICT) in the field of disaster risk management (DRM) as practiced in the Caribbean. These activities included an in-depth study that encompassed a survey of disaster management organizations in the region, an Expert Group Meeting attended by the heads of several national disaster offices, and a training workshop for professionals working in DRM in the Caribbean. One of the notable conclusions of ECLAC’s investigation on this topic is that the lack of human capacity is the single largest constraint that is faced in the implementation of ICT projects for DRM in the Caribbean. In considering strategies to address the challenge of limited human capacity at a regional level, two separate issues are recognized – the need to increase the ICT capabilities of disaster management professionals, and the need to make ICT specialists available to disaster management organizations to advise and assist in the implementation of technology-focused projects. To that end, two models are proposed to engage with this issue at a regional level. The first entails the establishment of a network of ICT trainers in the Caribbean to help DRM staff develop a strategic understanding of how technology can be used to further their organizational goals. The second is the development of “Centres of Excellence” for ICT in the Caribbean, which would enable the deployment of specialized ICT expertise to national disaster management offices on a project-by-project basis.

Working Experience and Librarians' Knowledge of Information and Communication Technologies (ICTs) in Nigerian University Libraries

This paper discuses the influence of librarians' years of working experience and sources of acquisition of ICTs' knowledge and skills. The study is based on 169 librarians working in thirteen university libraries in the universities of six states located in the South-South zone of Nigeria. The purpose of the paper is to find out if years of working experience has an effect on librarians' sources/means of acquisition of ICT knowledge and skills. The questionnaires used were answered by two categories of librarians. Those with longer years of experience – 16 years and above and those with fewer years of working experience. It was concluded that librarians with fewer years of working experience explore means of acquiring ICTs knowledge and skills more than librarians with more years of working experience. It was recommended that librarians with longer years of working experience develop more interest in sources through which they can acquire ICT knowledge and skills.

Monitoring and Assessment of Desertification and Land Degradation: Knowledge Management, Institutions and Economics: White Paper of the DSD Working Group 3

The White Paper is a review of leading scientific knowledge on the role of knowledge management, institutions and economics in monitoring and assessment of land degradation and desertification. It provides key recommendations for more effective policies and actions for combating desertification both withn the UNCCD and beyond. This White Paper is the result of an international collaboration and consultation led jointly by the Association of DesertNet International and the United Nations University - Institute for Water, Environment and Health (UNU-INWEH), of the Dryland Science for Development Consortium (DSD). The findings were presented at the First UNCCD Scientific Conference held during the COP-9 in Buenos Aires, 2009.

Knowledge Management and Decision Support for Sustainable Land Management

Much research has focused on desertification and land degradation assessments without putting sufficient emphasis on prevention and mitigation, although the concept of sustainable land management (SLM) is increasingly being acknowledged. A variety of SLM measures have already been applied at the local level, but they are rarely adequately recognised, evaluated, shared or used for decision support. WOCAT (World Overview of Technologies and Approaches) has developed an internationally recognised, standardised methodology to document and evaluate SLM technologies and approaches, including spatial distribution, allowing the sharing of SLM knowledge worldwide. The recent methodological integration into a participatory process allows now analysing and using this knowledge for decision support at the local and national level. The use of the WOCAT tools stimulates evaluation (self-evaluation as well as learning from comparing experiences) within SLM initiatives where all too often there is not only insufficient monitoring but also a lack of critical analysis. The comprehensive questionnaires and database system facilitate to document, evaluate and disseminate local experiences of SLM technologies and their implementation approaches. This evaluation process - in a team of experts and together with land users - greatly enhances understanding of the reasons behind successful (or failed) local practices. It has now been integrated into a new methodology for appraising and selecting SLM options. The methodology combines a local collective learning and decision approach with the use of the evaluated global best practices from WOCAT in a concise three step process: i) identifying land degradation and locally applied solutions in a stakeholder learning workshop; ii) assessing local solutions with the standardised WOCAT tool; iii) jointly selecting promising strategies for implementation with the help of a decision support tool. The methodology has been implemented in various countries and study sites around the world mainly within the FAO LADA (Land Degradation Assessment Project) and the EU-funded DESIRE project. Investments in SLM must be carefully assessed and planned on the basis of properly documented experiences and evaluated impacts and benefits: concerted efforts are needed and sufficient resources must be mobilised to tap the wealth of knowledge and learn from SLM successes.