A randomized control trial of nursing-based case management for patients with chronic obstructive pulmonary disease

This study assessed the impact of a randomized trial of nursing-based case management for patients with chronic obstructive pulmonary disease, their caregivers, and nursing and medical staff. Sixty-six patients were matched by FEV1 on admission to hospital, and randomized into an intervention or control group. Intervention group patients reported significantly less anxiety at 1 month postdischarge; however, this effect was not sustained. There was little difference between groups in terms of unplanned readmissions, depression, symptoms, support, and subjective well being. Interviews with patients and caregivers found that the case management improved access to resources and staff-patient communication. Interviews with nursing and medical staff found that case management improved communication between staff and enhanced patient care.

Does primary medical practitioner involvement with a specialist team improve patient outcomes? A systematic review.

Patients with chronic or complex medical or psychiatric conditions are treated by many practitioners, including general practitioners (GPs). Formal liaison between primary and specialist is often assumed to offer benefits to patients The aim of this study was to assess the efficacy of formal liaison of GPs with specialist service providers on patient health outcomes, by conducting a systematic review of the published literature in MEDLINE, EMBASE, PsychINFO, CINAHL and Cochrane Library databases using the following search terms family physicians': synonyms of 'patient care planning', 'patient discharge' and 'patient care team'; and synonyms of 'randomised controlled trials'. Seven studies were identified, involving 963 subjects and 899 controls. most health outcomes were unchanged, although some physical and functional health outcomes were improved by formal liaison between GPs and specialist services, particularly among chronic mental illness patients. Some health outcomes worsened during the intervention. Patient retention rates within treatment programmes improved with GP involvement, as did patient satisfaction. Doctor (GP and specialist) behaviour changed, with reports of more rational use of resources and diagnostic tests, improved clinical skills, more frequent use of appropriate treatment strategies, and more frequent clinical behaviours designed to detect disease complications Cost effectiveness could not be determined. In conclusion, formal liaison between GPs and specialist services leaves most physical health outcomes unchanged, but improves functional outcomes in chronically mentally ill patients. It may confer modest long-term health benefits through improvements in patient concordance with treatment programmes and more effective clinical practice.

Sport-specific practice and the development of expert decision-making in team ball sports

The role of sport-specific practice in the development of decision-making expertise in the sports of field hockey, netball, and basketball was examined. Fifteen expert decision-makers and 13 experienced non-expert athletes provided detailed information about the quantity and type of sport-specific and other related practice activities they had undertaken throughout their careers. Experts accumulated more hours of sport-specific practice from age 12 years onwards than did non-experts, spending on average some 13 years and 4,000 hours on concentrated sport-specific practice before reaching international standard. A significant negative correlation existed between the number of additional activities undertaken and the hours of sportspecific training required before attaining expertise, suggesting a functional role for activities other than sport-specific training in the development of expert decision-making.

Characterization and Evaluation of young ring hockey team

Ring hockey is a complex team sport with physical tecnical and tactical high demans (Manaças, 1988; Rodriguez, 1991). In teh absence of a battery of specific tests we proceed to the aplication of the 20 meters shuttle run test (Luc Leger, 1982) in youthfuk athletes of the juveniles.

Evaluation of a program to reduce back pain in nursing personnel

OBJECTIVE: To evaluate the effectiveness of a program designed to reduce back pain in nursing aides. METHODS: Female nursing aides from a university hospital who had suffered episodes of back pain for at least six months were included in the study. Participants were randomly divided into a control group and an intervention group. The intervention program involved a set of exercises and an educational component stressing the ergonomic aspect, administered twice a week during working hours for four months. All subjects answered a structured questionnaire and the intensity of pain was assessed before and after the program using a visual analogue scale (VAS). Student's t-test or the Wilcoxon Rank Sum Test for independent samples, and Chi-square test or the Exact Fisher test for categorical analysis, were used. The McNemar test and the Wilcoxon matched pairs test were used to compare the periods before and after the program. RESULTS: There was a statistically significant decrease in the frequency of cervical pain in the last two months and in the last seven days in the intervention group. There was also a reduction in cervical pain intensity in the two periods (2 months, 7 days) and lumbar pain intensity in the last 7 days. CONCLUSIONS: The results suggest that a program of regular exercise with an emphasis on ergonomics can reduce musculoskeletal symptoms in nursing personnel.

Cooperation mechanism for team-work based multi-agent system in dynamic scheduling through meta-heuristics

This paper describes a Multi-agent Scheduling System that assumes the existence of several Machines Agents (which are decision-making entities) distributed inside the Manufacturing System that interact and cooperate with other agents in order to obtain optimal or near-optimal global performances. Agents have to manage their internal behaviors and their relationships with other agents via cooperative negotiation in accordance with business policies defined by the user manager. Some Multi Agent Systems (MAS) organizational aspects are considered. An original Cooperation Mechanism for a Team-work based Architecture is proposed to address dynamic scheduling using Meta-Heuristics.

Measuring spatial interaction behavior in team sports using superimposed Voronoi diagrams

In team sports, the spatial distribution of players on the field is determined by the interaction behavior established at both player and team levels. The distribution patterns observed during a game emerge from specific technical and tactical methods adopted by the teams, and from individual, environmental and task constraints that influence players' behaviour. By understanding how specific patterns of spatial interaction are formed, one can characterize the behavior of the respective teams and players. Thus, in the present work we suggest a novel spatial method for describing teams' spatial interaction behaviour, which results from superimposing the Voronoi diagrams of two competing teams. We considered theoretical patterns of spatial distribution in a well-defined scenario (5 vs 4+ GK played in a field of 20x20m) in order to generate reference values of the variables derived from the superimposed Voronoi diagrams (SVD). These variables were tested in a formal application to empirical data collected from 19 Futsal trials with identical playing settings. Results suggest that it is possible to identify a number of characteristics that can be used to describe players' spatial behavior at different levels, namely the defensive methods adopted by the players.

Spatial segregation of calving and nursing Risso's dolphins (Grampus griseus), and its conservation implications

"Conhecer o Mar dos Açores III - Fórum científico de apoio à decisão". Biblioteca Pública e Arquivo Regional João José da Graça, Horta, Faial, Açores, 19-20 de setembro de 2013.

Health-related quality of life and working conditions among nursing providers

OBJECTIVE: To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS: Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and health symptoms were collected using self-administered questionnaires. The following questionnaires were also used: Job Stress Scale, Effort-Reward Imbalance (ERI) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Ordinal logistic regression analysis using proportional odds model was performed to evaluate each dimension of the SF-36. RESULTS: Around 22% of the sample was found to be have high strain and 8% showed an effort-reward imbalance at work. The dimensions with the lowest mean scores in the SF-36 were vitality, bodily pain and mental health. High-strain job, effort-reward imbalance (ERI>1.01), and being a registered nurse were independently associated with low scores on the role emotional dimension. Those dimensions associated to mental health were the ones most affected by psychosocial factors at work. CONCLUSIONS: Effort-reward imbalance was more associated with health than high-strain (high demand and low control). The study results suggest that the joint analysis of psychosocial factors at work such as effort-reward imbalance and demand-control can provide more insight to the discussion of professional roles, working conditions and HRQL of nursing providers.

Effects of team task structure on team climate for innovation and team outcomes

In this cross-sectional study we analyzed, whether team climate for innovation mediates the relationship between team task structure and innovative behavior, job satisfaction, affective organizational commitment, and work stress. 310 employees in 20 work teams of an automotive company participated in this study. 10 teams had been changed from a restrictive to a more self-regulating team model by providing task variety, autonomy, team-specific goals, and feedback in order to increase team effectiveness. Data support the supposed causal chain, although only with respect to team innovative behavior all required effects were statistically significant. Longitudinal designs and larger samples are needed to prove the assumed causal relationships, but results indicate that implementing self-regulating teams might be an effective strategy for improving innovative behavior and thus team and company effectiveness.

Management Structure and Work Team Processes; Responsibilities and Responsiveness

This paper explores the management structure of the team-based organization. First it provides a theoretical model of structures and processes of work teams. The structure determines the team’s responsibilities in terms of authority and expertise about specific regulation tasks. The responsiveness of teams to these responsibilities are the processes of teamwork, in terms of three dimensions, indicating to what extent teams indeed use the space provided to them. The research question that this paper addresses is to what extent the position of responsibilities in the team-based organization affect team responsiveness. This is done by two hypotheses. First, the effect of the so-called proximity of regulation tasks is tested. It is expected that the responsibility for tasks positioned higher in the organization (i.e. further from the team) generally has a negative effect on team responsiveness, whereas tasks positioned lower in the organization (i.e. closer to the team) will have a positive effect on the way in which teams respond. Second, the relationship between the number of tasks for which the team is responsible with team responsiveness is tested. Theory suggests that teams being responsible for a larger number of tasks perform better, i.e. show higher responsiveness. These hypotheses are tested by a study of 109 production teams in the automotive industry. The results show that, as the theory predicts, increasing numbers of responsibilities have positive effects on team responsiveness. However, the delegation of expertise to teams seems to be the most important predictor of responsiveness. Also, not all regulation tasks show to have effects on team responsiveness. Most tasks do not show to have any significant effect at all. A number of tasks affects team responsiveness positively, when their responsibility is positioned lower in the organization, but also a number of tasks affects team responsiveness positively when located higher in the organization, i.e. further from the teams in the production. The results indicate that more attention can be paid to the distribution of responsibilities, in particular expertise, to teams. Indeed delegating more expertise improve team responsiveness, however some tasks might be located better at higher organizational levels, indicating that there are limitations to what responsibilities teams can handle.