A Video Analysis of Intra- and Inter-professional Leadership Behaviours Within “The Burns Suite”: Identifying Key Leadership Models

Objective Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. Methods A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. Results All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence “maintaining standards”), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that “distributed leadership” was predominant, whereby leadership was “distributed” or “shared” among team members. The leadership behaviors within TBS also seemed to fall in line with the “direction, alignment, and commitment” ontology. Conclusions Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.

Interprofessional collaboration in nursing homes (interprof): A grounded theory study of general practitioner experiences and strategies to perform nursing home visits

Background: Interprofessionalism, considered as collaboration between medical professionals, has gained prominence over recent decades and evidence for its impact has grown. The steadily increasing number of residents in nursing homes will challenge medical care and the interaction across professions, especially nurses and general practitioners (GPS). The nursing home visit, a key element of medical care, has been underrepresented in research. This study explores GP perspectives on interprofessional collaboration with a focus on their visits to nursing homes in order to understand their experiences and expectations. This research represents an aspect of the interprof study, which explores medical care needs as well as the perceived collaboration and communication by nursing home residents, their families, GPS and nurses. This paper focusses on GPS' views, investigating in particular their visits to nursing homes in order to understand their experiences. Methods: Open guideline-interviews covering interprofessional collaboration and the visit process were conducted with 30 GPS in three study centers and analyzed with grounded theory methodology. GPS were recruited via postal request and existing networks of the research partners. Results: Four different types of nursing home visits were found: visits on demand, periodical visits, nursing home rounds and ad-hoc-decision based visits. We identified the core category "productive performance" of home visits in nursing homes which stands for the balance of GPŚ individual efforts and rewards. GPS used different strategies to perform a productive home visit: preparing strategies, on-site strategies and investing strategies. Conclusion: We compiled a theory of GPS home visits in nursing homes in Germany. The findings will be useful for research, and scientific and management purposes to generate a deeper understanding of GP perspectives and thereby improve interprofessional collaboration to ensure a high quality of care.

Key factors affecting purchase intention in Russian online context

Russian e-commerce has drawn a lot of attention in academic publications as well as in public media lately. The market is growing with a speed of rocket offering companies enormous business opportunities. However, combination of Russian culture, consumer online purchasing and decision-making process forms a subject yet completely unknown. From international online business perspective it is vital for companies to know how a culture affects consumer’s purchase decision and what are the key elements that need to be modified in order to successfully expand online operations to Russian market. Here, the main purpose is to define the key factors affecting Russian consumer’s online purchase intention. In order to answer the main research question, firstly the role of culture in purchase intention context is researched. Secondly, focus is drawn to the factors that affect online purchase intention. Lastly, it is researched how Russian culture is affecting e-commerce attributes modification. The objective is not only to expand the theoretical understanding of the subject but also to provide companies with a clear vision on how the online operations should be conducted in Russian online market. Ranganathan’s and Jha’s conceptual framework was chosen as a ground theory in this study. Here, three main categories Computer Self-Efficacy and Past Online Experience, Website Quality and Costumer Concerns form basis for the study. Various articles and academic literature supplemented this theoretical approach. Qualitative research method was adapted and the study was conducted through five expert interviews. As a conclusion it can be stated that culture forms a ground for entire purchase decision-making process in online context. Results from the interviews were grouped according to main three theoretic categories and placed with Ranganathan’s and Jha’s original framework. This formed a new theoretical framework that defines diverse factors affecting specifically Russian consumer’s online purchase intention. This study suggests that following factors need to be taking into serious consideration in Russian online context: photography style, detailed product and company information, colors, language, product variety, reviews, recommendations, strong social media presence, fast check out and minimalistic order information, counterfeit fear, cash on delivery payment, training and guidance, extensive customer service, consumers’ insecurity, inexperience, high interest for technology and their individualistic personality.

'Danger Theory: The Link between AIS and IDS?'

Abstract We present ideas about creating a next generation Intrusion Detection System (IDS) based on the latest immunological theories. The central challenge with computer security is determining the difference between normal and potentially harmful activity. For half a century, developers have protected their systems by coding rules that identify and block specific events. However, the nature of current and future threats in conjunction with ever larger IT systems urgently requires the development of automated and adaptive defensive tools. A promising solution is emerging in the form of Artificial Immune Systems (AIS): The Human Immune System (HIS) can detect and defend against harmful and previously unseen invaders, so can we not build a similar Intrusion Detection System (IDS) for our computers? Presumably, those systems would then have the same beneficial properties as HIS like error tolerance, adaptation and self-monitoring. Current AIS have been successful on test systems, but the algorithms rely on self-nonself discrimination, as stipulated in classical immunology. However, immunologist are increasingly finding fault with traditional self-nonself thinking and a new 'Danger Theory' (DT) is emerging. This new theory suggests that the immune system reacts to threats based on the correlation of various (danger) signals and it provides a method of 'grounding' the immune response, i.e. linking it directly to the attacker. Little is currently understood of the precise nature and correlation of these signals and the theory is a topic of hot debate. It is the aim of this research to investigate this correlation and to translate the DT into the realms of computer security, thereby creating AIS that are no longer limited by self-nonself discrimination. It should be noted that we do not intend to defend this controversial theory per se, although as a deliverable this project will add to the body of knowledge in this area. Rather we are interested in its merits for scaling up AIS applications by overcoming self-nonself discrimination problems.

Jung and Goddess: the significance of Jungian and post-Jungian theory to the development of the Western Goddess Movement

This study is concerned with the significance of Jungian and post-Jungian theory to the development of the contemporary Western Goddess Movement, which includes the various self-identified nature-based, Pagan, Goddess Feminism, Goddess Consciousness, Goddess Spirituality, Wicca, and Goddess-centred faith traditions that have seen a combined increase in Western adherents over the past five decades and share a common goal to claim Goddess as an active part of Western consciousness and faith traditions. The Western Goddess Movement has been strongly influenced by Jung’s thought, and by feminist revisions of Jungian Theory, sometimes interpreted idiosyncratically, but presented as a route to personal and spiritual transformation. The analysis examines ways in which women encounter Goddess through a process of Jungian Individuation and traces the development of Jungian and post-Jungian theories by identifying the key thinkers and central ideas that helped to shape the development of the Western Goddess Movement. It does so through a close reading and analysis of five biographical ‘rebirth’ memoirs published between 1981 and 1998: Christine Downing’s (1981) The Goddess: Mythological Images of the Feminine; Jean Shinoda Bolen’s (1994) Crossing to Avalon: A Woman’s Midlife Pilgrimage; Sue Monk Kidd’s (1996) The Dance of the Dissident Daughter: A Woman’s Journey from Christian Tradition to the Sacred Feminine; Margaret Starbird’s (1998) The Goddess in the Gospels: Reclaiming the Sacred Feminine; and Phyllis Curott’s (1998) Book of Shadows: A Modern Woman’s Journey into the Wisdom of Witchcraft and the Magic of the Goddess. These five memoirs reflect the diversity of the faith traditions in the Western Goddess Movement. The enquiry centres upon two parallel and complementary research threads: 1) critically examining the content of the memoirs in order to determine their contribution to the development of the Goddess Movement and 2) charting and sourcing the development of the major Jungian and post-Jungian theories championed in the memoirs in order to evaluate the significance of Jungian and post-Jungian thought in the Movement. The aim of this study was to gain a better understanding of the original research question: what is the significance of Jungian and post-Jungian theory for the development of the Western Goddess Movement? Each memoir is subjected to critical review of its intended audiences, its achievements, its functions and strengths, and its theoretical frameworks. Research results offered more than the experiences of five Western women, it also provided evidence to analyse the significance of Jungian and post-Jungian theory to the development of the Western Goddess Movement. The findings demonstrate the vital contributions of the analytical psychology of Carl Jung, and post-Jungians M Esther Harding, Erich Neumann, Christine Downing, E.C. Whitmont, and Jean Shinoda Bolen; the additional contributions of Sue Monk Kidd, Margaret Starbird, and Phyllis Curott, and exhibit Jungian and post-Jungian pathways to Goddess. Through a variety of approaches to Jungian categories, these memoirs constitute a literature of Individuation for the Western Goddess Movement.

'Danger Theory: The Link between AIS and IDS?'

Abstract We present ideas about creating a next generation Intrusion Detection System (IDS) based on the latest immunological theories. The central challenge with computer security is determining the difference between normal and potentially harmful activity. For half a century, developers have protected their systems by coding rules that identify and block specific events. However, the nature of current and future threats in conjunction with ever larger IT systems urgently requires the development of automated and adaptive defensive tools. A promising solution is emerging in the form of Artificial Immune Systems (AIS): The Human Immune System (HIS) can detect and defend against harmful and previously unseen invaders, so can we not build a similar Intrusion Detection System (IDS) for our computers? Presumably, those systems would then have the same beneficial properties as HIS like error tolerance, adaptation and self-monitoring. Current AIS have been successful on test systems, but the algorithms rely on self-nonself discrimination, as stipulated in classical immunology. However, immunologist are increasingly finding fault with traditional self-nonself thinking and a new 'Danger Theory' (DT) is emerging. This new theory suggests that the immune system reacts to threats based on the correlation of various (danger) signals and it provides a method of 'grounding' the immune response, i.e. linking it directly to the attacker. Little is currently understood of the precise nature and correlation of these signals and the theory is a topic of hot debate. It is the aim of this research to investigate this correlation and to translate the DT into the realms of computer security, thereby creating AIS that are no longer limited by self-nonself discrimination. It should be noted that we do not intend to defend this controversial theory per se, although as a deliverable this project will add to the body of knowledge in this area. Rather we are interested in its merits for scaling up AIS applications by overcoming self-nonself discrimination problems.

Danger theory: the link between AIS and IDS?

We present ideas about creating a next generation Intrusion Detection System (IDS) based on the latest immunological theories. The central challenge with computer security is determining the difference between normal and potentially harmful activity. For half a century, developers have protected their systems by coding rules that identify and block specific events. However, the nature of current and future threats in conjunction with ever larger IT systems urgently requires the development of automated and adaptive defensive tools. A promising solution is emerging in the form of Artificial Immune Systems (AIS): The Human Immune System (HIS) can detect and defend against harmful and previously unseen invaders, so can we not build a similar Intrusion Detection System (IDS) for our computers? Presumably, those systems would then have the same beneficial properties as HIS like error tolerance, adaptation and self-monitoring. Current AIS have been successful on test systems, but the algorithms rely on self-nonself discrimination, as stipulated in classical immunology. However, immunologist are increasingly finding fault with traditional self-nonself thinking and a new ‘Danger Theory’ (DT) is emerging. This new theory suggests that the immune system reacts to threats based on the correlation of various (danger) signals and it provides a method of ‘grounding’ the immune response, i.e. linking it directly to the attacker. Little is currently understood of the precise nature and correlation of these signals and the theory is a topic of hot debate. It is the aim of this research to investigate this correlation and to translate the DT into the realms of computer security, thereby creating AIS that are no longer limited by self-nonself discrimination. It should be noted that we do not intend to defend this controversial theory per se, although as a deliverable this project will add to the body of knowledge in this area. Rather we are interested in its merits for scaling up AIS applications by overcoming self-nonself discrimination problems.

Current knowledge on the role of the inferior frontal gyrus in Theory of Mind - a commentary on Schurz and Tholen (2016)

Schurz and Tholen (2016) argue that common approaches to studying the neural basis of “theory of mind” (ToM) obscure a potentially important role for inferior frontal gyrus (IFG) in managing conflict between perspectives, and urge new work to address this question: “to gain a full understanding of the IFG's role in ToM, we encourage future imaging studies to use a wider range of control conditions.” (p332). We wholeheartedly agree, but note that this observation has been made before, and has already led to a programme of work that provides evidence from fMRI, EEG, and TMS on the role of IFG in managing conflict between self and other perspectives in ToM. We highlight these works, and in particular we demonstrate how careful manipulation within ToM tasks has been used to act as an internal control condition, wherein conflict has been manipulated within-subject. We further add to the discussion by framing key questions that remain regarding IFG in the context of these. Using limitations in the existing research, we outline how best researchers can proceed with the challenge set by Schurz and Tholen (2016).

Heaven's Sense: a novel / At hand-grips with ruin: the psychology of writer's block

There is a significant attitude of scepticism when it comes to belief in the existence of writer's block as a valid psychological phenomenon, alongside what might be described as the "Tortured Artist Personality". It is contended here that both writer's block and the "Tortured Artist Personality" do exist in a minority of professional and aspiring fiction writers, and furthermore that these phenomena are forms of personality behaviour that have already been well-catalogued by the academic fields of psychiatry, psychology and psychotherapy: specifically, writer's block is a form of unconscious maladaptive procrastination - expressed through avoidance coping or escape coping behaviour - which in turn arises from the fully-accepted personality trait of perfectionism. Aspects of perfectionism, together with various sub-scale traits and mediators, are also the key components in at least one form of "Tortured Artist Personality". This paper lays out the extensive evidence for these assertions, using existing research in the fields of psychology, psychiatry, psychotherapy and neuroscience.

Multicultural work environment as a key in cross-cultural negotiations and organizations’ performance: Canada overview

Es necesario que los gerentes sean líderes y establezcan relaciones sólidas con los empleados, para luego establecer las mismas con socios potenciales. Para lograr este objetivo, Con el fin de cumplir este objetivo, el uso de estrategias y técnicas de negociación es crucial, así como la importancia de la conciencia cultural y de la diversidad. La globalización no sólo ha movido a los mercados sino también a las personas, la inmigración es un fenómeno fuerte hoy en día y varios países, como Canadá, han sido inclusivos y han apoyado a estos nuevos ciudadanos. Las empresas de Canadá, sin importar la industria, han asumido el reto de integrar una fuerza laboral diversa con el propósito de adquirir nuevos conocimientos y crecer a nivel nacional, pero sobre todo en el ámbito internacional. Igualmente, es esencial tener en cuenta las ventajas y limitaciones del multiculturalismo dentro de la empresa y específicamente en las negociaciones interculturales.

Professional Autonomy. Key Competence for Teachers in Commercial Education

The way in which the teaching autonomy is materialized, considered as part of the path traveled by the teaching community on their way to become owners of the disciplinary knowledge and the required pedagogical competencies to practice their role has motivated this paper.  For success, Commercial Education requires the urgent transformation of the teaching role and the development of key competences to promote interdisciplinary integration, academic and administrative leadership and the use of contemporary pedagogies.  The level of awareness reached by the teaching group about the impact of the learning that is promoted within the educational context will allow the empowerment of the knowledge that comes from the relationship between theory and practice-key element for professional autonomy.

Rethinking the block. The 1970s European discourses on the city and the IBA Berlin 1979-87

The dissertation explores the relationship between projects for urban blocks and the discourses on the city between the late 1960s and the 1980s, with a particular focus on the blocks of the Internationale Bauausstellung (IBA) Berlin 1979-87. The main research questions center on whether and how the block changed in connection with the emerging ideas of the city during this period and whether these changes had, in turn, effects on the whole city. Thus far, despite extensive research on the theories and the ideas of the city between the 1960s and 1980s, there is a lack of studies that interweave this research with insights into the block. To fill this gap, this dissertation examines how the block was thematized in the 1970s discourses on the city. It highlights projects for blocks designed between the late 1960s and the 70s in various European cities, particularly West Berlin. Then, it focuses on the blocks of the IBA Berlin 1979-87, examining them through theory, history, and drawings. The study of the examples reveals three distinctive aspects of all blocks considered in the dissertation: the overcoming of small private plots, the individualization of the buildings, and the accessibility of the courtyards from public streets. These aspects reflect the changing understandings of the city and of the urban spaces in the 1970s and 1980s, which resulted in new compositional logics of the block. When examined with critical distance, the blocks of the 1970s and 80s offer a lesson in architectural and urban composition which is still current. - The author has made every effort to contact the owners of the copyrights of the material in the dissertation. The author is available to the right holders with whom it was not possible to communicate as well as for any omissions or inaccuracies in quoting the sources.

Ikkε Is Key To Induction Of Insulin Resistance In The Hypothalamus, And Its Inhibition Reverses Obesity.

IKK epsilon (IKKε) is induced by the activation of nuclear factor-κB (NF-κB). Whole-body IKKε knockout mice on a high-fat diet (HFD) were protected from insulin resistance and showed altered energy balance. We demonstrate that IKKε is expressed in neurons and is upregulated in the hypothalamus of obese mice, contributing to insulin and leptin resistance. Blocking IKKε in the hypothalamus of obese mice with CAYMAN10576 or small interfering RNA decreased NF-κB activation in this tissue, relieving the inflammatory environment. Inhibition of IKKε activity, but not TBK1, reduced IRS-1(Ser307) phosphorylation and insulin and leptin resistance by an improvement of the IR/IRS-1/Akt and JAK2/STAT3 pathways in the hypothalamus. These improvements were independent of body weight and food intake. Increased insulin and leptin action/signaling in the hypothalamus may contribute to a decrease in adiposity and hypophagia and an enhancement of energy expenditure accompanied by lower NPY and increased POMC mRNA levels. Improvement of hypothalamic insulin action decreases fasting glycemia, glycemia after pyruvate injection, and PEPCK protein expression in the liver of HFD-fed and db/db mice, suggesting a reduction in hepatic glucose production. We suggest that IKKε may be a key inflammatory mediator in the hypothalamus of obese mice, and its hypothalamic inhibition improves energy and glucose metabolism.

[the Teaching Of Social Sciences In Health: Between Practice And Theory].

The models of teaching social sciences and clinical practice are insufficient for the needs of practical-reflective teaching of social sciences applied to health. The scope of this article is to reflect on the challenges and perspectives of social science education for health professionals. In the 1950s the important movement bringing together social sciences and the field of health began, however weak credentials still prevail. This is due to the low professional status of social scientists in health and the ill-defined position of the social sciences professionals in the health field. It is also due to the scant importance attributed by students to the social sciences, the small number of professionals and the colonization of the social sciences by the biomedical culture in the health field. Thus, the professionals of social sciences applied to health are also faced with the need to build an identity, even after six decades of their presence in the field of health. This is because their ambivalent status has established them as a partial, incomplete and virtual presence, requiring a complex survival strategy in the nebulous area between social sciences and health.

Atomic Charge Transfer-counter Polarization Effects Determine Infrared Ch Intensities Of Hydrocarbons: A Quantum Theory Of Atoms In Molecules Model.

Atomic charge transfer-counter polarization effects determine most of the infrared fundamental CH intensities of simple hydrocarbons, methane, ethylene, ethane, propyne, cyclopropane and allene. The quantum theory of atoms in molecules/charge-charge flux-dipole flux model predicted the values of 30 CH intensities ranging from 0 to 123 km mol(-1) with a root mean square (rms) error of only 4.2 km mol(-1) without including a specific equilibrium atomic charge term. Sums of the contributions from terms involving charge flux and/or dipole flux averaged 20.3 km mol(-1), about ten times larger than the average charge contribution of 2.0 km mol(-1). The only notable exceptions are the CH stretching and bending intensities of acetylene and two of the propyne vibrations for hydrogens bound to sp hybridized carbon atoms. Calculations were carried out at four quantum levels, MP2/6-311++G(3d,3p), MP2/cc-pVTZ, QCISD/6-311++G(3d,3p) and QCISD/cc-pVTZ. The results calculated at the QCISD level are the most accurate among the four with root mean square errors of 4.7 and 5.0 km mol(-1) for the 6-311++G(3d,3p) and cc-pVTZ basis sets. These values are close to the estimated aggregate experimental error of the hydrocarbon intensities, 4.0 km mol(-1). The atomic charge transfer-counter polarization effect is much larger than the charge effect for the results of all four quantum levels. Charge transfer-counter polarization effects are expected to also be important in vibrations of more polar molecules for which equilibrium charge contributions can be large.