Prospective study of the barriers to nutritional support in a paediatric intensive care unit : P16

Introduction and aim: Children hospitalised in a paediatric intensive care unit (PICU) are mainly fed by nutritional support (NS) which may often be interrupted. The aims of the study were to verify the relationship between prescribed (PEI) and actual energy intake (AEI) and to identify the reasons for NS interruption. Methods: Prospective study in a PICU. PEI and AEI from day 1 to 15, type of NS (enteral, parenteral, mixed), position of the feeding tube, interruptions in NS and reasons for these were noted. Inter - ruptions were classified in categories of barriers and their frequency and duration were analysed. Results: Fifteen children (24 ± 25.2 months) were studied for 84 days. The NS was exclusively enteral (69%) or mixed (31%). PEI were significantly higher than AEI (54.7 ± 32.9 vs 49.2 ± 33.6 kcal/kg, p = 0.0011). AEI represented 93% of the PEI. Ninety-eight interruptions were noted and lasted 189 h, i.e. 9.4% of the evaluated time. The most frequent barriers were nursing procedures, respiratory physiotherapy and unavailability of intravenous access. The longest were caused by the necessity to stop NS for surgery or diagnostic studies, to treat burns or to carry out medical procedures. Conclusion: AEI in PICU were inferior by 7% to PEI, considerably lower than in adult studies. Making these results available to medical staff for greater anticipation and compensation could reduce NS interruptions. Starving protocols should be reconsidered.

Iowa's Barriers to Prenatal Care Project, July 2015

The findings in this summary are based on the Iowa Barriers to Prenatal Care project. Ongoing since 1991, the purpose of this project is to obtain brief, accurate information about women delivering babies in Iowa hospitals. Specifically, the project seeks to learn about women’s experiences getting prenatal or delivery care during their current pregnancy. Other information is included which may be pertinent to health planners or those concerned with the systematic development of health care services. This project is a cooperative venture of all of Iowa’s maternity hospitals, the University of Northern Iowa Center for Social and Behavioral Research, and the Iowa Department of Public Health. The Robert Wood Johnson Foundation funded the first three years of this project. The current funding is provided by the Iowa Department of Public Health. The Director is Dr. Mary Losch, University of Northern Iowa Center for Social and Behavioral Research. The Coordinator for the project is Rodney Muilenburg. The questionnaire is distributed to nearly ninety maternity hospitals across the state of Iowa. Nursing staff or those responsible for obtaining birth certificate information in the obstetrics unit are responsible for approaching all birth mothers prior to dismissal to request their participation in the study. The questionnaire takes approximately ten minutes to complete. Completed questionnaires are returned to the University of Northern Iowa Center for Social and Behavioral Research for data entry and analysis. Returns are made monthly, weekly, or biweekly depending on the number of births per week in a given hospital. Except in the case of a mother who is too ill to complete the questionnaire, all mothers are eligible to be recruited for participation. The present yearly report includes an analysis of large Iowa cities, frequencies by income, and a trend analysis of the last ten years. Also presented in this report is a frequency analysis of all variables included in the 2014 questionnaire. Unless otherwise noted, all entries reflect percentages. Please note that, because percentages were rounded, total values may not equal 100%. Data presented are based upon 2014 questionnaires received to date (n = 24,696). All analyses reflect unweighted percentages of those responding.

Utilization of Knowledge Management in Business Process Modeling and Process Improvements

Tutkimuksen tavoitteena on tutkia telekommunikaatioalalla toimivan kohdeyrityksen ohjelmistojen toimitusprosessia° Tutkimus keskittyy mallintamaan toimitusprosessin, määrittelemään roolit ja vastuualueet, havaitsemaan ongelmakohdat ja ehdottamaan prosessille kehityskohteita. Näitä tavoitteita tarkastellaan teoreettisten prosessimallinnustekniikoiden ja tietojohtamisen SECI-prosessikehyksen läpi. Tärkein tiedonkeruun lähde oli haastatteluihin perustuva tutkimus, johon osallistuvat kaikki kohdeprosessiin kuuluvat yksiköt. Mallinnettu toimitusprosessi antoi kohdeyritykselle paremman käsityksen tarkasteltavasta prosessista ja siinä toimivien yksiköiden rooleistaja vastuualueista. Parannusehdotuksia olivat tiedonjaon kanavoinnin määritteleminen, luottamuksen ja sosiaalisten verkostojen parantaminen, ja tietojohtamisen laajamittainen implementointi.

Business Benefits of Content Management

Hyvällä sisällönhallinnalla on mahdollista vaikuttaa myönteisesti liiketoiminnalliseen tulokseen, jos sisällönhallinnan eri vaikutusmahdollisuudet tunnistetaan. Kun organisaatiossa syntyvä tieto on vapaasti saatavilla, ja sitä voidaan tulkita ja hyödyntää erilaisiin tarpeisiin, tietojärjestelmän avulla voidaan vauhdittaa kehitystä ja uuden tiedon löytämistä. Tiedon keskeisin tehtävä on kehittää ja parantaa organisaation osaamista, jolloin pitää olla tietoa siitä, mitä, miksi ja kuinka tietoa on käytetty organisaatiossa. Kaiken liiketoimintaprosesseissa tuotetun tiedon kohdalla pitäisi miettiä kolmea tiedonhallinnan osa-aluetta: tiedon luontia, hallintaa ja hyödyntämistä. Tavoitteena on saavuttaa yrityksen määrämuotoisen tietopääoman paras mahdollinen hallinta.Työssä kuvataan sitä, mitä sisällönhallinta on, sen eri tasoja, sen käsitteellistä sijoittumista tietämyksenhallintaan, sisällönhallinnan järjestelmiä ja niiden merkitystä liiketoimintaprosesseissa. Lisäksi tarkastellaan niitä syitä, joiden vuoksi yritykset kiinnostuvat organisaatiossa olevan määrämuotoisen tiedon sisällönhallinnasta. Lopuksi analysoidaan, millaisia voivat olla liiketoiminnalliset, kilpailulliset tai rahalliset tavoitteet, joita asetetaan sisällönhallinnan tietojärjestelmäprojektille. Työn tueksi on haastateltu neljän suomalaisen suuryrityksen sisällönhallinnan tietojärjestelmäprojektin asiantuntijoita. Heidän kommenttejaan on analysoitu ja niiden perusteella on tehty johtopäätöksiä niistä syistä, joiden vuoksi yritykset yleensä sijoittavat resurssejaan sisällönhallintaan.

Knowledge Management diskurssina suomalaisissa terveydenhuoltoalan tieteellisissä ja ammatillisissa lehdissä

Abstract: Knowledge Management as a discourse in Finnish scientific and professional journals on the health care field

Perceived Barriers to Physical Activity and Related Factors in Spanish University Students

Objective: The purpose of this study was to identify the influence of readiness of change for physical activity (PA), sociodemographic factors, lifestyle and physical activity status (PAS) on perceived barriers among Spanish university students. Participants: Seven hundred and seventy two (n = 772) men and women ages 17 - 39 at a north-west regional university in Spain participated in the study. Methods: The International Physical Activity Questionnaire, the States of Change for Physical Activity Behaviour Questionnaire and the Self-perceived Barriers for Physical Activity Questionnaire were used. Description, correlation and multiple regression analyses were completed. Results: Participants self-perceived low average-score barriers (2.6 ± 1.4 over 10.0). The 3-higher scores barriers corresponded to “too much work”; “lack of time for exercise” and “laziness”. Gender, PAS and self-perceived health were shown to be associated with perceived barriers. Conclusions: University institutions should consider those factors that predict barriers to PA to develop effective intervention programs.

Internal ambience of bee colonies submitted to strengthening management by adding broods

This study aimed to investigate the ideal brood area to be introduced for strengthening Apis mellifera colonies, considering variations in the hive's internal ambience. Therefore, eight colonies were equipped with data loggers for recording variations in temperature and humidity inside the hives. Then, these colonies were split in four treatments involving the swapping of four, three, two and one brood comb between strong and weak colonies. Growth in the amount of brood and food stores to the four colony strengthening treatments was assessed counting the comb cells to record changes in the brood and food area. The colonies tended to restore their normal thermoregulation within four hours after they had been manipulated and the hive cover had been closed, which quickly increased brood area in the receiving colonies. Results showed that adding up to three brood combs constitute an important alternative for strengthening Apis mellifera colonies because it did not interfere with nest thermoregulation, speeded up population growth in weak colonies and did not affect the development of strong colonies.

Tietojohtamisen esteet organisaatioissa: Case Sanoma Lehtimedia Oy

Tutkimuksen tavoitteena oli selvittää tietoon liittyviä tietojohtamisen esteitä organisaatiossa. Lisäksi selvitettiin, mitä esteitä löytyy organisaatiokulttuurin, johtamisen ja teknologian osalta, mihin tietoprosessiin ja millaiseen tietoon esteet liittyvät. Tutkimuksessa perehdyttiin tietoon, tietojohtamiseen, tietojohtamisen mahdollistajiin ja esteisiin. Tutkimus suoritettiin case-organisaatiossa laadullisena tapaustutkimuksena. Organisaation keskijohdon parissa tehtiin kuusi puolistrukturoitua haastattelua. Aineisto analysoitiin sisällön analyysinä. Suurimmat tietojohtamisen esteet olivat ajan puute ja sisäisen tiedon löytämisen, varastoinnin ja jakamisen puute. Eniten tietojohtamisen esteitä löytyi organisaatiokulttuurista. Esteitä löytyi kaikista tietoprosesseista, kun taas aiemmissa tutkimuksissa ne liittyivät pääosin tiedon jakamiseen. Tiedon löytämisen helpottaminen, kuten tietohakemistojen luominen ja intranetin ”siivoaminen”, tehostaisi työtä. Tärkeän tiedon kartoittaminen, varastointi, tiedon jakaminen sekä ilmapiirin avoimuus voisivat auttaa organisaatiota kohti tehokkaampaa tiedon liikkumista ja asiakaspalvelua.

An in-depth analysis of real and perceived barriers to speech and language program participation for children with speech and language delays : a question of barriers to service?

The current study investigated the effects that barriers (both real and perceived) had on participation and completion of speech and language programs for preschool children with communication delays. I compared 36 families of preschool children with an identified communication delay that have completed services (completers) to 13 families that have not completed services (non-completers) prescribed by Speech and Language professionals. Data findings reported were drawn from an interview with the mother, a speech and language assessment of the child, and an extensive package of measures completed by the mother. Children ranged in age from 32 to 71 mos. These data were collected as part of a project funded by the Canadian Language and Literacy Research Networks of Centres of Excellence. Findings suggest that completers and non-completers shared commonalities in a number of parenting characteristics but differed significantly in two areas. Mothers in the noncompleting group were more permissive and had lower maternal education than mothers in the completing families. From a systemic standpoint, families also differed in the number of perceived barriers to treatment experienced during their time with Speech Services Niagara. Mothers in the non-completing group experienced more perceived barriers to treatment than completing mothers. Specifically, these mothers perceived more stressors and obstacles that competed with treatment, perceived more treatment demands and they perceived the relevance of treatment as less important than the completing group. Despite this, the findings suggest that non-completing families were 100% satisfied with services. Contrary to predictions, there were no significant differences in child characterisfics and economic characteristics between completers and non-completers. The findings in this study are considered exploratory and tentative due to the small sample size.