Self-reported teamwork in family health team practices in Ontario:Organizational and cultural predictors of team climate

Objective: To determine the organizational predictors of higher scores on team climate measures as an indicator of the functioning of a family health team (FHT). Design: Cross-sectional study using a mailed survey. Setting: Family health teams in Ontario. Participants: Twenty-one of 144 consecutively approached FHTs; 628 team members were surveyed. Main outcome measures: Scores on the team climate inventory, which assessed organizational culture type (group, developmental, rational, or hierarchical); leadership perceptions; and organizational factors, such as use of electronic medical records (EMRs), team composition, governance of the FHT, location, meetings, and time since FHT initiation. All analyses were adjusted for clustering of respondents within the FHT using a mixed random-intercepts model. Results: The response rate was 65.8% (413 of 628); 2 were excluded from analysis, for a total of 411 participants. At the time of survey completion, there was a median of 4 physicians, 11 other health professionals, and 4 management and clerical staff per FHT. The average team climate score was 3.8 out of a possible 5. In multivariable regression analysis, leadership score, group and developmental culture types, and use of more EMR capabilities were associated with higher team climate scores. Other organizational factors, such as number of sites and size of group, were not associated with the team climate score. Conclusion: Culture, leadership, and EMR functionality, rather than organizational composition of the teams (eg, number of professionals on staff, practice size), were the most important factors in predicting climate in primary care teams.

Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: A longitudinal study.

Context: Family carers of palliative care patients report high levels of psychological distress throughout the caregiving phase and during bereavement. Palliative care providers are required to provide psychosocial support to family carers; however, determining which carers are more likely to develop prolonged grief (PG) is currently unclear.

Objectives: To ascertain whether family carers reporting high levels of PG symptoms and those who develop PG disorder (PGD) by six and 13 months postdeath can be predicted from predeath information.

Methods: A longitudinal study of 301 carers of patients receiving palliative care was conducted across three palliative care services. Data were collected on entry to palliative care (T1) on a variety of sociodemographic variables, carer-related factors, and psychological distress measures. The measures of psychological distress were then readministered at six (T2; n = 167) and 13 months postdeath (T3; n = 143).

Results: The PG symptoms at T1 were a strong predictor of both PG symptoms and PGD at T2 and T3. Greater bereavement dependency, a spousal relationship to the patient, greater impact of caring on schedule, poor family functioning, and low levels of optimism also were risk factors for PG symptoms.

Conclusion: Screening family carers on entry to palliative care seems to be the most effective way of identifying who has a higher risk of developing PG. We recommend screening carers six months after the death of their relative to identify most carers with PG.

A J-band detection of the sub-stellar mass donor in SDSS J1433+1011

We present time-resolved J-band spectroscopy of the short-period cataclysmic variable SDSS J143317.78+101123.3. We detect absorption lines from the sub-stellar donor star in this system, which contributes 38 +/- 5 per cent to the J-band light. From the relative strengths of the absorption lines in the J band, we estimate the spectral type of the donor star to be L2 +/- 1. These data are the first spectroscopic detection of a donor with a confirmed sub-stellar mass in a cataclysmic variable, and the spectral type is consistent with that expected from semi-empirical evolutionary models.

Using skew mapping, we have been able to derive an estimate for the radial velocity of the donor of K-d = 520 +/- 60 km/s. This value is consistent with, though much less precise than, predictions from mass determinations found via photometric fitting of the eclipse light curves.

You’re Wha…? Including young men in reproductive planning

The importance of including fathers in reproductive planning, pregnancy and childbirth cannot be overstated and it is increasingly recognised that addressing their sense of exclusion from maternity services requires further action. One very overlooked area, however, is in helping young men, alongside their partners, in preventing an unintended teenage pregnancy. The UK has the highest rate of teenage pregnancy in Western Europe and, while teenage men are seen as half of the problem, they are rarely regarded as half of the solution. We argue that education is an essential part of the process of increasing men's sense of inclusion and describe If I were Jack, an educational resource about unintended teenage pregnancy which has been developed specifically for young men.

Failed filament eruption inside a coronal mass ejection in active region 11121

Aims. We study the formation and evolution of a failed filament eruption observed in NOAA active region 11121 near the southeast
limb on November 6, 2010.
Methods. We used a time series of SDO/AIA 304, 171, 131, 193, 335, and 94 Å images, SDO/HMI magnetograms, as well as ROSA
and ISOON Hα images to study the erupting active region.
Results. We identify coronal loop arcades associated with a quadrupolar magnetic configuration, and show that the expansion and
cancellation of the central loop arcade system over the filament is followed by the eruption of the filament. The erupting filament
reveals a clear helical twist and develops the same sign of writhe in the form of inverse γ-shape.
Conclusions. The observations support the “magnetic breakout” process in which the eruption is triggered by quadrupolar reconnection
in the corona. We propose that the formation mechanism of the inverse γ-shape flux rope is the magnetohydrodynamic helical
kink instability. The eruption has failed because of the large-scale, closed, overlying magnetic loop arcade that encloses the active
region

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Background: Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.

Methods: We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.
Findings: We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women.

Interpretation: If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Bereavement outcomes: a quantitative survey identifying risk factors in family carers bereaved through cancer.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer’s risk into bereavement. Aim: to determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer’s bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who: registered the death of a person between 1st December 2011 and 31st May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire six weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre or post bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively impacted on bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased.

Factoring in family freight forwarder company: case study

Each freight forwarder company must independently determine whether factoring is the right choice for them and if will pay off. If the factoring as a financial method would not be economically viable, it certainly would not exist. There are several different financing methods, which are more or less useful. However, not all of them are appropriate for every company, just like all buyers do not represent equal risks for the suppliers. The same buyer can pay one supplier within the agreed period, and not pay the other supplier at all. Still, the most important elements are the agreement made with the customer, the method of insuring ourselves and the method of monitoring the implementation of the agreements. Problems rarely occur overnight and that is why we have to constantly supervise our buyers; otherwise account receivables can occur. My thesis contributes to the ongoing research into how the use of factoring within the Slovenian economic environment can help a small freight forwarder company to grow. In effect, the specific characteristics of the Slovenian economic, legal and institutional environment make such an analysis an interesting one to explore. I used data from a family freight forwarder company TOP Hrvatin in drugi d.n.o. in order to establish future company growth by applying factoring as a right choice of financing. After applying all the data and preparing the company's financial plan, my results suggest that factoring is not the right choice for financing future investments for this particular freight forwarder business. Furthermore, the results even show that factoring is an extremely undeveloped financing method in Slovenia and that practically there is no legal base for its use.

Questioning the Universality of Institutional Transformation Theories in Spatial Planning: Shopping Mall Developments in Palermo

Theories about institutional transformation in spatial planning, although mainly based on the Anglo-Saxon context, have assumed a dominant role in planning research and theory as means to understand the transformations that have been restructuring planning systems in recent decades in the Western world and beyond. The article, looking at transformations of planning practice through the lenses of the concept of planning cultures, debates the utility of building ‘universal’ theories for spatial planning and advocates for the need for a de-provincialization of planning theories. This is done through a case-study approach applied to the history of the transformation of the retail system in a context characterized by the specificities of the Italian planning context and Southern European cities, namely: the planning processes for, and power relationships underlying, the first shopping malls opened in Palermo, Italy, since 2009 — some decades later than most of Western cities.

Lines in class The ongoing attack on mass education in England

Andrew McGettigan’s analysis of the financial transformations of higher education (‘Who Let the Dogs Out? The Privatization of Higher Education’, RP 174)is important for comprehending the complexity of the changes universities are undergoing and their implications. As he argues, ‘it is mass higher education in England’ that is now under attack and adequately responding to this requires the development of new habits and new forms of thought. It is also necessary to contextualize this attack in relation to comparable changes occurring in other educational sectors in England, not least because it is through control of the points of intersection between primary, secondary, and tertiary education that the government’s political intent is being most effectively realized. An analysis of these changes reveals the broader nature of the attack on the idea and practice of mass education itself.

Para lá dos jornalistas: influencer relations, uma nova era de Media Relations

Dissertação apresentada à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Gestão Estratégica das Relações Públicas.