Development process and initial validation of the ethical conflict in nursing questionnaire-critical care version

Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.

Passport to a profession in the degree of pharmacy: how to integrate university students into the real world of work: "Passport to a profession in Pharmacy"

The incorporation of the Spanish university system into the European Higher Education Areahas brought about a series of adaptations. Among the recommendations is the inclusion ofan external training period in a company, which has resulted in significant changes in thedegree syllabus in order to balance the theoretical and practical education required by thestudents. This new framework has been legally confirmed by the Spanish Government and, inthe case of the University of Barcelona, by the publication of internal guidelines. Takingadvantage of this new opportunity to adapt the Pharmacy degree to real-world problems inindustry, the Dean’s team of the Faculty of Pharmacy, with the support of the Facultyadministrative staff and the Students Advisory Service, have assumed the challenge ofincluding a new subject in the syllabus entitled Training in Companies.In parallel, a new activity has been set up to ensure that the students choose the mostsuitable company department/job for them and to help them pass the company interview.Under the name of Passport to a Profession, a series of ten explanatory talks has beenscheduled every academic year. These talks deal with a broad range of topics aimed atproviding the students with the basic tools they will need to make the most of a companytraining period and to make headway in the professional world when they finish theirdegree. In addition, three Faculty of Pharmacy-Pharmaceutical company workshops and tworound-table conferences have been held in the last two years in order to bring the universityand industry together. Notably, the project to provide students with company training isexpanding on an international level, with two to three undergraduate students contractedevery year by a United Kingdom-based multinational pharmaceutical company.The statistical data of the whole process has been analysed for a more in-depthunderstanding of the activity and to improve the programme.

Chaos in human behavior: the case of work motivation

This study considers the complex dynamics of work motivation. Forty-eight employees completed a work-motivation diary several times per day over a period of four weeks. The obtained time series were analysed using different methodologies derived from chaos theory (i.e. recurrence plots, Lyapunov exponents, correlation dimension and surrogate data). Results showed chaotic dynamics in 75% of cases. The findings confirm the universality of chaotic behavior within human behavior, challenge some of the underlying assumptions on which work motivation theories are based, and suggest that chaos theory may offer useful and relevant information on how this process is managed within organizations.

Influence of process parameters on part quality and mechanical properties for DMLS and SLM with iron-based materials

Rapid manufacturing is an advanced manufacturing technology based on layer-by-layer manufacturing to produce a part. This paper presents experimental work carried out to investigate the effects of scan speed, layer thickness, and building direction on the following part features: dimensional error, surface roughness, and mechanical properties for DMLS with DS H20 powder and SLM with CL 20 powder (1.4404/AISI 316L). Findings were evaluated using ANOVA analysis. According to the experimental results, build direction has a significant effect on part quality, in terms of dimensional error and surface roughness. For the SLM process, the build direction has no influence on mechanical properties. Results of this research support industry estimating part quality and mechanical properties before the production of parts with additive manufacturing, using iron-based powders

La inclusión laboral y social de los jóvenes con discapacidad intelectual : el papel de la escuela = Work and social inclusion of young people with intellectual disabilities : the role of the school

The transition to adult life from the standpoint of inclusion is a complex process, especially for young people with intellectual disabilities. This article analyzes the context of transition processes showing the main relationships and differences of the different scenarios where young people with disabilities develop personal pathways that lead to adulthood. Among these scenarios, the school -the period of compulsory secondary education- plays a key role. Therefore, a specific section is devoted to developing an approach to the role of the school in the construction of bridges that facilitate social and work inclusion. Finally, it presents some major challenges that need to be faced to improve the processes of transition from an inclusive perspective

The forced adoption of a fast-track appraisal process for a breast cancer treatment in UK

Trastuzumab (Herceptin ®, Roche) is approved in UK for the treatment of the metastatic breast cancer since 2001. As of 2005, concomitantly with the publication of 3 studies that showed it produces a 50% reduction of the recurrence rates of breast cancer, trastuzumab started to be prescribed in the earlt adjuvant treatrnent of this disease. Und June 2006, trastuzumab did not have both: 1) regulatory approval and 2) NICE [National Institute for Health and Clinical Excellence] recommendation for the use in early stages of breast cancer. During the period until June 2006, the trastuzumab use in those patients was not reimbursed and because the cost of trastuzumab is equal with the yearly UK average income, most of patients could not self fund their treatrnent. Before the publication of the final NICE guidance, the new data of trastuzumab in early breast cancer raised enormous patient and professional interest and expectations. A great volume of public and professional pressure was generated to transcend a system by which Primary Care Trusts can reimburse a treatment only after a formal guidance was issued. This paper draw on a case study depicting and analyzing the process by which regulatory approval and NICE recommendations were achieved in a record time and how trastuzumab became a standard treatment on early adjuvant breast cancer. According to the data we gathered in this work we were witnessing one of the fastest processes of adoption of a health care technology since the creation of NICE, in 1999. This study addresses the following research question: How and why does the adoption pattern of trastuzumab differ from the rational decision-making model of the reimbursement process in UK? [Author, p. 4]

To analyse a trace or not? Evaluating the decision-making process in the criminal investigation

In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis.

The role of mentoring in facilitating the process of repurposing OER

This paper presents the initial data analysis of a research that is work in progress. It discusses the role of mentoring and peer support in facilitating the process of repurposing open educational resources (OER). It also reports on the lessons so far learned from the analysis of two distinct but related case studies on working with learners to use and disseminate OER.

A Game to Promote Understanding about UCD Methods and Process

The User-centered design (UCD) game is a tool forhuman-computer interaction practitioners to demonstrate the key user-centered design methodsand how they interrelate in the design process in an interactive and participatory manner. The target audiences are departments and institutions unfamiliar with UCD but whose work is related to the definition, creation, and update of a product or service.

Fostering Collaborative Knowledge Building by the Effective Provision of Knowledge about the Discussion Process

Peer-reviewed

Improving the effectiveness of supply chain development work – an expert role perspective

This study focuses to the intersection of three sets of activities in a company: expert work, development work and supply chain management, SCM. Experts and expert work represent a set of individuals whose efficiency and impact this study is intended to improve, while development work defines the set of organizational activities to focus on. SCM as an expertise area acts as the platform on which this study is built. The study has two aims. Firstly, it aims to derive a model helping an SCM expert to increase the effectiveness of expert work in development tasks by understanding the encountered organizational situations and processes better, reflecting his/her past and future actions to organizational processes and selecting and adjusting the processes and contents of his/her work accordingly. Secondly, it aims to develop applicable approaches and methods to understand, evaluate and manage the organizational processes and situations in development work. The integrative model on approaches and methods to improve the effectiveness of development processes is split to two aggregate dimensions: technical performance of the developed solution and consumption of resources of the development process. Six potential approaches and methods aiming at helping in the management of organizational dimensions are presented in enclosed publications. The approaches focus on three subtasks of development work: decision making, implementation and change, and knowledge accumulation. The approaches and methods have been tested in case studies representing typical development processes in the area of supply chain management. As a result, four suggestions are presented. Firstly, SCM experts are advised to consider the SCM development work to be consisting of development processes. Secondly, inside these processes they should identify and evaluate the risk of difficult decision-making related to organizational factors. Thirdly, they are prompted for an active role in implementation and change, supporting the implementation through whole process. Finally, the development should be seen in a holistic view, taking into account the stage of knowledge and organizational issues related to it, and adopt a knowledge development strategy.

Integration of a Bioethanol Process to a Pulp Mill

Tässä diplomityössä tutkittiin puuhakkeen esihydrolyysi- ja hakkuujätteen hydrolyysiprosessien integroimista sellutehtaaseen bioetanolin tuottamiseksi. Tällaisesta ns. biojalostamosta luotiin WinGEMS-simulointiohjelmalla simulointimalli, jonka avulla tutkittiin bioetanoliprosessin vaikutusta sellutehtaan massa- ja energiataseisiin sekä alustavaa biojalostamon kannattavuutta. Simuloinnissa tarkasteltiin kolmea eri tapausta, joissa mäntysellun tuotannon ajateltiin olevan 1000 tonnia päivässä ja hakkuujätettä käytettävän 10 % tarvittavan kuitupuun määrästä: 1) Puuhakkeen esihydrolyysi ja hakkuujätteen hydrolyysi etanolin tuottamiseksi 2) Puuhakkeen esihydrolyysi, hakkuujäte kuorikattilaan poltettavaksi 3) Ei esihydrolyysiä, hakkuujäte kuorikattilaan poltettavaksi Verrattuna tapaukseen 3, puun kulutus kasvaa 16 % esihydrolysoitaessa puuhake ennen keittoa tapauksissa 1 ja 2. Kasvaneella puun kulutuksella tuotetaan tapauksessa 1 149 tonnia etanolia ja 240 MWh enemmän ylimääräsähköä päivässä. Tapauksessa 2 tuotetaan 68 tonnia etanolia ja 460 MWh enemmän ylimääräsähköä päivässä. Tämä tuottaisi vuotuista lisäkassavirtaa 18,8 miljoonaa euroa tapauksessa 1 ja 9,4 miljoonaa euroa tapauksessa 2. Hydrolyysin tuoteliuoksen, hydrolysaatin, haihduttaminen sekä hydrolyysiprosessien orgaanisten jäännöstuotteiden haihduttaminen ja polttaminen kasvattavat haihduttamon ja soodakattilan kuormitusta. Verrattuna tapaukseen 3, tapauksissa 1 ja 2 haihduttamon vaiheiden määrä on kasvatettava viidestä seitsemään ja tarvittavat lämmönsiirtopinta-alat lähes kaksinkertaistettava. Soodakattilan kuormitus kasvaa 39 % tapauksessa 1 ja 26 % tapauksessa 2.

Characterization of Microparticle Retention Systems with Retention Process Analyzer

In the literature survey retention mechanisms, factors effecting retention and microparticles were studied. Also commercial microparticle retention systems and means to measure retention were studied. Optical retention measurement with RPA and Lasentec FBRM was studied. The experimental part contains study of different cationic polyacrylamides, anionic silica, bentonite and new generation micropolymer. In these studies the dosage, dosing order and dosing history were changing factors. The experimental work was done with RPA-apparatus with which, the retention process can be followed in real time. In testing was found that silica yielded better retention, when dosed nontraditionally before the polymer. Also silica was very dependant on the polymer dosage. With bentonite good colloidal retention was achieved with relatively low doses. Unlike silica bentonite was not dependant on polymer dosage. The relation of bentonite and polymer dosage is more defining when high retention is wanted. With 3-component systems using bentonite very high retention was achieved. With silica no improvement in retention was found in 3-component systems compared to dual component systems.

Creating and implementing a financial management process to an international company

The objectives of this thesis areto identify the best elements from Information Technology Infrastructure Library financial management for an international company. The elements need to be customized to fit existing elements and the thesis needs to provide implementation proposal. The new IT financial management needs to improve cost visibility and bring benefits to the company. In order to find the best elements for IT financial management, there needs to be a research to discover the companys business needs. The ITIL library is used to find answers and solutions to the companys issues in IT financial management. Other IT frameworks can and will be used as well, if they are able to work with ITIL model. ITIL consists from budgeting, accounting and charging in IT financial management, which all needs to be investigated. In addition more ITIL elements such as contract management and supplier management can be used, in order to make IT financial management work better.

Welding of Sheet metal using Modified short arc MIG/MAG welding process

In this research work, the results of an investigation dealing with welding of sheet metals with diverse air gap using FastROOT modified short arc welding method and short circuit MAG welding processes have been presented. Welding runs were made under different conditions and, during each run, the different process parameters were continuously monitored. It was found that maximum welding speed and less HAZ are reached under specific welding conditions with FastROOT method with the emphasis on arc stability. Welding results show that modified short arc exhibits a higher electrode melting coefficient and with virtually spatter free droplet transition. By adjusting the short circuit duration the penetration can be controlled with only a small change in electrode deposition. Furthermore, by mixing pulsed MIG welding with modified arc welding the working envelope of the process is greatly extended allowing thicker material sections to be welded with improved weld bead aesthetics. FastROOT is a modified short arc welding process using mechanized or automated welding process based on dip transfer welding, characterized by controlled material deposition during the short circuit of the wire electrode to the workpiece.