The palliative care education needs of nursing home staff

Background: Palliative care is delivered in a number of settings, including nursing homes, where staff often have limited training in palliative care. Aim: We explored the level of palliative care knowledge among qualified staff delivering end-of-life care in nursing home settings, to inform the development of an appropriate education and training programme. Design: An audit of the educational needs assessment was performed using an anonymous postal questionnaire sent to 528 qualified nursing staff within 48 nursing homes. Findings: In total, 227 questionnaires were returned giving a response rate of 43%. Results indicated that less than half the sample had obtained formal training in the area of pain assessment and management and less than a quarter had obtained training in non-malignant conditions. Registered nurses in this study reported a lack of awareness of palliative care principles or national guidelines. Conclusion: Qualified nursing home staff agree that palliative care is a valuable model for care in their setting. There are clear opportunities for improvement in nursing home care, based on education and training in palliative care. Results also support the need for enhanced liaison between nursing homes and specialist palliative care services. © 2006 Elsevier Ltd. All rights reserved.

A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities

BACKGROUND: The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details.

METHODS/DESIGN: This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial.

DISCUSSION: The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are significant benefits to be gained globally, if structured education programmes are adapted and shown to be successful for people with ID and other cognitive impairments.

TRIAL REGISTRATION: Registered with International Standard Randomised Controlled Trial (identifier: ISRCTN93185560 ) on 10 November 2014.

Application of disturbance management principles in fresh food supply chains

The desire for more robust supply chains has led to a growth in theoretical and practical interest in the application of both preventive and impact reductive disturbance management principles. This application should ultimately lead to less vulnerable and more competitive supply chains. Based on the extant literature we identify fresh food supply chain's contextual factors (products, processes, supply chain networks and supply chain business environment) and their corresponding characteristics, as well as the main disturbance management principles used. To analyse their influence on the selection and application of disturbance management principles in fresh food supply chains we conducted three case studies. In each case we collected data on the relevant contextual factors, disturbance management principles applied and company background. As an underlying methodology, we first conduct within-case analysis and then expand the analyses to a cross-case context. Based on the findings from these case studies, propositions are built concerning the nature of contextual factors and their characteristics, and their influence on the selection and application of disturbance management principles in fresh food supply chains. Our main findings are related to the identification of contextual characteristics of fresh food supply chains that are either critical vulnerability sources, critical enablers or conditionals and as such require, facilitate or condition selection and application of disturbance management principles.

Management and engineering education in the 1950s and 1960s

The career destiny of many graduate engineers is in industry. Quite how well prepared they were for that career became a matter of political importance in the late 1950s and early 1960s as the issue of Britain's relatively poor economic performance grew in salience. This article looks at this preparation with particular reference to management training. It examines the attitudes of those parties most interested in engineering education ‐ the government, industry, the engineering institutions and the educators themselves. All of these saw management training as being part of the formation of at least a portion of professional engineers at some stage in their career. But there was no general agreement between them about what this should consist of or when it should be provided. At the same time broader changes in engineering education were taking place which cut across and to some extent militated against attempts to enhance the role of management training. The result, it is argued, is that by the end of the 1960s little progress had been achieved.

Knowledge management in higher education institutions: a framework to improve collaboration

The purpose of this paper is to present a framework that increases knowledge sharing and collaboration in Higher Education Institutions. The paper discusses the concept of knowledge management in higher education institutions, presenting a systematization of knowledge practices and tools to linking people (students, teachers, researchers, secretariat staff, external entities)and promoting the knowledge sharing across several key processes and services in a higher education institution, such as: the research processes, learning processes, student and alumni services, administrative services and processes, and strategic planning and management. The framework purposed in this paper aims to improve knowledge practices and processes which facilitate an environment and a culture of knowledge collaboration,sharing and discovery that should characterize an institution of higher education.

Learning Activities with Semantic. Hypermedia in Higher Education

The increasing use of information and communication technologies (ICT) in diverse professional and personal contexts calls for new knowledge, and a set of abilities, competences and attitudes, for an active and participative citizenship. In this context it is acknowledged that universities have an important role innovating in the educational use of digital media to promote an inclusive digital literacy. The educational potential of digital technologies and resources has been recognized by both researchers and practitioners. Multiple pedagogical models and research approaches have already contributed to put in evidence the importance of adapting instructional and learning practices and processes to concrete contexts and educational goals. Still, academic and scientific communities believe further investments in ICT research is needed in higher education. This study focuses on educational models that may contribute to support digital technology uses, where these can have cognitive and educational relevance when compared to analogical technologies. A teaching and learning model, centered in the active role of the students in the exploration, production, presentation and discussion of interactive multimedia materials, was developed and applied using the internet and exploring emergent semantic hypermedia formats. The research approach focused on the definition of design principles for developing class activities that were applied in three different iterations in undergraduate courses from two institutions, namely the University of Texas at Austin, USA and the University of Lisbon, Portugal. The analysis of this study made possible to evaluate the potential and efficacy of the model proposed and the authoring tool chosen in the support of metacognitive skills and attitudes related to information structuring and management, storytelling and communication, using computers and the internet.

Relating leadership, thinking styles, self-concept, motivation and stress management in education

Seventy-five principals and vice-.wincipals from public elementary and secondary schools in Hamilton, Ontario, Canada participated in this study. Participants provided ,information concerning their thinking styles, motivations, and the physical effects of stress. This information was examined to find out how satisfaction-oriented, and how security-oriented the thinking styles of the participants were. Second, the data were analysed to see how the thinking style orientations related to life style habits and the effects of stress. The satisfaction-oriented thinking styles scored higher than all of the security-oriented thinking styles by a wide margin with a small preference for the satisfaction-people-oriented styles labelled humanistic-helpful, and affiliative as opposed to the satisfaction-task-oriented styles labeled achievement, and self-actualizing. Although all eight of the security-oriented thinking styles scored well below all of the satisfaction-oriented thinking styles on the Life Styles Inventory, the perfectionistic style scored higher than all of the security-oriented styles by an impressive margin. The next highest scores were recorded by a cluster of three passive-defensive people-oriented thinking styles labeled approval, conventional, and dependent. The competitive style scored lower, and the styles labeled avoidance, oppositional, and power scored the lowest of all the defensive-security-oriented styles. These findings suggest that principals and vice-principals see themselves as relaxed, flexible, and satisfied with their ability to adapt to the stress levels they experience in their lives; however, there was some support for medical research findings that suggest that specific security-oriented thinking styles are associated with emotional stresses that contribute to the development of specific lifestyle habits, physical symptoms, and illnesses. Although the number of females in this study provides very limited generalizability, the findings of this study suggest that high achieving females tend to develop satisfaction-growth styles to a higher level than males, and they tend to use security-oriented styles to a lesser degree than males.

The self-management approach of health education in the treatment of chronic illnesses

Health education is essential to the successful treatment of individuals with chronic illnesses. Self-management is a philosophical model of health education that has been shown to be effective in teaching individuals with chronic arthritis to manage their illness as part of their daily lives. Despite the proven results of arthritis self-management programs, some limitations of this form of health education were apparent in the literature. The present study attempted to address the problems of the self-management approach of health education such as reasons for lack of participation in programs and poor course outcomes. In addition, the study served to investigate the relationship between course outcomes and participation in programs with the theory upon which arthritis self-management programs are based, known as self-efficacy theory. Through a combination of qualitative and quantitative methodologies, data collection, and analysis, a deeper understanding of the self-management phenomenon in the treatment of chronic arthritic conditions was established. Findings of the study confirm findings of previous studies that suggest that arthritis self-management programs result in enhanced levels of self-efficacy and are effective in teaching individuals with arthritis to self-manage their health and health care. Findings of the study suggest that there are many factors that determine the choice of participants to participate in programs and the outcomes for the individuals who do choose to participate in programs. Some of the major determinants of enrollment and outcomes of programs include: the participant's personality, beliefs, attitudes and abilities, and the degree of emotional acceptance of the illness. Other determinants of course enrollment and outcomes included class size and length of time, timing of participation, and ongoing support after the program. The results of the study are consistent with the self-management literature and confirm the relationship between the underlying philosophies of adult education and Freire's model of education and self-management.

Leadership in higher education : a decanal perspective /

This is a study which examines the roles and responsibilities of Deans, specifically focussing on the Deans in the Faculties of Education at three Ontario Universities - Brock University, the University of Western Ontario, and the University of Windsor. This study examines the roles of Deans in the context of leadership and as a management position. The initial belief of the researcher was that Deans acted as middle managers at their institution besides being role models, scholars and leaders. Data were collected through interviews with the various participants and through the examination of the official job descriptions at each institution. Concepts such as leadership, motivation, empowerment, and management are discussed in relation to the position of Dean. The research concludes that a Dean is a leader in higher education who is responsible for a variety of issues. Besides academic related responsibilities such as faculty development, program development and research, a Dean is also responsible for a wide range of administrative tasks including financial management and obligations to external groups. As a role model and scholar, the Dean must ensure that all areas have sufficient energies devoted to them. This creates a heavy burden on Deans as they have a great deal of responsibilities to manage while still maintaining their role as a scholar. The researcher concludes that the position of Dean requires additional support from the institution. This support could be in an Associate Dean or an Executive Assistant with training and support mechanisms on an ongoing basis.

Management Council for Responsible Labour Relations records, 1970-1979, n.d.

The Management Council for Responsible Labour Relations was a group of industry representatives who sought to improve the public image of management in labour disputes. They hoped to accomplish this by improving communication with the media, as well as by educating the general public about labour issues from management’s perspective. The Council had representatives from Inco, Gulf, Algoma, Westinghouse, Kimberly Clark, Ford, Stelco, Massey Ferguson, Alcan, Shell, Northern Electric, Bank of Montreal, Canada Packers and Dupont.

Ethical Principles as a Guide in Implementing Policies for the Management of Food Allergies in Schools

This article represents a prime example of applied ethics in public health policy development. The article provides guidance on the development of food allergy policies for child care settings based on core ethical principles in bioethics and public health ethics.

Management of Higher Educational Institutions in Kerala

Economists consider education as an investment in man. Education develops human resources necessary for the economic and political growth of any nation. Adam Smith stressed the importance of education and included the acquired and useful activities of all the inhabitants or members of society in his concept of fixed capital.‘ Karl Marx shared with Smith's view when he laid down that the function of education in a socialist society will be to overcome the alienation of the worker from the means of production; while developing the technical skill it will make him a complete man as well as a producer.2 Education is also considered as a powerful instrument for social change. By inculcating moral and spiritual values, it brings changes both in the individual and in the society. It aims at creating a social order founded on the values of freedom, social justice and equal opportunity.3 The objective of this exploratory study is to enquire into the existing system of managing higher educational institutions in Kerala, compare it with the accepted principles of management believed to be applicable to all organisations, and develop a model capable of introducing more effective management practices

Influence of education levels on dissemination of soil fertility management information in the central highlands of Kenya

Inadequate links between researchers and farmers has resulted in low uptake of research advances recommended to improve food security in the central highlands of Kenya. Access to timely and accurate information by extension agents and farmers is paramount in dissemination of soil fertility management practices. Hence, the study sought to investigate the effect of education levels on communication channels used to disseminate soil fertility technologies in the Central highlands of Kenya. Questionnaires were used to elicit information from 105 extension agents and 240 farmers. About 50.5% of the extension officers were certificate holders while 29.5% were diploma holders from agricultural institutes. Majority of the farmers had attained primary education (59.6%) while 25.8% and 9.2% had attained secondary and post secondary education, respectively. Research institutions were the most accessible sources of information on soil fertility management practices by extension agents while internet and scientific conferences were the least scored as accessible sources of soil fertility management information by extension agents. Education levels significantly influenced preference of individual approach methods by farmers. There was a significant positive relationship between education and accessibility of internet as a source of information on green manure. The implication of the study was that education levels influenced the mode of communication used in the transfer of soil fertility research outputs to the end users. Consequently, it is extremely important to consider education levels in selection of dissemination pathways used in agriculture.

Polimorfismos del gen Butirilcolinesterasa responsables de reacciones adversas en pacientes consumidores de “cocaína”

La butirilcolinesterasa humana (BChE; EC 3.1.1.8) es una enzima polimórfica sintetizada en el hígado y en el tejido adiposo, ampliamente distribuida en el organismo y encargada de hidrolizar algunos ésteres de colina como la procaína, ésteres alifáticos como el ácido acetilsalicílico, fármacos como la metilprednisolona, el mivacurium y la succinilcolina y drogas de uso y/o abuso como la heroína y la cocaína. Es codificada por el gen BCHE (OMIM 177400), habiéndose identificado más de 100 variantes, algunas no estudiadas plenamente, además de la forma más frecuente, llamada usual o silvestre. Diferentes polimorfismos del gen BCHE se han relacionado con la síntesis de enzimas con niveles variados de actividad catalítica. Las bases moleculares de algunas de esas variantes genéticas han sido reportadas, entre las que se encuentra las variantes Atípica (A), fluoruro-resistente del tipo 1 y 2 (F-1 y F-2), silente (S), Kalow (K), James (J) y Hammersmith (H). En este estudio, en un grupo de pacientes se aplicó el instrumento validado Lifetime Severity Index for Cocaine Use Disorder (LSI-C) para evaluar la gravedad del consumo de “cocaína” a lo largo de la vida. Además, se determinaron Polimorfismos de Nucleótido Simple (SNPs) en el gen BCHE conocidos como responsables de reacciones adversas en pacientes consumidores de “cocaína” mediante secuenciación del gen y se predijo el efecto delos SNPs sobre la función y la estructura de la proteína, mediante el uso de herramientas bio-informáticas. El instrumento LSI-C ofreció resultados en cuatro dimensiones: consumo a lo largo de la vida, consumo reciente, dependencia psicológica e intento de abandono del consumo. Los estudios de análisis molecular permitieron observar dos SNPs codificantes (cSNPs) no sinónimos en el 27.3% de la muestra, c.293A>G (p.Asp98Gly) y c.1699G>A (p.Ala567Thr), localizados en los exones 2 y 4, que corresponden, desde el punto de vista funcional, a la variante Atípica (A) [dbSNP: rs1799807] y a la variante Kalow (K) [dbSNP: rs1803274] de la enzima BChE, respectivamente. Los estudios de predicción In silico establecieron para el SNP p.Asp98Gly un carácter patogénico, mientras que para el SNP p.Ala567Thr, mostraron un comportamiento neutro. El análisis de los resultados permite proponer la existencia de una relación entre polimorfismos o variantes genéticas responsables de una baja actividad catalítica y/o baja concentración plasmática de la enzima BChE y algunas de las reacciones adversas ocurridas en pacientes consumidores de cocaína.