Workforce Issues in the Greater Boston Health Care Industry: Implications for Work and Family

Interviews with more than 40 leaders in the Boston area health care industry have identified a range of broadly-felt critical problems. This document synthesizes these problems and places them in the context of work and family issues implicit in the organization of health care workplaces. It concludes with questions about possible ways to address such issues. The defining circumstance for the health care industry nationally as well as regionally at present is an extraordinary reorganization, not yet fully negotiated, in the provision and financing of health care. Hoped-for controls on increased costs of medical care – specifically the widespread replacement of indemnity insurance by market-based managed care and business models of operation--have fallen far short of their promise. Pressures to limit expenditures have produced dispiriting conditions for the entire healthcare workforce, from technicians and aides to nurses and physicians. Under such strains, relations between managers and workers providing care are uneasy, ranging from determined efforts to maintain respectful cooperation to adversarial negotiation. Taken together, the interviews identify five key issues affecting a broad cross-section of occupational groups, albeit in different ways: Staffing shortages of various kinds throughout the health care workforce create problems for managers and workers and also for the quality of patient care. Long work hours and inflexible schedules place pressure on virtually every part of the healthcare workforce, including physicians. Degraded and unsupportive working conditions, often the result of workplace "deskilling" and "speed up," undercut previous modes of clinical practice. Lack of opportunities for training and advancement exacerbate workforce problems in an industry where occupational categories and terms of work are in a constant state of flux. Professional and employee voices are insufficiently heard in conditions of rapid institutional reorganization and consolidation. Interviewees describe multiple impacts of these issues--on the operation of health care workplaces, on the well being of the health care workforce, and on the quality of patient care. Also apparent in the interviews, but not clearly named and defined, is the impact of these issues on the ability of workers to attend well to the needs of their families--and the reciprocal impact of workers' family tensions on workplace performance. In other words, the same things that affect patient care also affect families, and vice versa. Some workers describe feeling both guilty about raising their own family issues when their patients' needs are at stake, and resentful about the exploitation of these feelings by administrators making workplace policy. The different institutions making up the health care system have responded to their most pressing issues with a variety of specific stratagems but few that address the complexities connecting relations between work and family. The MIT Workplace Center proposes a collaborative exploration of next steps to probe these complications and to identify possible locations within the health care system for workplace experimentation with outcomes benefiting all parties.

Importancia de la inducción y tendencias de fuentes de reclutamiento

El área de Recursos humanos administra distintos procesos y controla aspectos en las organizaciones, pero en la actualidad con el nuevo pensamiento y tendencias se ha convertido en la conciencia y mano derecha de la gerencia general. Se preocupa por la atracción de talento, retención del mismo y la fase de desarrollo, entrenamiento y capacitación, además de las otras funciones que desempeña. Los anteriores tres aspectos involucran numerosos procesos detrás, uno de ellos conocido como provisión de personal. El objetivo de éste es tener control del headcount de una compañía teniendo en cuenta sus necesidades y requerimientos del negocio, pero además atraer individuos con potencial de crecimiento que aporten conocimientos y resultados a la organización. Para ello debe pasar por una serie de procesos y procedimientos que le permitirán encontrar a dichas personas con el fin de integrarlas y generar un engagement desde el día de ingreso a la empresa. En cada etapa de la provisión de personal se cumple con tareas necesarias e importantes para dar el siguiente paso, y combinado con el trabajo en equipo con otras áreas y la comunicación efectiva se logran los objetivos en cada uno de ellas. Por eso es vital entender con claridad los procesos dentro de éste, su importancia e interrelación y como cada una de ellas afecta o beneficia a la empresa. Una vez comprendido esto se podrá entender la relevancia de las fuentes de reclutamiento y la inducción, y como las nuevas tendencias globales en el área de recursos humanos y específicamente en las dos anteriores, permitirán brindar oportunidades de mejora para la provisión de personal y generación de valor al cliente interno y la compañía en la Región Andina (Bolivia, Colombia, Ecuador, Perú, Venezuela).

Teachers in action : tasks for in-service language teacher education and development.

Ofrece un marco flexible para alentar a los profesores de lengua en la investigación de temas que son relevantes para su propio desarrollo profesional. Contiene una serie de recursos diseñados específicamente para ayudarles a desarrollar sus habilidades, conocimientos y actitudes. Estos recursos son extensas tareas presentadas en hojas de trabajo, que pueden fotocopiarse y que sirven para la formación continua del profesor y para el desarrollo de programas.

Teaching children English : a training course for teachers fo English to children.

En este recurso se examinan las necesidades educativas y lingüísticas en el aprendizaje del inglés de los alumnos de enseñanza primaria y da una visión general de las técnicas apropiadas en el aula. Ofrece prácticas en la planificación de la lección en términos de los objetivos del lenguaje. La obra está estructurada en dos partes, con diez unidades cada una, dedicadas a un aspecto específico de la metodología de la enseñanza y la práctica en el aula. Incluye historias, rimas, canciones, trabajos prácticos y tareas de lenguaje.

Efficiency and Equity in Learning Communities and schools

Traditionally, school efficiency has been measured as a function of educational production. In the last two decades, however, studies in the economics of education have indicated that more is required to improve school efficiency: researchers must explore how significant changes in school organization affect the performance of at-risk students. In this paper we introduce Henry Levin’s adoption of the X-efficiency approach to education and we describe the efficient and cost-effective characteristics of one Learning Communities Project School that significantly improved its student outcomes and enrollment numbers and reduced its absenteeism rate to zero. The organizational change that facilitated these improvements defined specific issues to address. Students’ school success became the focus of the school project, which also offered specific incentives, selected teachers, involved parents and community members in decisions, and used the most efficient technologies and methods. This case analysis reveals new two elements—family training and community involvement—that were not explicit parts of Levin’s adaptation. The case of the Antonio Machado Public School should attract the attention of both social scientists and policy makers

A new concept for museum training in Germany

To talk about a new concept for museum training seems perhaps, to be a little bit exaggerated. For long time you have all been talking about concepts and contents for museum training and as I figured out the debate on the topic in Germany is as old as the appearance of national museums in the 19th century. Men like Theodor Mommsen, Rudolph Virchow, Alfred Lichtwark, all well known historians and supporters of the museum idea, spoke and wrote not only about the importance of museums as cultural and educational institutions but also supported the idea of professionalisation of museums work. Some of the ideas of our ancestors are still part of an ongoing discussion. The topic of my talk today will be what king of personnel a museum of our time needs to cope with the growing demand for internal and external organization. I shall present to you a new training program for museum workers in Germany which aims not to produce a new group of researchers but to prepare students for the practical work in the museum field.

Working in partnership with the Museum Training Institute providing in service training for museum personnel

The South Eastern Museums Service is one of ten Area Museums Councils in Great Britain. They are partnerships; membership organizations to which the 2 000 + museums belong. They provide advice, support, technical services, information and training for their members. They are the principal channel of government grant-in-aid to local government, university and independent museums. This funding comes from the Department of National Heritage via the Museums & Galleries Commission. At the South Eastern Museums Service I am responsible for the development and delivery of training for 600 museums in our region and the provision of information about museums and of interest to museums. This paper explains how we approach in-service training and the value of the definition of national standards for our work. It will pose some questions: What is training? What is a training need? and describe a new initiative, the development of training materials and their delivery.

Musem Training Institute - its current status

Museum Training Institute: Kershaw House, 55 Well Street, Bradford, BD1 5PS Britain’s system of vocational training and qualifications has been undergoing a fundamental revolution in recent years. The single most important feature of this revolution is the concept of competence - the ability to perform to the standards required in employment. It is in recognition of this ability that National and Scottish Vocational Qualifications are awarded.

Dental training system using haptic technology

In the U.K., dental students require to perform training and practice on real human tissues at the very early stage of their courses. Currently, the human tissues, such as decayed teeth, are mounted in a human head like physical model. The problems with these models in teaching are; (1) every student operates on tooth, which are always unique; (2) the process cannot be recorded for examination purposes and (3) same training are not repeatable. The aim of the PHATOM Project is to develop a dental training system using Haptic technology. This paper documents the project background, specification, research and development of the first prototype system. It also discusses the research in the visual display, haptic devices and haptic rendering. This includes stereo vision, motion parallax, volumetric modelling, surface remapping algorithms as well as analysis design of the system. A new volumetric to surface model transformation algorithm is also introduced. This paper includes the future work on the system development and research.

Modelling effects of prolonged conditioning on dormancy and germination of Striga hermonthica

The impact of environment on the germination biology of the parasite was studied in the laboratory with seeds conditioned at various water potentials, urea concentrations and at 17.5 to 37.5°C for up to 133 days. Maximum germination was observed at 20 to 25°C. Water stress and urea suppressed maximum germination. The final percentage germination response to period of conditioning showed a non-linear relationship and suggests the release of seeds from dormancy during the initial period and later on dormancy induction. Germination percentage increased with increase in conditioning period to a threshold and remained stable for variable periods followed by a decline with further extension of conditioning time. The decline in germination finally terminated in zero germination in most treatments before the end of experimentation. The investigated factors of temperature, water potential and urea showed clear effects on the expression of dormancy pattern of the parasite. The effects of water potential and urea were viewed as modifying a primary response of seeds to temperature during conditioning. The changes in germinability potential during conditioning were consistent with the hypothesis that dormancy periods are normally distributed within seed populations and that loss of primary dormancy precedes induction of secondary dormancy. Hence an additive mathematical model of loss of primary dormancy and induction of secondary as affected by environment was developed as: G = {[Φ-1 (Kp+ (po+pnN+pwW) (T-Tb) t)]-[Φ-1 (Ks+ ((swW+sa)+sorT)t)]}[Φ-1(aT2+bT+c+cwW)].

Genomic and genetic analyses of diversity and plant interactions of Pseudomonas fluorescens

Background: Pseudomonas fluorescens are common soil bacteria that can improve plant health through nutrient cycling, pathogen antagonism and induction of plant defenses. The genome sequences of strains SBW25 and Pf0-1 were determined and compared to each other and with P. fluorescens Pf-5. A functional genomic in vivo expression technology (IVET) screen provided insight into genes used by P. fluorescens in its natural environment and an improved understanding of the ecological significance of diversity within this species. Results: Comparisons of three P. fluorescens genomes (SBW25, Pf0-1, Pf-5) revealed considerable divergence: 61% of genes are shared, the majority located near the replication origin. Phylogenetic and average amino acid identity analyses showed a low overall relationship. A functional screen of SBW25 defined 125 plant-induced genes including a range of functions specific to the plant environment. Orthologues of 83 of these exist in Pf0-1 and Pf-5, with 73 shared by both strains. The P. fluorescens genomes carry numerous complex repetitive DNA sequences, some resembling Miniature Inverted-repeat Transposable Elements (MITEs). In SBW25, repeat density and distribution revealed 'repeat deserts' lacking repeats, covering approximately 40% of the genome. Conclusions: P. fluorescens genomes are highly diverse. Strain-specific regions around the replication terminus suggest genome compartmentalization. The genomic heterogeneity among the three strains is reminiscent of a species complex rather than a single species. That 42% of plant-inducible genes were not shared by all strains reinforces this conclusion and shows that ecological success requires specialized and core functions. The diversity also indicates the significant size of genetic information within the Pseudomonas pan genome.

Inhibition of coxsackie B virus infection by soluble forms of its receptors: Binding affinities, altered particle formation, and competition with cellular receptors

We previously reported that soluble decay-accelerating factor (DAF) and coxsackievirus-adenovirus receptor (CAR) blocked coxsackievirus 133 (CVB3) myocarditis in mice, but only soluble CAR blocked CVB3-mediated pancreatitis. Here, we report that the in vitro mechanisms of viral inhibition by these soluble receptors also differ. Soluble DAF inhibited virus infection through the formation of reversible complexes with CVB3, while binding of soluble CAR to CVB induced the formation of altered (A) particles with a resultant irreversible loss of infectivity. A-particle formation was characterized by loss of VP4 from the virions and required incubation of CVB3-CAR complexes at 37 degrees C. Dimeric soluble DAF (DAF-Fc) was found to be 125-fold-more effective at inhibiting CVB3 than monomeric DAF, which corresponded to a 100-fold increase in binding affinity as determined by surface plasmon resonance analysis. Soluble CAR and soluble dimeric CAR (CAR-Fc) bound to CVB3 with 5,000- and 10,000-fold-higher affinities than the equivalent forms of DAF. While DAF-Fc was 125-fold-more effective at inhibiting virus than monomeric DAF, complement regulation by DAF-Fc was decreased 4 fold. Therefore, while the virus binding was a cooperative event, complement regulation was hindered by the molecular orientation of DAF-Fc, indicating that the regions responsible for complement regulation and virus binding do not completely overlap. Relative contributions of CVB binding affinity, receptor binding footprint on the virus capsid, and induction of capsid conformation alterations for the ability of cellular DAF and CAR to act as receptors are discussed.

Overview of an innovative EU-China collaboration in education and research in sustainable built environment

This paper introduces an international collaboration of EU and Asia in education, training and research in the field of sustainable built environment, which attempts to develop a network of practical and intellectual knowledge and training exchange between Chinese and European Universities in the field of sustainable building design and construction. The projects funded by the European Commission Asia Link program, UK Foreign & Commonwealth Office, British Council and the UK Engineering Physical Sciences Council (EPSRC) have been introduced. The projects have significant impacts on promoting sustainable development in built environment in China. The aim of this paper is to share the experiences with those who are interested and searching the ways to collaborate with China in education and research.

Prebiotics and probiotics: potential strategies for reducing travellers' diarrhoea in athletes competing abroad

Travellers’ diarrhoea (TD) is the most common gastrointestinal illness to affect athletes competing abroad. Consequences of this debilitating condition include difficulties with training and/or participating in competitions which the athlete may have spent several years preparing for. Currently, there are no targeted strategies to reduce TD incidence in athletes. General methods used to reduce TD risk, such as avoidance of contaminated foods, chemoprophylactics and immunoprophylactics, have disadvantages. Since most causative agents of TD are microbial, strategies to minimise TD risks may be better focused on the gut microbiota. Prebiotics and probiotics can fortify the gut microbial balance, thus potentially aiding the fight against TD-associated microorganisms. Specific probiotics have shown promising actions against TD-associated microorganisms through antimicrobial activities. Use of prebiotics has led to an improved intestinal microbial balance which may be better equipped to combat TD-associated microorganisms. Both approaches have shown promising results in general travelling populations; therefore, a targeted approach for athletes has the potential to provide a competitive advantage.

Teaching assistants and pupils' academic and social engagement in mainstream schools: insights from systematic literature reviews

The last 20 years have seen a huge expansion in the additional adults working in classrooms in the UK, USA, and other countries. This paper presents the findings of a series of systematic literature reviews about teaching assistants. The first two reviews focused on stakeholder perceptions of teaching assistant contributions to academic and social engagement. Stakeholders were pupils, teachers, TAs, headteachers and parents. Perceptions focused on four principal contributions that teaching assistants contribute to: pupils’ academic and socio-academic engagement; inclusion; maintenance of stakeholder relations; and support for the teacher. The third review explored training. Against a background of patchy training provision both in the UK and the USA, strong claims are made for the benefits to TAs of training provided, particularly in building confidence and skills. The conclusions include implications for further training and the need for further research to gain an in-depth understanding as to precisely the manner in which TAs engage with children.