Sudden Cardiac Death in Brazil: Study Based on Physicians' Perceptions of the Public Health Care System

Background: There are no available statistical data about sudden cardiac death in Brazil. Therefore, this study has been conducted to evaluate the incidence of sudden cardiac death in our population and its implications. Methods: The research methodology was based on Thurstone's Law of Comparative Judgment, whose premise is that the more an A stimulus differs from a B stimulus, the greater will be the number of people who will perceive this difference. This technique allows an estimation of actual occurrences from subjective perceptions, when compared to official statistics. Data were collected through telephone interviews conducted with Primary and Secondary Care physicians of the Public Health Service in the Metropolitan Area of Sao Paulo (MASP). Results: In the period from October 19, 2009, to October 28, 2009, 196 interviews were conducted. The incidence of 21,270 cases of sudden cardiac death per year was estimated by linear regression analysis of the physicians responses and data from the Mortality Information System of the Brazilian Ministry of Health, with the following correlation and determination coefficients: r = 0.98 and r2= 0.95 (95% confidence interval 0.81.0, P < 0.05). The lack of waiting list for specialized care and socioadministrative problems were considered the main barriers to tertiary care access. Conclusions: The incidence of sudden cardiac death in the MASP is high, and it was estimated as being higher than all other causes of deaths; the extrapolation technique based on the physicians perceptions was validated; and the most important bureaucratic barriers to patient referral to tertiary care have been identified. (PACE 2012; 35:13261331)

Hurdles at work: perceptions of hospital food handlers

Abstract Background Food handlers have a very important role in preventing food contamination during its preparation and distribution. This responsibility is even greater in hospitals, since a large number of patients have low immunity and consequently food contamination by pathogenic bacteria could be particularly harmful. Therefore, a good working environment and periodic training should be provided to food handlers by upper management. Methods This study is qualitative research by means of focus group and thematic content analysis methodologies to examine, in detail, the statements by food handlers working in the milk and specific-diet kitchens in a hospital to understand the problems they face in the workplace. Results We found that food handlers are aware of the role they play in restoring patients' health; they consider it important to offer a good-quality diet. However, according to their perceptions, a number of difficulties prevent them from reaching this aim. These include: upper management not prioritizing human and material resources to the dietetic services when making resource allocation decisions; a perception that upper management considers their work to be of lesser importance; delayed overtime payments; lack of periodic training; managers lacking administrative skills; insufficient dietitian staff assistants, leading to overwork, at the same time as there is an excess of dietitians; unhealthy environmental working conditions – high temperature, high humidity, loud and constant noise level, poor ventilation; lack of food, and kitchen utensils and equipment; and relationship conflicts with chief dieticians and co-workers. Conclusion From these findings, improvement in staff motivation could be achieved by considering non-financial incentives, such as improvement in working conditions and showing appreciation and respect through supervision, training and performance appraisal. Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems.

Palliative care in the home: perceptions of nurses in the Family Health Strategy

OBJECTIVE: To understand the perception of nurses from the Family Health Strategy in relation to palliative care in the home. METHODS: A descriptive, exploratory study with a qualitative approach conducted with nine nurses from the Family Health Strategy of the municipality of Lavras - MG. Semi-structured interviews were conducted and data were subjected to content analysis. RESULTS: The various dimensions of care in the home context were identified, along with the performance and limitations of nurses in the care of the patient and his family at end of life. The capacity to establish a bond, by the proximity to people who receive their care, is a remarkable point of the action of these nurses with patients and families in end of life situations. CONCLUSION: The nurses consider the patient and his family as the unit of care, they have the opportunity to share solidarity, experiences and learning, not only from a professional standpoint, but above all, from a human one.

Exercising the self : On the Role of Exercise, Gender and Culture in Physical Self-Perceptions

In modern society, individuals constantly pass judgments on their own body and physical competence as well as that of other people. All too often, the verdict is less favourable. For the person, these physical self-perceptions (PSP) may negatively affect global self-esteem, identity, and general mental well being. The overall aim of this thesis is to examine primarily the role that exercise, but also the roles that gender and culture, play in the formation of PSP. In Study I, using confirmatory factor analyses, strong support for the validity of a first-order, and a second-order hierarchical and multidimensional model of the Physical Self-Perception Profile (PSPP: Fox & Corbin, 1989) was found across three national samples (Great Britain, Sweden and Turkey) of university students. Cross-cultural differences were detected, with the British sample demonstrating higher latent means on all PSPP subdomains except for the physical condition subdomain (Condition), than the Swedish and Turkish samples. In Study II, a higher self-reported exercise frequency was associated with more positive PSP (in particular for Condition) and more importance attributed to PSP in Swedish university students. Males demonstrated higher overall PSPP-scores than females. In Study III, a true-experimental design with randomisation into an intervention and a control group was adopted. Strong support for the effects of an empowerment-based exercise intervention programme on PSP and social physique anxiety (SPA) over six months for adolescent girls was found. The relations of exercise, gender and culture with PSP, SPA and self-esteem are discussed from the standpoints of a variety of theoretical models (the EXSEM-model), and frameworks (self-presentation and objectification theory). The two theories of self-enhancement and skill-development are examined with regard to the direction of the exercise-physical self relationship and motivation for exercise. Arguments for the relevance of exercise and PSP for practitioners in promoting general mental well-being and preventing modern-day diseases are outlined.

Internationalization intentions: micro-foundations and psychological distance perceptions in immigrant and non-immigrant entrepreneurs

This dissertation project aims at shedding light on the micro-foundations of international entrepreneurship, focusing on the pre-internationalization phase and taking an individual-level perspective. Three research questions are investigated building on a cognitive model of internationalization intentions. First, what are the antecedents to internationalization intentions, i.e. desirability and feasibility, and how they interact with psychological distance towards internationalization options. Second, what is the role of previous entrepreneurs’ experience on such antecedents, in particular for immigrant vs. non-immigrant entrepreneurs. Third, how are these antecedent elements influenced by entrepreneurs’ individual-level motivations and goals. Using a new data set from 140 independent, non-internationalized, high-tech SMEs and their 169 owners, a variety of analytical techniques are used to investigate the research questions, such as structural equation modeling, hierarchical regression and a "laddering" technique. This project advances our theoretical understanding of internationalization and international entrepreneurship and has relevant implications for entrepreneurs and policy-makers.

I think of my family, therefore I am: perceptions of daily occupations of some Albanians in Switzerland

The purpose of this qualitative study was to increase the understanding of the relationship between culture and occupation by exploring the perceptions of current daily occupations of some immigrants living in Switzerland. Semi-structured interviews with eight healthy Muslim Albanian men doing blue-collar work were analysed in a comparative manner followed by an interpretation. Three themes were identified: "Everything I do I do for my family"; "Where do I belong?"; and "Doing something for myself". These themes reflect the occupational perceptions of the participants. The findings are discussed in relation to the ongoing discourses on individualism and collectivism. To offer occupational therapy appropriately to a multicultural clientele the findings indicate the necessity to be conscious of the differences between one's own and the client's attitudes regarding individualism and collectivism.

Chemotherapy patients' perceptions of drug administration safety

To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.

Oncology nurses' perceptions about involving patients in the prevention of chemotherapy administration errors

To explore oncology nurses' perceptions and experiences with patient involvement in chemotherapy error prevention.

Individual Differences in First and Fourth Year College Women’s Short Term Mating Strategy Preferences and Perceptions

Using survey methodology, a cross sectional study was undertaken to ascertain whether first and fourth year college women have different perceptions and behavior associated with short term mating preferences. It was hypothesized that after incurring significant negative or costly experiences associated with hooking up, fourth year women would prefer men who had qualities associated with a desired long term partner as opposed to characteristics associated with short term mating partners. The results were partially consistent with the hypothesis. Reported preferences in a desired partner and perspective on hooking up differ between first and fourth year groups. No difference was found between frequency and willingness to hookup between the two groups. The findings are explained in terms of evolutionary theory, social exchange theory, and sexual script concepts.

Individual differences in first and fourth year college women’s short term mating strategy preferences and perceptions

Using survey methodology, a cross sectional study was undertaken to ascertain whether first and fourth year college women have different perceptions and behavior associated with short term mating preferences. It was hypothesized that after incurring significant negative or costly experiences associated with hooking up, fourth year women would prefer men who had qualities associated with a desired long term partner as opposed to characteristics associated with short term mating partners. The results were partially consistent with the hypothesis. Reported preferences in a desired partner and perspective on hooking up differ between first and fourth year groups. No difference was found between frequency and willingness to hookup between the two groups. The findings are explained in terms of evolutionary theory, social exchange theory, and sexual script concepts.

'New perspectives on well-known issues': patients' experiences and perceptions of safety in Swiss hospitals

Patients' reports of safety-related events and perceptions of safety can be a valuable source for hospitals. Patients of eight acute care hospitals in Switzerland were surveyed for safety-related events and concerns for safety. In workshops with hospitals areas for improvement were analyzed and priorities for change identified. To evaluate the benefit of the approach, semi-structured interviews were conducted with hospital risk managers. 3,983 patients returned the survey (55% response rate). 21.4% reported at least one definite safety event, and the mean number of 'definite' incidents per patient was 0.31 (95% CI=0.29 to 0.34). 3.2% were very concerned and 14.7% were somewhat concerned about medical errors and safety. Having experienced a safety-related event, younger age, length of stay, poor health and a poor education increased the probability of reporting concerns. With some exceptions, results confirmed the hospitals' a priori expectations regarding the strengths and weaknesses of their institutions. Risk managers emphasized the usability of results for their work and the special value of referring to the patient's perspective at their home institutions. A considerable fraction of patients subjectively experiences safety-related events and is concerned about safety. Patient-generated data introduced a new quality into the discussion of safety issues within hospitals, and some expected that patients' experiences and concerns could affect patient volumes. Though the study is limited by the short time horizon and the lack of follow-up, the results suggest that the described approach is feasible and can serve as a supplemental tool for risk identification and management.

Patients' and healthcare workers' perceptions of a patient safety advisory

To assess patients' and healthcare workers' (hcw) attitudes and experiences with a patient safety advisory, to investigate predictors for patients' safety-related behaviors and determinants for staff support for the advisory.

Fear of the unknown: local knowledge and perceptions of the Eurasian lynx

The remnant population of Balkan lynx Lynx lynx martinoi is small, isolated and highly threatened. Since 2006 a conservation project has surveyed its status and promoted its recovery in Albania and Macedonia. Eurasian lynx are often associated with conflicts of an economic or social nature, and their conservation requires a focus on the people sharing the landscape with the species. In this study we adopt methods and conceptual frameworks from anthropology to explore the local knowledge and perceptions of lynx among rural hunters and livestock breeders in the western mountains of the Republic of Macedonia in south-east Europe. The main finding was that local people rarely saw or interacted with lynx. As the level of interactions with this species is very low, the lynx doesn?t appear to be a species associated with conflicts in Macedonia. There was also a general lack of both scientific and local knowledge, which has led to somewhat negative attitudes, mainly based on myths and rumours. Poaching of lynx and their prey seem to be the main barriers to lynx conservation.

How Do Relationship Labels Affect Partner Treatment And Relationship Status Perceptions?

The present research examined which terms are most used by college students to define relationships, and how these various terms prime or affect partner treatment and relationship status perceptions. Once primed with the labels ¿hooking-up,¿ ¿exclusive¿ or ¿boyfriend/girlfriend,¿ it was hypothesized that public displays of affection, commitment, jealousy and sociosexuality would influence partner treatment. The results indicate that being primed with various relationship labels does influence public displays of affection. This priming does not influence jealousy, and it influences commitment on some occasions. The data collected can further our understanding of relationship dynamics among college students by differentiating between various terms.