Applying Trained Skills on the Job: The Importance of the Work Environment

The influence of the work environment on the transfer of newly trained supervisory skills was examined. Participants were 505 supermarket managers from 52 stores. The work environment was operationalized in terms of transfer of training climate and continuous-learning culture. Climate and culture were hypothesized to have both direct and moderating effects on posttraining behaviors. Accounting for pretraining behaviors and knowledge gained in training, the results from a series of LISREL analyses showed that both climate and culture were directly related to posttraining behaviors. In particular, the social support system appeared to play a central role in the transfer of training. Moderating effects were not found. Implications for enhancing the transfer of training are discussed.

Literacia em saúde mental acerca da depressão e abuso de álcool de adolescentes e jovens Portugueses

RESUMO Objetivo: Este estudo tem como objetivos comparar a literacia em saúde mental dos adolescentes e jovens portugueses, relativamente à depressão e ao abuso de álcool e analisar o padrão de respostas em termos de consistência e concordância para ambas as perturbações. Método: A amostra é constituída por 4938 adolescentes e jovens, 43,0% do sexo masculino e 56,7% do sexo feminino, com uma média de idades de 16,75 anos (desvio padrão = 1,62 anos), que frequentam as escolas do 3.º ciclo do ensino básico e do ensino secundário, pertencentes à Direção Regional de Educação do Centro. Para a colheita de dados foi utilizado o QuALiSMental (LSM). Resultados: Os resultados revelam um nível de LSM modesto na generalidade das componentes. Ainda que se encontrem diferenças estatisticamente significativas (p < 0,05) em 88,0% dos itens da LSM, o que indicia diferentes formas de encarar ambos os problemas de saúde mental, os resultados revelam consistência, em termos das componentes conhecimentos e competências para prestar a primeira ajuda e apoio aos outros e conhecimentos acerca do modo de prevenção das perturbações mentais. ABSTRACT Objectives: This study aims to compare mental health literacy of adolescents and young Portuguese in what concerns depression and alcohol abuse and analyzes the pattern of responses in terms of consistency and agreement for both disorders. Method: The sample consisted of 4938 adolescents and young people, 43.0% males and 56.7% females with a mean age of 16.75 years (standard deviation = 1,62 years), who attend schools of the 3rd cycle of basic education and secondary school, belonging to the Regional Education Directorate – Center. For data collection was used QuALiSMental (MHL). Results: The results showed a modest level of MHL in most components. Although there are statistically significant differences (p < 0.05) in 88.0% of the items of MHL, suggesting different ways of looking to both mental health problems, the results show consistency in terms of the components of knowledge and skills to providing first aid and support to others and knowledge about the prevention of mental disorders.

Att möta patienter med psykisk ohälsa : Sjuksköterskans attityder och erfarenheter av att vårda patienter med psykisk ohälsa inom den somatiska vården

Bakgrund: Psykisk ohälsa ökar i hela världen, även i Sverige, främst hos den unga, kvinnliga befolkningen. Psykiska problem är ofta kopplade till somatisk ohälsa. Kvaliteten på den somatiska vården blir ofta sämre, mycket på grund av att många sjuksköterskor inte har tillräckligt med kunskap och erfarenhet inom psykiatriska omvårdnaden. Syfte: Föreliggande arbete avser att undersöka sjuksköterskors attityder och erfarenheter av patienter med psykisk ohälsa inom den somatiska vården. Metod: Litteraturöversikt av vetenskapliga artiklar. Litteratursökning i databaser med hjälp av lämpliga sökord. Artiklarnas kvalitet granskas sedan med hjälp av granskningsmallar. Resultat: Sammanlagt granskades 15 artiklar, varav 8 kvalitativa och 7 kvantitativa. Undersökningen visar att sjuksköterskor ofta har negativa erfarenheter av att vårda patienter med psykisk ohälsa. En förklaring kan vara bristande kunskap och färdigheter, vilket leder till rädsla, frustration och stress i mötet med dessa patienter. Även miljön nämns som som en stress- och orsaksfaktor till detta. Dessa faktorer leder till att sjuksköterskor till övervägande del har negativa attityder mot denna patientgrupp. Slutsats: Slutsatsen av undersökningen visar att de identifierade bristerna när det gäller kunskap och färdigheter bland annat leder till otrygghet vid vård av patienter med psykisk ohälsa inom den somatiska vården. Förbättring av detta tillstånd kan uppnås genom att höja sjuksköterskors kompetens, t.ex. genom att lägga större vikt på den psykiatriska omvårdnaden inom den praktiska utbildningen.

An Exploration of Clinical Psychologist and Educational Psychologist Constructs of Mental Health in the Context of Secondary School Aged Children

Over the past decade, Mental Health (MH) has increasingly appeared on the ‘school agenda’, both in terms of rising levels of MH difficulties in the student population, and also the expectation that schools have a role to play in supporting good MH. MH is a term fraught with ambiguities leading to uncertainty around the most appropriate ways to provide support. A review of current literature reveals a wide range of definitions and interpretations, sometimes within the same team of supporting professionals. The current study seeks to explore the perspectives held by two professional groups seemingly well placed to support young persons’ (YPs’) MH. Six Clinical Psychologists (CPs) and six Educational Psychologists (EPs) are interviewed, exploring their constructs of MH, and their perceptions of their own role and the roles of others in supporting secondary school aged YPs’ MH. The data are analysed through Thematic Analysis. Findings suggest that there are variations between the two professions’ constructs of MH, and EPs in particular have no unified concept of MH. This is likely due to less experience or training in this area. CPs and EPs hold similar perceptions of the school’s role for promoting good MH, and flagging up concerns to more specialist professionals when necessary. However, there are discrepancies in the EP and CP perceptions of each other’s roles. The conflicting views appear to emerge through incomplete information about the other, and professional defensiveness in a context where resources and funding are scarce. The current study suggests that these challenges can be addressed through: greater reflectivity on professional biases, exploration of MH constructs within other epistemological positions, and greater communication regarding professional roles, leading to clearer collaboration in supporting the MH of YP.

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.

Curricular training report: 7 months as a study coordinator at Blueclinical LTD

The present report describes in detail the activities undertaken under the coordination of clinical and observational studies during the curricular internship at Blueclinical Ltd., inserted in the Master of Pharmaceutical Biomedicine. Blueclinical Ltd.company operates in three different areas: R&D consultancy, management and coordination of trial centers, and a phase I unit. The curricular internship had the duration of seven months during which I was able to perform different tasks relating to coordination of clinical trials in Centro Hospitalar do Baixo Vouga, E.P.E., (CHBV) in Aveiro, Portugal. This academic internship allowed me to develop theoretical and practical skills in the field of clinical trials and observational studies. I also had the opportunity to further the knowledge I gained throughout my academic journey. During this internship, I had the opportunity to interact with different health professionals and develop my knowledge in the field of several therapeutic indications. I also could interact with distinct monitors and sponsors. This experience allowed me to improve time management, communication and problems resolution skills.

Care planning for aggression management in a specialist secure mental health service: user involvement

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation.

Giving Peru a productivity boost : towards a system of continuous education and training

In spite of impressive rates of economic growth, the quality of the labor force’s human capital is considered a major challenge for sustaining medium term economic growth in Peru. This note reviews the skills of the Peruvian labor force, and the status of the continuous education and training system. Based on such an assessment and on learnings from international best practices, it proposes a system of continuous education and training that draws from international best practices, but that addresses local capacity and institutional issues.

The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol

Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.

Entrepreneurial skills of students of polytechnic higher education in Portugal: Business influences

Introduction: Most of entrepreneurial ideas does not appear ready or over. Any business opportunity needs to be developed and improved throughout the enterprise process. Educational institutions may facilitate the ability of the students had undertaken, identifying and building business opportunities, enhancing their knowledge and formative experiences along the learning process. Objectives: Evaluate the business influences the entrepreneurial ability of students of the Polytechnic. Methodology: Correlational quantitative study, conducted with 1604 students from 18 institutions of the Polytechnic of Portugal. Data collection took place between July and November/2015, with a questionnaire to assess the entrepreneurial profile, Carland Entrepreneurship Index (CEI) and sociodemographic variables of students. Results: We found four business factors that influence entrepreneurship, "availability of funds" (4:13, SD = .67); "Have stable customers and incentives" (3.99, SD = .58); "Social and economic instability" (3:08, SD = 1.17) and "opportunities in the sector and area of residence" (3:36, SD = 1.05). On a scale range between (1-5), we obtained an overall score of 3.86 (SD = .55), for the corporate influences on entrepreneurship. Conclusion: For students entrepreneurial influences are important, with a greater sense of fear with regard to economic instability, reinforcing the need for further training and academic investment in the business.

Entrepreneurial skills of students of polytechnic higher education in Portugal: Business influences

Background Most entrepreneurial ideas do not appear ready or finished. Any business opportunity needs to be developed and improved throughout the enterprise process. Educational institutions may facilitate the ability of the students in undertaking, identifying and building business opportunities, enhancing their knowledge and formative experiences along the learning process. Objective: Evaluate business influences on the entrepreneurial ability of students of the Polytechnic. Methods Correlational quantitative study, conducted with 1,604 students from 18 institutions of the Polytechnic of Portugal. Data collection took place between July and November/2015, with a questionnaire to assess the entrepreneurial profile, the Carland Entrepreneurship Index (CEI) and sociodemographic variables of students. Results We found four business factors that influence entrepreneurship: "availability of funds" (4:13, SD = .67); "Having stable customers and incentives" (3.99, SD = .58); "Social and economic instability" (3:08, SD = 1.17) and "Opportunities in the sector and area of residence" (3:36, SD = 1.05). On a scale ranging between 1 and 5, we obtained an overall score of 3.86 (SD = .55), for the corporate influences on entrepreneurship. Conclusions For students, entrepreneurial influences are important, with a greater sense of fear with regard to economic instability, reinforcing the need for further training and academic investment in business.

Vocational training and knowledge development: a deeper understanding

Construction management research literature has identified the importance of understanding the practical realities of skills and training provision and the role of reflective practice in the development of knowledge. This paper examines vocational training of experienced site staff in the development of their knowledge through SVQ training to investigate the primary factors for successful learning in site-based construction staff with a supervisory/management role. Using semi-structured interviews the impact of vocational training on individual candidates and other sitebased staff are investigated. The paper explores, through the reflections of 26 SVQ candidates (20 SVQ3 and 6 SVQ4), a deeper understanding of how site supervisors and site managers learn through the SVQ process and develop tacit knowledge through formal reflection. Reflective practice develops practical wisdom (Phronesis). The investigation explains aspects of practical wisdom and how knowledge, practice and skills are developed through vocational training. There is a clear perception by those completing the qualification that it has enabled them to perform their job better identifying numerous examples relating to problem solving, critical thinking, making decisions and leadership. It has been found that Phronesis is evident on a day-to-day basis on site activities developed through reflective practice in personal development. The reflective practice in developing knowledge also builds, within individuals, a better understanding of themselves and their capabilities through the learning achieved in the SVQ. Future work is identified around analysing the role of the assessor in facilitating Phronesis in the SVQ context.

Peer-training model in basic life support in high education health students

Background: Disseminate Basic Life Support (BLS) skills, through a peer-training programme, to high education health students (ESTeSL) and determine its effectiveness.

O desenvolvimento e integração de estratégias de cálculo mental no 5.º ano de escolaridade

Relatório de estágio apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ensino do 1.º e 2.º Ciclo do Ensino Básico

Five-year review of an international clinical research-training program

The exponential increase in clinical research has profoundly changed medical sciences. Evidence that has accumulated in the past three decades from clinical trials has led to the proposal that clinical care should not be based solely on clinical expertise and patient values, and should integrate robust data from systematic research. As a consequence, clinical research has become more complex and methods have become more rigorous, and evidence is usually not easily translated into clinical practice. Therefore, the instruction of clinical research methods for scientists and clinicians must adapt to this new reality. To address this challenge, a global distance-learning clinical research-training program was developed, based on collaborative learning, the pedagogical goal of which was to develop critical thinking skills in clinical research. We describe and analyze the challenges and possible solutions of this course after 5 years of experience (2008-2012) with this program. Through evaluation by students and faculty, we identified and reviewed the following challenges of our program: 1) student engagement and motivation, 2) impact of heterogeneous audience on learning, 3) learning in large groups, 4) enhancing group learning, 5) enhancing social presence, 6) dropouts, 7) quality control, and 8) course management. We discuss these issues and potential alternatives with regard to our research and background.