Comfort Care Rounds: A Staff Capacity-Building Initiative in Long-Term Care Homes

This article reports a pilot evaluation of Comfort Care Rounds (CCRs)-a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation.

A strategy towards professionalism in the dissecting room

The teaching and cultivation of professionalism is an integral part of medical education as professionalism is central to maintaining the public’s trust in the medical profession. Traditionally professional values would have been acquired through an informal process of socialisation and observation of role models. Recently, however, medical educators have accepted the responsibility to explicitly teach and effectively evaluate professionalism. A comprehensive working definition of the term professionalism and a universally agreed list of the constituent elements of professionalism are currently debated. The School of Medicine and Dentistry of The Queen’s University of Belfast uses an approach of self-directed learning for teaching anatomy, and students are given the opportunity to learn anatomy from human dissection. Self-directed learning teams have been found to be underutilised as educational strategies and presented an opportunity to utilise the first year dissection room teaching environment to nurture the development of the attributes of professionalism. An educational strategy based on role-playing was developed to engage all students around the dissection table. Students received comprehensive background reviews on professionalism, its attributes and the identification of such attributes in the context of the dissection room. Roles, with specific duties attached, were allocated to each team member. Circulating academic staff members directly observed student participation and gave formative feedback. Students were given the opportunity to reflect on their ability to identify the attributes and reflect on their own and their peer’s ability to develop and practise these attributes. This strategy indicated that small group learning teams in the dissection room utilise widely accepted principles of adult learning and offer an opportunity to create learning activities that will instil in students the knowledge, values, attitudes and behaviours that characterise medical professionalism. Anatomy faculty have a responsibility to nurture and exemplify professionalism and play a significant role in the early promotion and inculcation of professionalism. It remains imperative not only to assess this strategy but also to create opportunities for critical reflection and evaluation within the strategy. Key words: Medical Education – Professionalism – Anatomy - Reflective Practise – Role-play

Curricular Unit: Pharmacotherapy Follow-Up

Objectives: Pharmaceutical care is a patient-centered philosophy of assistential practice in which the pharmacist, as a health care team member, has responsibilities in patient medication. The correct use of medicines will significantly decrease the negative outcomes of pharmacotherapy, namely untreated health problem..

Studies of dynamics of physical agent ecosystems

This thesis addresses the problem of learning in physical heterogeneous multi-agent systems (MAS) and the analysis of the benefits of using heterogeneous MAS with respect to homogeneous ones. An algorithm is developed for this task; building on a previous work on stability in distributed systems by Tad Hogg and Bernardo Huberman, and combining two phenomena observed in natural systems, task partition and hierarchical dominance. This algorithm is devised for allowing agents to learn which are the best tasks to perform on the basis of each agent's skills and the contribution to the team global performance. Agents learn by interacting with the environment and other teammates, and get rewards from the result of the actions they perform. This algorithm is specially designed for problems where all robots have to co-operate and work simultaneously towards the same goal. One example of such a problem is role distribution in a team of heterogeneous robots that form a soccer team, where all members take decisions and co-operate simultaneously. Soccer offers the possibility of conducting research in MAS, where co-operation plays a very important role in a dynamical and changing environment. For these reasons and the experience of the University of Girona in this domain, soccer has been selected as the test-bed for this research. In the case of soccer, tasks are grouped by means of roles. One of the most interesting features of this algorithm is that it endows MAS with a high adaptability to changes in the environment. It allows the team to perform their tasks, while adapting to the environment. This is studied in several cases, for changes in the environment and in the robot's body. Other features are also analysed, especially a parameter that defines the fitness (biological concept) of each agent in the system, which contributes to performance and team adaptability. The algorithm is applied later to allow agents to learn in teams of homogeneous and heterogeneous robots which roles they have to select, in order to maximise team performance. The teams are compared and the performance is evaluated in the games against three hand-coded teams and against the different homogeneous and heterogeneous teams built in this thesis. This section focuses on the analysis of performance and task partition, in order to study the benefits of heterogeneity in physical MAS. In order to study heterogeneity from a rigorous point of view, a diversity measure is developed building on the hierarchic social entropy defined by Tucker Balch. This is adapted to quantify physical diversity in robot teams. This tool presents very interesting features, as it can be used in the future to design heterogeneous teams on the basis of the knowledge on other teams.

Planeamento e orientação de uma equipa de Basquetbol do escalão de juniores "B" ao longo da época 2010/2011

RESUMO:O Basquetebol como desporto global, sendo visualizado e praticado em variados contextos e realidades, deve igualmente perceber-se que existem diferentes formas de vê-lo e treiná-lo. Não existe assim uma forma correta ou incorreta, mas sim várias maneiras de entender o jogo. Neste relatório, no âmbito do Mestrado em Treino Desportivo, expomos a nossa maneira de pensar o jogo bem como as decisões e ações tomadas no processo de treino dos jovens jogadores da equipa de Basquetebol de Juniores “B” Masculinos dos Salesianos Oficinas de São José (OSJ) durante a época desportiva de 2010/2011. A Escola de Basquetebol dos Salesianos OSJ surgiu há cerca de vinte anos, e é um clube integrante e sólido da formação em basquetebol na região de Lisboa. O planeamento foi estruturado num macrociclo, dividido em dois mesociclos, apresentando cada os seus pressupostos e objetivos. O primeiro mesociclo constituído por doze microciclos e o segundo mesociclo por oito microciclos, num total de cento e cinco unidades de treino. A equipa era constituída por treze atletas, com idades compreendidas entre os quinze e os dezanove anos. Relativamente aos jogadores e à equipa consideramos que os objetivos traçados foram alcançados com sucesso, sendo que os jogadores evoluíram significativamente como jogadores e pessoas, e que a equipa atingiu as classificações ambicionadas. Como Treinador considero que foi uma época enriquecedora, que proporcionou vários momentos de reflexão, sendo que estes deverão fazer parte da nossa maneira de estar no desporto, pois só através deles poderemos enriquecer a condução do processo de treino. ABSTRACT: Basketball as a global sport, being viewed and practiced in various contexts and realities, should also realize that are different ways of watching and training it. However, there’s no correct or incorrect way, but many ways of understanding the game. In this report, under the Master of Sports Training, we present our way of thinking the game and the decisions and actions taken in the process of training young basketball players from the Salesianos Oficinas de São José (OSJ) Junior “B” men´s team, during the 2010/2011 sports season. The Salesianos OSJ Basketball School was created about twenty years ago and it’s a strong team member of Young Basketball Training in the Lisbon Region. The team plan was structured in a macrocycle, divided in two mesocycles and each one has its own assumptions and goals. The first mesocycle is composed by twelve microcycles and the second one by eight microcycles, in a total of one hundred and five training sessions. The team is composed by thirteen players, aged between fifteen and nineteen years old. Relating to the players and the team, we believe that the goals were successfully achieved, and the players have evolved meaningly not only as players but also as people, and the team’s coveted standings. As a coach, I think it was an enriching season, which provided many reflective moments and these should be part of our way of being in sport, because only through them we can enrich the process of conducting the training.

Online self and peer assessment in large, multi-campus, multi-cohort contexts

The increasing use of team assignments within higher education is well documented. The driving forces behind this include desires to facilitate reflective and collaborative learning, to develop generic teamwork skills for graduate employment and to reduce the grading workloads of faculty staff. Students however consistently report dissatisfaction when the assessment of team assignments produces a common grade for all team members. Self-andpeer-assessment (SAPA) is presented as a fair, valid and reliable method of producing information about ongoing team processes. This information can provide ongoing feedback to team members and rich formative data to instructors attempting to assess the team process and students’ teamwork skills. This data can also enable individualised summative assessment in dysfunctional teams or situations of uneven team member contributions. Whilst manual SAPA protocols can work effectively for smaller classes, computer-assisted SAPA offers a solution to the problems of large classes. This paper reports on the early stages of an online SAPA tool, originally developed for small classes of architecture students, adapted for use by very large business communication classes comprising up to 1000 students in a semester. This large unit is delivered on four Australian campuses as well as off-campus and in off-shore mode, by up to fourteen instructors at any one time. The paper documents how three researchers from very different backgrounds worked to create their own research team, implement a pilot study, and adapt the online tool, whilst adhering to comparability of assessment constraints and maintaining integrity of research design.

Atuação das equipes da atenção primária na identificação precoce do câncer infanto-juvenil

Identificar o conhecimento de profissionais da atenção primária sobre a identificação precoce do câncer infanto-juvenil e descrever o desempenho das equipes de saúde antes da realização de treinamentos para identificação precoce do câncer infanto-juvenil. Método: Os dados foram obtidos por um questionário e grupo focal com 30 profissionais de uma Unidade de Saúde da Família, e analisados por temas geradores. Resultados: Os profissionais possuem conhecimentos sobre a identificação do câncer infanto-juvenil, e, demandam conhecer mais sobre os sinais e sintomas para identificação precoce, e a prestação de uma assistência sistematizada. Conclusão: Torna-se fundamental estimular a qualificação dos profissionais da atenção primária para a identificação precoce e o fortalecimento de uma rede de assistência que proporcione atendimento integral e a redução no retardo do diagnóstico de câncer infanto-juvenil

No caleidoscópio o estresse da equipe de enfermagem da UTI de um Hospital Universitário em Natal-RN

This study aimed to analyze stress on nursing staff of intensive care at the Teaching Hospital Onofre Lopes. The study sample consisted of thirty-eight (38) nursing professionals, including technicians and nurses working in the ICU of the hospital Data were collected between September to November 2011 in two stages.The first was the application of the Lipp Stress Symptoms Inventory (LSSI), which allowed us to measure the stress phase in which each team member was. After that, data were tabulated in Microsoft Excel spreadsheets and analyzed according to the 2010 inventory guidelines proposed by the author. After this analysis it was possible to complete the second phase of the research, which consisted of a semi-structured interview designed for those workers who were in the second phase of stress, resistance. Data analysis was based on Bardin 2004 content analysis, enabling the creation of categories based on grouping the ideas present in the interviewees' statements. It was found that the study population was mostly female (78.9%) aged from 30 to 39 years (50%), married (52.3%) and with dual-employment (65.7%). The most predominant phase, according to the Lipp inventory, was the stress resistance, present in 44.7% of the team and having as most predominant physical symptoms the constant feeling of physical exhaustion, verified in 16.8% of the participants, and psychological, the excessive irritability and emotional sensitivity in 26.3%. Regarding the qualitative data it was possible to establish three categories and four subcategories, with the following categories: the stressors of the workplace, overwork and the interpersonal relationships of the nursing staff in the ICU. And as subcategories: Routine care in the ICU; Pressures and Individual Charges; double journey: professional reflections on daily life, the night shift nursing staff and the body suffers, the manifestations of stress; deficient communication between team members. Thus, this study allowed the visualization of the stress phenomenon on nursing staff of the Teaching Hospital Onofre Lopes as a kaleidoscope of thoughts, feelings and experiences perceived by these professionals in different areas of their lives. It was also verified that the strengthening of the stress theme among nursing professionals need to be exploited and stimulated in several nursing areas of discussion so these workers are encouraged to take better care of themselves so they can take care of others health

O agente comunitário de saúde frente ao processo de trabalho em equipe: facilidades e dificuldades

O estudo propõe-se a analisar as dificuldades e facilidades dos Agentes Comunitários de Saúde (ACS) frente ao trabalho em equipe. A análise pautou-se na perspectiva hermenêutica-dialética, tendo como referência os princípios do método de interpretação dos sentidos. As dificuldades e facilidades apontadas por eles revelam que trabalhar em equipe demanda relações efetivas, com ênfase na comunicação, respeito e cooperação, sendo as reuniões de equipe estratégia importante para isso. Depreende-se a necessidade de constantes investimentos nas relações entre os membros da equipe.

A Organização do trabalho de uma equipe gestora e o desempenho escolar dos alunos

Pós-graduação em Educação Escolar - FCLAR

Food choices and practices during pregnancy of immigrant and Aboriginal women in Canada: a study protocol

Abstract Background Facilitating the provision of appropriate health care for immigrant and Aboriginal populations in Canada is critical for maximizing health potential and well-being. Numerous reports describe heightened risks of poor maternal and birth outcomes for immigrant and Aboriginal women. Many of these outcomes may relate to food consumption/practices and thus may be obviated through provision of resources which suit the women's ethnocultural preferences. This project aims to understand ethnocultural food and health practices of Aboriginal and immigrant women, and how these intersect with respect to the legacy of Aboriginal colonialism and to the social contexts of cultural adaptation and adjustment of immigrants. The findings will inform the development of visual tools for health promotion by practitioners. Methods/Design This four-phase study employs a case study design allowing for multiple means of data collection and different units of analysis. Phase 1 consists of a scoping review of the literature. Phases 2 and 3 incorporate pictorial representations of food choices (photovoice in Phase 2) with semi-structured photo-elicited interviews (in Phase 3). The findings from Phases 1-3 and consultations with key stakeholders will generate key understandings for Phase 4, the production of culturally appropriate visual tools. For the scoping review, an emerging methodological framework will be utilized in addition to systematic review guidelines. A research librarian will assist with the search strategy and retrieval of literature. For Phases 2 and 3, recruitment of 20-24 women will be facilitated by team member affiliations at perinatal clinics in one of the city's most diverse neighbourhoods. The interviews will reveal culturally normative practices surrounding maternal food choices and consumption, including how women negotiate these practices within their own worldview and experiences. A structured and comprehensive integrated knowledge translation plan has been formulated. Discussion The findings of this study will provide practitioners with an understanding of the cultural differences that affect women's dietary choices during maternity. We expect that the developed resources will be of immediate use within the women's units and will enhance counseling efforts. Wide dissemination of outputs may have a greater long term impact in the primary and secondary prevention of these high risk conditions.

The gender typicality of faces and its impact on visual processing and on hiring decisions

Past research has shown that the gender typicality of applicants’ faces affects leadership selection irrespective of a candidate’s gender: A masculine facial appearance is congruent with masculine-typed leadership roles, thus masculine-looking applicants are hired more certainly than feminine-looking ones. In the present study, we extended this line of research by investigating hiring decisions for both masculine- and feminine-typed professional roles. Furthermore, we used eye tracking to examine the visual exploration of applicants’ portraits. Our results indicate that masculine-looking applicants were favored for the masculine-typed role (leader) and feminine-looking applicants for the feminine-typed role (team member). Eye movement patterns showed that information about gender category and facial appearance was integrated during first fixations of the portraits. Hiring decisions, however, were not based on this initial analysis, but occurred at a second stage, when the portrait was viewed in the context of considering the applicant for a specific job.

Zonal playfield attributes – A stochastic approach to subjective passing affordances in football

Introduction: According to the ecological view, coordination establishes byvirtueof social context. Affordances thought of as situational opportunities to interact are assumed to represent the guiding principles underlying decisions involved in interpersonal coordination. It’s generally agreed that affordances are not an objective part of the (social) environment but that they depend on the constructive perception of involved subjects. Theory and empirical data hold that cognitive operations enabling domain-specific efficacy beliefs are involved in the perception of affordances. The aim of the present study was to test the effects of these cognitive concepts in the subjective construction of local affordances and their influence on decision making in football. Methods: 71 football players (M = 24.3 years, SD = 3.3, 21 % women) from different divisions participated in the study. Participants were presented scenarios of offensive game situations. They were asked to take the perspective of the person on the ball and to indicate where they would pass the ball from within each situation. The participants stated their decisions in two conditions with different game score (1:0 vs. 0:1). The playing fields of all scenarios were then divided into ten zones. For each zone, participants were asked to rate their confidence in being able to pass the ball there (self-efficacy), the likelihood of the group staying in ball possession if the ball were passed into the zone (group-efficacy I), the likelihood of the ball being covered safely by a team member (pass control / group-efficacy II), and whether a pass would establish a better initial position to attack the opponents’ goal (offensive convenience). Answers were reported on visual analog scales ranging from 1 to 10. Data were analyzed specifying general linear models for binomially distributed data (Mplus). Maximum likelihood with non-normality robust standard errors was chosen to estimate parameters. Results: Analyses showed that zone- and domain-specific efficacy beliefs significantly affected passing decisions. Because of collinearity with self-efficacy and group-efficacy I, group-efficacy II was excluded from the models to ease interpretation of the results. Generally, zones with high values in the subjective ratings had a higher probability to be chosen as passing destination (βself-efficacy = 0.133, p < .001, OR = 1.142; βgroup-efficacy I = 0.128, p < .001, OR = 1.137; βoffensive convenience = 0.057, p < .01, OR = 1.059). There were, however, characteristic differences in the two score conditions. While group-efficacy I was the only significant predictor in condition 1 (βgroup-efficacy I = 0.379, p < .001), only self-efficacy and offensive convenience contributed to passing decisions in condition 2 (βself-efficacy = 0.135, p < .01; βoffensive convenience = 0.120, p < .001). Discussion: The results indicate that subjectively distinct attributes projected to playfield zones affect passing decisions. The study proposes a probabilistic alternative to Lewin’s (1951) hodological and deterministic field theory and enables insight into how dimensions of the psychological landscape afford passing behavior. Being part of a team, this psychological landscape is not only constituted by probabilities that refer to the potential and consequences of individual behavior, but also to that of the group system of which individuals are part of. Hence, in regulating action decisions in group settings, informers are extended to aspects referring to the group-level. References: Lewin, K. (1951). In D. Cartwright (Ed.), Field theory in social sciences: Selected theoretical papers by Kurt Lewin. New York: Harper & Brothers.

Introduction to public health preparedness for disaster and emergency response

The unprecedented attacks of September 11, 2001, and the subsequent anthrax-related events thrust our nation's often forgotten public health system into the forefront of public attention. A strong public health system with a well-prepared workforce plays a critical role in preparing for and responding to the threat of bioterrorism and other disasters and emergencies. Technical expertise is critical as is a basic awareness and understanding of core public health competencies especially as they relate to disaster and emergency response is also imperative for a public health agency to function as a vital Emergency Response team member. Ideally this training should begin at the Public Health graduate level so as to provide the baseline core tools to be able to function as a vital team member when they are practicing out in the real world. Online learning is an efficient and effective method for providing public health education to in a flexible format to meet the needs of busy student-professions. This Public Health Disaster Preparedness online course developed during an Emergency Response state program practicum is a practical and proficient approach to accomplish this endeavor. ^

Guide to Writing a Programmatic Resource Management Plan/ Environmental Impact Statement for the Bureau of Land Management

This guide is written for Booz Allen Hamilton (BAH) employees assigned to the Public Lands team who may have some National Environmental Policy Act (NEPA) knowledge, possibly have experience with writing Environmental Impact Statements (EIS), and with little or no experience writing programmatic EIS documents. The guide contains information encompassing the preparation of a complete Resource Management Plan/Environmental Impact Statement (RMP/EIS) for the Bureau of Land Management. The RMP/EIS is a programmatic NEPA document which has many differences and nuances distinct from a typical project type EIS. This guide provides the information necessary for a BAH Public Lands team member to understand the project process and the RMP/EIS document to successfully maneuver through the entire project from beginning to end.