The management of bone tools from the Bronze Age site of El Portalón of Cueva Mayor, Sierra de Atapuerca, Burgos

In this paper we analyze the set of Bronze Age bone tools recovered at the archaeological site of El Portalón of Cueva Mayor in the Sierra de Atapuerca (Burgos). The Bronze Age cultural period is the best represented in the cavity and its study has forced us to unify the different excavation and stratigraphical criteria undertaken from the earliest archaeological excavations developed by J.M. Apellániz during the 70s until the excavations of the current research team (EIA) since 2000. We propose here for the first time a relationship between the initial system of “beds” used by Apellániz and our recent sedimentary sequence that recognizes eleven stratigraphic levels radiometrically dated from the late Upper Pleistocene to the Middle Age. Within the bone industry assemblage we recognize a large variety of utensils and ornamental elements, with native and allochthonous features, that make evident a regional as well as long distance relationships of these populations of the interior of the Iberian Peninsula during the recent Prehistory.

The pervasiveness and trajectory of methodological choices: A 20 year review of human resource management research

This paper examines the methodological choices of researchers studying the HR practices–outcome relationship via a content analysis of 281 studies published across the last twenty years. The prevalence and trajectory of change over time are reported for a wide range of methodological choices relevant to internal, external, construct, and statistical conclusion validity. While the results indicate a high incidence of potentially problematic cross-sectional, single informant, and single level designs, they also reveal significant improvements over time across many validity relevant methodological choices. This broad based improvement in the methodological underpinnings of HR research suggests that researchers and practitioners can view the findings reported in the HR literature with increasing confidence. Directions for future research are provided.

GPs’ and community pharmacists’ opinions on medication management at transitions of care in Ireland

Objective. The aim of this study was to survey GPs and community pharmacists (CPs) in Ireland regarding current practices of medication management, specifically medication reconciliation, communication between health care providers and medication errors as patients transition in care.
Methods. A national cross-sectional survey was distributed electronically to 2364 GPs, 311 GP Registrars and 2382 CPs. Multivariable associations comparing GPs to CPs were generated and content analysis of free text responses was undertaken.
Results. There was an overall response rate of 17.7% (897 respondents—554 GPs/Registrars and 343 CPs). More than 90% of GPs and CPs were positive about the effects of medication reconciliation on medication safety and adherence. Sixty per cent of GPs reported having no formal system of medication reconciliation. Communication between GPs and CPs was identified as good/very good by >90% of GPs and CPs. The majority (>80%) of both groups could clearly recall prescribing errors, following a transition of care, they had witnessed in the previous 6 months. Free text content analysis corroborated the positive relationship between GPs and CPs, a frustration with secondary care communication, with many examples given of prescribing errors.
Conclusions. While there is enthusiasm for the benefits of medication reconciliation there are limited formal structures in primary care to support it. Challenges in relation to systems that support inter-professional communication and reduce medication errors are features of the primary/secondary care transition. There is a need for an improved medication management system. Future research should focus on the identified barriers in implementing medication reconciliation and systems that can improve it.

The Family Model - A transgenerational approach to mental health in families: personal, clinical, educational, research, systems and policy perspectives

The Family Model – A transgenerational approach to mental health in families This workshop will provide an overview on The Family Model (TFM) and its use in promoting and facilitating a trans­generational family focus in Mental Health services, over the past 10­ - 15 years. Each of the speakers will address a different perspective, including service user/consumer, clinical practice, education & training, research and policy. Adrian Falkov (chair) will provide an overview of TFM to set the scene and a ‘policy to practice’ perspective, based on use of TFM in Australia. Author: Heide Lloyd. The Family Model ­ A personal (consumer/patient) perspective | United Kingdom Heide will provide a description of her experiences as a child, adult, parent & grandparent, using TFM as the structure around which to ‘weave’ her story and demonstrate how TFM has assisted her in understanding the impact of symptoms on her & family and how she has used it in her management of symptoms and recovery (personal perspective). The Family Model ­ Education & training perspective ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway Authors: ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway This combined (UK & Norwegian) presentation will cover historical background to TFM and its use in eLearning (the Social Care Institute for Excellence)and a number of other UK initiatives, together with a description of the postgraduate masters course at the University Oslo/Akershus, using TFM. The Family Model ­ A research perspective PhD Anne Grant | Northern Ireland Author: PhD Anne Grant | Ireland Anne Grant will describe how she used TFM as the theoretical framework for her PhD looking at family focused (nursing) practice in Ireland. The Family Model ­ A service systems perspective ­ Mary Donaghy | Northern Ireland Authors: PhD Adrian Falkov | Australia ­ Mary Donaghy | N Ireland Mary Donaghy will discuss how TFM has been used to support & facilitate a cross service ‘whole of system’ change program in Belfast (NI) to achieve improved family focused practice. She will demonstrate its utility in achieving a broader approach to service design, delivery and evaluation.

Behavior change theory, content and delivery of interventions to enhance adherence in chronic respiratory disease: A systematic review

Background: We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease. Methods: We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content (grouped into psychological, education and self-management/supportive, telemonitoring, shared decision-making); and delivery. “Effective” studies were those with p < 0.05 for adherence rate between groups. We conducted a narrative synthesis and assessed risk of bias. Results: 12,488 articles screened; 46 included studies (n = 42,91% in OSA or asthma) testing 58 interventions (n = 27, 47% were effective). Nineteen (33%) interventions (15 studies) used 12 different behavior change theories. Use of theory (n = 11,41%) was more common amongst effective interventions. Interventions were mainly educational, self-management or supportive interventions (n = 27,47%). They were commonly delivered by a doctor (n = 20,23%), in face-to-face (n = 48,70%), one-to-one (n = 45,78%) outpatient settings (n = 46,79%) across 2–5 sessions (n = 26,45%) for 1–3 months (n = 26,45%). Doctors delivered a lower proportion (n = 7,18% vs n = 13,28%) and pharmacists (n = 6,15% vs n = 1,2%) a higher proportion of effective than ineffective interventions. Risk of bias was high in >1 domain (n = 43, 93%) in most studies. Conclusions: Behavior change theory was more commonly used to design effective interventions. Few adherence interventions have been developed using theory, representing a gap between intervention design recommendations and research practice.

From Management to Prevention: the New Cure for Sports Concussion

A case for directing attention away from concussion management and towards the prevention of concussions in sport.

BAP Guidelines on the Management of Weight Gain, Metabolic Disturbances and Cardiovascular Risk Associated With Psychosis and Antipsychotic Drug Treatment

Excess deaths from cardiovascular disease are a major contributor to the significant reduction in life expectancy experienced by people with schizophrenia. Important risk factors in this are smoking, alcohol misuse, excessive weight gain and diabetes. Weight gain also reinforces service users’ negative views of themselves and is a factor in poor adherence with treatment. Monitoring of relevant physical health risk factors is frequently inadequate, as is provision of interventions to modify these. These guidelines review issues surrounding monitoring of physical health risk factors and make recommendations about an appropriate approach. Overweight and obesity, partly driven by antipsychotic drug treatment, are important factors contributing to the development of diabetes and cardiovascular disease in people with schizophrenia. There have been clinical trials of many interventions for people experiencing weight gain when taking antipsychotic medications but there is a lack of clear consensus regarding which may be appropriate in usual clinical practice. These guidelines review these trials and make recommendations regarding appropriate interventions. Interventions for smoking and alcohol misuse are reviewed, but more briefly as these are similar to those recommended for the general population. The management of impaired fasting glycaemia and impaired glucose tolerance (‘pre-diabetes’), diabetes and other cardiovascular risks, such as dyslipidaemia, are also reviewed with respect to other currently available guidelines. These guidelines were compiled following a consensus meeting of experts involved in various aspects of these problems. They reviewed key areas of evidence and their clinical implications. Wider issues relating to primary care/secondary care interfaces are discussed but cannot be resolved within guidelines such as these.

Seeking To Understand, Aspiring to Teach: Exploring How Life Shapes Emotional and Personal Development in Global Health Leaders

Thesis (Master's)--University of Washington, 2016-08

A Study of Implicit Leadership Theories Among Business & Management Undergraduate Students

This qualitative study explores the subjective experience of being led by investigating the impact of their Implicit Leadership Theories (ILTs) on followers’ cognitive processes, affective responses and behavioural intentions towards leadership-claimants. The study explores how such responses influence the quality of hierarchical work-place relationships using a framework based on Leader-Member Exchange (LMX) Theory. The research uses focus groups to elicit descriptions of ILTs held by forty final year undergraduate Business and Management students. The data was then analysed using an abductive process permitting an interpretative understanding of the meanings participants attach to their past experiences and future expectations. This research addresses a perceived gap by making a theoretical contribution to knowledge and understanding in this field, focusing on how emotional responses affect their behaviour, how this impacts on organisational outcomes, and what the implications are for HRD practitioners. The findings support previous research into the content and structure of ILTs but extend these by examining the impact of affect on workplace behaviour. Findings demonstrate that where follower ILT needs are met then positive outcomes ensued for participants, their superiors, and their organisations. Conversely, where follower ILT needs are not matched, various negative effects emerged ranging from poor performance and impaired well-being, to withdrawal behaviour and outright rebellion. The research findings suggest dynamic reciprocal links amongst outcomes, behaviours, and LMX, and demonstrate an alignment of cognitive, emotional and behavioural responses that correspond to either high-LMX or low-LMX relationships, with major impacts on job satisfaction, commitment and well-being. Copyright

Assessing variation in personal health service delivery and workplace smoking ban enforcement by local health departments

Thesis (Ph.D.)--University of Washington, 2016-08

Trabalho e família: um estudo da interação de papéis com secretários executivos

The balance between the demands of two important spheres of human life, work and family, has become a challenge due to the pressures of the contemporary that is expanding around the difficulties of reconciling these two comínios. In this sense, this research aimed to understand the work-family interaction in the perception of executive secretaries. The analysis approach used was qualitative research, by worrying about a reality that can not be quantified due to the subjectivity of his goal. The data collection technique used was the semistructured interview to twenty executive secretaries, servants of a Federal Institution of Higher Education. For the understanding and interpretation of the data, we used the technique of content analysis. The results of both analyzes identified the existence of conflict as enrichment in this interaction. The time was identified as the largest generator of conflict work. The overload, relationship stress and conflict emerged as elements common to both domains. As main implications of labor disputes, were revealed: problamas health for secretaries and stress. As main implications of family conflicts emerged: motivation for work, lower performance and lack of concentration. The attempt at balance was identified as the strategy most used by secretaries to minimize work-family conflict. The work-family enrichment was seen as resources that contribute to improving the lives of the secretary in both domains. The opportunity to add knowledge was highlighted as enriching element of work and family values ​​as elements enriching family. The support and experience emerged as enrichment items common to both domains. Regarding the implications of enrichment resulting from the interaction of work and family, the more perceived by respondents were: increased knowledge and skills, material and psychological benefits, improved quality of life and personal and professional fulfillment. From the perception of executive secretaries, work and family spheres of human life are essential and complementary, and that help is contrary, however, this relationship is the primary management of conflicts, ie, how the individual sees and manages the negative side of the work-family

Comunicação pública e marketing político na gestão pública municipal

Based on the definitions of Public Communication, Political Marketing, Public Interest Information and Communication as a Tool of Governance, the study notes the use of the news section of the websites of the City Christmas and Mossoro, Rio Grande do Norte, in regard to strengthening citizenship and encouraging participatory management, from the characterization of materials like pieces of Political Marketing and Public Communication. Data collection in qualitative research was conducted from August to September 2011 and content analysis showed that the appropriation of public property for personal use is a reality, despite legal requirements to the detriment of strategic communication and governance for results from the dissemination of information of public interest and the establishment of a communication channel between State Government and Society. Elements of this study suggest the need for further research to deepen the discussion

Condições de trabalho e saúde na perspectiva de bem-estar : um estudo realizado com os profissionais de saúde da Policlínica Zona Oeste de Natal/RN

This study had like general objective analyzed the relation observed between working conditions and healthy, in the welfare perspective, by the Policilínica Zona Oeste´s healthy professionals. Were used like theoretical bases the categories of working conditions of Borges et al. (2013): working conditions and contractual legal; physical working conditions and materials; working conditions and characteristics of the work processes and working conditions and social management. For the analise of personal wellness in the job, were used the categories of Dessen and Paz (2010): friendship relations, relationship with the organization, growth opportunity, relations with customers , valuation and realization. For this, this research use the descriptive statistic and Bardin (1977) ´s content analysis besides the help of Manyeyes software, using the word clouds and trees words. Was possible identify that the working conditions have strong relations with the health of the health professionals of Policlínica, mainly about the physical and materials conditions that are precarious and influences the other dimensions of working conditions and conditions health. The welfare professionals is spoiled in the dimensions of realization and growth opportunity and influences the professional´s health

Digital rights management –systeemit ja kuluttajien suhtautuminen niihin peliteollisuudessa

Tämän kandidaatintutkimuksen tarkoituksena on löytää vastaus siihen, miten vahva voi olla DRM-systeemi, ennen kuin kuluttajat eivät enää hyväksy sitä. DRM-systeemejä on monen tasoisia, mutta ne eivät ole soveltuvia sellaisenaan kaikille eri alustoille. Peliteollisuuden digitaalisten käyttöoikeuksien hallintajärjestelmillä on omanlaisensa lainalaisuudet kuin esimerkiksi musiikkiteollisuudella. Lisäksi on olemassa tietty tämän hetkinen hyväksytty DRM:n taso, josta voi olla vaarallista poiketa. Tutkimus on luonteeltaan laadullinen tutkimus. Työssä on sovellettu sekä diskurssi- että sisällönanalyysin oppeja. Tutkimuksen aineistona on erilaisten viestiketjujen tekstit, joiden pohjalta pyritään löytämään vastaus tutkimuskysymykseen. Ketjut on jaettu eri vahvuisiksi sen perusteella, miten vahva on DRM:ää koskeva uutinen, jonka pohjalta viestiketju on syntynyt. Koska aineisto on puhuttua kieltä ja sillä on aina oma merkityksensä kontekstissaan, ovat valitut menetelmät soveltuvia analysoimaan aineistoa. Eri ketjujen analyysien tuloksien pohjalta voidaan sanoa, että DRM ei voi olla sitä tasoa suurempi kuin mikä on sen hetkinen vallitseva taso. Jos tästä tasosta poiketaan pikkaisenkin, voi se aiheuttaa suurta närästystä kuluttajien keskuudessa, jopa siihen saakka, että yritys menettää tuloja. Sen hetkiseen tasoon on päästy erinäisten kokeilujen kautta, joista kuluttajat ovat kärsineet, joten he eivät suosiolla hyväksy yhtään sen suurempaa tasoa kuin mikä vallitsee sillä hetkellä. Jos yritys näkee, että tasoa on pakko tiukentaa, täytyy tiukennus tehdä pikkuhiljaa ja naamioida se lisäominaisuuksilla. Kuluttajat ovat tietoisia omista oikeuksistaan, eivätkä he helpolla halua luopua niistä yhtään sen enempää kuin on tarpeellista.

Surgical treatment of thymoma. Personal experience

Introduction. Thymomas (THs) are rare epithelial tumors of the thymus gland. In this study we report our personal experience in the management and surgical treatment of THs. Case reports. We report two clinical cases treated with combined therapy (surgery followed by adjuvant therapy). Results. Total transternal thymectomy was performed in both patients. The post-operative course was uneventful. The patients received adjuvant radiotherapy and chemotherapy. No relapse has been observed during follow-up. Discussion. THs are usually slowly growing tumors with similar incidence in both sexes. They occur through a wide age range, with a peak in the fifth and sixth decades. Distinctive features reminiscent of the normal thymus make the pathologic diagnosis of THs easy in most cases. Malignant behaviour is indicated by microscopic or macroscopic invasion of the tumor capsule or surrounding organs or by the presence of metastases. Although there is no standardized staging system for thymoma, the one proposed by Masaoka is commonly employed. Total thymectomy is the procedure of choice, even for encapsulated tumors, with carefully exploration of the mediastinum for evidence of ectopic thymic tissue or local invasion. Conclusions. Despite an indolent course and a cytologically bland appearance, all thymic tumors can manifest a malignant behavior. Surgery continues to be the mainstay of treatment, and the ability to achieve complete resection seems to be the most important prognostic factor. Multimodality treatment involving postoperative chemotherapy and radiotherapy appears to increase the rate of complete resection and improves survival in advanced THs.