Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

OpenAIRE Guidelines for Literature Repositories, Data Archives and CRIS managers

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

A distributed, cloud-ready, digital content processing and transformation platform and a specific use case

Poster at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Interoperability specifications and an automatic validation tool as a key factor for the support of a repository ecosystem

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Exploring the Impact of Mental Health Education on Adolescents’ Perceptions About Mental Health and Mental Illness. Improving community health

The purpose of this study was to explore perceptions of mental health and mental illness as well as the perceptions towards people with mental illness among adolescents, and further to examine the impact that a mental health educational intervention has on these perceptions. The review of the literature revealed a small number of publications on mental health educational interventions among adolescents which aimed at increasing knowledge and affecting attitudes towards mental illness with positive results. Fifty nine pupils (13-16 years old) from two randomly selected secondary schools around Athens, Greece, participated in this study. These schools were randomly selected as the experimental group (n=28) which participated in the mental health educational intervention, and the comparison group (n=31), which did not receive any intervention. Data were collected using individual interviews with open-ended questions, drawings and a questionnaire (Opinions about Mental Illness - O.M.I. scale). The participants described mental health and mental illness before and after the intervention, using the same expressions for both terms. Among the experimental group, changes were seen within the same expressions after the intervention, although some descriptions did not change. However, after the intervention, participants in the experimental group did not confuse mental health with mental illness and they also included specific diagnostic examples or stated that mental illness can happen to anyone and it can be managed. Moreover, they expressed positive attitudes towards mentally ill people, which they had not done before the intervention. The analysis of the drawings before the intervention showed that mentally ill persons were drawn similarly in both groups. After the intervention, the drawings of the participants in the experimental group changed, including fewer negative elements, while the drawings of the comparison group did not change. Regarding the results on the O.M.I. scale, it was found that the score on the Social Discrimination factor significantly decreased from pre-test to post-test in both study groups. The experimental group had higher levels on Social Discrimination at pre-test compared to the comparison group, but this difference was not significant at post-test. No significant changes were found for the Social Restriction factor for either study group. Scores of the Social Care and Social Integration factors increased significantly only in the intervention group. Overall, the results of this study indicate that the mental health educational intervention had a positive impact on the perceptions about mental health and mental illness among adolescents, and (mental) health professionals can use these results for implementing similar interventions and further research.

Karl Polanyi, Athens and us: the contemporary significance of Polanyi's thought

Karl Polanyi is considered one of the most prominent social scientists of the 20th century. In his writings, an important concern was the relationship between the markets and the society (therefore, the state) as a whole; to discuss it, he introduced the concept of "embeddedness", fundamental for his study of the origins and consequences of the Industrial Revolution. An important part of his heritage is the study of the economic history of what he called "ancient societies," especially of Classical Greece. Polanyi used these studies to compare the ancient societies with his own times, in an effort to understand them all. This paper aims to relate Polanyi's work on the Athenian society with his studies about the modern times, showing that it is possible to draw lessons from Polanyi's thought on the relationship between the society, the state and the market that can help to design a political agenda for our days. In the first part, we present the most important aspects o the life and work of Polanyi, and in the second we discuss the most important aspects of his worldview. Then, in the third part, we study his view of the early Athenian economy; mainly, we focus on the coexistence of a kind of state planning and a market, showing how this understanding is crucial for the whole Polanyian legacy, with its emphasis in the comparison of different societies and times. We conclude by underlining the relevance of this interpretation advanced by Polanyi to understand the societies of our days, focusing on some proposals to extend his approach to deal with our contemporary problems.

Competitividade e restrição externa na Zona do Euro

The recent debt crisis in Greece, Ireland and Portugal has exposed the fragility existing in the Eurozone for promoting development and economic convergence between the countries that have adopted the currency. Way beyond the fear of insolvency, what is observed is a growing disparity of the most-developed countries in comparison to the less-developed ones, with perverse consequences for the last ones. Once the nominal exchange rates are fixed, the divergent movements in relative prices and wages between the countries have led to totally distinct paths for the real exchange rates. Worsening the scenario, one can observe the incompleteness of the political union, the monetarist focus of the ECB and the lack of labor mobility between the countries, what distances from the argument stated by the theory and puts in jeopardize the future of the Monetary Union.

An international investigation on the validity of the CSAPPA scale in screening for developmental coordination disorder /

The main objective of the present investigation was to continue the research initiated by Hay and colleagues (2004) in examining the efficacy of the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) scale as a proxy for the short form of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF) in screening for Developmental Coordination Disorder (DCD) in children. To better appreciate DCD knowledge outside Canada, the measurements of this investigation were expanded in Greece. A translated Greek CSAPP A scale and the BOTMP-SF were administered for the first time in Greek children. A second objective was to investigate the relationship between DCD and various risk factors of coronary artery disease (CAD) in Canadian and Greek children. A sample of 591 (Ms=322; Fs=269) Canadian and 392 (Ms=211; Fs=181) Greek children, aged 9 to 13 years, consented to the BOTMP-SF, CSAPP A Scale, participation in physical activity questionnaire, Leger 20-meter Multistage Shuttle Run test, and body fat using bioelectric impedance. Prevalence of DCD in Canada and Greece was 8% and 19%, respectively. Significant agreement (p

Ethnic conflicts and international politics : an analysis of the communal regional, and global dimensions of the Cyprus problem

The thesis assesses the impact of international factors on relations between Greek and Turkish Cypriots during and after the Cold War. Through an analysis of the Cyprus problem it explores both why external actors intervene in communal conflicts and how they influence relations between ethnic groups in plural societies. The analytical framework employed throughout the study draws on contributions of International Relations theorists and students of ethnic conflict. The thesis argues that, as in the global political system, relations between ethnic groups in unranked communal systems are anarchic; that is, actors within the system do not recognize a sovereign political authority. In bipolar communal systems dominated by two relatively equal groups, the struggle for security and power often leads to appeals for assistance from external actors. The framework notes that neighboring states and Great Powers may heed calls for assistance, or intervene without a prior request, if it is in their interest to do so. The convergence of regional and global interests in communal affairs exacerbates ethnic conflicts and precludes the development of effective political institutions. The impact of external intervention in ethnic conflicts has the potential to alter the basis of communal relations. The Cyprus problem is examined both during and after the Cold War in order to gauge how global and regional actors and the structure of their respective systems have affected relations between ethnic groups in Cyprus. The thesis argues that Cyprus's descent into civil war in 1963 was due in part to the entrenchment of external interests in the Republic's constitution. The study also notes that power politics involving the United States, Soviet Union, Greece and Turkey continued to affect the development of communal relations throughout the 1960s, 70s, and, 80s. External intervention culminated in July and August 1974, after a Greek sponsored coup was answered by Turkey's invasion and partition of Cyprus. The forced expulsion of Greek Cypriots from the island's northern territories led to the establishment of ethnically homogeneous zones, thus altering the context of communal relations dramatically. The study also examines the role of the United Nations in Cyprus, noting that its failure to settle the dispute was due in large part to a lack of cooperation from Turkey, and the United States' and Soviet Union's acceptance of the status quo following the 1974 invasion and partition of the island. The thesis argues that the deterioration of Greek-Turkish relations in the post-Cold War era has made a solution to the dispute unlikely for the time being. Barring any dramatic changes in relations between communal and regional antagonists, relations between Greek and Turkish Cypriots will continue to develop along the lines established in July/August 1974. The thesis concludes by affirming the validity of its core hypotheses through a brief survey of recent works touching on international politics and ethnic conflict. Questions requiring further research are noted as are elements of the study that require further refinement.

Heidegger's tragic Greeks : the relation between presence and deinon

Martin Heidegger's interpretation of the ancients was born out of something like a crisis in the interpretation of the Greeks, which can be characterized as nothing other than the realization of the idea that the Greek philosophers put a serious question mark over existence. This idea, which had its germination in Prussia with Jakob Burckhart and his teacher, but first came to be seriously cultivated in the Philosophy of Friedrich Nietzsche, was the first in depth investigation into whether the Greeks, on the one hand, questioned existence or, on the other hand, put a question mark over existence. To question existence is rather innocuous, since it amounts to little more, in the end, than a child looking up at the stars and asking what it all means. To put a question mark over existence, however, is another business entirely. For the Greeks, as the life work of Martin Heidegger amply demonstrates, the nature of Greek thinking and the objects towards which it is directed follows so absolutely from the tragic view of the human person that, in a certain sense, philosophy is Greek and could only have developed in Greece. Perhaps stating it a little less categorically, philosophy could have developed elsewhere at least to the extent that something like they way the Greeks understood life was at the forefront: presence, in other words. This thesis deals with the problem ofHeidegger's relation to the Greeks, specifically in terms of his understanding of the Greeks and presence. It is the position of this dissertation that the Greek notion of presence is, as Heidegger understands it, the homeliness of the hearth that radiates through all the things that humans concern themselves with. This is thought by Heidegger, as the Greeks did, specifically in contrast with the uncanninesslunhomeliness of the hqrnan apart from his or her concern with things. Therefore, the thesis is an attempt at exposing the relation between presence and the unhomely by situating it withing Greek existence and the meaning of the Greek Philosopher. In order to support this position, the thesis has been divided into five parts. The first two chapters deal with Heidegger's explanation of the relation between Greek notion of physics (Phusis), metaphysics (specifically in relation to an analysis of time and motion in Greek thought), and what Heidegger calls the fundamental attunement of Dasein (boredom). More exactly, it deals with these issues only so far as they allow us to bring out something like the notion of 'presence' in relation to things and homelessness or restlessness in relation to the human being. The rationale for these two chapters in relation to the central problem of the paper is that in Heidegger's elucidation of physics and metaphysics, he conducts his analysis in such a way that he explicitly uncovers that dimension of human existence that he calls the fundamental attunement of Dasein. This fundamental attunement is, in tum, similar to what the Greeks understood as the deinon, the uncanninesslunhomeliness of the human. The third and fourth chapters take as their explicit themes the problem of the Greek understanding of the assertion and the ways in which the person can comport himlherself toward things, two issues which are not separable. The rationale for these two chapters in relation to the central theme of the paper is that Heidegger's analysis of these two areas in Greek thought brings out precisely why the philosopher and the philosophical way of life is the highest mode of existence for the Greeks and how this is thought specifically in tenns of the uncanniness of humans. The final cijapter gives a complete elucidation of presence as the homeliness of the hearth and shows specifically how this is thought of in contradistinction to the uncanny/unhomely for the Greeks. 1I1 This last chapter also explains Martin Heidegger's reaction to the Greek's interpretation of the highest mode of existence, and what he posited as a counter-thought. The essay as a whole is an attempt to fully concertize an important dimension of Heidegger' s understanding of the Greeks, that is, the relation between presence and the deinon or Greek notion ofunhomely, which, to my la)owledge, has not been offered anywhere in commentaries on Heidegger.

Intraspecific and interspecific social variation in the sweat bee Lasioglossum Malachurum and other members of the subgenus Evylaeus

Sweat bees exhibit a range of social behaviours, from solitary nesting, in which no workers are produced, to strong eusociality, in which workers exhibit a high degree of altruism, behaviour that is measured by the degree of personal reproductive sacrifice. Field studies were carried out for seven weeks during May-June 2000 in southern Greece in order to investigate intraspecific social variation, and test the hypothesis of a north-south cline of decreasing eusociality in the obligately eusocial sweat bee L. (E.) malachurum. A comparative study, using principal components analysis, was performed to determine if patterns of intraspecific social variation in L. malachurum reflect the patterns of social variation within the subgenus, Evylaeus, as a whole. The results of the field study reveal that, in Greece, two worker broods were produced followed by a third brood consisting of gynes, males and some workers, indicating that there was an overlap in worker and gyne production. There was strong caste distinction between queens and workers. Workers actively foraged and participated in nest construction as most workers (58%, n=303) had a high degree of mandibular wear. Workers did not participate in the oviposition of Brood 3 gynes since only 0.7% (n=278) of workers were mated. Furthermore, queen survival until the end of Brood 3 and a substantial size differential of 10.6% between queens and workers suggested that queen domination over worker behaviour during the early to mid-part of the colony cycle was plausible. Male production in Brood 3 by some workers was likely, since the timing of worker ovarian development corresponded with the timing of male production. These findings suggest that workers of the first two broods were primarily altruistic, but some (28%) Brood 1 (9%) and Brood 2 (19%) workers produced males, indicating that the degree of altruistic behaviour declined during the lifetime of the colony. In comparison with other L. malachurum populations in Europe, the Greek population of L. malachurum had a weaker social level as a result of the higher proportion of workers potentially involved in male production, thus 3 supporting the hypothesis of a southerly cline of decreasing eusociality. Furthermore, intraspecific variation in social level across Europe appears to be due to longer breeding seasons in more southerly locations that would promote the production of larger colonies and provide opportunities for workers to evade queen control. The comparative study using principal components analysis on 20 solitary (of the subgenera Evylaeus and Lasioglossum), eusocial and socially polymorphic Evylaeus species and populations reveals that six traits are closely associated with stronger eusociality in Evylaeus. These traits are: (1) a reduction in the proportion of males in the early brood(s); (2) a reduction in the proportion of females that mate; (3) an increase in the mean number of first brood workers; (4) a reduction in the proportion of females with developed ovaries; (5) an increase in size dimorphism between castes, and (6) nest guarding. These are traits that most significantly define principal component one and therefore distinguish social type as indicated by a clear separation of the eusocial and the solitary populations, with a socially polymorphic species falling in between. Furthermore, most of these traits are under foundress control and may suggest that the evolutionary loss or gain of eusociality is based on selection pressures on a founding female. Colony size and female ovarian development are common factors distinguishing social variation in L. malachurum and within the subgenus as a whole. The principal components analysis excluding the solitary species and the socially aberrant L. marginatum populations show the L. malachurum populations separated based on an increasing proportion of workers with developed ovaries as populations are found more south, lending further support to the hypothesis of a north-south cline of decreasing eusociality.

Gender and Healing in the Hippocratic Corpus

Hippocratic physicians sought to establish themselves as medical authorities in ancient Greece. An examination of the deontological texts of the Hippocratic corpus reveals that the Hippocratics created a medical authority based on elite male characteristics. The key quality of the Hippocratic physician was sōphrosunē, a quality closely associated with men and used in the differentiation of genders in the Greek world. Women were not believed to innately possess this quality and so their healing activities were restricted within the Hippocratic framework. Women’s healing activities are only mentioned in the corpus when women are involved in the treatment of other women or self-treatment. The Hippocratic construction of medicine as a male domain fit within a Classical cultural framework, as the cultural anxiety concerning women healers and women’s use of pharmaka are evident in both Greek myth and literature.

Rollin's History Volumes 1-7

A seven volume set of books that cover the history of the Egyptians, Carthaginians, Assyrians, Babylonians, Medes and Persians, Grecians and Macedonians. Each of the volumes state that they are translated from the original French. The first volume begins with a memoir of the other Charles Rollin. The first volume also contains a note addressed to Mr.William Woodruff, thanking hime for the loan of the first 4 volumes and asking if he can loan the other volumes. The note is singed by Fred Goring in July of 1838. All volumes are stamped "The property of William Woodruff, St. Davids, Niagara" or "The property of William Woodruff, Niagara". See the full text of volumes 1-7 in the Brock University Special Collections and Archives.

Les régimes providentiels à l'ère post-industrielle: reconfiguration ou résilience ?

L'approche des régimes providentiels élaborée par Esping-Andersen dans les années 1990 présente un grand intérêt dans l'appréhension des lignes directrices de la protection sociale: elle met en relief le jeu d'interrelations entre différents piliers de bien-être (l'État, le marché et la famille) dans la production et la distribution du bien-être. Esping-Andersen a identifié à cet effet trois types de régimes providentiels: les régimes social-démocrate, libéral et conservateur (qui correspondent respectivement aux pays nordiques, anglo-saxons et d'Europe continentale) auxquels certains observateurs ont rajouté le type latin, qui correspond aux pays d'Europe du Sud (Espagne, Grèce, Italie, Portugal). Ces régimes se sont consolidés dans un contexte industriel d'après-guerre et on peut se demander s'ils peuvent tenir la route à l'ère post-industrielle. En effet, le jeu d'interrelations entre l'État, le marché et la famille est appelé à connaître des reconfigurations, pour répondre plus adéquatement aux divers risques nouveaux qu'encourent les individus. La résilience des régimes providentiels est donc mise à l'épreuve et doit composer avec de nouvelles réalités sociales et économiques qui peuvent l'amener vers des terrains qui lui étaient jusque là inconnus. Notre examen s'intéresse à l'évolution des régimes providentiels à l'ère post-industrielle. Nous cherchons à caractériser et à différencier vingt pays de l'OCDE sur la base d'indicateurs quantitatifs de dépenses publiques et de situations socio-économiques couvrant la période de 1985 aux années 2000. Au moyen de l'analyse factorielle des correspondances et de l'analyse de classification hiérarchique, nous avons pu dégager des regroupements de pays qui correspondent assez fidèlement à la typologie d'Esping-Andersen et à ses développements subséquents et à mettre en relief différentes formes de protection sociale à l'ère post-industrielle: soit "l'activation laissée au marché" dans les pays anglo-saxons, "l'activation comme projet en devenir" dans les pays d'Europe continentale et, finalement, "la faible référence à l'activation" dans les pays d'Europe du Sud.

Structures spatiales dans la pensée religieuse grecque de l'époque archaïque : la représentation de quelques espaces insondables: l'éther, l'air, l'abîme marin

Cette thèse se propose d’étudier les façons dont la pensée et l’imaginaire grec de l’époque archaïque se représentaient quelques pans du réel qui ne se laissaient jamais voir ni atteindre: l’éther, l’air et l’abîme marin. Vu le caractère insondable de ces espaces, l’imagination et l’abstraction se sont ingéniées à les appréhender par un discours spécifique et à les intégrer dans le système de connaissances et de croyances propre à l’époque en leur assignant une place dans le système de l’univers, en les rattachant à une hiérarchie de l’ordre cosmologique, en leur donnant une forme, en classant leurs objets et en les rapportant aux modèles du monde connu, en les aménageant par les moyens les plus divers. Une étude des formes d’expression de la pensée grecque archaïque, autant littéraires qu’iconographiques, permet de cerner les diverses formes de représentation des domaines inaccessibles et les modèles d’organisation spatiale issus de ce type de pensée. Grâce à la dialectique particulière qui ressort du rapport entre espace et mouvement, cette thèse se propose également d’interroger le corpus des sources grecques archaïques sous des angles jusqu’ici peu explorés: comment maîtrise-t-on l’espace par les déplacements physiques en dehors des parcours terrestres? Comment les schémas du mouvement dans l’espace se sont-ils forgés? Comment les dichotomies issues de la logique spatiale archaïque (haut/bas, droite/gauche, est/ouest, en deça/au-delà, etc.) influent-elles sur la structuration spatiale? Quelles espèces d’espace révèlent les déplacements à travers les différents niveaux du monde, que ce soit ceux des dieux, ceux des mortels et d’autres entités, forces physiques et substances privilégiées dans le commerce avec le divin et le monde d’en haut? Ces analyses mettent en valeur les façons dont l’imagination et l’abstraction plutôt que l’expérience vécue ont contribué, à leur façon, à structurer l’espace et à forger l’image du monde comme κόσμος, monde mis en ordre et soumis autant aux lois physiques qu’aux lois divines.