Using Workload Measurement Tools in Diverse Care Contexts: the Experience of Staff in Mental Health and Learning Disability Inpatient Settings

Introduction The critical challenge of determining the correct level and skill-mix of nursing staff required to deliver safe and effective healthcare has become an international concern. It is recommended that evidence-based staffing decisions are central to the development of future workforce plans. Workforce planning in mental health and learning disability nursing is largely under-researched with few tools available to aid the development of evidence-based staffing levels in these environments. Aim It was the aim of this study to explore the experience of staff using the Safer Nursing Care Tool (SNCT) and the Mental Health and Learning Disability Workload Tool (MHLDWT) in mental health and learning disability environments. Method Following a 4-week trial period of both tools a survey was distributed via Qualtrics on-line survey software to staff members who used the tools during this time. Results The results of the survey revealed that the tools were considered a useful resource to aid staffing decisions; however specific criticisms were highlighted regarding their suitability to psychiatric intensive care units (PICU) and learning disability wards. Discussion This study highlights that further development of workload measurement tools is required to support the implementation of effective workforce planning strategies within mental health and learning disability services. Implications for Practice With increasing fiscal pressures the need to provide cost-effective care is paramount within NHS services. Evidence-based workforce planning is therefore necessary to ensure that appropriate levels of staff are determined. This is of particular importance within mental health and learning disability services due to the reduction in the number of available beds and an increasing focus on purposeful admission and discharge.

University Chorale in a Program for the American Choral Directors Northwest Division Convention, February 27, 1976

Concert program for University Chorale, February 27, 1976

A Concert of American Music, February 9, 1964

Concert Program for A Concert of American Music, February 9, 1964

Gestão de relações com stakeholders multiculturais: uma abordagem baseada nos valores

A presente dissertação assenta na ideia de que os factores culturais influenciam as relações das organizações com os stakeholders, pois a envolvente é cada vez mais multicultural. Os critérios culturais revelam‐se, assim, importantes para as organizações que actuam em cenários internacionais e multiculturais e ganham maior importância numa realidade em que pessoas com diferentes backgrounds culturais habitam no mesmo espaço. Perante esta realidade, os profissionais de Relações Públicas têm a responsabilidade de gerir as relações entre a organização e os stakeholders multiculturais, da mesma forma que devem ter a capacidade de construir espaços de relação entre diferentes intervenientes das diversas culturas. Este é um dos papéis que as Relações Públicas devem desempenhar na nossa sociedade, contribuindo para um diálogo e compreensão entre organizações, grupos e pessoas de diferentes culturas.

Absorbance enhancement in microplate wells for improved-sensitivity biosensors

A generic optical biosensing strategy was developed that relies on the absorbance enhancement phenomenon occurring in a multiple scattering matrix. Experimentally, inserts made of glass fiber membrane were placed into microplate wells in order to significantly lengthen the trajectory of the incident light through the sample and therefore increase the corresponding absorbance. Enhancement factor was calculated by comparing the absorbance values measured for a given amount of dye with and without the absorbance-enhancing inserts in the wells. Moreover, the dilution of dye in solutions with different refractive indices (RI) clearly revealed that the enhancement factor increased with the ΔRI between the membrane and the surrounding medium, reaching a maximum value (EF>25) when the membranes were dried. On this basis, two H2O2-biosensing systems were developed based on the biofunctionalization of the glass fiber inserts either with cytochrome c or horseradish peroxidase (HRP) and the analytical performances were systematically compared with the corresponding bioassay in solution. The efficiency of the absorbance-enhancement approach was particularly clear in the case of the cytochrome c-based biosensor with a sensitivity gain of 40 folds and wider dynamic range. Therefore, the developed strategy represents a promising way to convert standard colorimetric bioassays into optical biosensors with improved sensitivity.

Screening for occupational asthma by using a self-administered questionnaire in a clinical setting

OBJECTIVE: Because of its high prevalence, early screening for occupational asthma (OA) is crucial. We aimed to evaluate the screening performance of the Occupational Asthma Screening Questionnaire-11 items (OASQ-11) in a clinical setting. METHODS: Between January 2009 and December 2011, 169 workers referred for potential OA to our hospital completed the OASQ-11 and underwent workups to determine the final diagnosis. The discriminative abilities of the OASQ-11 as a whole and in relation to demographic and exposure parameters were determined by the area under the receiving operator characteristic curve (AUC). RESULTS: Model 1, consisting of the OASQ's items, showed fair discrimination (AUC, 0.69; 95% confidence interval, 0.58 to 0.80). Addition of age and exposure duration to model 1 improved discrimination (AUC, 0.80; confidence interval, 0.72 to 0.88). CONCLUSION: A simple model consisting of the OASQ-11's items, age, and exposure duration could well discriminate subjects with OA in a clinical setting.

A critical examination of the involvement of Canadian high-performance athletes in the development of anti-doping policy

The use of certain perfonnance enhancing substances and methods has been defined as a major ethical breach by parties involved in the governance of highperfonnance sport. As a result, elite athletes worldwide are subject to rules and regulations set out in international and national anti-doping policies. Existing literature on the development of policies such as the World Anti-Doping Code and The Canadian antiDoping Program suggests a sport system in which athletes are rarely meaningfully involved in policy development (Houlihan, 2004a). Additionally, it is suggested that this lack of involvement is reflective of a similar lack of involvement in other areas of governance concerning athletes' lives. The purpose ofthis thesis is to examine the history and current state of athletes' involvement in the anti-doping policy process in Canada's high-perfonnance sport system. It includes discussion and analysis of recently conducted interviews with those involved in the policy process as well as an analysis of relevant documents, including anti-doping policies. The findings demonstrate that Canadian athletes have not been significantly involved in the creation of recently developed antidoping policies and that a re-evaluation of current policies is necessary to more fully recognize the reality of athletes' lives in Canada's high-perfonnance sport system and their rights within that system.

Dancing politics : connecting women's experiences of rave in Toronto to ageism and patriarchy

Based on a critical analysis of recent Canadian and British media, academic, and political representations of rave, in conjunction with the author's and ten female interviewees' past experiences as active rave participants, the purpose of this thesis is to show the ways that rave can be understood as political. Drawing on a post-structural understanding of politics, which understands macro social issues and micro personal experiences as intimately linked and inseparable, this thesis fills a gap in the existing rave literature by explicitly drawing out (a) the ways that active rave participation is entangled in dominant understandings of age and gender-appropriate activities, and (b) the implications that these entanglements have on the ways that some women experience and construct their past active rave participation. Specifically, the author examines the ways that age and gender intersect and inform the discourses on which research participants drew to describe and rationalize their experiences of becoming, being, and ceasing to be active rave participants in Toronto, Ontario, Canada. At the same time that the majority of research participants' introductions to rave followed heterosexualized and heternormative patterns, they also constructed active rave participation as a way to challenge popular representations of rave as an inappropriate activity, especially for young women. When rationalizing the cessation of their active rave participation, however, these women reproduced depictions of rave participation as a transitory and juvenile phase where older women are particularly misplaced. The various ways that these women simultaneously challenged, experienced, and facilitated dominant ageist and patriarchal discourses about who does and does belong in rave are interpreted as evidence that micro rave experiences cannot be divorced from macro discriminatory discourses, and that "the personal is political."