Nursing care practices at an outpatient care center from an integrative perspective

Aim: to analyze nursing care practices at a Specialized Outpatient Care Center from the perspective of an integrative health care activity. Method: Interviews with 24 nursing professionals were undertaken. For data analysis, Thematic Content Analysis as proposed by Bardin was applied, resulting in the following themes: the team size and its commitment to health care; professional practices and activity of the nursing team. Results: The size of the nursing team was considered insufficient, which compromises the quality of care and results in work overload and dissatisfaction of the nursing professionals. On the other hand, they were satisfied with the tasks performed day-to-day and related integrality to individual care, considered it essential and usually practiced it daily. Conclusion: It is considered that the nursing team has the potential and commitment to develop their care practice combined with the integrative perspective, and therefore providing quality health care to the population.

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.

Safety climate and its association with office type and team involvement in primary care

OBJECTIVE To assess differences in safety climate perceptions between occupational groups and types of office organization in primary care. METHODS Primary care physicians and nurses working in outpatient offices were surveyed about safety climate. Explorative factor analysis was performed to determine the factorial structure. Differences in mean climate scores between staff groups and types of office were tested. Logistic regression analysis was conducted to determine predictors for a 'favorable' safety climate. RESULTS 630 individuals returned the survey (response rate, 50%). Differences between occupational groups were observed in the means of the 'team-based error prevention'-scale (physician 4.0 vs. nurse 3.8, P < 0.001). Medical centers scored higher compared with single-handed offices and joint practices on the 'team-based error prevention'-scale (4.3 vs. 3.8 vs. 3.9, P < 0.001) but less favorable on the 'rules and risks'-scale (3.5 vs. 3.9 vs. 3.7, P < 0.001). Characteristics on the individual and office level predicted favorable 'team-based error prevention'-scores. Physicians (OR = 0.4, P = 0.01) and less experienced staff (OR 0.52, P = 0.04) were less likely to provide favorable scores. Individuals working at medical centers were more likely to provide positive scores compared with single-handed offices (OR 3.33, P = 0.001). The largest positive effect was associated with at least monthly team meetings (OR 6.2, P < 0.001) and participation in quality circles (OR 4.49, P < 0.001). CONCLUSIONS Results indicate that frequent quality circle participation and team meetings involving all team members are effective ways to strengthen safety climate in terms of team-based strategies and activities in error prevention.

Conditions promoting good multiprofessional collaboration practices in Swiss all-day schools

Multiprofessional collaboration in all-day schools refers to teamwork and coordination that takes place between professionals with different vocational backgrounds. In Switzerland, all-day schoolscomprise regular school instruction and school-based extracurricular activities. Nevertheless, multiprofessional collaboration can also refer to collaboration between education professionals in all-day schools and professionals outside the school in a community-based setting of extracurricular activities. A synthesis of the literature shows that collaboration inside and outside the school setting is promoted by conditions in three areas: structural characteristics of the institution, characteristics of the team, and interpersonal processes (Schüpbach, Jutzi & Thomann 2012). In view of these findings, it was the aim of this study to analyze conditions of good collaboration practices in all-day schools in Switzerland. This qualitative study examined 10 all-day schools in five different cantons in the German-speaking part of Switzerland that showed good collaboration practice. In the course of this study, we conducted 18 problem-centered interviews and 10 focus group discussions. In the process of data evaluation, we applied the method of qualitative content analy sis. The findings show that all of the three areas of conditions promoting good collaboration proved to be relevant in the whole sample of all-day schools. Nevertheless, for the three different types of collaboration found? The school- oriented, the mixed/in termediate, and the social environment-oriented type? We identified different conditions of good collaboration practice.

Practices of pediatric oncology and hematology providers regarding fertility issues: A European survey.

BACKGROUND Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations based on scientific evidence are needed and before their development we wanted to assess the practice patterns of fertility preservation in Europe. PROCEDURES On behalf of the PanCare network, we sent a questionnaire to pediatric onco-hematology institutions across Europe. The survey consisted of 21 questions assessing their usual practices around fertility preservation. RESULTS One hundred ninety-eight institutional representatives across Europe received the survey and 68 (response rate 34.3%) responded. Pre-treatment fertility counseling was offered by 64 institutions. Counseling was done by a pediatric onco-hematologist in 52% (33/64) and in 32% (20/64) by a team. The majority of institutions (53%) lacked recommendations for fertility preservation. All 64 centers offered sperm banking; eight offered testicular tissue cryopreservation for pre-pubertal males. For females, the possibility of preserving ovarian tissue was offered by 40 institutions. CONCLUSIONS There is a high level of interest in fertility preservation among European centers responding to our survey. However, while most recommended sperm cryopreservation, many also recommended technologies whose efficacy has not been shown. There is an urgent need for evidence-based European recommendations for fertility preservation to help survivors deal with the stressful topic of fertility. Pediatr Blood Cancer 2014;9999:1-5. © 2014 Wiley Periodicals, Inc.

Enhancing European Cooperation in Financial Supervision and Crisis Management. ACES Working Papers, August 2009

To overcome the regulatory pitfalls, regulatory capacity and resources in financial markets governance need to be enhanced, not only at national but also at global levels. In order to shed light on policy issues and agendas in international financial policy cooperation, this paper focuses on the case of European financial integration and regulations. The analysis of policy developments at the European level in coordinating differing national interests, supervisory systems, and practices among EU member states highlights fundamental elements of global financial regulatory cooperation.

Application of radiochemistry techniques in food processing research : radioisotopic tracer techniques in evaluation and improvement of industry practices for removal of pesticide residues from foods /

Report prepared by project team and edited by Walter A. Mercer.

Interagency collaboration between child protection and mental health services: Practices, attitudes and barriers

Objective: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. Method: A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers. 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). Results: Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. Conclusions: Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level. (c) 2005 Published by Elsevier Ltd.

Strategic practices:an activity theory perspective on continuity and change

This paper draws upon activity theory- to analyse an empirical investigation of the micro practices of strategy in three UK universities. Activity theory provides a framework of four interactive components from which strategy emerges; the collective structures of the organization, the primary actors, in this research conceptualized as the top management team (TMT), the practical activities in which they interact and the strategic practices through which interaction is conducted. Using this framework, the paper focuses specifically on the formal strategic practices involved in direction setting, resource allocation, and monitoring and control. These strategic practices arc associated with continuity of strategic activity in one case study but are involved in the reinterpretation and change of strategic activity in the other two cases. We model this finding into activity theory-based typologies of the cases that illustrate the way that practices either distribute shared interpretations or mediate between contested interpretations of strategic activity. The typologies explain the relationships between strategic practices and continuity and change of strategy as practice. The paper concludes by linking activity theory to wider change literatures to illustrate its potential as an integrative methodological framework for examining the subjective and emergent processes through which strategic activity is constructed. © Blackwell Publishing Ltd 2003.

Charting new territory for organizational ethnography:insights from a team-based video ethnography of reinsurance trading in Lloyd’s of London

An increasing interest in “bringing actors back in” and gaining a nuanced understanding of their actions and interactions across a variety of strands in the management literature, has recently helped ethnography to unknown prominence in the field of organizational studies. Yet, calls remain that ethnography should “play a much more central role in the organization and management studies repertoire than it currently does” (Watson, 2011: 202). Ironically, those organizational realities that ethnographers are called to examine have at the same time become less and less amenable to ethnographic study. In this paper, we respond to these calls for innovative ethnographic methods in two ways. First, we report on the practices and ethnographic experiences of conducting a year-long team-based video ethnography of reinsurance trading in Lloyd’s of London. Second, drawing on these experiences, we propose an initial framework for systematizing new approaches to organizational ethnography and visualizing the ways in which they are ‘expanding’ ethnography as it was traditionally practiced.

Climate setting in sourcing teams:developing a measurement scale for team creativity climate

Creative sourcing strategies, designed to extract more value from the supply base, have become a competitive, strategic differentiator. To fuel creativity, companies install sourcing teams that can capitalize on the specialized knowledge and expertise of their employees across the company. This article introduces the concept of a team creativity climate (TCC) - team members' shared perceptions of their joint policies, procedures, and practices with respect to developing creative sourcing strategies – as a means to address the unique challenges associated with a collective, cross-functional approach to develop value-enhancing sourcing strategies. Using a systematic scale development process that validates the proposed concept, the authors confirm its ability to predict sourcing team performance, and suggest some research avenues extending from this concept.

The perceptions of best mentoring practices in an early literacy intervention project: A case study of nine coaches

There is significant national evidence the language development of four year-olds is a critical area for later school success (Brooks-Gunn, Fuligni, & Berlin, 2003; Cunningham, & Stanovich, 1998). This study originated as part of Literacy Intervention X (LIX), a larger national study conducted to examine the effectiveness of early literacy curricula implemented in subsidized childcare centers. The professional development of childcare center providers is key to improving the quality of subsidized care. In exploring the mentoring practices of nine LIX literacy coaches, the researcher investigated the perceptions of what best mentoring practices facilitated the implementation of literacy curricula by childcare providers. A qualitative case study was conducted using a combination of participant observer notes, document analysis, and focus group semi-structured interviews. The researcher is a participant observer, one of the nine Literacy Coaches. The best mentoring practices from the perspective of the literacy coaches are related to building relationships including trust, mutual respect, support, empathy, and encouragement with the childcare providers, the center directors, and with fellow literacy coaches. Clear, constant, and consistent communication with the childcare providers was a vital mentoring practice in building a relationship between the literacy coach and childcare provider. Another best mentoring practice in building a relationship with the childcare provider was the perceptions of the literacy coaches as co-learners in the mentoring process. The best mentoring practices highlighted in this study exemplified the kind of effective professional development that builds on the strengths of the childcare providers and does not disrupt the childcare centers or the services provided by the subsidized childcare programs that meet the needs of children and families. The experience of these nine literacy coaches, including their perceptions of effective mentoring practices, along with lesson learned about relationships, mentoring team structures, and general project design sheds light on the challenge of mentoring subsidized childcare providers in future literacy intervention projects.

An investigation of the strategies used by organizations participating in the welfare-to-work network program and correlation of the strategies with the retention data to determine best practices for job retention among former welfare recipients

This ex post facto study (N = 209) examined the relationships between employer job strategies and job retention among organizations participating in Florida welfare-to-work network programs and associated the strategies with job retention data to determine best practices. ^ An internet-based self-report survey battery was administered to a heterogeneous sampling of organizations participating in the Florida welfare-to-work network program. Hypotheses were tested through correlational and hierarchical regression analytic procedures. The partial correlation results linked each of the job retention strategies to job retention. Wages, benefits, training and supervision, communication, job growth, work/life balance, fairness and respect were all significantly related to job retention. Hierarchical regression results indicated that the training and supervision variable was the best predictor of job retention in the regression equation. ^ The size of the organization was also a significant predictor of job retention. Large organizations reported higher job retention rates than small organizations. There was no statistical difference between the types of organizations (profit-making and non-profit) and job retention. The standardized betas ranged from to .26 to .41 in the regression equation. Twenty percent of the variance in job retention was explained by the combination of demographic and job retention strategy predictors, supporting the theoretical, empirical, and practical relevance of understanding the association between employer job strategies and job retention outcomes. Implications for adult education and human resource development theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of job strategies as a means for improving former welfare workers’ job retention.^

The relationship between educational placement, instructional practices, and achievement gains of Black students with specific learning disabilities in secondary urban school settings

Black students, in general, are underserved academically (Darling-Hammond, 2000; Townsend, 2002) and overrepresented in special education (Donovan & Cross, 2002). Black students with disabilities are further overrepresented in more restrictive educational environments (Skiba, Poloni-Staudinger, Gallini, Simmons & Feggins-Azziz, 2006). Although the National Longitudinal Transition Study 2 (NLTS2) revealed that the academic performance of students with learning disabilities is positively related to the percentage of courses taken in the general education setting (Newman, 2006), the research specifically on placement of Black students with disabilities, particularly at the secondary level, as it relates to academic achievement is lacking. While previous studies have sought to determine which placement is better for students with disabilities, no study was found that specifically examined the impact of placement specific to Black students with specific learning disabilities (SLD) in urban settings (Fore, III, Hagan-Burke, Burke, Boon & Smith, 2008; Rea, McLaughlin & Walther-Thomas, 2002). This study examined educational placement, instructional best practices, and achievement gains of Black students with SLD in urban secondary settings using an ex post facto research design. Achievement, placement, and demographic data were collected and analyzed on approximately 314 Black eighth grade students with SLD. The Teacher Instructional Practices Survey was developed and used to collect and analyze data from the teachers of 78 of these students as it relates to instructional best practices. Results indicate no significant difference in reading but a significant difference in math gains of students served in inclusive settings as compared to resource settings with a small effect size. Also, no significant relationship was found between achievement gains and the reported use of instructional best practices. However, there was a relationship between educational placement and the use of instructional best practices. The results implied that there is a need for training with both general and special education teachers on instructional best practices for SWD and that there should be certain IEP team considerations when making placement decisions for this population of students with disabilities. It is recommended that future research in this area include classroom observations and factors other than test scores to measure growth in achievement.

Infant feeding practices of Cuban mothers residing in Dade County, Florida

Research has shown that infant feeding practices differ between cultures. A convenience sample of 51 first generation Cuban mothers with infants birth to 12 months of age were surveyed to identify their infant feeding practices, and why they introduce foods to their infants in the manner in which they do. Data obtained from the mothers' responses to an English/Spanish Questionnaire were summarized by frequencies. Findings revealed that Cuban mothers consider a variety of foods from the major four food groups to be suitable for their infants. They introduced solids to their infants at the average age of four months and fed their infants in the manner in which they did because they thought it was healthy/nutritious. Cuban mothers may feed their infants as taught by health care professionals if their infant feeding practices are incorporated in the culture specific infant feeding programmes developed by the health team.