Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services

BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge. AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care. METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis. RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality. CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

Corners, squares and urban identities: perceptions, attitudes and values

In February 2000, the new Victorian Labor Government announced that they were removing the western shard from Lab Architecture Studio's winning Melbourne Federation Square design. then under construction. The specific 'contested terrain' at the intersection of Flinders Street and Swanston Street Walk. Melbourne, allows the exploration of the politics of place construction over time, through an examination of Young and Jackson's Hotel [1861]. St Paul's Cathedral [1886). Flinders Street Station [1912]. the Westin Hotel [1999) and Federation Square. This site brings together architectural and social history, questions public space and identity, and looks at Melburnian's perceptions, attitudes and values. It further demonstrates that the fragmentation of the professions, and fragmentary histories. lead to the preservation of 'bits' of architecture and the destruction of the urban/landscape context, jeopardizing the Identity of place.

Australian higher education institutions transforming the future of teaching and learning through 3D virtual worlds

What are educators‟ motivations for using virtual worlds with their students? Are they using them to support the teaching of professions and if this is the case, do they introduce virtual worlds into the curriculum to develop and/or expand students' professional learning networks? Are they using virtual worlds to transform their teaching and learning? In  recognition of the exciting opportunities that virtual worlds present for higher education, the DEHub Virtual Worlds Working Group was formed. It is made up of Australian university academics who are investigating the role that virtual worlds will play in the future of education and actively implementing the technology within their own teaching practice and  curricula. This paper presents a typology for teaching and learning in 3D virtual worlds and applies the typology to a series of case studies based on the ways in which academics and their institutions are exploiting the power of virtual worlds for diverse purposes ranging from business scenarios and virtual excursions to role-play, experimentation and language development. The case studies offer insight into the ways in which institutions are transforming their teaching for an unknown future through innovative teaching and learning in virtual worlds. The paper demonstrates how virtual worlds enable low cost alternatives to existing pedagogies as well as creating opportunities for rich, immersive and authentic activities that would otherwise not be feasible or maybe not even be possible. Through the use of virtual worlds, teaching and learning can be transformed to cater for an unknown future.

E-Simulations for educating the professions in blended learning environments

This chapter introduces digital, role-based simulations as an emerging and powerful educational approach for the professions and for broader workforce development purposes. It is acknowledged that simulations used for education, professional development, and training, have a long history of development and use. The focus is on digital simulations (e-simulations) situated in blended learning environments and the improved affordances of the newer digital media used via the web to enhance the value of their contribution to learning and teaching in professional and vocationally-oriented fields. This is an area which has received less attention in the whole “e-learning” literature compared with the voluminous body of knowledge and practice on computer-mediated communication, online community building, social networking, and various forms of online (usually automated) assessment. A framework of blended e-simulation design is outlined. The chapter concludes by examining what the future might hold for simulations in further and higher education, and ongoing work-based learning.

Sharing questions and initiatives, the professional organizations' point of view

The Book Designer: Careers and Professionalisation features contrubutions from 62 International design educators and professionals.  These leaders in their field provide analysis and expert commontary on the skill and epertise now required for sucessful career in design.

Celebrity and public persona

Research on celebrity and public persona derives from fundamentally interdisciplinary sources. Although at its core, the study of public personality has been the object of investigations by those more closely associated with media and communication, the key disciplines of sociology, cultural studies, literary studies, political science, social psychology, and even anthropology and history have been part of its analysis. Celebrity identifies the “extra-textual” dimensions of the famous, in which the lives of the renowned are followed, read, and reported. It is a public celebration of individuality that is (but not exclusively) connected to consumer culture and democratic capitalism. Through these larger cultural tropes celebrity has had its strongest affiliations with the contemporary entertainment industries, particularly in terms of how they are covered by the media and the press for further value beyond the cultural forms that are often the origins of stardom—the public individual’s performances in fields such as film, television, sport, and popular music. Celebrity is a site of celebration and derogation in any culture: these public individuals are truly exalted and given a status beyond others, but they are also ridiculed for their believed-to-be unearned credentials for having such a public platform and voice. Moreover, the study of celebrity and public persona is also an investigation into the connection between the populace and these public personalities, where parasocial relations most evident in fandom identify how celebrities embody audiences with an affective connection that is truly powerful in contemporary culture. That power of embodiment and connection that celebrities possess is subsequently exploited by the media industries to promote and sell new connected cultural products. Identifying celebrities as part of a spectrum of public personas links the study of celebrity to the investigation of the celebrated and famed in a variety of professions and fields well beyond entertainment. Thus, the term persona is used in these studies of public personalities to acknowledge the mask that is deployed to present a public version of the self for this external consumption and reading by an audience, a collective, a network, a nation, a citizenry, or a community. Research into public personas has led to related studies of political leadership, self-branding, notoriety in business, and reputation management, and research delves into the presentation of the public self by greater portions of the populace in online cultures. Celebrity and public persona is a field in which research aims to investigate the significance and meaning of various versions of the public self in both contemporary culture and historically.

Supporting culturally and linguistically diverse students during clinical placement: strategies from both sides of the table

Background: Increasing proportions of Culturally and Linguistically Diverse (CALD) students within health professional courses at universities creates challenges in delivering inclusive training and education. Clinical placements are a core component of most health care degrees as they allow for applied learning opportunities. A research gap has been identified in regard to understanding challenges and strategies for CALD students in health professional placements.

Methods: A key stakeholder approach was used to examine barriers and enablers experienced by CALD students in clinical placement. Semi-structured focus groups with healthcare students (n = 13) and clinical placement supervisors (n = 12) were employed. The focus groups were analysed using open coding and thematic analysis.

Results: Three main barrier areas were identified: placement planning and preparation; teaching, assessment and feedback; and cultural and language issues. Potential solutions included addressing placement planning and preparation barriers, appropriate student placement preparation, pre-placement identification of higher risk CALD students, and diversity training for supervisors. For the barrier of teaching, assessment & feedback, addressing strategies were to: adapt student caseloads, encourage regular casual supervisor-student conversations, develop supportive placement delivery modes and structures, set expectations early, model the constructive feedback process, use visual aids, and tailor the learning environment to individual student needs. The enablers for cultural & language issues were to: build language and practical approaches for communication, raise awareness of the healthcare system (how it interacts with healthcare professions and how patients access it), and initiate mentoring programs.

Conclusions: The findings suggest that teaching and learning strategies should be student-centred, aiming to promote awareness of difference and its impacts then develop appropriate responses by both student and teacher. Universities and partnering agencies, such as clinical training providers, need to provide an inclusive learning environment for students from multiple cultural backgrounds.

Position, professional expertise and functions of an educator of child care homes in Lithuania

Speaking about professionals, working with children at child care homes in Lithuania, first of all we encounter a problem of terminology. This problem rises, because in various countries and languages we call these professionals differently. In Lithuania we call them ”aukletojai”. We also use the word ”aukletojas” when speaking about both professionals, working directly with children at kindergartens, and parents, as all parents are educators of their children. We suppose, that the word ”aukletojas” corresponds to the German “erzieher”, and “aukleti” to “erziehen”. Every “aukletojas” in Lithuania clearly realizes, that he is a pedagogue, because in this country every professional, involved in educational work with children – an ”aukletojas”, a teacher, a social pedagogue and a special pedagogue – is called a pedagogue. In this context it is essential to conceive that in Lithuania an ”educator” and a ”social pedagogue” are different pedagogical professions and that none of the ”aukletojas” identify himself as a social pedagogue.

Gender Stereotypes and Gendered Vocational Aspirations among Secondary School Students

Research Topic/Aim: Horizontal gender inequalities appear to be rather stable, with girls more often choosing ‘female' service professions, and boys choosing career paths related to science, technology, engineering or mathematics, since measures to bring more women into typical ‘male' jobs and more men into typical ‘female' jobs did not turn out to be sustainable. This paper focuses on gender stereotypes, namely non-egalitarian patriarchal gender-role orientations and gender associations of the school subjects German and mathematics. Dealing with and abolishing such gender stereotypes may be key strategy to reach sustainability regarding more equal vocational choices. Thus, gender stereotypes will be theorised and empirically analysed as a major predictor of gender-typical vocational perspectives considering interest in these school subjects as a mediating factor. Furthermore, we focus on structural patriarchy as a root of gender-role orientations, and teacher gender regarding its impact on gendered images of subjects. Theoretical and methodology framework: Our analyses of gender segregation in vocational aspirations and vocational choice center on Gottfredson's (2002; Gottfredson and Becker, 1981) Theory of Circumscription, Compromise and Self-Creation. One of the main assumptions of this theory is that people associate jobs with particular sexes and those jobs that do not fit particular gender roles are not considered. Empirical analyses are based on survey data of eighth-graders in the Swiss canton of Bern (N = 672). Structural Equation Models (SEM) for male and female students are estimated. Conclusions/Findings: Results reveal different patterns for boys and girls; for boys, gender-typical (male) vocational perspective could be explained via gender role orientations, interest in mathematics and gender associations of the school subjects, for girls, the factors under consideration could be empirically linked to ‘atypical vocational perspective'. Relevance to Nordic educational research: The study focuses on gender relations in society and how they are reproduced. Gender segregation in vocational choice and at the labour market is a universal issue - affecting both egalitarian and non-egalitarian gender regimes in similar ways. Although in general Northern countries appear to be more equal regarding gender inequality, gender segregation is rather persistent (Jarman, Blackburn and Brooks, 2012) and therefore remains a relevant topic.

Does gender-fair language pay off? The social perception of professions from a cross-linguistic perspective

In many languages, masculine forms (e.g., German Lehrer, “teachers, masc.”) have traditionally been used to refer to both women and men, although feminine forms are available, too. Feminine-masculine word pairs (e.g., German Lehrerinnen und Lehrer, “teachers, fem. and teachers, masc.”) are recommended as gender-fair alternatives. A large body of empirical research documents that the use of gender-fair forms instead of masculine forms has a substantial impact on mental representations. Masculine forms activate more male representations even when used in a generic sense, whereas word pairs (e.g., German Lehrerinnen und Lehrer, “teachers, fem. and teachers, masc.”) lead to a higher cognitive inclusion of women (i.e., visibility of women). Some recent studies, however, have also shown that in a professional context word pairs may be associated with lesser status. The present research is the first to investigate both effects within a single paradigm. A cross-linguistic (Italian and German) study with 391 participants shows that word pairs help to avoid a male bias in the gender-typing of professions and increase women's visibility; at the same time, they decrease the estimated salaries of typically feminine professions (but do not affect perceived social status or competence). This potential payoff has implications for language policies aiming at gender-fairness.

The role of workplace absence as an organizational mechanism in predicting employee alcohol and drug disorders

Background. EAP programs for airline pilots in companies with a well developed recovery management program are known to reduce pilot absenteeism following treatment. Given the costs and safety consequences to society, it is important to identify pilots who may be experiencing an AOD disorder to get them into treatment. ^ Hypotheses. This study investigated the predictive power of workplace absenteeism in identifying alcohol or drug disorders (AOD). The first hypothesis was that higher absenteeism in a 12-month period is associated with higher risk that an employee is experiencing AOD. The second hypothesis was that AOD treatment would reduce subsequent absence rates and the costs of replacing pilots on missed flights. ^ Methods. A case control design using eight years (time period) of monthly archival absence data (53,000 pay records) was conducted with a sample of (N = 76) employees having an AOD diagnosis (cases) matched 1:4 with (N = 304) non-diagnosed employees (controls) of the same profession and company (male commercial airline pilots). Cases and controls were matched on the variables age, rank and date of hire. Absence rate was defined as sick time hours used over the sum of the minimum guarantee pay hours annualized using the months the pilot worked for the year. Conditional logistic regression was used to determine if absence predicts employees experiencing an AOD disorder, starting 3 years prior to the cases receiving the AOD diagnosis. A repeated measures ANOVA, t tests and rate ratios (with 95% confidence intervals) were conducted to determine differences between cases and controls in absence usage for 3 years pre and 5 years post treatment. Mean replacement costs were calculated for sick leave usage 3 years pre and 5 years post treatment to estimate the cost of sick leave from the perspective of the company. ^ Results. Sick leave, as measured by absence rate, predicted the risk of being diagnosed with an AOD disorder (OR 1.10, 95% CI = 1.06, 1.15) during the 12 months prior to receiving the diagnosis. Mean absence rates for diagnosed employees increased over the three years before treatment, particularly in the year before treatment, whereas the controls’ did not (three years, x = 6.80 vs. 5.52; two years, x = 7.81 vs. 6.30, and one year, x = 11.00cases vs. 5.51controls. In the first year post treatment compared to the year prior to treatment, rate ratios indicated a significant (60%) post treatment reduction in absence rates (OR = 0.40, CI = 0.28, 0.57). Absence rates for cases remained lower than controls for the first three years after completion of treatment. Upon discharge from the FAA and company’s three year AOD monitoring program, case’s absence rates increased slightly during the fourth year (controls, x = 0.09, SD = 0.14, cases, x = 0.12, SD = 0.21). However, the following year, their mean absence rates were again below those of the controls (controls, x = 0.08, SD = 0.12, cases, x¯ = 0.06, SD = 0.07). Significant reductions in costs associated with replacing pilots calling in sick, were found to be 60% less, between the year of diagnosis for the cases and the first year after returning to work. A reduction in replacement costs continued over the next two years for the treated employees. ^ Conclusions. This research demonstrates the potential for workplace absences as an active organizational surveillance mechanism to assist managers and supervisors in identifying employees who may be experiencing or at risk of experiencing an alcohol/drug disorder. Currently, many workplaces use only performance problems and ignore the employee’s absence record. A referral to an EAP or alcohol/drug evaluation based on the employee’s absence/sick leave record as incorporated into company policy can provide another useful indicator that may also carry less stigma, thus reducing barriers to seeking help. This research also confirms two conclusions heretofore based only on cross-sectional studies: (1) higher absence rates are associated with employees experiencing an AOD disorder; (2) treatment is associated with lower costs for replacing absent pilots. Due to the uniqueness of the employee population studied (commercial airline pilots) and the organizational documentation of absence, the generalizability of this study to other professions and occupations should be considered limited. ^ Transition to Practice. The odds ratios for the relationship between absence rates and an AOD diagnosis are precise; the OR for year of diagnosis indicates the likelihood of being diagnosed increases 10% for every hour change in sick leave taken. In practice, however, a pilot uses approximately 20 hours of sick leave for one trip, because the replacement will have to be paid the guaranteed minimum of 20 hour. Thus, the rate based on hourly changes is precise but not practical. ^ To provide the organization with practical recommendations the yearly mean absence rates were used. A pilot flies on average, 90 hours a month, 1080 annually. Cases used almost twice the mean rate of sick time the year prior to diagnosis (T-1) compared to controls (cases, x = .11, controls, x = .06). Cases are expected to use on average 119 hours annually (total annual hours*mean annual absence rate), while controls will use 60 hours. The cases’ 60 hours could translate to 3 trips of 20 hours each. Management could use a standard of 80 hours or more of sick time claimed in a year as the threshold for unacceptable absence, a 25% increase over the controls (a cost to the company of approximately of $4000). At the 80-hour mark, the Chief Pilot would be able to call the pilot in for a routine check as to the nature of the pilot’s excessive absence. This management action would be based on a company standard, rather than a behavioral or performance issue. Using absence data in this fashion would make it an active surveillance mechanism. ^

Predictive validity of the personal background and preparation survey and effectiveness of targeted interventions among health science community college students

Existing data, collected from 1st-year students enrolled in a major Health Science Community College in the south central United States, for Fall 2010, Spring 2011, Fall 2011 and Spring 2012 semesters as part of the "Online Navigational Assessment Vehicle, Intervention Guidance, and Targeting of Risks (NAVIGATOR) for Undergraduate Minority Student Success" with CPHS approval number HSC-GEN-07-0158, was used for this thesis. The Personal Background and Preparation Survey (PBPS) and a two-question risk self-assessment subscale were administered to students during their 1st-year orientation. The PBPS total risk score, risk self-assessment total and overall scores, and Under Representative Minority Student (URMS) status were recorded. The purpose of this study is to evaluate and report the predictive validity of the indicators identified above for Adverse Academic Status Events (AASE) and Nonadvancement Adverse Academic Status Events (NAASE) as well as the effectiveness of interventions targeted using the PBPS among a diverse population of health science community college students. The predictive validity of the PBPS for AASE has previously been demonstrated among health science professions and graduate students (Johnson, Johnson, Kim, & McKee, 2009a; Johnson, Johnson, McKee, & Kim, 2009b). Data will be analyzed using binary logistic regression and correlation using SPSS 19 statistical package. Independent variables will include baseline- versus intervention-year treatments, PBPS, risk self-assessment, and URMS status. The dependent variables will be binary AASE and NAASE status. ^ The PBPS was the first reliable diagnostic and prescriptive instrument to establish documented predictive validity for student Adverse Academic Status Events (AASE) among students attending health science professional schools. These results extend the documented validity for the PBPS in predicting AASE to a health science community college student population. Results further demonstrated that interventions introduced using the PBPS were followed by approximately one-third reduction in the odds of Nonadvancement Adverse Academic Status Events (NAASE), controlling for URMS status and risk self-assessment scores. These results indicate interventions introduced using the PBPS may have potential to reduce AASE or attrition among URMS and nonURMS attending health science community colleges on a broader scale; positively impacting costs, shortages, and diversity of health science professionals.^

News in engineering education in Spain effective from 2010 in presence of external changes and mixed crisis, looking mostly to agro and civil engineers.

The engineering careers models were diverse in Europe, and are adopting now in Spain the Bolonia process for European Universities. Separated from older Universities, that are in part technically active, Civil Engineering (Caminos, Canales y Puertos) started at end of 18th century in Spain adopting the French models of Upper Schools for state civil servants with exam at entry. After 1800 intense wars, to conserve forest regions Ingenieros de Montes appeared as Upper School, and in 1855 also the Ingenieros Agrónomos to push up related techniques and practices. Other Engineers appeared as Upper Schools but more towards private factories. These ES got all adapted Lower Schools of Ingeniero Tecnico. Recently both grew much in number and evolved, linked also to recognized Professions. Spanish society, into European Community, evolved across year 2000, in part highly well, but with severe discordances, that caused severe youth unemployment with 2008-2011 crisis. With Bolonia process high formal changes step in from 2010-11, accepted with intense adaptation. The Lower Schools are changing towards the Upper Schools, and both that have shifted since 2010-11 various 4-years careers (Grado), some included into the precedent Professions, and diverse Masters. Acceptation of them to get students has started relatively well, and will evolve, and acceptation of new grades for employment in Spain, Europe or outside will be essential. Each Grado has now quite rigid curricula and programs, MOODLE was introduced to connect pupils, some specific uses of Personal Computers are taught in each subject. Escuela de Agronomos centre, reorganized with its old name in its precedent buildings at entrance of Campus Moncloa, offers Grados of Agronomic Engineering and Science for various public and private activities for agriculture, Alimentary Engineering for alimentary activities and control, Agro-Environmental Engineering more related to environment activities, and in part Biotechnology also in laboratories in Campus Monte-Gancedo for Biotechnology of Plants and Computational Biotechnology. Curricula include Basics, Engineering, Practices, Visits, English, ?project of end of career?, Stays. Some masters will conduce to specific professional diploma, list includes now Agro-Engineering, Agro-Forestal Biotechnology, Agro and Natural Resources Economy, Complex Physical Systems, Gardening and Landscaping, Rural Genie, Phytogenetic Resources, Plant Genetic Resources, Environmental Technology for Sustainable Agriculture, Technology for Human Development and Cooperation.

Brandon/Hill selected list of print books and journals in allied health*

This list of 424 books and 77 journals is intended as a selection guide for print literature to be used in a library supporting allied health educational programs or allied health personnel in either an academic or health care setting. Because of the impossibility of covering the large number and wide variety of allied health professions and occupations, the recommended publications are focused primarily on the educational programs listed and recognized by the American Medical Association and other accrediting bodies. Books and journals are categorized by subject; the book list is followed by an author/editor index, and the subject list of journals by an alphabetical title listing. Items suggested for initial purchase (167 books and 31 journals) are indicated by asterisks. To purchase the entire collection of books and journals (2000 subscriptions) would require an expenditure of about $31,970. The cost of only the asterisked items totals $12,515.

Teamwork in Health and Rehabilitation Sciences: Evaluation of a multiprofessional workshop

This paper outlines a multiprofessional education workshop piloted and subsequently conducted with a cohort of 81 graduate entry students of occupational therapy, physiotherapy, speech pathology and audiology. The rationale for, and format of, the workshop is outlined, followed by comparisons between students' knowledge about teamwork prior to and after the four-hour workshop. The workshop was based on a real case scenario of a child with Developmental Coordination Disorder (DCD). Students completed pre- and post-workshop questionnaires about their knowledge of DCD, teamwork and the roles of various professionals and parents; and a post-workshop questionnaire about their views regarding the utility of the workshop, its strengths, and learning outcomes. The evaluation indicated that the workshop was overwhelmingly successful from the students' perspective in: (1) enhancing their understanding about DCD and its multifaceted impact on school age children; (2) developing a deeper appreciation of the importance of teamwork itself; (3) refining their understanding of their own profession's role and (4) developing an appreciation of the role of other professions and parents in working with children with complex needs, and their families. Limitations of this study and directions for future research are discussed.