Inovação tecnológica: análise comparativa entre dois métodos de coleta de dados sobre riscos e danos em enfermagem

Estudo de comparação entre dois métodos de coleta de dados, através da aplicação de um software, para avaliação dos fatores de risco e danos no trabalho de enfermagem em hospital. Objetiva analisar o uso do software (eletrônico) em comparação com o uso do instrumento impresso. Trata-se de um estudo estatístico, descritivo com abordagem quantitativa, desenvolvido nas enfermarias dos Serviços de Internações Clínicas e Serviços de Internações Cirúrgicas de um Hospital Universitário, no estado do Rio de Janeiro. A população do estudo foram os trabalhadores de enfermagem das unidades. A amostra foi definida por meio de amostragem não-probabilística e alocação da amostra ocorreu de forma aleatória em dois grupos, denominados grupo impresso e grupo eletrônico, com 52 participantes cada. Previamente a coleta de dados foram implementadas estratégias de pesquisa denominada teaser, através da comunicação digital aos trabalhadores. Posteriormente, foi ofertado aos participantes do formato impresso o questionário impresso, e os participantes do formato eletrônico receberam um link de acesso a home page. Os dados foram analisados através da estatística descritiva simples. Após a aplicação do questionário nos dois formatos, obteve-se resposta de 47 trabalhadores do grupo impresso (90,3%), e 17 trabalhadores do grupo eletrônico (32,7%). A aplicação do questionário impresso revelou algumas vantagens como o número de pessoas atingidas pela pesquisa, maior interação pesquisador e participante, taxa de retorno mais alta, e quanto às desvantagens a demanda maior de tempo, erros de transcrição, formulação de banco de dados, possibilidades de resposta em branco e erros de preenchimento. No formato eletrônico as vantagens incluem a facilidade de tabulação e análise dos dados, impossibilidade de não resposta, metodologia limpa e rápida, e como desvantagens, o acesso à internet no período de coleta de dados, saber usar o computador e menor taxa de resposta. Ambos os grupos observaram que o questionário possui boas instruções e fácil compreensão, além de curto tempo para resposta. Os trabalhadores perceberam a existência dos riscos ocupacionais, principalmente os ergonômicos, biológicos e de acidentes. Os principais danos à saúde provocados ou agravos pelo trabalho percebidos pelos trabalhadores foram os problemas osteomusculares, estresse, transtornos do sono, mudanças de humor e alterações de comportamento e varizes. Pode-se afirmar que não ocorreram diferenças acentuadas de percentual ao comparar a percepção dos trabalhadores do grupo impresso e do grupo eletrônico frente aos riscos e danos à saúde. Conclui-se que os dois processos de coleta de dados tiveram boa aceitação, no entanto, deve ser indicada a aplicação do questionário eletrônico junto com a ferramenta de acesso, no caso o computador, tablet.

Aprendizagem do profissional de saúde na web: perfis, percepções e representações sociais

No campo da educação permanente na área da saúde, podem ser citadas diferentes iniciativas que visam formar profissionais com o uso das Tecnologias de Informação e Comunicação (TICs). No entanto, pouco se sabe ainda sobre o uso da web por profissionais da saúde como estratégia da aprendizagem formal, menos ainda quando se aborda a aprendizagem informal. Percebe-se que as ações no campo da educação com uso e, sobretudo, para o uso da tecnologia como ferramenta de aprendizagem ainda são feitas de forma muito intuitivas, por acerto e erro, tendo em vista a própria evolução da tecnologia em um curto período temporal. Sendo assim, o objetivo geral da pesquisa é compreender o perfil, as percepções e representações sociais sobre aprendizagem na web de médicos, enfermeiros e cirurgiões-dentistas e uma possível influência desse uso no cotidiano profissional. Para atingir o objetivo delimitado, foi empregada a metodologia quali-quantitativa através da utilização de um questionário on-line, contendo questões fechadas e questões abertas, respondido por 277 alunos do Curso de Especialização em Saúde da Família oferecido pelo núcleo da Universidade do Estado do Rio de Janeiro (UERJ) da Universidade Aberta do Sistema Único de Saúde (UNA-SUS). Para análise das questões fechadas, foi utilizada a estatística descritiva e testes bivariados não paramétricos. A análise das questões abertas foi feita à luz da teoria da representações sociais com emprego da técnica da análise do conteúdo e das evocações livres. Os resultados da pesquisa foram apresentados em formato de três trabalhos para apresentação em eventos e quatro artigos submetidos para publicação em revistas de alta qualidade acadêmica. Com base nos resultados, destaca-se como preocupação que o simples consumo de informações esteja justificando e a ele esteja restrito o uso da internet para os sujeitos, em detrimento às possibilidades educacionais da cibercultura. Acredita-se ser necessário o desenvolvimento de ações que subsidiem uma prática mais reflexiva a fim de reverter um possível uso reduzido das potencialidades da TICs.

Educação a distância na formação pedagógica de preceptores: avaliando a construção de ambientes colaborativos

O Núcleo de Apoio Psicopedagógico ao Residente (NAPPRE) em parceria com a Coordenadoria de Desenvolvimento Acadêmico (CDA) do Hospital Universitário Pedro Ernesto (HUPE) da Universidade do Estado do Rio de Janeiro (UERJ), desenvolve desde 2010 o Curso de Formação Pedagógica para a Prática da Preceptoria (CFPPP) curso de extensão na modalidade aperfeiçoamento, tendo como eixos estruturantes cuidado, educação e gestão. Sustentado nos princípios e diretrizes do Sistema Único de Saúde (SUS) e orientado pelas Diretrizes Curriculares Nacionais de Graduação em Saúde (DCNs), o curso apresenta-se como uma estratégia de Educação Permanente em Saúde (EPS) desta instituição utilizando, tanto nas atividades presenciais como na educação à distância, metodologias ativas para o desenvolvimento da competência pedagógica do preceptor. O projeto político pedagógico do curso valoriza a integração dos profissionais de diferentes categorias para o trabalho em equipe. O alcance dos objetivos educacionais e a construção de projetos de intervenção a serem desenvolvidos nas instituições de origem durante o curso exige interação constante dos participantes e desenvolvimento de espaços colaborativos facilitados por estratégias mistas de educação em atividades presenciais e à distância. Considerando que, aproximadamente, 57% da carga horária do curso corresponde à atividades no ambiente virtual de aprendizagem é fundamental compreender a relevância e funcionalidade deste modelo pedagógico para promover a aprendizagem e induzir práticas colaborativas interdisciplinares compreendidas como um caminho para o desenvolvimento da capacidade criativa, da solidariedade e da inteligência coletiva favorecendo a autonomia crescente, individual e coletiva, a autoria e a produção de cuidado e educação. Estes são elementos constitutivos de práticas educacionais coerentes com as necessidades de formação dos profissionais para qualificar o cuidado em saúde no nosso País. Este projeto de pesquisa tem como objetivo principal avaliar como a Educação à Distância (EaD) favorece a construção de ambientes colaborativos na formação pedagógica de preceptores. Trata-se de um estudo de caso único, retrospectivo, com duas unidades de análise, explanatório, intrínseco e educacional. São integrantes dessa pesquisa, como participantes, todos os preceptores da 1 e 2 turmas (anos 2010 e 2011 respectivamente). O planejamento educacional do curso foi contextualizado considerando as competências pedagógicas que são objetivos de aprendizagem. Foram analisados documentos produzidos de forma individual e coletiva durante as etapas do curso. Os dados quantitativos foram analisados através de estatística descritiva e a análise dos dados coletados no material documental foi por análise de conteúdo segundo as proposições de Bardin com identificação de núcleos e/ou validação destes núcleos através das nuvens de palavras construídas através do wordle.

Characterizing Jobos Bay, Puerto Rico: a watershed modeling analysis and monitoring plan

Land-based pollution is commonly identified as a major contributor to the observed deterioration of shallow-water coral reef ecosystem health. Human activity on the coastal landscape often induces nutrient enrichment, hypoxia, harmful algal blooms, toxic contamination and other stressors that have degraded the quality of coastal waters. Coral reef ecosystems throughout Puerto Rico, including Jobos Bay, are under threat from coastal land uses such as urban development, industry and agriculture. The objectives of this report were two-fold: 1. To identify potentially harmful land use activities to the benthic habitats of Jobos Bay, and 2. To describe a monitoring plan for Jobos Bay designed to assess the impacts of conservation practices implemented on the watershed. This characterization is a component of the partnership between the U.S. Department of Agriculture (USDA) and the National Oceanic and Atmospheric Administration (NOAA) established by the Conservation Effects Assessment Project (CEAP) in Jobos Bay. CEAP is a multi-agency effort to quantify the environmental benefits of conservation practices used by private landowners participating in USDA programs. The Jobos Bay watershed, located in southeastern Puerto Rico, was selected as the first tropical CEAP Special Emphasis Watershed (SEW). Both USDA and NOAA use their respective expertise in terrestrial and marine environments to model and monitor Jobos Bay resources. This report documents NOAA activities conducted in the first year of the three-year CEAP effort in Jobos Bay. Chapter 1 provides a brief overview of the project and background information on Jobos Bay and its watershed. Chapter 2 implements NOAA’s Summit to Sea approach to summarize the existing resource conditions on the watershed and in the estuary. Summit to Sea uses a GIS-based procedure that links patterns of land use in coastal watersheds to sediment and pollutant loading predictions at the interface between terrestrial and marine environments. The outcome of Summit to Sea analysis is an inventory of coastal land use and predicted pollution threats, consisting of spatial data and descriptive statistics, which allows for better management of coral reef ecosystems. Chapters 3 and 4 describe the monitoring plan to assess the ecological response to conservation practices established by USDA on the watershed. Jobos Bay is the second largest estuary in Puerto Rico, but has more than three times the shoreline of any other estuarine area on the island. It is a natural harbor protected from offshore wind and waves by a series of mangrove islands and the Punta Pozuelo peninsula. The Jobos Bay marine ecosystem includes 48 km² of mangrove, seagrass, coral reef and other habitat types that span both intertidal and subtidal areas. Mapping of Jobos Bay revealed 10 different benthic habitats of varying prevalence, and a large area of unknown bottom type covering 38% of the entire bay. Of the known benthic habitats, submerged aquatic vegetation, primarily seagrass, is the most common bottom type, covering slightly less than 30% of the bay. Mangroves are the dominant shoreline feature, while coral reefs comprise only 4% of the total benthic habitat. However, coral reefs are some of the most productive habitats found in Jobos Bay, and provide important habitat and nursery grounds for fish and invertebrates of commercial and recreational value.

Developing a toolkit for assessing the impact of health library services on patient care

Urquhart,C., Spink, S., Thomas, R. & Weightman, A. (2007). Developing a toolkit for assessing the impact of health library services on patient care. Report to LKDN (Libraries and Knowledge Development Network). Aberystwyth: Department of Information Studies, Aberystwyth University. Sponsorship: Libraries and Knowledge Development Network/ NHS

Assessing the Oral Health Needs of Public Housing Residents

Objectives: “Tooth Smart Healthy Start” is a randomized clinical trial which aims to reduce the incidence of early childhood caries (ECC) in Boston public housing residents as part of the NIH funded Northeast Center for Research to Evaluate and Eliminate Dental Disparities. The purpose of this project was to assess public housing stakeholders' perception of the oral health needs of public housing residents and their interest in replicating “Tooth Smart Healthy Start” in other public housing sites across the nation. Methods: The target population was the 180 attendees of the 2010 meeting of the Health Care for Residents of Public Housing National Conference. A ten question survey which assessed conference attendees' beliefs about oral health and its importance to public housing residents was distributed. Data was analyzed using SAS 9.1. Descriptive statistics were calculated for each variable and results were stratified by participants' roles. Results: Thirty percent of conference attendees completed the survey. The participants consisted of residents, agency representatives, and housing authority personnel. When asked to rank health issues facing public housing residents, oral health was rated as most important (42%) or top three (16%) by residents. The agency representatives and housing authority personnel rated oral health among the top three (33% and 58% respectively) and top five (36% and 25% respectively). When participants ranked the three greatest resident health needs out of eight choices, oral health was the most common response. Majority of the participants expressed interest in replicating the “Tooth Smart Healthy Start” program at their sites. Conclusion: All stakeholder groups identified oral health as one of the greatest health needs of residents in public housing. Furthermore, if shown to reduce ECC, there is significant interest in implementing the program amongst key public housing stakeholders across the nation.

Hospital clinicians information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey

Background: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. Aims:  This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians perceptions and attitudes to the introduction of a CI into their clinical teams. Methods: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. Results: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. Conclusion: This paper highlights the factors that characterise and limit hospital clinicians information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

The relationship between rural livelihoods and livestock keeping: the case of Sidama Zone, Southern Ethiopia

This study examines the relationship between rural livelihoods and livestock keeping in Sidama Zones, southern Ethiopia. The livelihood context, assets and strategies of households are the key features of rural livelihoods considered in the study; while households’ livestock ownership, dependence on livestock and livestock management are the main aspects of livestock keeping examined. The study used the sustainable livelihood approach as a framework for data collection and analysis. Describing the main features of rural livelihoods and livestock keeping, and the general pattern of relationship between them, this study mainly aims at identifying the main livelihood factors that determine livestock keeping in the study area. Descriptive statistics, pair wise correlations, mean comparisons and analysis of variance were used to describe rural livelihoods and livestock keeping as well as the relationship between them. Tobit regressions were used to examine the effect of the various livelihood factors on households’ livestock ownership and dependence; Poisson regressions are used to investigate the factors that influence the intensity of livestock management measured by the use of different technologies and inputs. The findings indicated that a number of livelihood factors - assets, livelihood strategies, livelihood shocks and institutional supports - significantly determine the different aspects of livestock keeping. These include: human assets such as age, education and family size; social assets such as membership to social groups; financial assets such as credit; natural assets such as land, and household physical assets; and livelihood strategies such as diversification into farm and nonfarm activities, and coping mechanisms. In addition the livelihood vulnerability context such as shocks and institutional support are among the main determinants of livestock keeping. The results, by and large, matched the findings of previous studies, and it is concluded that households livestock keeping depends on their livelihoods. Accordingly, it is recommended that policies aiming at livestock asset building and productivity improvement should take the livelihoods of rural households in to consideration. As such the study contribute to scholarly works in the area of rural livelihoods, in general, and livestock keeping, in particular. It also contributes to a better understanding of the problems of livestock keeping within the context of rural livelihoods in the country and to the formulation of appropriate policy for the development of the sector.

Survival analysis of adult tuberculosis disease

Background: We conducted a survival analysis of all the confirmed cases of Adult Tuberculosis (TB) patients treated in Cork-City, Ireland. The aim of this study was to estimate Survival time (ST), including median time of survival and to assess the association and impact of covariates (TB risk factors) to event status and ST. The outcome of the survival analysis is reported in this paper. Methods: We used a retrospective cohort study research design to review data of 647 bacteriologically confirmed TB patients from the medical record of two teaching hospitals. Mean age 49 years (Range 18–112). We collected information on potential risk factors of all confirmed cases of TB treated between 2008–2012. For the survival analysis, the outcome of interest was ‘treatment failure’ or ‘death’ (whichever came first). A univariate descriptive statistics analysis was conducted using a non- parametric procedure, Kaplan -Meier (KM) method to estimate overall survival (OS), while the Cox proportional hazard model was used for the multivariate analysis to determine possible association of predictor variables and to obtain adjusted hazard ratio. P value was set at <0.05, log likelihood ratio test at >0.10. Data were analysed using SPSS version 15.0. Results: There was no significant difference in the survival curves of male and female patients. (Log rank statistic = 0.194, df = 1, p = 0.66) and among different age group (Log rank statistic = 1.337, df = 3, p = 0.72). The mean overall survival (OS) was 209 days (95%CI: 92–346) while the median was 51 days (95% CI: 35.7–66). The mean ST for women was 385 days (95%CI: 76.6–694) and for men was 69 days (95%CI: 48.8–88.5). Multivariate Cox regression showed that patient who had history of drug misuse had 2.2 times hazard than those who do not have drug misuse. Smokers and alcohol drinkers had hazard of 1.8 while patients born in country of high endemicity (BICHE) had hazard of 6.3 and HIV co-infection hazard was 1.2. Conclusion: There was no significant difference in survival curves of male and female and among age group. Women had a higher ST compared to men. But men had a higher hazard rate compared to women. Anti-TNF, immunosuppressive medication and diabetes were found to be associated with longer ST, while alcohol, smoking, RICHE, BICHE was associated with shorter ST.

The effect of a urinary incontinence self-management program for older women in South Korea: A pilot study

© 2015 Chinese Nursing Association.Background Although self-management approaches have shown strong evidence of positive outcomes for urinary incontinence prevention and management, few programs have been developed for Korean rural communities. Objectives This pilot study aimed to develop, implement, and evaluate a urinary incontinence self-management program for community-dwelling women aged 55 and older with urinary incontinence in rural South Korea. Methods This study used a one-group pre- post-test design to measure the effects of the intervention using standardized urinary incontinence symptom, knowledge, and attitude measures. Seventeen community-dwelling older women completed weekly 90-min group sessions for 5 weeks. Descriptive statistics and paired t-tests and were used to analyze data. Results The mean of the overall interference on daily life from urine leakage (pre-test: M = 5.76 ± 2.68, post-test: M = 2.29 ± 1.93, t = -4.609, p < 0.001) and the sum of International Consultation on Incontinence Questionnaire scores (pre-test: M = 11.59 ± 3.00, post-test: M = 5.29 ± 3.02, t = -5.881, p < 0.001) indicated significant improvement after the intervention. Improvement was also noted on the mean knowledge (pre-test: M = 19.07 ± 3.34, post-test: M = 23.15 ± 2.60, t = 7.550, p < 0.001) and attitude scores (pre-test: M = 2.64 ± 0.19, post-test: M = 3.08 ± 0.41, t = 5.150, p < 0.001). Weekly assignments were completed 82.4% of the time. Participants showed a high satisfaction level (M = 26.82 ± 1.74, range 22-28) with the group program. Conclusions Implementation of a urinary incontinence self-management program was accompanied by improved outcomes for Korean older women living in rural communities who have scarce resources for urinary incontinence management and treatment. Urinary incontinence self-management education approaches have potential for widespread implementation in nursing practice.

Scholarly research productivity is not related to higher three-year licensure pass rates for physical therapy academic programs.

BACKGROUND: In the domain of academia, the scholarship of research may include, but not limited to, peer-reviewed publications, presentations, or grant submissions. Programmatic research productivity is one of many measures of academic program reputation and ranking. Another measure or tool for quantifying learning success among physical therapists education programs in the USA is 100 % three year pass rates of graduates on the standardized National Physical Therapy Examination (NPTE). In this study, we endeavored to determine if there was an association between research productivity through artifacts and 100 % three year pass rates on the NPTE. METHODS: This observational study involved using pre-approved database exploration representing all accredited programs in the USA who graduated physical therapists during 2009, 2010 and 2011. Descriptive variables captured included raw research productivity artifacts such as peer reviewed publications and books, number of professional presentations, number of scholarly submissions, total grant dollars, and numbers of grants submitted. Descriptive statistics and comparisons (using chi square and t-tests) among program characteristics and research artifacts were calculated. Univariate logistic regression analyses, with appropriate control variables were used to determine associations between research artifacts and 100 % pass rates. RESULTS: Number of scholarly artifacts submitted, faculty with grants, and grant proposals submitted were significantly higher in programs with 100 % three year pass rates. However, after controlling for program characteristics such as grade point average, diversity percentage of cohort, public/private institution, and number of faculty, there were no significant associations between scholarly artifacts and 100 % three year pass rates. CONCLUSIONS: Factors outside of research artifacts are likely better predictors for passing the NPTE.

Workplace violence and intentions to quit: results from a survey of London nurses

Study Objective: Work-place violence, harassment and abuse is an increasing feature of nurses’ experience of work in many countries. There is some evidence that the experience of workplace violence affects levels of job satisfaction (Hesketh et al 2003) and career decisions (e.g. Mayer et al 1999, Fernandes et al 1999). This paper reports on verbal and physical abuse by patients, relatives and carers, as well as racial and sexual harassment in Acute Hospitals in London and investigates whether workplace violence affects nurses’ intentions to leave either their current job or the nursing profession, controlling for a number of other factors that are known to affect career decisions, such as workload, pay and own health. Method: A questionnaire designed by two of the authors (Reeves and West) to assess many different aspects of nurses work life was used in a postal survey of nurses grades A to I practising in twenty London acute trusts in 2002. A total of 6,160 clinical nurses were mailed the questionnaires and 2,880 returned completed questionnaires, resulting in an overall response rate of 47%, discounting undelivered questionnaires. Respondents worked in a wide variety of clinical settings but mainly in acute medical and surgical wards. In addition to descriptive statistics, results were analysed using logistic regression with robust standard errors: the appropriate test when the dependent variable is dichotomous and the individual respondents clustered within units (nurses working within hospitals are not statistically independent). Results: Our results show high levels of racial (%), sexual (%) and other, unspecified forms of harassment (%), as well as verbal and physical abuse (14% had been physically assaulted with 5% being assaulted more than once), over the previous 6 months. A very small number (1%) reported experiencing all three forms of harassment; 12% two forms and 29% one form. Only 45% of this sample intended to stay in nursing for at least 3 years; 40% were undecided and 15% intended to leave. Logistic regression estimates showed that reported levels of abuse and harassment had a significant impact on respondents’ career intentions, even in models that controlled for known factors affecting career decisions. About 70% of our respondents reported that they had had too little training in dealing with aggressive behaviour—or none at all—but there was no statistical relationship between lack of training and reported assaults. Conclusions: The international shortage of health care workers is due at least in part to low retention rates. It is crucial to investigate nurses’ experiences of work to identify the factors that shape their career decisions. Workplace violence is increasingly acknowledged as an international, service-wide, health care problem. This paper adds to the literature that shows that workplace violence has an impact on nurses’ career decisions. The implications for managers and policy makers are that strengthening systems of security and providing nurses with training in interpersonal relationships including dealing with aggressive patients could slow nurse turnover.

The challenge of patients’ unmet palliative care needs in the final stages of chronic illness.

Background: There is consensus in the literature that the end of life care for patients with chronic illness is suboptimal, but research on the specific needs of this population is limited. Aim: This study aimed to use a mixed methodology and case study approach to explore the palliative care needs of patients with a non-cancer diagnosis from the perspectives of the patient, their significant other and the clinical team responsible for their care. Patients (n 18) had a diagnosis of either end-stage heart failure, renal failure or respiratory disease. Methods: The Short Form 36 and Hospital and Anxiety and Depression Questionnaire were completed by all patients. Unstructured interviews were (n 35) were conducted separately with each patient and then their significant other. These were followed by a focus group discussion (n 18) with the multiprofessional clinical team. Quantitative data were analysed using simple descriptive statistics and simple descriptive statistics. All qualitative data were taped, transcribed and analysed using Colaizzi’s approach to qualitative analysis. Findings: Deteriorating health status was the central theme derived from this analysis. It led to decreased independence, social isolation and family burden. These problems were mitigated by the limited resources at the individual’s disposal and the availability of support from hospital and community services. Generally resources and support were perceived as lacking. All participants in this study expressed concerns regarding the patients’ future and some patients described feelings of depression or acceptance of the inevitability of imminent death. Conclusion: Patients dying from chronic illness in this study had many concerns and unmet clinical needs. Care teams were frustrated by the lack of resources available to them and admitted they were ill-equipped to provide for the individual’s holistic needs. Some clinicians described difficulty in talking openly with the patient and family regarding the palliative nature of their treatment. An earlier and more effective implementation of the palliative care approach is necessary if the needs of patients in the final stages of chronic illness are to be adequately addressed. Pa

Predictors of attitudes toward inclusion of students with special educational needs in future education professionals

One of the main pillars in the development of inclusive schools is the initial teacher training. Before determining if it is necessary to make changes (and of what type) in training programs or curriculum guides related to the attention to diversity and inclusive education, the attitudes of future education professionals in this area should be analyzed. This includes the identification of the relevant predictors of inclusive attitudes. The research reported in this article pursued this objective, doing so with a quantitative survey methodology based on the use of cross-sectional structured data collection and statistical analyses related to the quality of the attitude questionnaire (factor analysis and Cronbach's alpha), descriptive statistics, correlations, hypothesis tests for difference of means, and regression analysis in order to predict attitudes towards inclusion in education. Firstly, the results show that the participants held very positive attitudes toward the inclusion of students with special educational needs. Particularly, older respondents, those with a longer training and, to a lesser extent, women and those who had been in touch with disabled people stood out within this attitude. Secondly, it is evidenced that self-transcendence values ​and, more weakly, contact, function as robust predictors of attitudes of future practitioners towards the inclusion of students with special needs. Some applications for the initial professionalization of educators are suggested in the discussion.

Recognising the co-occurance of domestic and child abuse: a comparison of community and hospital-based midwives

This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the cooccurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P <0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.