Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries

Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.

Knowledge, attitudes and beliefs of parents regarding fever in children: a Danish interview study

Aim: Fever and febrile illness are some of the most common conditions managed by parents. The aim of this study was to examine the knowledge, attitudes and beliefs of parents around fever in children under five years of age. Methods: Between July and August 2014, a convenience sample of parents was invited to participate in this study in Copenhagen, Denmark. Results were analysed thematically using a constant comparison method. Results: Twenty-one parents participated in the study. Five themes emerged from the data: parental concern, help-seeking behaviour, parental knowledge, parent fever management practices and initiatives. Parents used a range of information sources to obtain their knowledge on management of fever; however, due to issues of trust with these sources, reassurance was often sought from healthcare practitioners. There was a desire amongst most parents for initiatives to be introduced which provide general information on how to manage fever in children. Conclusion: Parents were very concerned when their child was febrile and instigated practices obtained from accessible information sources. This study has identified a need for specific and reliable information initiatives to be introduced as a means of reducing parental concern and ensuring evidence-based strategies for managing a child with fever.

Effective Knowledge Integration in Emergency Response Organizations

Natural and man-made disasters have gained attention at all levels of policy-making in recent years. Emergency management tasks are inherently complex and unpredictable, and often require coordination among multiple organizations across different levels and locations. Effectively managing various knowledge areas and the organizations involved has become a critical emergency management success factor. However, there is a general lack of understanding about how to describe and assess the complex nature of emergency management tasks and how knowledge integration can help managers improve emergency management task performance. The purpose of this exploratory research was first, to understand how emergency management operations are impacted by tasks that are complex and inter-organizational and second, to investigate how knowledge integration as a particular knowledge management strategy can improve the efficiency and effectiveness of the emergency tasks. Three types of specific knowledge were considered: context-specific, technology-specific, and context-and-technology-specific. The research setting was the Miami-Dade Emergency Operations Center (EOC) and the study was based on the survey responses from the participants in past EOC activations related to their emergency tasks and knowledge areas. The data included task attributes related to complexity, knowledge area, knowledge integration, specificity of knowledge, and task performance. The data was analyzed using multiple linear regressions and path analyses, to (1) examine the relationships between task complexity, knowledge integration, and performance, (2) the moderating effects of each type of specific knowledge on the relationship between task complexity and performance, and (3) the mediating role of knowledge integration. As per theory-based propositions, the results indicated that overall component complexity and interactive complexity tend to have a negative effect on task performance. But surprisingly, procedural rigidity tended to have a positive effect on performance in emergency management tasks. Also as per our expectation, knowledge integration had a positive relationship with task performance. Interestingly, the moderating effects of each type of specific knowledge on the relationship between task complexity and performance were varied and the extent of mediation of knowledge integration depended on the dimension of task complexity.

Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study

Objective
To explore the concerns, needs and knowledge of women diagnosed with Gestational Diabetes Mellitus (GDM).
Design
A qualitative study of women with GDM or a history of GDM.
Methods
Nineteen women who were both pregnant and recently diagnosed with GDM or post- natal with a recent history of GDM were recruited from outpatient diabetes care clinics. This qualitative study utilised focus groups. Participants were asked a series of open-ended questions to explore 1) current knowledge of GDM; 2) anxiety when diagnosed with GDM, and whether this changed overtime; 3) understanding and managing GDM and 4) the future impact of GDM. The data were analysed using a conventional content analysis approach.
Findings
Women experience a steep learning curve when initially diagnosed and eventually become skilled at managing their disease effectively. The use of insulin is associated with fear and guilt. Diet advice was sometimes complex and not culturally appropriate. Women appear not to be fully aware of the short or long-term consequences of a diagnosis of GDM.
Conclusions
Midwives and other Health Care Professionals need to be cognisant of the impact of a diagnosis of GDM and give individual and culturally appropriate advice (especially with regards to diet). High quality, evidence based information resources need to be made available to this group of women. Future health risks and lifestyle changes need to be discussed at diagnosis to ensure women have the opportunity to improve their health.

The Use of Conceptual Business Model in Managing Information Technology Projects

The business model of an organization is an important strategic tool for its success, and should therefore be understood by business professionals and information technology professionals. By this context and considering the importance of information technology in contemporary business models, this article aims to verify the use of the business model components in the information technology (IT) projects management process in enterprises. To achieve this goal, this exploratory research has investigated the use of the Business Model concept in the information technology projects management, by a survey applied to 327 professionals from February to April 2012. It was observed that the business model concept, as well as its practices or its blocks, are not so well explored in its whole potential, possibly because it is relatively new. One of the benefits of this conceptual tool is to provide an understanding in terms of the core business for different areas, enabling a higher level of knowledge in terms of the essential activities of the enterprise IT professionals and the business area.

Community perceptions of collaborative processes for managing freshwater resources

Six of New Zealand’s 16 regional councils are trialling collaborative planning as a means of addressing complex challenges in freshwater management. Although some work has been undertaken to evaluate similarities and differences across those processes, the success or failure rests with the public’s acceptance of the processes and their outcomes. This is the first study to evaluate public perceptions of freshwater management in regions with collaborative processes. We surveyed 450 respondents in Hawke’s Bay, Northland, and Waikato, some of whom live in catchments in which collaborative processes are under way and some of whom do not. In addition to assessing awareness of the collaborative planning processes, the survey measured perceptions regarding the regional council’s management of freshwater resources, the extent of agreement regarding freshwater management among various interests, the fairness of freshwater management, and the extent to which respondents believe that their interests and concerns are included in freshwater management. We hypothesized that relative to respondents in parts of the region in which traditional processes are in places, respondents in catchments with collaborative management of freshwater resources would have more positive perceptions of management, agreement, fairness, and interests, even if there is low awareness that a collaborative planning process is under way. Survey results indicate that knowledge of collaborative processes is generally low and that living in catchments with collaborative processes does not impact respondents’ perceptions of management, agreement, fairness, or interests in Northland or Waikato. However, relative to Hawke’s Bay respondents living outside of the collaborative catchment, respondents living inside the collaborative catchment believe that the regional council’s freshwater management is better and fairer. Moreover, Hawke’s Bay residents living inside the collaborative catchment perceive less conflict over freshwater management than Hawke’s Bay respondents living outside the collaborative catchment. Further research is needed to identify the reasons for this regional variation.

Managing and utilizing information flow for new products’ periodic account sales process

The goal was to understand, document and module how information is currently flown internally in the largest dairy organization in Finland. The organization has undergone radical changes in the past years due to economic sanctions between European Union and Russia. Therefore, organization’s ultimate goal would be to continue its growth through managing its sales process more efficiently. The thesis consists of a literature review and an empirical part. The literature review consists of knowledge management and process modeling theories. First, the knowledge management discusses how data, information and knowledge are exchanged in the process. Knowledge management models and processes are describing how knowledge is created, exchanged and can be managed in an organization. Secondly, the process modeling is responsible for visualizing information flow through discussion of modeling approaches and presenting different methods and techniques. Finally, process’ documentation procedure was presented. In the end, a constructive research approach was used in order to identify process’ related problems and bottlenecks. Therefore, possible solutions were presented based on this approach. The empirical part of the study is based on 37 interviews, organization’s internal data sources and theoretical framework. The acquired data and information were used to document and to module the sales process in question with a flowchart diagram. Results are conducted through construction of the flowchart diagram and analysis of the documentation. In fact, answers to research questions are derived from empirical and theoretical parts. In the end, 14 problems and two bottlenecks were identified in the process. The most important problems are related to approach and/or standardization for information sharing, insufficient information technology tool utilization and lack of systematization of documentation. The bottlenecks are caused by the alarming amount of changes to files after their deadlines.

Dynamically managing sensed context data

This thesis reports on an investigation of the feasibility and usefulness of incorporating dynamic management facilities for managing sensed context data in a distributed contextaware mobile application. The investigation focuses on reducing the work required to integrate new sensed context streams in an existing context aware architecture. Current architectures require integration work for new streams and new contexts that are encountered. This means of operation is acceptable for current fixed architectures. However, as systems become more mobile the number of discoverable streams increases. Without the ability to discover and use these new streams the functionality of any given device will be limited to the streams that it knows how to decode. The integration of new streams requires that the sensed context data be understood by the current application. If the new source provides data of a type that an application currently requires then the new source should be connected to the application without any prior knowledge of the new source. If the type is similar and can be converted then this stream too should be appropriated by the application. Such applications are based on portable devices (phones, PDAs) for semi-autonomous services that use data from sensors connected to the devices, plus data exchanged with other such devices and remote servers. Such applications must handle input from a variety of sensors, refining the data locally and managing its communication from the device in volatile and unpredictable network conditions. The choice to focus on locally connected sensory input allows for the introduction of privacy and access controls. This local control can determine how the information is communicated to others. This investigation focuses on the evaluation of three approaches to sensor data management. The first system is characterised by its static management based on the pre-pended metadata. This was the reference system. Developed for a mobile system, the data was processed based on the attached metadata. The code that performed the processing was static. The second system was developed to move away from the static processing and introduce a greater freedom of handling for the data stream, this resulted in a heavy weight approach. The approach focused on pushing the processing of the data into a number of networked nodes rather than the monolithic design of the previous system. By creating a separate communication channel for the metadata it is possible to be more flexible with the amount and type of data transmitted. The final system pulled the benefits of the other systems together. By providing a small management class that would load a separate handler based on the incoming data, Dynamism was maximised whilst maintaining ease of code understanding. The three systems were then compared to highlight their ability to dynamically manage new sensed context. The evaluation took two approaches, the first is a quantitative analysis of the code to understand the complexity of the relative three systems. This was done by evaluating what changes to the system were involved for the new context. The second approach takes a qualitative view of the work required by the software engineer to reconfigure the systems to provide support for a new data stream. The evaluation highlights the various scenarios in which the three systems are most suited. There is always a trade-o↵ in the development of a system. The three approaches highlight this fact. The creation of a statically bound system can be quick to develop but may need to be completely re-written if the requirements move too far. Alternatively a highly dynamic system may be able to cope with new requirements but the developer time to create such a system may be greater than the creation of several simpler systems.

Speech by Mr. Alban Sandi Bonilla, Dean, Faculty of Arts at the Inauguration of Professional Lecture "Managing Information in Specialized Areas in Costa Rican

Friends: Although we have not devoted special sessions to discuss the matter, the truth is that in some informal occasions we talked lightly about the relevance of the School of Library, Documentation and Information is at the Faculty of Arts. We have consistently defined our School Faculty as a humanist. The human reality in all its modes of symbolic production is the object of study that brings us together as an area of knowledge. A school is that, a major academic unit, which it brings together different disciplines deserve epistemological affinity for joint development. Cooperation, ease of interdisciplinary association are elements that justify the existence of the faculties. And our conversations, I insist, casual and light, have led us to establish two positions may seem superficially divergent, but are not. The Library mates look as techniques themselves, and feel that can be placed almost anywhere Faculty, and at first glance does not explain its presence in a humanities faculty. Let me turn away from this self-image.

Managing Fisheries in the context of an integrated policy: the importance of spatial issues

A variety of conservation policies now frame the management of fishing activity and so do also the spatial planning of different sectorial activities. These framework policies are additional to classical fishery management. There is a risk that the policies applying on the marine system are not coherent from a fisheries point of view. The spatial management of fishing activity at regional scale has the potential to meet multiple management objectives, on a habitat basis. Here we consider how to integrate multiple objectives of different policies into integrated ocean management scenarios. In the EU, European Directives and the CFP are now implementing the ecosystem approach to the management of human activity at sea. In this context, we further identify three research needs: • Develop Management Strategy Evaluation (MSE) for multiple-objective and multiple-sector spatial management schemes • Improve knowledge on and evaluation of functional habitats • Develop spatially-explicit end-to-end models with appropriate complexity for spatial MSE The contribution is based on the results of a workshop of the EraNet COFASP.

Current knowledge on the role of the inferior frontal gyrus in Theory of Mind - a commentary on Schurz and Tholen (2016)

Schurz and Tholen (2016) argue that common approaches to studying the neural basis of “theory of mind” (ToM) obscure a potentially important role for inferior frontal gyrus (IFG) in managing conflict between perspectives, and urge new work to address this question: “to gain a full understanding of the IFG's role in ToM, we encourage future imaging studies to use a wider range of control conditions.” (p332). We wholeheartedly agree, but note that this observation has been made before, and has already led to a programme of work that provides evidence from fMRI, EEG, and TMS on the role of IFG in managing conflict between self and other perspectives in ToM. We highlight these works, and in particular we demonstrate how careful manipulation within ToM tasks has been used to act as an internal control condition, wherein conflict has been manipulated within-subject. We further add to the discussion by framing key questions that remain regarding IFG in the context of these. Using limitations in the existing research, we outline how best researchers can proceed with the challenge set by Schurz and Tholen (2016).

Extending the Simple Knowledge Organization System for Concept Management in Vocabulary Development Applications

In this article, we describe the development of an exten- sion to the Simple Knowledge Organization System (SKOS) to accommodate the needs of vocabulary devel- opment applications (VDA) managing metadata schemes and requiring close tracking of change to both those schemes and their member concepts. We take a neo- pragmatic epistemic stance in asserting the need for an entity in SKOS modeling to mediate between the abstract concept and the concrete scheme. While the SKOS model sufficiently describes entities for modeling the current state of a scheme in support of indexing and search on the Semantic Web, it lacks the expressive power to serve the needs of VDA needing to maintain scheme historical continuity. We demonstrate prelimi- narily that conceptualizations drawn from empirical work in modeling entities in the bibliographic universe, such as works, texts, and exemplars, can provide the basis for SKOS extension in ways that support more rig- orous demands of capturing concept evolution in VDA.

[between The Country And The Laboratory: The Dynamics Of The Production Of Knowledge At The Menopause Outpatients Clinic At Caism, Unicamp.]

This study investigates the practices involved in the production of knowledge about menopause at Caism, Unicamp, a reference center for public policies for women's health. Gynecological appointments and psychological support meetings were observed, and women and doctors were interviewed in order to identify what discourse circulates there and how different actors are brought in to ensure that the knowledge produced attains credibility and travels beyond the boundaries of the teaching hospital to become universal. The analysis is based on localized studies aligned with social studies of science and technology.

[between The Country And The Laboratory: The Dynamics Of The Production Of Knowledge At The Menopause Outpatients Clinic At Caism, Unicamp].

This study investigates the practices involved in the production of knowledge about menopause at Caism, Unicamp, a reference center for public policies for women's health. Gynecological appointments and psychological support meetings were observed, and women and doctors were interviewed in order to identify what discourse circulates there and how different actors are brought in to ensure that the knowledge produced attains credibility and travels beyond the boundaries of the teaching hospital to become universal. The analysis is based on localized studies aligned with social studies of science and technology.

A Rosetta Stone For Nature's Benefits To People.

After a long incubation period, the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) is now underway. Underpinning all its activities is the IPBES Conceptual Framework (CF), a simplified model of the interactions between nature and people. Drawing on the legacy of previous large-scale environmental assessments, the CF goes further in explicitly embracing different disciplines and knowledge systems (including indigenous and local knowledge) in the co-construction of assessments of the state of the world's biodiversity and the benefits it provides to humans. The CF can be thought of as a kind of Rosetta Stone that highlights commonalities between diverse value sets and seeks to facilitate crossdisciplinary and crosscultural understanding. We argue that the CF will contribute to the increasing trend towards interdisciplinarity in understanding and managing the environment. Rather than displacing disciplinary science, however, we believe that the CF will provide new contexts of discovery and policy applications for it.