Evaluation of contextual influences on the medication administration practice of paediatric nurses

Aim. This paper is a report of a study conducted to explore the impact of preidentified contextual themes (related to work environment and socialization) on nursing medication practice. Background. Medication administration is a complex aspect of paediatric nursing and an important component of day-to-day nursing practice. Many attempts are being made to improve patient safety, but many errors remain. Identifying and understanding factors that influence medication administration errors are of utmost importance. Method. A cross-sectional survey was conducted with a sample of 278 paediatric nurses from the emergency department, intensive care unit and medical and surgical wards of an Australian tertiary paediatric hospital in 2004. The response rate was 67%. Result. Contextual influences were important in determining how closely medication policy was followed. Completed questionnaires were returned by 185 nurses (67%). Younger nurses aged <34 years thought that their medication administration practice could be influenced by the person with whom they checked the drugs (P = 0·001), and that there were daily circumstances when it was acceptable not to adhere strictly to medication policy (P < 0·001), including choosing between following policy and acting in the best interests of the child (P = 0·002). Senior nurses agreed that senior staff dictate acceptable levels of medication policy adherence through role modelling (P = 0·01). Less experienced nurses reported greater confidence with computer literacy (P < 0·001). Conclusions. Organizations need to employ multidisciplinary education programmes to promote universal understanding of, and adherence to, medication policies. Skill mix should be closely monitored to ensure adequate support for new and junior staff.

Contextual Influences on Saliency

This article describes a model for including scene/context priors in attention guidance. In the proposed scheme, visual context information can be available early in the visual processing chain, in order to modulate the saliency of image regions and to provide an efficient short cut for object detection and recognition. The scene is represented by means of a low-dimensional global description obtained from low-level features. The global scene features are then used to predict the probability of presence of the target object in the scene, and its location and scale, before exploring the image. Scene information can then be used to modulate the saliency of image regions early during the visual processing in order to provide an efficient short cut for object detection and recognition.

How does bureaucracy impact individual creativity? A cross-level investigation of team contextual influences on goal orientation-creativity relationships

Offering important counterpoint to work identifying team influences stimulating creative expression of individual differences in goal orientation, we develop cross-level theory establishing that team bureaucratic practices (centralization and formalization) constrain creative expression. Speaking to the tension between bureaucracy and creativity, findings indicate that this influence is not only negative and that effects of centralization and formalization differ. Surveying 330 employees in 95 teams at the Taiwan Customs Bureau, we found that learning and "performance avoid" goal orientations had, respectively, stronger positive and weaker negative relationships with creativity under low centralization. A "performance- prove" orientation was positively related to creativity under low formalization. © Academy of Management Journal.

I don't see me like you see me, but is that a problem? Cultural influences on rating discrepancy in 360-degree feedback instruments

360-degree feedback from a variety of rater sources yields important information about leaders' styles, strengths and weaknesses for development. Results where observer ratings are discrepant (i.e., different) from self-ratings are often seen as indicators of problematic leadership relationships, skills, or lack of self-awareness. Yet research into the antecedents of such self-observer rating discrepancy suggests the presence of systematic influences, such as cultural values. The present study investigates the variation of rating discrepancies on three leadership skills (decision making, leading employees, and composure) in dependence of one exemplary culture dimension (power distance) on data from 31 countries using multilevel structural equation modelling. Results show that cultural values indeed predict self-observer rating discrepancies. Thus, systemic and contextual influences such as culture need to be taken into consideration when interpreting the importance and meaning of self-observer rating discrepancies in 360-degree instruments.

Factors that influence Information Systems decisions and outcomes: A summary of key themes from four case studies" (2006). ACIS 2006 Proceedings. Paper 43.

This paper reports a summary of key findings from an examination of Information Systems decision making in four organisations. The study focused on what factors influenced decision makers during the critical preimplementation phase of Information Systems projects when systems were evaluated, selected and acquired. Using data gathered from interviews and organisational documentation, a critical hermeneutic analysis was performed in order to build an understanding of how informational and contextual influences acted on decision makers. Eight broad themes of factors were identified as having influence on decision makers and outcomes.

What if you're really different? Case studies of children with high functioning autism participating in the Get REAL programme who had atypical learning trajectories.

Evaluation of the Get REAL programme in an inclusive primary school setting has indicated its effectiveness in promoting pro-social behaviour for children with high functioning Autism. However, two children with co-morbid diagnoses and complex personal circumstances showed less consistent improvements. In order to explain their unique trajectories, not readily derived from quantitative studies, an exploratory case study approach was used to examine contextual influences on patterns of progress. Multiple data sources included coded video footage from the Get REAL programme, school reports on conduct, and parents and classroom teacher reports using the Strengths and Difficulties Questionnaire. While results provide support for the efficacy of the Get REAL programme for the two children, they also highlight the value of co-ordinated strategies and collaborative individualised approaches in more complex cases. This paper outlines the Get REAL intervention and a range of other school and support agency strategies impacting progress.

Looking back and looking forward : exploring distributed leadership with Queensland Prep teachers

There is an increasing expectation that early childhood teachers will be pedagogical leaders, particularly in a global context of curriculum reform. This paper reports on the distributed leadership experiences of early childhood teachers’ during the 2003 Preparatory Year (Prep) trial in Queensland, Australia. In 2010, 13 of the first Prep teachers participated in interviews to discuss their definitions of leadership and reflect on the opportunities they had to lead curriculum development during and since the 2003 trial. Data were examined using a conceptual framework based on the work of Woods et al. (2004), with a focus on the structural and agential aspects of distributed leadership. Participants identified a range of contextual influences, challenges, skills and enabling strategies that illustrate the complexities in leading curriculum.

Asymmetric price range effects on vertical extensions

Vertical line extensions, both step-up and step-down, are common occurrence in consumer products. For example, Timex recently launched its luxury high-end Valentino line. On the other hand, many companies use downscale extensions to increase the overall sales volume. For instance, a number of luxury watch brands recently introduced watch collections with lower price points, like TAG Heur’s affordable watch the Aquaracer Calibre 5. Previous literature on vertical extensions has investigated how number of products in the line (Dacin and Smith 1994), the direction of the extension, brand concept (Kim, Lavack, and Smith 2001), and perceived risk (Lei, de Ruyter, and Wetzels 2008) affect extensions’ evaluation. Common to this literature is the use of models based on adaptation-level theory, which states that all relevant price information is integrated into a single prototype value and used in consumer judgments of price (Helson 1947; Mazumdar, Raj, and Sinha 2005). In the current research we argue that, while adaptation-level theory can be viewed as a useful simplification to understanding consumers’ evaluations, it misses out important contextual influences caused by a brand’s price range. Drawing on research on range-frequency theory (Mellers and Cooke 1994; Parducci 1965) we investigate the effects of price point distance and parent brand’s price range on evaluations of vertical extensions. Our reasoning leads to two important predictions that we test in a series of three experiments...

Exploring the contribution of workplace learning to an HRD strategy in the Scottish legal profession.

Purpose – The purpose of this paper is to explore the relevance of human resource development (HRD) for law firms in the UK. It examines how the characteristics of legal professional practice in the UK, including the partnership structure, long established methods of targeting solicitors and the law society, may act as barriers to the implementation of HRD. Design/methodology/approach – The paper uses an exploratory case study research approach to investigate characteristics and issues influencing the adoption of HRD in a Scottish legal firm. Primary data are collected via semi-structured interviews with a cross-section of representatives. Findings – Despite recognition of the importance of learning, the characteristic elements of law firms, including the partnership structure; the pervasiveness of time-billed targets in the solicitor community; and HR’s profile and acceptance among the solicitor community, remain as barriers to the applicability of HRD. The research also exposes variability on the level and scope of development opportunities, an emphasis on technical skills development, and a lack of solicitors’ self-managed learning ability. Research limitations/implications – While the research findings provide a useful insight into the barriers to HRD in one legal firm, this does not allow for any generalisations being drawn from the study. Practical implications – The paper explores the suitability of workplace learning to support legal professional development. Originality/value – There is a dearth of research into HRD in legal practices in the UK. The paper contributes to the contextual influences that limit the applicability of HRD to legal professional practices.

International perspectives on the influence of structure and process of weaning from mechanical ventilation.

Background 
Recently, clinical and research attention has been focused on refining weaning processes to improve outcomes for critically ill patients who require mechanical ventilation. One such process, use of a weaning protocol, has yielded conflicting results, arguably because of the influence of existing context and processes.

Objective 
To compare international data to assess differences in context and processes in intensive care units that could influence weaning.  

Methods 
Review of existing national data on provision of care for critically ill patients, including structure, staffing, skill mix, education, roles, and responsibilities for weaning in intensive care units of selected countries.

Results 
Australia, New Zealand, Denmark, Norway, Sweden, and the United Kingdom showed similarities in critical care provision, structure, skill mix, and staffing ratios in intensive care units. Weaning in these countries is generally a collaborative process between nurses and physicians. Notable differences in intensive care units in the United States were the frequent use of an open structure and inclusion of respiratory therapists on the intensive care unit’s health care team. Nurses may be excluded from direct management of ventilator weaning in some institutions, as this role is primarily assumed by respiratory therapists guided by medical directives. Availability of critical care beds was highest in the United States and lowest in the United Kingdom.

Conclusion 
Context and processes of care that could influence ventilator weaning outcomes varied considerably across countries. Further quantification of these contextual influences should be considered when translating research findings into local clinical practice and when designing randomized, controlled trials.

Trajectories of Adolescent Aggression and Family Cohesion: The Potential to Perpetuate or Ameliorate Political Conflict

Correlations between intergroup violence and youth aggression are often reported. Yet longitudinal research is needed to understand the developmental factors underlying this relation, including between-person differences in within-person change in aggression through the adolescent years. Multilevel modeling was used to explore developmental and contextual influences related to risk for youth aggression using 4 waves of a prospective, longitudinal study of adolescent/mother dyad reports (N = 820; 51% female; 10–20 years old) in Belfast, Northern Ireland, a setting of protracted political conflict. Experience with sectarian (i.e., intergroup) antisocial behavior predicted greater youth aggression; however, that effect declined with age, and youth were buffered by a cohesive family environment. The trajectory of aggression (i.e., intercepts and linear slopes) related to more youth engagement in sectarian antisocial behavior; however, being female and having a more cohesive family were associated with lower levels of youth participation in sectarian acts. The findings are discussed in terms of protective and risk factors for adolescent aggression, and more specifically, participation in sectarian antisocial behavior. The article concludes with clinical and intervention implications, which may decrease youth aggression and the perpetuation of intergroup violence in contexts of ongoing conflict.

Situated regional university incubation: A multi-level stakeholder perspective

From a macro perspective, it is widely acknowledged that University incubation models within a region are important stimulants of economic development through innovation and job creation. With the emergence of quadruple helix innovation ecosystems, universities have had re-evaluate their University incubation activity and models to engage more fully with industry and end users. However, within a given region, the type of University may influence their ability to engage with quadruple helix stakeholders and consequently impact their incubation activity. To date there is a scarcity of research which explores this 'meso' environment and its subsequent impact on University incubation models. Therefore, the aim of this paper is to use a stakeholder lens to explore University Incubation models within unique regional and organisational characteristics and constraints. The research methodology employed was based on a comparative case analysis of incubation of two different Universities within a UK peripheral region. It was found that variances existed in relation to the two universities incubation models which were found to result from both regional (macro environment) and organisational (meso environment) influences (i.e. university type). This research contributes to both regional and national agendas by empirically illustrating the need for appropriate design and tailoring of university incubation models (via acknowledgement of quadruple helix stakeholder influence) to incorporate contextual influences rather than adopting a best practise approach.

Stressors and turning points in high school and dropout : a stress process, life course framework

High school dropout is commonly seen as the result of a long-term process of failure and disengagement. As useful as it is, this view has obscured the heterogeneity of pathways leading to dropout. Research suggests, for instance, that some students leave school not as a result of protracted difficulties but in response to situations that emerge late in their schooling careers, such as health problems or severe peer victimization. Conversely, others with a history of early difficulties persevere when their circumstances improve during high school. Thus, an adequate understanding of why and when students drop out requires a consideration of both long-term vulnerabilities and proximal disruptive events and contingencies. The goal of this review is to integrate long-term and immediate determinants of dropout by proposing a stress process, life course model of dropout. This model is also helpful for understanding how the determinants of dropout vary across socioeconomic conditions and geographical and historical contexts.

Pre-Attentive Segmentation in the Primary Visual Cortex

Stimuli outside classical receptive fields have been shown to exert significant influence over the activities of neurons in primary visual cortexWe propose that contextual influences are used for pre-attentive visual segmentation, in a new framework called segmentation without classification. This means that segmentation of an image into regions occurs without classification of features within a region or comparison of features between regions. This segmentation framework is simpler than previous computational approaches, making it implementable by V1 mechanisms, though higher leve l visual mechanisms are needed to refine its output. However, it easily handles a class of segmentation problems that are tricky in conventional methods. The cortex computes global region boundaries by detecting the breakdown of homogeneity or translation invariance in the input, using local intra-cortical interactions mediated by the horizontal connections. The difference between contextual influences near and far from region boundaries makes neural activities near region boundaries higher than elsewhere, making boundaries more salient for perceptual pop-out. This proposal is implemented in a biologically based model of V1, and demonstrated using examples of texture segmentation and figure-ground segregation. The model performs segmentation in exactly the same neural circuit that solves the dual problem of the enhancement of contours, as is suggested by experimental observations. Its behavior is compared with psychophysical and physiological data on segmentation, contour enhancement, and contextual influences. We discuss the implications of segmentation without classification and the predictions of our V1 model, and relate it to other phenomena such as asymmetry in visual search.

Visual Segmentation without Classification in a Model of the Primary Visual Cortex

Stimuli outside classical receptive fields significantly influence the neurons' activities in primary visual cortex. We propose that such contextual influences are used to segment regions by detecting the breakdown of homogeneity or translation invariance in the input, thus computing global region boundaries using local interactions. This is implemented in a biologically based model of V1, and demonstrated in examples of texture segmentation and figure-ground segregation. By contrast with traditional approaches, segmentation occurs without classification or comparison of features within or between regions and is performed by exactly the same neural circuit responsible for the dual problem of the grouping and enhancement of contours.