Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses

Background Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses’ beliefs associated with performing hand hygiene guided by the World Health Organization’s (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses’ decisions to perform hand hygiene according to the recently implemented national guidelines. Methods Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. Results Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. Conclusions The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses’ hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses’ hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient’s surroundings continues to be reported as the most neglected opportunity for compliance.

Shaping gender inequalities: critical moments and critical places

Purpose – There is much scientific interest in the connection between the emergence of gender-based inequalities and key biographical transition points of couples in long-term relationships. Little empirical research is available comparing the evolution of a couple’s respective professional careers over space and time. The purpose of this paper is to contribute to filling this gap by addressing the following questions: what are the critical biographical moments when gender (in)equalities within a relationship begin to arise and consolidate? Which biographical decisions precede and follow such critical moments? How does decision making at critical moments impact the opportunities of both relationship partners in gaining equal access to paid employment? Design/methodology/approach – These questions are addressed from the perspectives of intersectionality and economic citizenship. Biographical interviewing is used to collect the personal and professional narratives of Swiss-, bi-national and migrant couples. The case study of a Swiss-Norwegian couple illustrates typical processes by which many skilled migrant women end up absently or precariously employed. Findings – Analysis reveals that the Scandinavian woman’s migration to Switzerland is a primary and critical moment for emerging inequality, which is then reinforced by relocation (to a small town characterized by conservative gender values) and the subsequent births of their children. It is concluded that factors of traditional gender roles, ethnicity and age intersect to create a hierarchical situation which affords the male Swiss partner more weight in terms of decision making and career advancement. Practical implications – The paper’s findings are highly relevant to the formulation of policies regarding gender inequalities and the implementation of preventive programmes within this context. Originality/value – Little empirical research is available comparing the evolution of a couple’s respective professional careers over space and time. The originality of this paper is to fill this research gap; to include migration as a critical moment for gender inequalities; to use an intersectional and geographical perspective that have been given scant attention in the literature; to use the original concept of economic citizenship; and to examine the case of a bi-national couple, which has so far not been examined by the literature on couple relationships.

Qualitative analysis of critical moments in basketball

The aim of this paper was to know the coach point of view about the critical moment concept in basketball. The methodology used in our research is a qualitative methodology. The instrument used to obtain the data was the semi- structured interviews. There were interviewed 12 ACB league coaches during the 2011/12 season. Results show that incertitude is associated to the critical moment concept. Last minutes of close games and also overtime are identified as critical moment of the game. There is nott any variable in statistics considered by all coaches to determine the critical moment, and they were agree that respecting some game rules is basic to face up the critical moment.

Analysis of the critical moments in the League ACB 2007-2008

The aim of this paper was to identify the variables that determine winning or losing in the critical moments of the basketball games. A total of forty one critical moments were analyzed, corresponding to 30 games of the regular season from the Spanish Professional League (ACB, season 2007-2008). Games were selected according to the definition of critical moments (described in the available literature), which corresponded to overtime and the last 5 minutes of games with score differences equal or below to six points. The results revealed better values in the winners in defensive rebounds and successful free-throws.

Análisis cuantitativo y cualitativo de los momentos críticos en baloncesto = Quantitative and qualitative analysis of the critical moments in basketball

El MC en baloncesto es aquel fenómeno relacionado con el juego que presenta unas características particulares determinadas por la idiosincrasia de un equipo y puede afectar a los protagonistas y por ende al devenir del juego. En la presente Tesis se ha estudiado la incidencia del MC en Liga A.C.B. de baloncesto y para su desarrollo en profundidad se ha planteado dos investigaciones una cuantitativa y otra cualitativa cuya metodología se detalla a continuación: La investigación cuantitativa se ha basado en la técnica de estudio del “Performance analysis”, para ello se han estudiado cuatro temporadas de la Liga A.C.B. (del 2007/08 al 2010/11), tal y como refleja en la bibliografía consultada se han tomado como momentos críticos del juego a los últimos cinco minutos de partidos donde la diferencia de puntos fue de seis puntos y todos los Tiempos Extras disputados, de tal manera que se han estudiado 197 momentos críticos. La contextualización del estudio se ha hecho en función de la variables situacionales “game location” (local o visitante), “team quality” (mejores o peores clasificados) y “competition” (fases de LR y Playoff). Para la interpretación de los resultados se han realizado los siguientes análisis descriptivos: 1) Análisis Discriminante, 2) Regresión Lineal Múltiple; y 3) Análisis del Modelo Lineal General Multivariante. La investigación cualitativa se ha basado en la técnica de investigación de la entrevista semiestructurada. Se entrevistaron a 12 entrenadores que militaban en la Liga A.C.B. durante la temporada 2011/12, cuyo objetivo ha sido conocer el punto de vista que tiene el entrenador sobre el concepto del MC y que de esta forma pudiera dar un enfoque más práctico basado en su conocimiento y experiencia acerca de cómo actuar ante el MC en el baloncesto. Los resultados de ambas investigaciones coinciden en señalar la importancia del MC sobre el resultado final del juego. De igual forma, el concepto en sí entraña una gran complejidad por lo que se considera fundamental la visión científica de la observación del juego y la percepción subjetiva que presenta el entrenador ante el fenómeno, para la cual los aspectos psicológicos de sus protagonistas (jugadores y entrenadores) son determinantes. ABSTRACT The Critical Moment (CM) in basketball is a related phenomenon with the game that has particular features determined by the idiosyncrasies of a team and can affect the players and therefore the future of the game. In this Thesis we have studied the impact of CM in the A.C.B. League and from a profound development two investigations have been raised, quantitative and qualitative whose methodology is as follows: The quantitative research is based on the technique of study "Performance analysis", for this we have studied four seasons in the A.C.B. League (2007/08 to 2010/11), and as reflected in the literature the Critical Moments of the games were taken from the last five minutes of games where the point spread was six points and all overtimes disputed, such that 197 critical moments have been studied. The contextualization of the study has been based on the situational variables "game location" (home or away), "team quality" (better or lower classified) and "competition" (LR and Playoff phases). For the interpretation of the results the following descriptive analyzes were performed: 1) Discriminant Analysis, 2) Multiple Linear Regression Analysis; and 3) Analysis of Multivariate General Linear Model. Qualitative research is based on the technique of investigation of a semi-structured interview. 12 coaches who belonged to the A.C.B. League were interviewed in seasons 2011/12, which aimed to determine the point of view that the coach has on the CM concept and thus could give a more practical approach based on their knowledge and experience about how to deal with the CM in basketball. The results of both studies agree on the importance of the CM on the final outcome of the game. Similarly, the concept itself is highly complex so the scientific view of the observation of the game is considered essential as well as the subjective perception the coach presents before the phenomenon, for which the psychological aspects of their characters (players and coaches) are crucial.

A Defensive "stand-by reaction" at Critical Moments of the Reproductive Life Cycle

Investigation about the psychological experiences of the reproductive life cycle showed that in critical moments special reactions may happen. These reactions seem to be defensive in nature, are set in motion in order to promote some kind of emotional protection and are performed in two opposite directions: a) a decreasing of the contact with aggressive impulses and b) an increasing of the use of rationalization and denial of frustrating situations. Examples of those rearrangements were observed at samples of: 1) pregnant women in obstetric high-risk consultation, 2) infertile couples waiting for infertility consultations and 3) pregnant women waiting for amniocentesis results. These data seem to be in accordance with the classical psychological points of view: a) gestation should be considered as a period of protection, b) during pregnancy a “primary maternal preoccupation” (Winnicot, 1958) emerges leading to the mobilization of all resources available for pregnant women and c) along gestational development psychological changes show how flexible maternal functioning may become. What was not expected is that in the absence of pregnancy, infertile couples should behave very similarly to what it is observed when pregnancy is in danger or when medical problems about the mother’s or the baby’s health arise in the horizon. Due to its “freezing” consequences upon emotional development we propose that this kind of reaction will be designated as “stand-by reaction”.

Letting go : a self-study utilizing critical literacy as method in improving my practice /

This is a Self-study about my role as a teacher, driven by the question: "How do I improve my practice?" (Whitehead, 1989)? In this study, I explored the discomfort that I had with the way that I had been teaching. Specifically, I worked to uncover the reasons behind my obsessive (mis)management of my students. I wrote of how I came to give my Self permission for this critique: how I came to know that all knowledge is a construction, and that my practice, too, is a construction. I grounded this journey within my experiences. I constructed these experiences in narrative fomi in order to reach a greater understanding of how I came to be the teacher I initially was. I explored metaphors that impacted my practice, re-constructed them, and saw more clearly the assumptions and influences that have guided my teaching. I centred my inquiry into my teaching within an Action Reflection methodology, bon-owing Jack Whitehead's (1989) term to describe my version of Action Research. I relied upon the embedded cyclical pattern of Action Reflection to understand my teaching Self: beginning from a critical moment, reflecting upon it, and then taking appropriate action, and continuing in this way, working to improve my practice. To understand these critical moments, I developed a personal definition of critical literacy. I then tumed this definition inward. In treating my practice as a textual production, I applied critical literacy as a framework in coming to know and understand the construction that is my teaching. I grounded my thesis journey within my Self, positioning my study within my experiences of being a grade 1 teacher struggling to teach critical literacy. I then repositioned my journey to that of a grade 1 teacher struggling to use critical literacy to improve my practice. This journey, then, is about the transition from critical literacyit as-subject to critical literacy-as-instmctional-method in improving my practice. I joumeyed inwards, using a critical moment to build new understandings, leading me to the next critical moment, and continued in this cyclical way. I worked in this meandering yet deliberate way to reach a new place in my teaching: one that is more inclusive of all the voices in my room. I concluded my journey with a beginning: a beginning of re-visioning my practice. In telling the stories of my journey, of my teaching, of my experiences, I changed into the teacher that I am more comfortable with. I've come to the frightening conclusion that I am the decisive element in the classroom. It's my personal approach that creates the climate. It's my daily mood that makes the weather As a teacher, I possess a tremendous power to make a person's life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humour, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated or de-escalated and a person humanized or de-humanized. (Ginott, as cited in Buscaglia, 2002, p. 22)

Beyond discovery : a case study of teacher interaction, young children and computer tasks

The integration of computer technologies into everyday classroom life continues to provide pedagogical challenges for school systems, teachers and administrators. Data from an exploratory case study of one teacher and a multiage class of children in the first years of schooling in Australia show that when young children are using computers for set tasks in small groups, they require ongoing support from teachers, and to engage in peer interactions that are meaningful and productive. Classroom organization and the nature of teacher-child talk are key factors in engaging children in set tasks and producing desirable learning and teaching outcomes.

Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative

Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The ‘5 critical moments’ of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses’ hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses’ hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.

Desenho organizacional e sua influência sobre o processo decisório de veto presidencial

Descreve o processo decisório de aposição e apreciação de vetos presidenciais, no período de 2011 a 2013, descrevendo os elementos organizacionais dos poderes Legislativo e Executivo, analisando o vínculo entre eles, e apontando momentos críticos no fluxo dos processos decisórios identificados. Justifica-se sua realização para contribuir na discussão sobre o processo decisório político. As conclusões apontam para a hipótese da prática de não decisão pelo Congresso, a impossibilidade de relacioná-la ao desenho organizacional, bem como a relevância do fator tempo.

O herói e o inimigo no imaginário do jacobinismo brasileiro 1894/1897

Esta dissertação tem como objetivo compreender e analisar o jacobinismo brasileiro tendo como foco os anos de 1894 até 1897. Pretende-se perceber como esse grupo conseguiu construir um projeto de personalização do poder em torno do Marechal Floriano Peixoto em momentos críticos da história República brasileira: durante a Revolta da Armada de 1894; no momento de transição do governo militar para o governo civil de Prudente de Moraes em 1894/95; e na ocasião da morte do Marechal Floriano Peixoto em 1895. Para tanto, o estudo propõe uma reflexão sobre a utilização do discurso jornalístico como instrumento na fabricação da imagem dos revoltosos da Marinha como restauradores monarquistas e de Floriano como herói da República, buscando assim, perceber igualmente a dinâmica de sua elaboração e as suas repercussões na sociedade brasileira. Chegaremos a conclusão que as forças jacobinas enfraqueceram no momento do atentado a Prudente de Morais em 1897, mas seus discursos ainda tiveram eco na primeira metade do século XX na República brasileira.

华南震旦纪-寒武纪两期成磷事件及其地球动力学意义

Phosphorus is an important biological and ecological element that to a certain degree constrains ecological environment and nutrient (including carbon) cycling. Marine sedimentary phosphorites are the principal phosphorus supply of the mankind. In the eastern to southern margins of the Yangtze Craton, South China, there are two phosphogenetic events at the Doushantuo stage of the Late Sinian and the Meishucun stage of the Early Cambrian respectively, corresponding two explosion events of life across the Precambrian\Cambrian boundary. Phosphorus ores from the Sinian and Cambrian phosphate in South China can be classified roughly into two categories, namely, grained and non-grained phosphorites. Grained phosphorites, hosted in dolostone type of phosphogenetic sequences and with larger industrial values, occur mainly in margins of the Upper Yangtze Platform, formed in shallow-water environments with high hydraulic energy and influenced by frequent sea-level change. Non-grained phosphorites, hosted principally in black-shale type of phosphogenetic sequences and with smaller industrial values, are distributed mainly in the Jiangnan region where deeper-water sub-basins with low hydraulic energy were prevailing at the time of phosphogenesis. Secular change ofδ~(13)C, δ~(18) O, ~(86)Sr/~(87)Sr values of carbonates from Sinian and Cambrian sequences were determined. A negative abnormal ofδ~(13)C, δ~(18)O values and positive abnormal of 86Sr/87Sr values from the fossiliferous section of the Lowest Cambrian Meishucun Formation implies life depopulation and following explosion of life across the PrecambriamCambrian boundary. Based on a lot of observations, this paper put forward a six-stage genetic model describing the whole formational process of industrial phosphorites: 1) Phosphorus was transported from continental weathering products and stored in the ocean; 2) dissolved phosphates in the seawater were enriched in specific deep seawater layer; 3) coastal upwelling currents took this phosphorus-rich seawater to a specific coastal area where phosphorus was captured by oceanic microbes; 4) clastic sediments in this upwelling area were enriched in phosphorus because of abundant phosphorus-rich organic matters and because of phosphorus absorption on grain surfaces; 5) during early diagenesis, the phosphorus enriched in the clastic sediments was released into interstitial water by decomposition and desorption, and then transported to the oxidation-reduction interface where authigenic phosphates were deposited and enriched; 6) such authigenic phosphate-rich layers were scoured, broken up, and winnowed in shallow-water environments resulting in phosphate enrichment. The Sinian-Cambrian phosphorites in South China are in many aspects comparable with coastal-upwelling phosphorites of younger geological ages, especially with phosphorites from modern coastal upwelling areas. That implies the similarities between the Sinian-Cambrian ocean and the modern ocean. Although Sinian-Cambrian oceanic life was much simpler than modern one, but similar oceanic planktons prevail, because oceanic planktons (particularly phytoplanktons) are crucial for phosphate enrichment related to coastal upwelling. It implies also a similar seawater-layering pattern between the Sinian-Cambrian ocean and the modern ocean. The two global phosphate-forming events and corresponding life-explosion events at the Sinian and Cambrian time probably resulted from dissolved-phosphate accumulation in seawater over a critical concentration during the Earth's evolution. Such an oceanic system with seawater phosphorus supersaturation is evidently unstable, and trends to return to normal state through phosphate deposition. Accordingly, this paper put forward a new conception of "normal state <=> phosphorus-supersaturation state" cycling of oceanic system. Such "normal state <=> phosphorus-supersaturation state" cycling was not only important for the three well-known global phosphate-forming events, also related to the critical moments of life evolution on the Earth. It might be of special significance. The favorable paleo-oceanic orientation in regard to coastal-upwelling phosphorite formation suggests a different orientation of the Yangtze Craton between the Sinian time and the present time (with a 135° clockwise difference), and a 25° anti-clockwise rotation of the Yangtze Craton from late Sinian to early Cambrian. During the Sinian-Cambrian time, the Yangtze Craton might be separated from the Cathaysia Block, but might be still associated with the North China Craton.

东营凹陷成藏组合体研究与勘探实践

With the development of petroleum exploration, subtle reservoir has become the main exploration object in Dongying Depression, which requires some new technologies and methods to further reveal the geological characteristics in step with the mature exploration stage. In this paper, on the references to the studies of petroleum system and multiple oil-gas accumulation belt with flexible maneuverability, and the application of systematic theory, the concept of reservoir assemblage is initially defined as "the association of active source rock(s) and hydrocarbon reservoir(s) that are genetically related, with the bridge of pathway system in an oil and gas bearing basin". Compared with the theories of petroleum system and multiple oil-gas accumulation belts, it emphasizes on the processes of petroleum migration and accumulation and the correlation among active source rock, trapped hydrocarbon and migration pathway, and has been confirmed to be more suitably applied to high maturely explored basin. In the first study of this paper, sequence stratigraphy and subtle analytical technology of source rock have been employed to find that two categories of source rock with their characteristic types of organic matter and substantial states occurred in Dongying Depression. The first category, consisting of the oil shales within the third-order sequences of lacustrine expanding system tracts in the upper interval of the fourth Member of Shahejie Formation and both in the middle and lower intervals of the third Member of Shahejie Formation, is featured with the highest abundance of total organic matter (TOC) and the strongest abilities of hydrocarbon generation and expulsion, which is classified into the standard of good hydrocarbon source rock. Exploration assessment confirmed that about 70-80% of hydrocarbon in Dongying Depression came from this set of source rock for which the low sedimentary rate and strong oxygen-free environment would play the key role during its generation. The second category, composed of organic matter of dark mudstone in high stand system tracts in the upper and middle intervals of the third Member of Shahejie Formation, has been characterized by low content of total organic matter which mostly dispersedly distributes, and formed in the pre-delta to delta front environments. In classification, it belongs to the ordinary standard of source rocks. In the second research part, through the studies of high frequency sequence stratigraphy, fault geometry and active history combining with geochemistry of fluid inclusion and nitrogen compound and simulation test of hydrocarbon migration and accumulation, the faults have been thought to be the principal conduits, and the sandy bodies and unconformities might played the complementary pathways for hydrocarbon migration and accumulation in Dongying Depression of the continental faulted basin. Therefore, the fault activities may mainly constrain on the development of hydrocarbon pathways in space and time. Even more, using homogenization temperatures of fluid inclusion in digenetic minerals, three critical moments for hydrocarbon accumulation have been determined as well in Dongying Depression, which happened during the late stage of Dongying Formation (Ed), the early stage of Guantao Formation (Nig) and the early stage of Minghuazhen Formation (Nim), respectively. Comparatively, the last stage is looked as the main forming-reservoir period, which has also been supported by the results of geochemical analysis and simulation experiments of hydrocarbon generation and expulsion. Clearly, the times of hydrocarbon migration and accumulation are consistent with those of the fault activities in Dongying Depression, which indicate that tectonic activities would control the forming-reservoir. A conceptual model of faulting-episodic expulsion coupled with episodic forming-reservoir has then been established in this study. In the third part of this paper, some focusing areas were selected for the fine descriptions of pathway distribution and forming-reservoir, which has given four types of reservoir assemblage in terms of the main pathway and its correlation with the reservoir and trap: (1) mainly consisted of sandy bodies; (2) mainly consisted of faults; (3) mainly consisted of unconformities; and (4) their complex with two or three types of pathways. This classified criteria has also been applied to access the risk of some prospected traps in Dongying Depression. Finally, through the application of reservoir assemblage integrated with pathway distribution to all the prospective targets in Dongying Depression, the new favorably hydrocarbon accumulated belts have been figured out, and more subtle reservoirs have also been found. For examples, during 2000 and 2002, in the mature exploration areas, such as Liangjialou and Shengtuo structural closures etc., newly proved reserves were 2274 * 104t, and forecasted oil reserves 5660-5860xl04t; and in the predicted favorable areas, newly additional controlled oil reserves was 3355xl04t. Besides those, many other favorable exploration areas need to be further appraised.