THE RELATIONSHIP BETWEEN ATTITUDE ASSESSMENT/ROLE PERCEPTION AND THE FINANCIAL PERFORMANCE OF HOSPITAL DEPARTMENT MANAGERS

Much of the current healthcare financial literature addresses the concern of government officials, the public, and healthcare providers regarding the need for control of health care costs. The literature suggests that attitudes of hospital department managers toward their role in financial management affects their ability to effect favorable financial results.^ There were several objectives of the dissertation: (1) To identify whether or not there exists a relationship between the attitude/role perception of hospital managers and the financial performance of their departments. (2) To compile a descriptive survey data base of key factors identified in the financial literature from individual hospitals. (3) To compile a brief descriptive survey of hospital managers' financial management background and training (both formal and informal). (4) To conduct an attitude assessment/role perception survey regarding the importance or relevance of a suggested financial management role set (i.e., issues discussed in the current literature) as viewed by the selected hospital managers and their matched administrators. (5) To propose plausible theoretical models and statistical tests of seven proposed hypotheses.^ The statistical results of a variety of methods generally suggested, for the sample population, that the null hypothesis should not be rejected concerning the relationships between a department manager's financial attitudes and role perceptions and the resultant financial performance.^ The fact that the results of this study did not suggest that there was a significant relationship which existed between role perception and financial performance does not necessarily indicate that the theories supporting such a relationship in literature are false, not that such a relationship does not exist. Several alternative theories were postulated to explain the apparent lack of statistical relationship, and suggestions for refinement and/or improvement of further research were discussed. ^

Journalism students’ professional views in eight countries : the role of motivations, education, and gender

The global trend toward university-based journalism education has led to a growing scrutiny of students’ experiences at university and the extent to which professional views may be shaped there. Three main influences have been identified in the literature: students’ preferences for certain news beats, their gender, and students’ stage of progression in a journalism program. Typically, however, analyses have focused on only one potential influence within one particular country at a time. Arguing that a comparative approach is needed, this article examines potential influences on journalism students’ role perceptions across eight countries. Results suggest that students’ motivations, and the amount of time they have spent in a program, play a part in influencing their professional views while gender has little influence.

La perception du rôle et les attitudes de cynisme et de désengagement chez le technicien ambulancier paramédic québécois dans le contexte des interventions non urgentes

Problématique : Le rôle des paramédics se transforme partout dans le monde. Les besoins des aînés et des malades chroniques entraînent une forte proportion d’interventions préhospitalières non urgentes. La confrontation entre la perception et l’expérience du rôle peut entraîner un conflit correspondant à un stress organisationnel modéré et chronique chez ces travailleurs. Pour y faire face, différentes stratégies d’adaptation peuvent être adoptées. Objectifs : Cette étude vise à dépeindre la réalité des interventions préhospitalières non urgentes des paramédics québécois et à explorer son influence sur leur perception du rôle et les manifestations de cynisme et de désengagement. Méthode : Les données qualitatives obtenues en entrevues semi-structurées ont été codifiées et analysées à partir d’un modèle adapté des théories en psychosociologie du travail et d’administration de la santé (n=13, 3 régions, intervenants de - de 3 à + de 20 ans de carrière). Résultats : Les paramédics reconnaissent vivre un conflit de rôle alors que la formation et la définition de leur pratique se rapportent exclusivement à l’urgence, au contraire de leur expérience. Ils manifestent des attitudes de cynisme et de désengagement affectant la qualité des services, précisant qu’il s’agit d’une réalité inhérente à leur expérience professionnelle intimement reliée à l’épuisement professionnel, plus qu’à un manque fondamental de professionnalisme. Conclusion : Les paramédics décrivent différents mécanismes à instaurer qui visent à reconnaître la dualité conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique à intervenir en première ligne dans un cadre préhospitalier non urgent ainsi que l’ajustement et le rehaussement des programmes de formation.

Dimensions of Indigenous journalism culture : exploring Maori news-making in Aotearoa New Zealand

Indigenous news media have experienced significant growth across the globe in recent years, but they have received only limited attention in mainstream society or the journalism and communication research community. Yet, Indigenous journalism is playing an arguably increasingly important role in contributing to Indigenous politics and identities, and is worthy of closer analysis. Using in-depth interviews, this article provides an overview of the main dimensions of Indigenous journalism as they can be found in the journalism culture of Māori journalists in Aotearoa New Zealand. It argues that Māori journalists see their role as providing a counter-narrative to mainstream media reporting and as contributing to Indigenous empowerment and revitalization of their language. At the same time, they view themselves as watchdogs, albeit within a culturally specific framework that has its own constraints. The article argues that the identified dimensions are reflective of evidence on Indigenous journalism from across the globe.

Cultural forces in journalism : the impact of cultural values on Māori journalists’ professional views

Social system-level analyses of journalism have tended to focus on political and economic influences, at the expense of other factors, such as the role that culture and cultural values play in shaping journalists' professional views and practices. This paper identifies cultural values as a particularly fruitful area for providing a more nuanced analysis of journalism culture. It examines this issue in the context of in-depth interviews with 20 M?ori journalists from Aotearoa New Zealand. The study finds that Indigenous journalism in that country is strongly influenced by M?ori cultural values, such as showing respect to others, following cultural protocols, and making use of culturally-specific language. Cultural limitations are also identified in the form of the social structures of M?ori society, and journalists' strategies in working around these are discussed. The paper highlights the implications a renewed focus on cultural values can have for the study of journalism culture more broadly.

The pre-socialization of future journalists

While the role of university journalism education in the professionalization of journalists has been extensively debated, systematic and comparative studies of journalism students are still scarce. This paper reports the findings from a comparative study of journalism students in seven countries: Australia, Brazil, Chile, Mexico, Spain, Switzerland, and the United States. The data show a number of similarities, but also important differences between pre-professional cultures in journalism around the world. The findings are in line with recent conceptualizations of media systems, although some variations and particularities are observed at the country level. While students in all countries reject a loyal approach and favor a citizen-oriented role, they also do so to different extents. Brazilian and Chilean students believe in the citizen-oriented and watchdog roles, whereas their counterparts in Australia, Switzerland, and the United States favor the consumer-oriented approach to a greater extent. Mexican and Spanish students, on the other hand, while supporting the citizen-oriented role, reject the loyal role comparatively less than the rest of the countries.

A different breed altogether? Distinctions between local and metropolitan journalism cultures

While a number of scholars have explored the special exigencies of local as opposed to metropolitan journalism, rarely have studies examined such differences in relation to journalism culture as constituted by journalists’ professional views. To address the gap in our knowledge, this study reports results from a representative survey of local and metropolitan newspaper journalists in Australia. Findings suggest that territorial context accounts for some significant differences in journalists’ demographics, as well as their role perceptions. In line with past research, local newspaper journalists exhibit much stronger support for the community forum and advocacy role. At the same time, and contrary to expectations, there is very little difference in their support of the watchdog role compared with metropolitan journalists. By combining questions about journalistic ideals and enactment in their work, and finding differences in the two, this study also has important implications for the methodological development of survey studies.

The impact of nurse-directed protocolised-weaning from mechanical ventilation on nursing practice: A quasi-experimental study

Background:
Internationally, nurse-directed protocolised-weaning has been evaluated by measuring its impact on patient outcomes. The impact on nurses’ views and perceptions has been largely ignored.

Aim:
To determine the change in intensive care nurses’ perceptions, satisfaction, knowledge and attitudes following the introduction of nurse-directed weaning. Additionally, views were obtained on how useful protocolised-weaning was to practice.

Methods:
The sample comprised nurses working in general intensive care units in three university-affiliated hospitals. Nurse-directed protocolised-weaning was implemented in one unit (intervention group); two ICUs continued with usual doctor-led practice (control group). Nurses’ perceptions, satisfaction, knowledge and attitudes were measured by self-completed questionnaires before (Phase I) and after the implementation of nurse-directed weaning (Phase II) in all units.

Results:
Response rates were 79% (n=140n=140) for Phase 1 and 62% (n=132n=132) for Phase II. Regression-based analyses showed that changes from Phase I to Phase II were not significantly different between the intervention and control groups. Sixty-nine nurses responded to both Phase I and II questionnaires. In the intervention group, these nurses scored their mean perceived level of knowledge higher in Phase II (6.39 vs 7.17, p=0.01p=0.01). In the control group, role perception (4.41 vs 4.22, p=0.01p=0.01) was lower and, perceived knowledge (6.03 vs 6.63, p=0.04p=0.04), awareness of weaning plans (6.09 vs 7.06, p=0.01p=0.01) and satisfaction with communication (5.28 vs 6.19, p=0.01p=0.01) were higher in Phase II. The intervention group found protocolised weaning useful in their practice (75%): this was scored significantly higher by junior and senior nurses than middle grade nurses (p=0.02p=0.02).

Conclusion

We conclude that nurse-directed protocolised-weaning had no effect on nurses’ views and perceptions due to the high level of satisfaction which encouraged nurses’ participation in weaning throughout. Control group changes are attributed to a ‘reactive effect’ from being study participants. Weaning protocols provide a uniform method of weaning practice and are particularly beneficial in providing safe guidance for junior staff.

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.

Perceptions des intervenants du Nunavik sur la non-observance aux antidépresseurs

La non-observance représente souvent, dans la pratique clinique des professionnels de la santé, un défi à surmonter puisqu’elle est liée à une non-conformité du comportement du patient aux recommandations émises par les intervenants. Dans la région éloignée du Nunavik, divisée en 14 communautés inuit, les intervenants de la santé et des services sociaux, en raison de leur rôle élargi en première ligne, rencontrent une diversité de clientèles. La formation, l’expérience professionnelle, la perception de son rôle, le contexte de travail et le contexte socioculturel influencent l’interprétation des multiples défis au sein de la population. De hauts taux de suicide, d’alcoolisme et de violence sont présents dans les communautés inuit. La prescription des antidépresseurs est un moyen utilisé pour soulager les patients qui présentent des problèmes dépressifs. De quelle façon doit-on aborder ce phénomène complexe, et ce, dans ce contexte particulier de région autochtone éloignée? Cette recherche exploratoire descriptive vise à décrire et à interpréter le phénomène de non-observance des antidépresseurs, plus spécifiquement par l’étude des perceptions des intervenants de la santé et des services sociaux participant à l’intervention directe auprès des Inuit ayant reçu un diagnostic de dépression. L’analyse des 12 entrevues semi-dirigées répond à la question suivante : Quelles sont les perceptions des différents intervenants de la santé et des services sociaux sur le phénomène de la non-observance de la prise d’antidépresseurs chez les Inuit du Nunavik? Les résultats permettent de prendre un recul sur un phénomène courant de la pratique clinique dans cette région spécifique. Ils mettent en lumière la complexité de la relation patient-intervenant, la fragilité de l’alliance thérapeutique et l’importance des interventions d’une équipe interdisciplinaire et interculturelle dans ce contexte de pratique.

The role of active locomotion in space perception

It has been shown that active control of locomotion increases accuracy and precision of nonvisual space perception, but psychological mechanisms of this enhancement are poorly understood. The present study explored a hypothesis that active control of locomotion enhances space perception by facilitating crossmodal interaction between visual and nonvisual spatial information. In an experiment, blindfolded participants walked along a linear path under one of the following two conditions: (1) They walked by themselves following a guide rope; and (2) they were led by an experimenter. Subsequently, they indicated the walked distance by tossing a beanbag to the origin of locomotion. The former condition gave participants greater control of their locomotion, and thus represented a more active walking condition. In addition, before each trial, half the participants viewed the room in which they performed the distance perception task. The other half remained blindfolded throughout the experiment. Results showed that although the room was devoid of any particular cues for walked distances, visual knowledge of the surroundings improved the precision of nonvisual distance perception. Importantly, however, the benefit of preview was observed only when participants walked more actively. This indicates that active control of locomotion allowed participants to better utilize their visual memory of the environment for perceiving nonvisually encoded distance, suggesting that active control of locomotion served as a catalyst for integrating visual and nonvisual information to derive spatial representations of higher quality.

Perception of ultraviolet light by crab spiders and its role in selection of hunting sites

The perception of ultraviolet (UV) light by spiders has so far been only demonstrated in salticids. Crab spiders (Thomisidae) hunt mostly on flowers and need to find appropriate hunting sites. Previous studies have shown that some crab spiders that reflect UV light use UV contrast to enhance prey capture. The high UV contrast can be obtained either by modulation of body colouration or active selection of appropriate backgrounds for foraging. We show that crab spiders (Thomisus sp.)hunting on Spathiphyllum plants use chromatic contrast, especially UV contrast, to make themselves attractive to hymenopteran prey. Apart from that, they are able to achieve high UV contrast by active selection of non-UV reflecting surfaces when given a choice of UV-reflecting and non-UV reflecting surfaces in the absence of odour cues. Honeybees (Apis cerana) approached Spathiphyllum plants bearing crab spiders on which the spiders were high UV-contrast targets with greater frequency than those plants on which the UV-contrast of the spiders was low. Thus, crab spiders can perceive UV and may use it to choose appropriate backgrounds to enhance prey capture, by exploiting the attraction of prey such as honeybees to UV.

Trauma typology as a risk factor for aggression and self-harm in a complex PTSD population: The mediating role of alterations in self-perception

This study examined the role of prolonged, repeated traumatic experiences such as childhood and sectarian trauma in the development of posttraumatic aggression and self-harm. Forty-four adult participants attending therapy for complex trauma in Northern Ireland were obtained via convenience sampling. When social desirability was controlled, childhood emotional and physical neglect were significant correlates of posttraumatic hostility and history of self-harm. These relationships were mediated by alterations in self-perception (e.g., shame, guilt). Severity of sectarian-related experiences was not related to self-destructive behaviors. Moreover, none of the trauma factors were related to overt aggressive behavior. The findings have implications for understanding risk factors for posttraumatic aggression and self-harm, as well as their treatment. © 2013 Copyright Taylor & Francis Group, LLC.