Understanding Workplace Conditions Contributing to Physician Burnout Prevalence in Maryland State

Physician burnout is a three-dimensional work-related response to prolonged and unresolved stress. The prevalence of up to 50 percent is higher among primary care providers in the U.S. and is a significant healthcare problem. This qualitative multiple-case study explored workplace conditions contributing to physician burnout in Maryland State. In a purposive sample, the researcher interviewed twenty-one (21) physicians comprised of Medical Doctors (M.D.), Doctors of Nursing Practitioners (DNPs), and Nurse Practitioners (NP). The Shanafelt\u27s well-being framework was applied to understand physician burnout, workplace conditions, and attrition. Data was collected and analyzed using semi-structured interviews and literature. Five themes analyzed are: Excessive workload, healthcare financing and insurance, limited workplace resources, systemic issues, and the COVID-19 pandemic. The implications include sub-optimal care quality and physician shortages, which continue to define the U.S. healthcare system despite high healthcare expenditure

Investigating mobile graphic-based reminders to support compliance of tuberculosis treatment

The phenomenon of rapid increment of the mobile phones can be utilized through supporting patients, such as those who have tuberculosis, for treatment adherence. This utilization will enable these patients to directly communicate their needs and requirements or receive health information such as reminder messages from healthcare facilities. However, the current mobile interventions, such as text messaging and speech reminder systems have limited use for people with low literacy levels. To overcome these challenges, this study proposed that the mobile graphic-based reminders be used to support tuberculosis patients to improve compliance with treatment regimens, especially for semi-literate and illiterate patients. A review of the literature and initial investigation study were carried out. The findings from the review were useful in understanding both the current practice of tuberculosis treatment regimens and the patients' needs and requirements. These findings, in addition, were referred in the choices of the components of the mobile graphic-based reminders to be implemented. A visual aid for communication theory was applied to the design and development of graphic-based reminder prototypes. An application prototype was implemented for the Android platform. Experiments were conducted to investigate the effects of an application prototype in supporting tuberculosis treatment. To measure the effect, the recovery rate was measured based on the effect of: (1) the graphic-based reminder group versus the control group; and (2) the graphic-based reminder group versus the speech-based reminder group. Data was collected using application event logs, interviews, field notes and audio recordings. It was found that treatment adherence of patients in the graphic-based group was higher than in the speech-based or in the control groups. It was further noted that the number of reminder responses in the graphic-based group was higher than in the speech-based group. Additionally, it was observed that patients in the graphic-based group responded sooner after receiving reminder messages compared to those in the speech-based group. The qualitative feedback also indicated that most patients not only found graphic-based reminders more useful to supporting their treatment than speech-based reminders and traditional care but believed that the application met their needs. This study provides empirical evidence that graphic-based reminders, designed for and based on patients' needs and requirements, can support the treatment of tuberculosis for patients of all literacy levels

Risk in Sports and Challenges for Sports Organizations

Success, injuries, future career opportunities of athletes, and the societal gains of participating in sports and organizing (mega) sports events are all related to individual risk-taking behavior. Although the sports economics and management literature has broadly addressed these issues, it is surprising that less attention has been paid to the implications of risk-taking on the organization of sports in general and, more particularly, on the design and behavior of sports organization members

Risk in Sports and Challenges for Sports Organizations

Success, injuries, future career opportunities of athletes, and the societal gains of participating in sports and organizing (mega) sports events are all related to individual risk-taking behavior. Although the sports economics and management literature has broadly addressed these issues, it is surprising that less attention has been paid to the implications of risk-taking on the organization of sports in general and, more particularly, on the design and behavior of sports organization members

Software Takes Command

This book is available as open access through the Bloomsbury Open Access programme and is available on www.bloomsburycollections.com. Software has replaced a diverse array of physical, mechanical, and electronic technologies used before 21st century to create, store, distribute and interact with cultural artifacts. It has become our interface to the world, to others, to our memory and our imagination - a universal language through which the world speaks, and a universal engine on which the world runs. What electricity and combustion engine were to the early 20th century, software is to the early 21st century. Offering the the first theoretical and historical account of software for media authoring and its effects on the practice and the very concept of 'media,' the author of The Language of New Media (2001) develops his own theory for this rapidly-growing, always-changing field. What was the thinking and motivations of people who in the 1960 and 1970s created concepts and practical techniques that underlie contemporary media software such as Photoshop, Illustrator, Maya, Final Cut and After Effects? How do their interfaces and tools shape the visual aesthetics of contemporary media and design? What happens to the idea of a 'medium' after previously media-specific tools have been simulated and extended in software? Is it still meaningful to talk about different mediums at all? Lev Manovich answers these questions and supports his theoretical arguments by detailed analysis of key media applications such as Photoshop and After Effects, popular web services such as Google Earth, and the projects in motion graphics, interactive environments, graphic design and architecture. Software Takes Command is a must for all practicing designers and media artists and scholars concerned with contemporary media

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Literature Review of the Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes

Regional development at the borders of the European Union (proceedings of the Jean Monnet international conference, Oradea, 5th - 7th of November 2020)

The present volume of studies and analyses, the second one in a series dedicated to investigating regional development at the borders of the European Union was conceived starting from the theoretical underpinnings presented above. However, it does not claim to be exhaustive. The chief purpose of its two sections is to improve approaches to regional development through new levels of analysing contemporary realities. At the same time, its aim is to bring to the attention of the academic community, researchers and policy makers the particularities in the development of the EU's eastern border regions. The topics were discussed during the international conference Jean Monnet Regional Development at the Borders of the European Union, organized in Oradea in November 2019, within the project "Development of the border regions in Central and Eastern Europe countries", funded by the Erasmus + program of European Union, the Jean Monnet Program. Coordinators of special issue: Chirodea, Florentina; Toca, Constantin Vasile; Soproni, Luminita; Czimre, Klára

Software Takes Command

This book is available as open access through the Bloomsbury Open Access programme and is available on www.bloomsburycollections.com. Software has replaced a diverse array of physical, mechanical, and electronic technologies used before 21st century to create, store, distribute and interact with cultural artifacts. It has become our interface to the world, to others, to our memory and our imagination - a universal language through which the world speaks, and a universal engine on which the world runs. What electricity and combustion engine were to the early 20th century, software is to the early 21st century. Offering the the first theoretical and historical account of software for media authoring and its effects on the practice and the very concept of 'media,' the author of The Language of New Media (2001) develops his own theory for this rapidly-growing, always-changing field. What was the thinking and motivations of people who in the 1960 and 1970s created concepts and practical techniques that underlie contemporary media software such as Photoshop, Illustrator, Maya, Final Cut and After Effects? How do their interfaces and tools shape the visual aesthetics of contemporary media and design? What happens to the idea of a 'medium' after previously media-specific tools have been simulated and extended in software? Is it still meaningful to talk about different mediums at all? Lev Manovich answers these questions and supports his theoretical arguments by detailed analysis of key media applications such as Photoshop and After Effects, popular web services such as Google Earth, and the projects in motion graphics, interactive environments, graphic design and architecture. Software Takes Command is a must for all practicing designers and media artists and scholars concerned with contemporary media