123 research outputs found

    Supporting healthcare staff after patient safety incidents: An exploration of policy, practice, and terminology:“There’s no point having a rhetoric of concern if nothing will be done”

    Get PDF
    Background and objectives: This project investigates the policies informing emotional and psychological support for healthcare staff after involvement in patient safety incidents, the support provided in practice, and the terminology used to describe those involved. Method: In a qualitative study design, semi-structured interviews were conducted with 27 healthcare professionals in England, with management, supervisory, or policy responsibility, to answer two research questions: 1) the policies, protocols, and practices they were aware of that aim to support healthcare personnel in their organisation who have experienced unanticipated adverse or near miss medical events, and 2) their views about the term “second victim”. Thematic analysis was chosen to analyse the interview data. Findings: Four themes were developed: 1) Severe and enduring impact; 2) Absence of policies; 3) No certainty of support; 4) Language undermines support. A notable gap exists between rhetoric about staff wellbeing, including in national and international healthcare policy reports, and the rarity of structured support after patient safety incidents (PSI). Staff are impacted both by the incidents and by the way their organisation treats them. Informal support depends upon the goodwill of close colleagues, and may not be available. There is an imbalance between the high expectations placed on staff and the support resources they can access. Routine language usage in healthcare negatively impacts support provision. The established “second victim” concept accurately reflects the feelings of staff affected by PSI, but is not a stable construct, has unwelcome connotations, and causes offence to some patient representatives. Conclusions: There are many national and international policy recommendations to support staff emotionally and psychologically after PSI. A small number of policies require support provision, without stipulating how. Support programmes known to exist are mostly in North America. In the UK, support is lacking, and necessary components of structured support are identifie

    Contributions d'un programme de formation continue virtuel sur les troubles concomitants au développement des compétences des infirmières : un devis mixte convergent

    Full text link
    Les personnes atteintes de troubles concomitants (TC) de santé mentale et d’usage de substances présentent des besoins biopsychosociaux particuliers et complexes, qui peuvent rendre leurs prises en charge plus ardue pour les professionnels de la santé. Au Canada comme dans d’autres pays, les infirmières et les infirmiers sont fréquemment appelés à intervenir auprès de personnes atteintes de TC par le biais d’une approche intégrée des soins centrés sur leurs besoins particuliers. Toutefois, les études soulignent des difficultés et barrières inhérentes à la complexité de cette prise en charge par les infirmières, comme le sentiment de fardeau ou d’échec professionnel, les attitudes défavorables ou l’inconfort à l’égard de ces personnes et le manque de connaissances ou d’habiletés quant à certaines approches psychothérapeutiques essentielles. Qui plus est, rares sont les occasions de formation continue portant spécifiquement sur les TC pour soutenir et mieux outiller les infirmières dans le développement de leurs compétences. Cette thèse par articles présente les résultats d’une étude visant à comprendre dans quelle mesure et de quelles manières un programme de formation continue virtuel portant sur les TC a contribué au développement des compétences des infirmières. Le programme de formation continue virtuel sur les TC développé et mis en place en 2018 au Centre hospitalier de l’Université de Montréal (CHUM) en s’appuyant sur le modèle Extension for Community Healthcare Outcomes (©ECHO), s’adresse à l’ensemble des professionnels de la santé et des services sociaux du Québec. Celui-ci constitue un modèle de formation continue visant à soutenir le développement des compétences de ces professionnels dans la prise en charge de conditions de santé chroniques et complexes. Le modèle ECHO repose sur trois théories sociales de l’apprentissage, incluant la Théorie sociale cognitive, la Théorie des communautés de pratique et la Théorie de l’apprentissage situé. Le programme ECHO sur les TC comprend des séances éducatives virtuelles offertes en continu, d’une durée de 90 minutes à chaque deux semaines, guidées par une équipe interprofessionnelle d’experts dans le domaine des TC. La participation au programme s’effectue par l’entremise de visioconférences simultanées, au cours desquelles les professionnels inscrits au programme sont invités à présenter une situation clinique vécue, laquelle faisant ensuite l’objet d’une riche discussion entre pairs et d’une rétroaction personnalisée par l’équipe d’experts. Des capsules didactiques portant sur les pratiques exemplaires dans le domaine des TC sont également présentées aux participants, en fonction de leurs besoins d’apprentissage. Un devis mixte convergent a été utiliser pour collecter et analyser les données QUANtitatives et QUALitatives issues d’une population potentielle de 65 infirmières ayant participé au programme de formation ECHO sur les TC pour les vagues de formation 2018-2019 et 2019-2020. Dans le volet QUAN, une étude de cohorte prospective observationnelle a été mené pour mesurer l’évolution des infirmières à six mois (T1) et 12 mois (T2) suivant leur entrée au programme (T0) quant à leur: 1) sentiment d’auto-efficacité; 2) participation; 3) satisfaction et acceptabilité; 4) connaissances; 5) attitude; et 6) perception de la performance clinique. Dans le volet QUAL, une étude descriptive interprétative a été réalisée auprès de 10 infirmières ayant participé au programme ECHO, afin d’explorer leur expérience et perceptions à l’égard du développement et de la mise en pratique de leurs compétences, ainsi que des facteurs ayant influencé ce processus. Enfin, l’emploi d’une stratégie de comparaison des résultats QUAN et QUAL a facilité leur intégration, permettant ainsi de mettre en évidence leurs similitudes, différences ou éléments de complémentarité. Les analyses de variance effectuées dans le volet QUAN de l’étude ont indiqué une amélioration significative quant au niveau de connaissances sur les TC (pT1–T0 = 0,0045; pT2–T0 = 0,0014) et au score d’attitude à l’égard des TC (pT1–T0 = 0,0472 ; pT2–T0 = 0,0139) des infirmières (n = 28) à T1 et T2. En contrepartie, seules les infirmières (n = 16/28) ayant participé à au moins 25 % des 20 séances virtuelles offertes au cours d’un curriculum de formation ont montré une augmentation significative de leur sentiment d’auto-efficacité à T2 (pT2–T0 = 0,0213). En complémentarité, l’analyse thématique réalisée dans le volet QUAL de l’étude a mis en lumière qu’au cours de leur participation, les infirmières ont davantage développé huit éléments de compétences propres à la pratique auprès de personnes atteintes de TC, et que plusieurs facteurs d’ordre personnel, interpersonnel, contextuel et organisationnel avaient facilité ou contraint ce processus. Enfin, les constats mixtes de l’étude, illustrés par six thèmes, font état de six conditions clés pour favoriser le développement des compétences et leur mise en œuvre dans la pratique: 1) des expériences de mise en pratique et de validation; 2) des relations de réciprocité et de confiance en contexte de formation interprofessionnelle; 3) un partage d’expériences similaires entre pairs et des activités de mentorat; 4) une collaboration avec des experts; 5) une attitude positive solidifiée à l’égard de l’exercice de son rôle professionnel en situation de complexité et d’adversité; et 6) des expériences d’apprentissage d’équipe, adaptées aux particularités des milieux et en partenariat avec les organisations. Cette étude a permis de mieux comprendre comment un programme de formation continue virtuel sur les TC reposant sur le modèle ECHO a contribué au développement des compétences des infirmières. Les résultats suggèrent que dans certaines conditions, le programme de formation ECHO sur les TC peut favorablement contribuer au développement des compétences des infirmières et au renouvellement de leur pratique. Des recommandations sont formulées à l’effet d’orienter la recherche vers l’évaluation des effets du modèle ECHO sur le changement des pratiques et la santé des personnes atteintes; et d’explorer des avenues de recherche visant la conjugaison de stratégies auprès des professionnels et sur le plan de l’intervention, du contexte et des organisations, pour favoriser la mise en œuvre effective des pratiques exemplaires.People with concurrent disorders (CD) in mental health and substance use have specific and complex biopsychosocial needs, which can make their care more challenging for healthcare professionals. In Canada, as in other countries, nurses are frequently called upon to intervene with people with CD through an integrated approach to care that focuses on their specific needs. However, studies point to difficulties and barriers for nurses caused by the complexity of this care. These include feelings of being burdened or of professional failure, judgmental attitudes about or discomfort with these individuals, and lack of knowledge or skills in certain essential psychotherapeutic approaches. Moreover, there are few continuing education opportunities specifically focused on CD to support nurses and give them the tools they need to develop their skills. This article-based thesis presents the results of a study carried out to understand how, and to what extent, a virtual continuing education program on CD contributed to nurses’ competency development. The virtual continuing education program for CD was developed and implemented in 2018 at the Centre hospitalier de l’Université de Montréal (CHUM), based on the Extension for Community Healthcare Outcomes (©ECHO) model. It is intended for all health and social services professionals in Quebec. ECHO is a model of continuing education designed to support the competency development of these professionals in the management of chronic and complex health conditions. The ECHO model is based on three social theories of learning, including the Social Cognitive Theory, the Communities of Practice Theory, and the Situated Learning Theory. The ECHO program for CD consists of 90 minute virtual educational sessions, offered bi-weekly on an ongoing basis. The sessions are guided by an interprofessional team of experts in the field of CD. Participation in the program takes place through videoconferences, during which professionals enrolled in the program are invited to present a real-life clinical situation, which is then the subject of a rich peer discussion and personalized feedback from the team of experts. Short didactic presentations on best practices in the field of CD are also presented to participants, based on their learning needs. A convergent mixed-methods design was used to collect and analyze QUANtitative and QUALitative data from a potential population of 65 nurses who participated in the ECHO CD program during its first two cycle (2018–2019 and 2019–2020). In the QUAN component, a prospective observational cohort study was conducted to measure nurses’ evolution at six months (T1) and 12 months (T2) following their entry into the program (T0) with respect to their: 1) self-efficacy; 2) participation; 3) satisfaction and acceptability; 4) knowledge; 5) attitude; and 6) perceived clinical performance. In the QUAL component, an interpretive descriptive study was conducted with 10 nurses who had participated in the ECHO program. The study explored their experiences and perceptions regarding the development of their competency and their clinical practice, as well as factors that influenced this process. Finally, a strategy of comparing QUAN and QUAL results facilitated their integration and thus highlighted their similarities, differences, or complementary elements. Longitudinal analyses of variance performed in the QUAN component of the study indicated a significant increase in the level of knowledge about CD (pT1–T0 = 0.0045; pT2–T0 = 0.0014) and in the attitude score toward CD (pT1–T0 = 0.0472; pT2–T0 = 0.139) of nurses (n= 28) at T1 and T2. In contrast, only nurses (n = 16/28) who participated in at least 25% of the 20 virtual sessions offered during a program cycle showed a significant increase in their self-efficacy score at T2 (pT2–T0 = 0.0213). In addition, the thematic analysis conducted in the QUAL component of the study revealed that, during their period of participation, nurses further developed eight competency elements specific to practice with people with CD, and that several personal, interpersonal, contextual, and organizational factors either facilitated or constrained this process. Finally, the study’s mixed-methods findings, illustrated by six themes, point to six key conditions that foster the development of nurses’ competencies and their implementation in clinical practice: 1) Opportunities for practice and validation; 2) Reciprocal and trusting relationships in an interprofessional learning environment; 3) Peer-to-peer sharing of similar experiences and mentoring activities; 4) Collaboration with experts; 5) Reinforcement of positive attitudes about performing professional role in complex and adverse situations; and 6) Learning experiences that are team-based, tailored to the setting specifics and receive organizational support. This study provides a better understanding of how a virtual continuing education program for CD, based on the ECHO model, contributed to nurses’ competency development. The results suggest that under certain conditions, the ECHO program for CD can contribute positively to the development of nurses’ competencies and the renewal of their clinical practice. Recommendations are made in two areas: first, to direct research toward evaluating the impact of the ECHO model on practice change and health outcomes; and, second, to explore research avenues for combining strategies among professionals and with regard to intervention, context and organizations, to support effective implementation of best practices

    The inevitability of arbuscular mycorrhiza for sustainability in organic agriculture—A critical review

    Get PDF
    The arbuscular mycorrhizal fungi (AMF) are significant fertility-promoting microbes in soils. They enable soil fertility, soil-health and boost crop productivity. There are generalist and specialist groups among AMF in natural soils. Optimized use of specific AMF concerning crops and soils can improve agricultural sustainability. Thus, AMF is becoming an inevitable biological tool for improving crop productivity and soil health. Especially in the context of chemicalized agriculture undermining the sustainability of food security, safety, and human and ecosystem health, alternative agricultural means have become inevitable. Therefore, AMF has become essential in nature-friendly, organic agriculture. Of such farm fields, natural biological activity is enhanced to sustain soil fertility. Crops show increased innate immunity against pests and diseases in many such systems. Moreover, ecosystems remain healthy, and the soil is teeming with life in such farms. The primary goal of the review was a thorough critical analysis of the literature on AMF in organic agriculture to assess its efficiency as an ecotechnological tool in sustainable agricultural productivity. The novelty is that this is the first comprehensive review of literature on AMF concerning all aspects of organic agriculture. A vital systematic approach to the exhaustive literature collected using regular databases on the theme is followed for synthesizing the review. The review revealed the essentiality of utilizing specific mycorrhizal species, individually or in consortia, in diverse environmental settings to ensure sustainable organic crop production. However, for the exact usage of specific AMF in sustainable organic agriculture, extensive exploration of them in traditional pockets of specific crop cultivations of both chemical and organic fields and wild environments is required. Moreover, intensive experimentations are also necessary to assess them individually, in combinations, and associated with diverse beneficial soil bacteria

    Future Perspectives on Positive Psychology:A Research Agenda

    Get PDF
    Just over two decades ago, Martin Seligman's inaugural lecture as the new president of the APA marked the dawn of Positive Psychology. Seligman called for a science of positive subjective experiences, positive individual states/traits/behaviours, and positive societal factors that improves the quality of life and wellbeing. Since then, this sub-discipline of psychology has shown extraordinary and inspiring growth in both the academy (e.g. research papers/books) and practice (e.g. establishment of professional associations, annual conferences). Positive psychology has increased our collective understanding of the factors that make life worth living, the drivers that enhance wellbeing and the elements that undermine them. It has given birth to many new theories, research models and methodologies that aim to measure, interpret, model and optimize the conditions that lead to flourishing individuals and thriving societies. It has also spawned a magnitude of sub-disciplines ranging from positive ageing, positive coaching, wellbeing therapies, positive relationships, positive health, positive organizational psychology etc. Despite building out its own identity, positive psychology has also been adopted in many adjacent fields like organizational studies, education, health, risk management, and even architectural sciences.In its relatively short life, positive psychology has provided new insights into the human condition and innovative means to solve complex individual, organizational and societal problems. Positive psychology has brought balance to psychology by establishing a platform to focus on more than just "fixing what is wrong" through focusing on optimizing what already works well. As a collective, we believe that positive psychology can continue to play a vital role in the future by deepening our understanding of 'positivity' and developing practical tools, methodologies, and interventions to enhance people, organizations, and societies' functioning.But what does the future of positive psychology hold? What are the strengths, opportunities, aspirations and results of positive psychology? And how can we, as a collective, build out the credibility and impact of the discipline's future? For us, these are some of the most challenging goals of positive psychology. With the rapid development of the field, detailed research and practice 'roadmaps' are required to direct the discipline's collective energies.This book address such by collating a series of research agendas about the future of positive psychology in different speciality areas. Specifically, the aim was to identify the limitations in our current understanding of the different theories, models, methods and interventions on which positive psychology is built and propose a roadmap for addressing such in the future. This aided in setting a specific, measurable, attainable, realistic and time-bound research agenda to direct the future development of positive psychology. Contributions discuss the current state of theory and research in positive psychology and presents a research agenda for future research

    Treatment guided by fractional exhaled nitric oxide in addition to standard care in 6- to 15-year-olds with asthma : the RAACENO RCT

    Get PDF
    Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and National Institute for Health and Care Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 9, No. 4. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

    The extent of Kuwaiti Islamic banks restrict the use of Islamic financing tools in their financial operations: a field study

    Get PDF
    This research aims to identify the extent to of Kuwaiti Islamic banks adhere to the use of Islamic financing tools in their financial operations. The study population consists of all (5) banks listed on the Kuwait Stock Exchange. As for the study sample, (100) respondents were selected from Financial managers, accountants, and workers in finance and investment departments work in these banks. The questionnaire was used as a tool for collecting primary data. The results showed that Kuwaiti Islamic banks adhere to the use of Islamic financing tools represented in Murabaha, Musharaka and Mudaraba in their financial operations to a high degree. The study recommended that Kuwaiti Islamic banks should be encouraged to play a more role in Murabaha operations and find appropriate solutions to technical obstacles and culture-related procedures that prevent the provision of Islamic financing through Murabaha

    Shared Decision Making in Mental Health: International Perspectives on Implementation

    Get PDF
    © 2021 The Authors. This work is distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/The application of shared decision making (SDM) to mental health issues and services is a recent development. An increased range of different styles of SDM in mental health exists, reflecting varieties concerning the power differential of clinicians vs. service users, and the place allocated to experiential knowledge vs. scientific knowledge. Yet, current evidence highlights that compulsory interventions are still very common in the context of mental illnesses compared with physical-somatic illnesses; and in some situations the threat of compulsion is overt or barely concealed. Although more decision-making aids exist, these tools are not always equally validated, and their application does not necessarily ensure that the principles of SDM are either applied in practice or contributes to SDM and health outcomes. While there is increased acceptance of the potential usefulness of applying SDM in everyday mental health practice, its implementation in practice is still lacking. Service users often do not know what SDM could mean, and clinicians often have reservations concerning the capacity of service users to make decisions and they often fear that SDM may lead to harmful risk taking (e.g., increase treatment non-adherence). Current research of SDM in mental health demonstrates the importance of an easy access to information concerning mental health interventions, and the relevance of respect and trust by both clinicians and service users in the process of SDM. Yet, SDM in mental health research ignores that many service users are keen to make their own decisions and experience SDM as a subtle form of manipulation by clinicians. In addition, we see less discussion of the fact that some service users stop taking medication unrelated to whether they are engaged in SDM or not, and the outcomes of this step are insufficiently looked at in existing research. We aim to include articles on original research describing completed and running SDM projects that we can learn from and advance the development of SDM and its implementation. Examples for relevant topics are research that: • Explores creatively yet methodically at least one key issue of SDM in mental health. • Applies in an evaluated way SDM across a whole mental health service. • Identifies barriers to implementing SDM and attempts systematically and ethically to devise ways of overcoming the barriers. • Uses facilitators, such as peer support workers and/or the strengths approach, to enhance the implementation of SDM in mental health in a systematic way. • Pays attention to reducing the power differential between service users and clinicians, considering ways of increasing more equal collaboration within the research design. • Addresses SDM with minority populationsFinal Published versio

    Handbook of Positive Psychology, Religion, and Spirituality

    Get PDF
    This handbook aims to bridge the gap between the fields of positive psychology and the psychology of religion and spirituality. It is the authoritative guide to the intersections among religion, spirituality, and positive psychology and includes the following sections: (1) historical and theoretical considerations, (2) methodological considerations, (3) cultural considerations, (4) developmental considerations, (5) empirical research on happiness and well-being in relation to religion and spirituality, (6) empirical research on character strengths and virtues in relation to religion and spirituality, (7) clinical and applied considerations, and (8) field unification and advancement. Leading positive psychologists and psychologists of religion/spirituality have coauthored the chapters, drawing on expertise from their respective fields. The handbook is useful for social and clinical scientists, practitioners in helping professions, practitioners in religious and spiritual fields, and students of psychology and religion/spirituality. This is an open access book

    Evaluation of PD-L1 expression in various formalin-fixed paraffin embedded tumour tissue samples using SP263, SP142 and QR1 antibody clones

    Get PDF
    Background & objectives: Cancer cells can avoid immune destruction through the inhibitory ligand PD-L1. PD-1 is a surface cell receptor, part of the immunoglobulin family. Its ligand PD-L1 is expressed by tumour cells and stromal tumour infltrating lymphocytes (TIL). Methods: Forty-four cancer cases were included in this study (24 triple-negative breast cancers (TNBC), 10 non-small cell lung cancer (NSCLC) and 10 malignant melanoma cases). Three clones of monoclonal primary antibodies were compared: QR1 (Quartett), SP 142 and SP263 (Ventana). For visualization, ultraView Universal DAB Detection Kit from Ventana was used on an automated platform for immunohistochemical staining Ventana BenchMark GX. Results: Comparing the sensitivity of two different clones on same tissue samples from TNBC, we found that the QR1 clone gave higher percentage of positive cells than clone SP142, but there was no statistically significant difference. Comparing the sensitivity of two different clones on same tissue samples from malignant melanoma, the SP263 clone gave higher percentage of positive cells than the QR1 clone, but again the difference was not statistically significant. Comparing the sensitivity of two different clones on same tissue samples from NSCLC, we found higher percentage of positive cells using the QR1 clone in comparison with the SP142 clone, but once again, the difference was not statistically significant. Conclusion: The three different antibody clones from two manufacturers Ventana and Quartett, gave comparable results with no statistically significant difference in staining intensity/ percentage of positive tumour and/or immune cells. Therefore, different PD-L1 clones from different manufacturers can potentially be used to evaluate the PD- L1 status in different tumour tissues. Due to the serious implications of the PD-L1 analysis in further treatment decisions for cancer patients, every antibody clone, staining protocol and evaluation process should be carefully and meticulously validated
    • …
    corecore