THE IMPACT OF WORK UNIT AND ORGANIZATION SUPPORT ON HOSPITAL PATIENT SAFETY

Based on the construct of a culture of safety, the study purpose was to discern the relationships between Organization Support (OS) and Work Unit Support (WS) on Hospital Patient Safety. OS and WS were operationalized using the National Database for Nursing Quality Indicators® (NDNQI®) RN Survey with Job Satisfaction Scales. Patient Safety was operationalized using four Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators: Decubitus Ulcer, Selected Infections due to Medical Care, Failure to Rescue (FTR), and Deep Vein Thrombosis. A structural equation model was developed with adequate fit indices (χ2 = 40.811, df= 27, p= 0.234; CFI= 0.930; RMSEA= 0.065; SRMR= 0.074). Unexpectedly, increased OS was associated significantly (p= .030) with increase Patient Safety events. A promising, though non-significant finding, was increased WS and OS were associated with decreased FTR rates. Teamwork, a component of WS was associated with decreased rates of FTR and Patient Safety events

Coordination of Care by Primary Care Practices: Strategies, Lessons and Implications

Documents successful strategies for coordinating care within primary care settings, including family and caregivers; with specialists; with hospital settings; and with community-based services. Discusses challenges, lessons learned, and implications

Positive Family Intervention for Families of Children with Fragile X Syndrome: Using Telehealth to Reduce Problem Behavior and Improve Maternal Mental Health Author(s): Carmen Ann Kemper Mootz

The present study was designed to evaluate the effectiveness of Positive Family Intervention (PFI), delivered via teletherapy, for a family of a child diagnosed with Fragile X syndrome (FXS). PFI combines elements of cognitive-behavioral therapy (CBT) and positive-behavior support (PBS). A single-subject AB design was used across one participant to evaluate changes in observed problem behavior. Following nine weeks of baseline data collection, the participating mother was administered PFI via WebEx for eight 90-minute sessions, once per week. After the treatment was complete, three weeks of post-treatment follow-up data on problem behavior were collected from video- recordings. The participant uploaded naturalistic videos of her child’s problem behavior in a specific setting to a secure online server. The effect of PFI on parental depression, stress, and cognitions was also evaluated using pre- and post- treatment data collection. Results indicated a substantial decrease in both observed and parent-reported problem behavior over the course of the treatment. Non-significant decreases were reported in parental depression and stress. Small to medium changes in parental attribution of child problem behavior were also reported following treatment. The implications of these changes are discussed, as well as the limitations of the present study and directions for future research

Positive Family Intervention for Families of Children with Fragile X Syndrome: Using Telehealth to Reduce Problem Behavior and Improve Maternal Mental Health

The present study was designed to evaluate the effectiveness of Positive Family Intervention (PFI), delivered via teletherapy, for a family of a child diagnosed with Fragile X syndrome (FXS). PFI combines elements of cognitive-behavioral therapy (CBT) and positive-behavior support (PBS). A single-subject AB design was used across one participant to evaluate changes in observed problem behavior. Following nine weeks of baseline data collection, the participating mother was administered PFI via WebEx for eight 90-minute sessions, once per week. After the treatment was complete, three weeks of post-treatment follow-up data on problem behavior were collected from video- recordings. The participant uploaded naturalistic videos of her child’s problem behavior in a specific setting to a secure online server. The effect of PFI on parental depression, stress, and cognitions was also evaluated using pre- and post- treatment data collection. Results indicated a substantial decrease in both observed and parent-reported problem behavior over the course of the treatment. Non-significant decreases were reported in parental depression and stress. Small to medium changes in parental attribution of child problem behavior were also reported following treatment. The implications of these changes are discussed, as well as the limitations of the present study and directions for future research

Exploiting biological pathways to infer temporal gene interaction models

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2006.Includes bibliographical references (p. 156-166).An important goal in genomic research is the reconstruction of the complete picture of temporal interactions among all genes, but this inference problem is not tractable because of the large number of genes, the small number of experimental observations for each gene, and the complexity of biological networks. We focus instead on the B cell receptor (BCR) signaling pathway, which narrows the inference problem and provides a clinical application, as B cell chronic lymphocytic leukemia (B-CLL) is believed to be related to BCR response. In this work, we infer population-dependent gene networks of temporal interaction within the BCR signaling pathway. We develop simple statistical models that capture the temporal behavior of differentially expressed genes and then estimate the parameters in an Expectation-Maximization framework, resulting in clusters with a biological interpretation for each subject population. Using the cluster labels to define a small number of modes of interaction and imposing sparsity constraints to effectively limit the number of genes influencing each target gene makes the ill-posed problem of network inference tractable.(cont.) For both the clustering and the inference of the predictive models, we have statistical results that show that we successfully capture the temporal structure of and the interactions between the genes relevant to the BCR. signaling pathway. We have confirmatory results from a biological standpoint, in which genes that we have identified as playing key roles in the networks have already been shown in previous work to be relevant to BCR. stimulation, but we also have results that guide future experiments in the study of other related genes, in order to further the long term goal of a full understanding of how and why B-CLL cells behave abnormally.by Corey Ann Kemper.Ph.D

Evaluating Social Marketing Messages in New Zealand’s Like Minds Campaign and Its Effect on Stigma

Background: A key objective of government and social marketers is to remove the institutionalized stigma of mental illness, increasing mental health service uptake. While research has evaluated past campaigns based on changes in attitudes and beliefs, very little research has examined the communication messages used in social marketing campaigns. Focus of the Article: This impact evaluation research identifies the institutionalized cultural-moral norms incorporated into New Zealand’s Like Minds mental health advertisements and examines how attitudes and beliefs changed over time in response to these norms. Importance to the Social Marketing Field: This research offers a new approach to social marketing evaluation and demonstrates the importance of consistent incorporation of cultural-moral institutional norms in social marketing campaigns. Method: Using macro-social marketing theory, thematic analysis is used to identify the cultural-moral institutional norms in the Like Minds campaign advertisements over a 10-year period (2002–2012). Results: The Like Minds campaign was found to have multiple cultural-moral institutional norms, such as Mental illness as a villain, Personal responsibility, and Inherent human dignity, as well as utilizing two different institutionalization processes of Socialization and Identity Formation. However, these norms were inconsistently and sometimes contradictorily presented and as a result, not all changes in mental health stigma beliefs and attitudes show long term change. Rates for service uptake also had mixed results during the campaign duration, though overall an increase in uptake was found. Recommendations for Research and Practice: The research highlights the importance of understanding the underlying institutionalized cultural-moral norms presented in communications and aligning those with the overall objectives of a social marketing campaign. Limitations: Like Minds campaign phases 2 to 5 are analyzed, phase 1 was inaccessible for analysis and advertisements after 2012 are not analyzed

Social marketing AS pedagogy

Purpose: This study aims to share the use of social marketing as pedagogy and provide a transformative social marketing pedagogy for social marketing educators. By this, the authors mean the same principles used by social marketers to improve the well-being of a person or group are used as a pedagogic tool to bolster students’ learning and understanding of social marketing. In the described course, students are asked to choose one area of their lives to try and change using concepts taught to them in class. They are then asked to reflect on their personal change journey and apply it to others in the form of a social marketing plan. Design/methodology/approach: The authors share a conceptual journey using social marketing as pedagogy following the evolution of a marketing for behavioural change undergraduate course. Benchmark criteria for social marketing are used to discuss and conceptualise a transformative social marketing pedagogy. The authors take a reflexive approach to explore course development, motivations, assumptions and activities to expand on their approach. Findings: Social marketing as pedagogy suggests that behaviour change is not just taught through course content but also embedded throughout the course as a learning tool and outcome. A social marketing course can encourage individual behaviour change by asking students to critically reflect on their own behaviour change journey to fully experience and understand the underpinnings and implications for social marketing. In this way, the authors adopt transformative learning as the outcome of social marketing AS pedagogy. The authors suggest through experiential learning, including active learning and reflexivity, students are able to change their frame of reference or how they interpret the world around them, in regard to complex social issues, which may encourage behaviour change. Originality/value: As social marketers, the authors must reflect not only on what they teach students (Kelly, 2013) but also on how they teach them. Previous literature has not provided any unique pedagogy for how to teach social marketing. This article provides the first pedagogy for social marketing education – the Transformative social marketing pedagogy which views social marketing AS pedagogy. The authors present the value of experiential learning as a three-pronged approach incorporating Interpretive Experiences, Transformative Experiences and developing Praxis, which includes elements of feeding forward and authentic assessment. This approach provides a unique contribution to the area by providing a pedagogical approach that goes beyond mere knowledge acquisition to transformative learning

Model Independent Form Factors for Spin Independent Neutralino-Nucleon Scattering from Elastic Electron Scattering Data

Theoretical calculations of neutralino-nucleon interaction rates with various nuclei are of great interest to direct dark matter searches such as CDMS, EDELWEISS, ZEPLIN, and other experiments since they are used to establish upper bounds on the WIMP-proton cross section. These interaction rates and cross sections are generally computed with standard, one or two parameter model-dependent nuclear form factors, which may not exactly mirror the actual form factor for the particular nucleus in question. As is well known, elastic electron scattering can allow for very precise determinations of nuclear form factors and hence nuclear charge densities for spherical or near-spherical nuclei. We use charge densities derived from elastic electron scattering data to calculate model independent, analytic form factors for various target nuclei important in dark matter searches, such as Si, Ge, S, Ca and others. We have found that for nuclear recoils in the range of 1-100 keV significant differences in cross sections and rates exist when the model independent form factors are used: at 30 keV nuclear recoil the form factors squared differ by a factor of 1.06 for $^{28}$Si, 1.11 for $^{40}$Ca, 1.27 for $^{70}$Ge, and 1.92 for $^{129}$Xe. We show the effect of different form factors on the upper limit on the WIMP-proton cross section obtained with a hypothetical $^{70}$Ge detector during a 100 kg-day effective exposure. Helm form factors with various parameter choices differ at most by 10--20% from the best (Fourier Bessel) form factor, and can approach it to better than 1% if the parameters are chosen to mimic the actual nuclear density.Comment: 20 pages, 8 figure

Screening for Gynecologic Conditions With Pelvic Examination US Preventive Services Task Force Recommendation Statement

IMPORTANCE Many conditions that can affect women\u27s health are often evaluated through pelvic examination. Although the pelvic examination is a common part of the physical examination, it is unclear whether performing screening pelvic examinations in asymptomatic women has a significant effect on disease morbidity and mortality. OBJECTIVE To issue a new US Preventive Services Task Force(USPSTF) recommendation on screening for gynecologic conditions with pelvic examination for conditions other than cervical cancer, gonorrhea, and chlamydia, for which the USPSTF has already made specific recommendations. EVIDENCE REVIEW The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women 18 years and older who are not at increased risk for any specific gynecologic condition. FINDINGS Overall, the USPSTF found inadequate evidence on screening pelvic examinations for the early detection and treatment of a range of gynecologic conditions in asymptomatic, nonpregnant adult women. CONCLUSIONS AND RECOMMENDATION The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women. (I statement) This statement does not apply to specific disorders for which the USPSTF already recommends screening (ie, screening for cervical cancer with a Papanicolaou smear, screening for gonorrhea and chlamydia)