Chaotic patterns of restraining power: The dynamics of personal decision making in a long-term care facility

This is a study of personal decision-making dynamics at multiple levels in an Ontario Home for the Aged, including managers, staff leaders, direct care workers, non-direct care workers and residents. Personnel dyadic units of differential decision-making power were postulated: managers/staff leaders, staff leaders/direct care workers and direct care workers/residents. Weber\u27s bureaucracy, other organizational power literature and chaos theory provide the theoretical frame. Staff completed a self administered questionnaire package which included variants of the Staff Involvement in Decision Making scale (Kruzich, 1989), open-ended and demographic questions. Residents were assisted in completing a similar, but shorter, questionnaire. Cognitively impaired residents\u27 decision behaviours were observed, field notes were transcribed and key informants interviewed. Quantitative analysis included descriptive analyses, correlations, T Tests and multiple regressions. While similar patterns emerged from a visual inspection of means on several demographic and decision variables across personnel groups, T Tests found no significant differences in decision scores between groups in each dyadic unit. However, there were significant differences between direct care workers and the non-direct care workers who were not represented in the care dyadic units. Multiple regression models found that staff decision-making power could be predicted by staff perception of supervisors\u27 decision-making power (greater than 40 %). Finally a fractal-like model is suggested as a tool for analysing decision-making power between dyadic units of staff in long-term care

An analysis of the McKee phonetic inventory for grade three.

Thesis (Ed.M.)--Boston Universit

Neonatal Skin Disorders: A Review of Selected Dermatologic Abnormalities

The skin serves many purposes, acting as a barrier to infection, protecting internal organs, contributing to temperature regulation, storing insulating fats, excreting electrolytes and water, and providing tactile sensory input. This article focuses on a review of normal skin structure and function and selected neonatal skin disorders. The disorders reviewed are Staphylococcal scalded skin syndrome, epidermolysis bullosa, and the ichthyoses. The basis for each skin disorder is presented. Nursing management and skin care are incorporated into the review of each selected disorder

Position of the Academy of Nutrition and Dietetics: nutrition and lifestyle for a healthy pregnancy outcome

It is the position of the Academy of Nutrition and Dietetics that women of childbearing age should adopt a lifestyle optimizing health and reducing risk of birth defects, suboptimal fetal development, and chronic health problems in both mother and child. Components leading to healthy pregnancy outcome include healthy prepregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Pregnancy is a critical period during which maternal nutrition and lifestyle choices are major influences on mother and child health. Inadequate levels of key nutrients during crucial periods of fetal development may lead to reprogramming within fetal tissues, predisposing the infant to chronic conditions in later life. Improving the well‐being of mothers, infants, and children is key to the health of the next generation. This position paper and the accompanying practice paper on the same topic provide registered dietitian nutritionists and dietetic technicians, registered; other professional associations; government agencies; industry; and the public with the Academy’s stance on factors determined to influence healthy pregnancy, as well as an overview of best practices in nutrition and healthy lifestyles during pregnancy

Including Value Orientations in Choice Models to Estimate Benefits of Wildlife Management Policies

Value orientations towards wildlife affect the way people perceive nature and their connection with animals. In particular, the social psychological literature within the environmental field suggests that there are two main orientations of people towards wildlife: mutualism and domination. This body of literature has shown how wildlife value orientations can serve as predictors of attitudes and behaviours toward wildlife and form the foundation of human-wildlife conflicts. A common approach in the non-market valuation literature is to include information on attitudes and values in the deterministic part of the utility function, leading to problems of endogeneity bias. To avoid this, analysts have recently shifted their attention to approaches based on latent variables. This paper presents an application of a latent variable and latent class model, to understand how latent orientations influence choices, in a case study in the Italian Alps. The intuition is that different underlying individual value orientation affects preferences and the level of willingness to pay and should be therefore considered in choice models. The latent variable is used to explain class membership of respondents. Results indicate that the latent variable has a significant effect in class allocation and that the hybrid model performs better than a simple two class model. Results provide guidance on the social acceptability of management interventions and can support public decision-makers in the modulation of wildlife management policies for balancing the needs of conservation and outdoor recreation, explicitly considering existing human-wildlife conflicts

Congenital myotonic dystrophy in a national registry

AIM: To describe the neonatal symptoms, developmental problems and chronic multisystem medical morbidities of congenital myotonic dystrophy (CDM) patients registered in the United States National Registry of Myotonic Dystrophy - a disease-specific, self-report program maintained since 2002. Comparisons with the Canadian Paediatric Surveillance Program for CDM are highlighted. METHODS: Genetically confirmed cases of CDM demonstrating symptoms in the first four weeks of life are described. Patients (or their caregivers) and physicians completed survey information at baseline and annually thereafter. RESULTS: Twenty-one patients were included (13 male and eight female), ranging from three to 24 years of age. The CTG trinucleotide repeat number ranged from 940 to 2100. Gastrointestinal, pneumonia and cardiac morbidities were most common. No deaths were noted. CONCLUSIONS: The United States Registry is a valuable resource for clinical research on patients with CDM; however, in contrast with the Canadian Paediatric Surveillance Program, some limitations are identified. ©2010 Pulsus Group Inc. All rights reserved