Employee Involvement in Decision-Making: European Attempts at Harmonization

Part I of this note examines the sources of Community power over employment policy. Part II analyzes two Community directives approximating laws regarding employee involvement in dismissal procedures. It also examines the impact of these Community directives on two Member States, the Federal Republic of Germany (FRG or West Germany) and the United Kingdom. The note focuses on the FRG because its statutes have served as the model for Community directives, and because the harmonization of laws throughout the Community will provide unique benefits to the FRG. The note examines the United Kingdom because its government has historically had a limited impact upon worker-management relations, and compliance with Community directives often involves significant alteration to existing statutes. Part III focuses on Community proposals that would directly involve employees in the management of the enterprise. It considers the obstacles to implementation of these proposals and the potential for adoption. The note argues that the directives which have been adopted illustrate the concern of the Community and its awareness that further action is necessary. It concludes, however, that the directives do not offer significant protection to Community workers. Although the proposals for participation in management are promising, political obstacles are likely to block implementation

An Innovative Interprofessional Assessment

This article describes and evaluates the assessment used for a UK-based module entitled IPL - Working with Others. The module was attended by 320 students from adult nursing, child health nursing, mental health nursing, midwifery, social work, operating department practice, diagnostic radiography and therapeutic radiography. Students were divided into interprofessional groups of eight students. The groups were given a case study of a service user coming into contact with different health and social care professionals. They had to work together to produce a poster, based on the case study. The interprofessional groups provided a ‘real’ experience of working together and understanding one another’s roles. The students then had to defend their poster as a group and respond to questions from two assessors. In order to review the assessment, both students and staff were asked to provide feedback about the assessment process, listing the positive and challenging aspects. All of the staff provided feedback (12), and 192 (60%) students also provided feedback. It was found that the assessment worked well, both staff and students having found it to be both a good learning experience as well as being a good way to assess IPL. Students had a ‘real’ experience of interprofessional working, facing barriers and challenges to overcome which are similar to those in practice

Preparation for Practice through Service User involvement in the Diagnostic Radiography curriculum at University Campus Suffolk

The purpose of this small-scale study was to evaluate the student experience of service user involvement in the curriculum for the module entitled ‘The Service User’ as part of a BSc (Hons) Diagnostic Radiography degree programme.Following four teaching sessions, at which service users came to speak to the students about their experiences, a questionnaire was distributed to 43 second year diagnostic radiography students. Twenty-six responses were received (60%). The questionnaire was used to evaluate the usefulness of the sessions. A mixture of open and attitudinal questions using a seven point Likert scale was employed.The results were analysed and the feedback was generally positive in terms of the involvement of service users within the curriculum

Barriers and Facilitators to Achieving Well-being in Pediatric Providers

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs). Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each group session was scheduled 2-3 months in advance to allow for maximum participation. Results: A total of 83 physicians and APPs participated in the focus groups. The majority of respondents were female, white, aged 31-50 years, and married with children living at home. When asked about current level of burnout, the most frequent response was 8 out of 10 (10 as highest, mean 5.5, std 2.5). Factors associated with higher burnout: outpatient providers (compared to inpatient) (p = 0.0361), female gender (p = 0.0127), and those without a mentor (p = 0.0021). Multiple factors were identified that improved and detracted from well-being. Well-being was positively impacted by the shift to telework practices and increased autonomy in scheduling and focus on self-care. Well-being was reduced by a perceived disconnect from leadership, lack of control, and societal influences and expectations. Conclusion: This study provides insight into modifiable factors that affect well-being at an academic institution that can support interventions and systemic modifications to promote physician well-being

Non-genomic actions of aldosterone: From receptors and signals to membrane targets.

In tissues which express the mineralocorticoid receptor (MR), aldosterone modulates the expression of membrane targets such as the subunits of the epithelial Na(+) channel, in combination with important signalling intermediates such as serum and glucocorticoid-regulated kinase-1. In addition, the rapid \u27non-genomic\u27 activation of protein kinases and secondary messenger signalling cascades has also been detected in aldosterone-sensitive tissues of the nephron, distal colon and cardiovascular system. These rapid actions are variously described as being coupled to MR or to an as yet unidentified, membrane-associated aldosterone receptor. The rapidly activated signalling cascades add a level of fine-tuning to the activity of aldosterone-responsive membrane transporters and also modulate the aldosterone-induced changes in gene expression through receptor and transcription factor phosphorylation

Aldosterone as a renal growth factor

Aldosterone regulates blood pressure through its effects on the cardiovascular system and kidney. Aldosterone can also contribute to the development of hypertension that leads to chronic pathologies such as nephropathy and renal fibrosis. Aldosterone directly modulates renal cell proliferation and differentiation as part of normal kidney development. The stimulation of rapidly activated protein kinase cascades is one facet of how aldosterone regulates renal cell growth. These cascades may also contribute to myofibroblastic transformation and cell proliferation observed in pathological conditions of the kidney. Polycystic kidney disease is a genetic disorder that is accelerated by hypertension. EGFR-dependent proliferation of the renal epithelium is a factor in cyst development and trans-activation of EGFR is a key feature in initiating aldosterone-induced signalling cascades. Delineating the components of aldosterone-induced signalling cascades may identify novel therapeutic targets for proliferative diseases of the kidney