Professional Work in Health Care Organizations: The Structural Influences of Patients in French, Canadian and American Hospitals

Although there are several studies of the impact of employment of health professionals in large bureaucratic organizations, there has been significantly less research focused on the structural influence of patients on this relationship. In this paper we present comparative qualitative data gathered on the work experiences of health care professionals in Canadian, U.S. and French hospitals. We elaborate specifically on a typology of structural influence of clients on health care professionals work in hospitals in terms of open and closed units.health professions, health care organizations, patients, hospitals, physicians, nurses, comparative perspectives

U.S. and Canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review

BACKGROUND: Although dietary supplements (DS) are widely sold in pharmacies, the legal, ethical, and practice responsibilities of pharmacists with respect to these products have not been well defined. This systematic review of pharmacists' attitudes, knowledge, and professional practice behaviours toward DS is intended to inform pharmacy regulators' and educators' decision making around this topic. METHODS: Eligible studies were identified through a systematic database search for all available years through to March 2006. Articles were analyzed for this review if they included survey data on U.S. or Canadian pharmacists' attitudes, knowledge, or professional practice behaviors toward DS published in 1990 or later. RESULTS: Due to the heterogeneity of the data, it was not possible to draw a conclusion with respect to pharmacists' general attitudes toward DS. Approximately equal numbers of pharmacists report positive as well as negative attitudes about the safety and efficacy of DS. There is strong agreement among pharmacists for the need to have additional training on DS, increased regulation of DS, and quality information on DS. In addition, survey data indicate that pharmacists do not perceive their knowledge of DS to be adequate and that pharmacists do not routinely document, monitor, or inquire about patients' use of DS. Despite this, a large proportion of pharmacists reported receiving questions about DS from patients and other health care practitioners. CONCLUSION: Further research is needed to explore the factors that influence pharmacists' beliefs and attitudes about DS, to accurately evaluate pharmacists' knowledge of DS, and to uncover the reasons why pharmacists do not routinely document, monitor, or inquire about patients' use of DS

Dynamic Model of a Piano Action Mechanism

While some attempts have been made to model the behaviour of the grand piano action (the mechanism that translates a key press into a hammer striking a string), most researchers have reduced the system to a simple model with little relation to the components of a real action. While such models are useful for certain applications, they are not appropriate as design tools for piano makers, since the model parameters have little physical meaning and must be calibrated from the behaviour of a real action. A new model for a piano action is proposed in this thesis. The model treats each of the five main action components (key, whippen, jack, repetition lever, and hammer) as a rigid body. The action model also incorporates a contact model to determine the normal and friction forces at 13 locations between each of the contacting bodies. All parameters in the model are directly measured from the physical properties of individual action components, allowing the model to be used as a prototyping tool for actions that have not yet been built. To test whether the model can accurately predict the behaviour of a piano action, an experimental apparatus was built. Based around a keyboard from a Boston grand piano, the apparatus uses an electric motor to actuate the key, a load cell to measure applied force, and optical encoders and a high speed video camera to measure the positions of the bodies. The apparatus was found to produce highly repeatable, reliable measurements of the action. The behaviour of the action model was compared to the measurements from the experimental apparatus for several types of key blows from a pianist. A qualitative comparison showed that the model could very accurately reproduce the behaviour of a real action for high force blows. When the forces were lower, the behaviour of the action model was still reasonable, but some discrepancy from the experimental results could be seen. In order to reduce the discrepancy, it was recommended that certain improvements could be made to the action model. Rigid bodies, most importantly the key and hammer, should be replaced with flexible bodies. The normal contact model should be modified to account for the speed-independent behaviour of felt compression. Felt bushings that are modelled as perfect revolute joints should instead be modelled as flexible contact surfaces

What Is It All For? : The Intentions and Priorities for Study Abroad in Canadian Teacher Education

Within the research literature and in public discourse on higher education, attention has focused on the need for new graduates to develop 21st century skills for success in an increasingly globalized world. Calls for institutions of higher education to support student mobility abound, with intentions that some have categorized as neoliberal and others ascribe to notions of global citizenship. In this paper, we bring together literature from the fields of internationalization, teacher education, and study abroad to provide a conceptual framing and response to an inquiry into the following research question: In what ways does a study abroad experience support the development of preservice teachers? Through a multi-phase, multiple-perspective case study approach, we draw on qualitative interview data to illuminate how faculties of education and their students conceptualize the role of study abroad in the development of preservice teachers. The intentions for these programs cluster under four themes: global citizenship, personal growth, professional development, and employability. The concept of structured encounters with difference emerges out of these themes as a conceptual frame for future study abroad initiatives

Load assessment and analysis of impacts in multibody systems

The evaluation of contact forces during an impact requires the use of continuous force-based methods. An accurate prediction of the impact force demands the identification of the contact parameters on a case-by-case basis. In this paper, the preimpact effective kinetic energy (Formula presented.) is put forward as an indicator of the intensity of the impact force along the contact normal direction. This represents a part of the total kinetic energy of the system that is associated with the subspace of constrained motion defined by the impact constraints at the moment of contact onset. Its value depends only on the mechanical parameters and the configuration of the system. We illustrate in this paper that this indicator can be used to characterize the impact force intensity. The suitability of this indicator is confirmed by numerical simulations and experimentsPostprint (author's final draft

Implementing health research through academic and clinical partnerships : a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

Background: The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural ‘test bed’ for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances. Design and methods: This study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide indepth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum. Discussion: The idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement

Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice

BACKGROUND: Complementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products. METHODS: Pharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated. RESULTS: 1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age. Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs. CONCLUSIONS: CMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products

A BRiTE Journey: 2013–2019

Resilience is widely acknowledged as important for teacher success, yet how to assist pre-service teachers build the skills and strategies for professional resilience is a question often asked by teacher educators. This chapter overviews the design, development and features of a series of five online learning modules designed to support pre-service teacher resilience. The BRiTE modules were informed by an analysis of the literature and content created to address the key themes. Five modules were developed: Building resilience, Relationships, Wellbeing, Taking initiative and Emotions. Each module was designed to be interactive and personalised, enabling users to build their personal toolkit to support their resilience. Since their launch in 2015, the modules have been widely used by pre-service teachers, teachers and a range of stakeholders with over 14,000 registered users at the beginning of 2020. Potential for future use in supporting teacher resilience is discussed

Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

<p>Abstract</p> <p>Background</p> <p>Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals.</p> <p>Method</p> <p>A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included.</p> <p>Result</p> <p>A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare.</p> <p>Conclusion</p> <p>There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field.</p