Work in Progress: What is "Enough"?

This poster presents dissertation work in progress on the question of ???enough.??? The research focus is the assessment of ???enough??? information to make a decision, in particular a medical decision determining the diagnosis of a patient. ???Enough??? is considered ???enough??? information to facilitate making a decision or taking an action. Qualities of qualities of ???enough??? are identified and described by analyzing case reports published in the New England Journal of Medicine. Findings are reported, and contribute to the development of a conceptual model of factors contributing to ???enough.??

An Educational Intervention to Promote a Shift in Attitude in Using Dexmedetomidine to Prevent Pediatric Emergence Delirium

Background: Emergence delirium (ED) is a common occurrence following anesthesia, especially after the use of inhaled anesthetics such as sevoflurane, desflurane, and isoflurane in children. ED is characterized by a state of mental confusion, agitation, and restlessness frequently observed in preschool age children. Its incidence ranges from 10-80%. Its etiology, associated risks, prevention, and management are still unclear. Despite the transient nature of this syndrome, it may produce psychological distress in the child, the parents, and the caregivers. Objective: The aim of the study is to promote a shift in the attitude and perception in anesthesia providers to encourage the use of dexmedetomidine to prevent the occurrence of emergence delirium. Methods: A literature review was conducted, multiple studies related to the use of dexmedetomidine in comparison to other pharmacological adjuvants previously used in preventing the occurrence of emergence delirium were analyzed. Additional studies were also found to support the use of an educational intervention to promote a change in attitude and perceptions of healthcare professionals towards new practices. A pretest survey assessed the providers’ initial knowledge, attitudes regarding dexmedetomidine. This step was followed by a PowerPoint presentation and a post-test survey. Results: The delivery of the educational presentation has proven to be effective as demonstrated by the pre and post test results. The QI project demonstrated an increase in the knowledge of dexmedetomidine in the treatment of emergence delirium, and a change in attitude and perception towards the implementation of dexmedetomidine in the providers anesthesia regimen. Conclusion: Dexmedetomidine shows promising results in preventing emergence delirium when compared to other agents previously used to treat ED. Further studies regarding right dosage and timing of administration to prevent emergence delay are needed

Can Self-Regulation Work? Lessons from the Private Security and Military Industry

The private security and military industry has undergone a dramatic shift over the past decade—from an under-regulated sphere of activity to one in which an array of self-regulatory schemes has emerged. These regulatory initiatives took shape as states, security companies, and the broader public recognized the need to clarify the legal framework applicable to private security and military companies. Private contractors, once regarded as mercenaries, have over the past two decades played an increasingly central role in support of modern militaries. Reasons for this phenomenon range from budgetary policy to the need for specialized expertise most readily available in the private sector. Given the prominence of private contractors on the modern battlefield, a consensus has formed around the need to establish standards to govern the conduct of this increasingly prominent category of non-state actor. The industry’s expanding scope of activity and client base — composed of not only states, but also international organizations, non-governmental organizations, and multinational corporations operating in volatile environments — has made regulation an even stronger priority. In just a few years, working jointly with states and civil society, the private security and military industry has developed a sophisticated self-regulatory framework applicable to its activities

The Connection Between Wellness Programs and Employee Job Satisfaction in Higher Education

Job dissatisfaction is becoming a fundamental concern for employers. Employee engagement makes an organization more productive and can reduce absenteeism. The purpose of this quantitative study was to examine the relationship between employer-sponsored wellness-program participation and job satisfaction among for-profit college and university leaders. Data collection involved an online survey of 400 faculty members\u27 from for-profit universities in the United States contacted using the Job Satisfaction Survey; 103 participants completed the survey. The theoretical framework was the need-satisfaction theory, which includes the factors that promote job satisfaction and job dissatisfaction. The results came from a multiple regression analysis that indicated a significant negative relationship between job satisfaction and participation in the employer-sponsored wellness program (β = -.22, t = -2.24, p = .027), where faculty who were not participating in the wellness program had higher levels of job satisfaction (M = 3.62) in comparison to those who did participate (M = 3.80). Interaction analyses indicated a relationship between gender and job satisfaction (β = -.26, t = -2.70, p = .008). Females were more likely than were males to have higher levels of job satisfaction, as well as years of experience and job satisfaction. Faculty who had been employed for between 11 and 15 years were more likely to have higher levels of job satisfaction. Job satisfaction appear lower for those who participate in employer-sponsored wellness programs because of the personal gratification employees\u27 experience. The findings may contribute to social change with information that leaders could use to reduce absenteeism, increase productivity, and profitability