45 research outputs found

    Demeanor Credibility

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    Say What You Mean to Say: Unpacking the Complexities of Communication Between Patients and Their Providers

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    DISCIPLINARY PROCEEDINGS AGAINST FEDERAL ADMINISTRATIVE LAW JUDGES

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    The ecological effects of bioturbation on the eelgras Zostera capensis : community interactions and the impacts on the biota of an intertidal sandflat

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    Bibliography: leaves 126-134.Thalassinidean prawns in the genus Callianassa have been singled out as important bioturbators because of their size and activity, and because they often occur at high densities and burrow deep into the sediments. The ecological effects of bioturbation by Callianassa kraussi on the eelgrass Zostera capensis, and its indirect effects on the sedentary mudprawn Upogebia africana and the biota of an intertidal sandflat were assessed at Langebaan Lagoon, South Africa, through comparative surveys, observations and field experiments. I hypothesised that C. kraussi and Z. capensis have mutually detrimental effects on each other, with bioturbation by C. kraussi leading to smothering of Z. capensis, and stabilising of sediments by Z. capensis impeding burrowing of C. kraussi. I also hypothesised that C. kraussi would be negatively correlated with U. africana because the latter relies on semi-permanent U-tubes to filter-feed, and bioturbation is likely to disrupt these

    The Feasibility of a Primary Care Based Navigation Service to Support Access to Health and Social Resources: The Access to Resources in the Community (ARC) Model

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    Introduction: We established a patient centric navigation model embedded in primary care (PC) to support access to the broad range of health and social resources; the Access to Resources in the Community (ARC) model. Methods: We evaluated the feasibility of ARC using the rapid cycle evaluations of the intervention processes, patient and PC provider surveys, and navigator log data. PC providers enrolled were asked to refer patients in whom they identified a health and/or social need to the ARC navigator. Results: Participants: 26 family physicians in four practices, and 82 of the 131 patients they referred. ARC was easily integrated in PC practices and was especially valued in the non-interprofessional practices. Patient overall satisfaction was very high (89%). Sixty patients completed the post-intervention surveys, and 33 reported accessing one or more service(s). Conclusion: The ARC Model is an innovative approach to reach and support a broad range of patients access needed resources. The Model is feasible and acceptable to PC providers and patients, and has demonstrated potential for improving patients’ access to health and social resources. This study has informed a pragmatic randomized controlled trial to evaluate the ARC navigation to an existing web and telephone navigation service (Ontario 211)

    Need for recovery amongst emergency physicians in the UK and Ireland: A cross-sectional survey

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    OBJECTIVES: To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores. DESIGN: Cross-sectional electronic survey. SETTING: Emergency departments (EDs) (n=112) in the UK and Ireland. PARTICIPANTS: Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019. MAIN OUTCOME MEASURE: NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery. RESULTS: The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5-90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%-50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%-75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%-100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9). CONCLUSION: Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible
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