Health risk perception of Karoo residents related to fracking, South Africa

Shale gas exploration by means of Hydraulic Fracturing (fracking) has been on the South African (SA) energy agenda since 2010 as a potential alternative energy source to coalmining. Internationally, the desirability of fracking is debated due to increasing evidence of the environmental and health risks fracking poses. However, experts favouring fracking propose this technology as a greener alternative to conventional energy sources such as coal. Limited scientific evidence is available internationally related to knowledge and risk perceptions of fracking and evidence is limited to studies conducted in the United States (US). South African risk perception studies relates to mining, farming, travelling in SA as a foreigner and sexual behaviour. The president of SA called fracking a 'Game-Changer' using industry jargon in the 2014 presidential address. However, SA has failed to produce exploration regulations to date despite oil and gas companies pushing their agendas. Public participation in the process thus far has been limited. This cross sectional study explored the knowledge, health risk perceptions and information sources related to fracking amongst 102 Central Karoo residents through a household survey. Beaufort West municipality was selected as the study site as this is one of the closestareas to Cape Town demarcated for fracking exploration. This study found that 40% of Central Karoo residents do not know what fracking is or the potential risks and benefits thereof. Media is the main information source of 59% of participants. Only half of participants trust their information sources. Those with more trust in their information sources perceived fracking as posing a greater risk. In contrast those believing fracking to pose a low risk were more likely to trust the government and oil and gas companies. More than half of participants (53%) believe that fracking poses an extreme health risk and 78% thought fracking will harm their health. Most commonly listed causes why fracking will make Karoo residents sick includes water pollution (47.4%) and air pollution (19.6%). Higher education was found to have an inverse relationship with trust in the national government A limitation of this study was that farms could not be randomly selected, affecting the representativeness of the sample. There is a major lack of knowledge pertaining to fracking among those living in the Central Karoo which has important implications for managing the process of public participation in the approval of shale gas exploration

Drawing on the knowledge of returned expatriates for organizational learning: Case studies in German multinational companies

In order to explore the potential contributions that returned expatriates can make towards helping their organizations to better understand and manage culturally diverse and changing conditions, a pilot study was conducted in two German-based companies with a long tradition of international operations. The interviews generated insights not only into the four categories of knowledge used in the organizational learning literature (declarative, procedural, conditional, and axiomatic) but also into a fifth (relational). The analysis indicates that a large gap remains between individual and organizational learning. The barriers encountered by the expatriates in transforming their knowledge into an organizational property lie more in the absence of supportive factors and conditions than in the actual presence of impediments. The authors suggest that many of the problems encountered by returned expatriates are not limited to this specific subgroup but rather serve to highlight those experienced by other employees who seek to introduce new ideas and practices into an organization. The study therefore concludes not only with recommendations for improving expatriation processes, but also with suggestions for identifying the learning needs of an organization and for creating a supportive framework for organizational learning from all employees. -- International tätige Unternehmen investieren viel in die Entsendung von Führungskräften ins Ausland. Was und wie können Unternehmen von diesen Führungskräften nach ihrer Rückkehr lernen? Um dieser Frage nachzugehen, wurde eine Pilotstudie in zwei deutschen Unternehmen durchgeführt, die beide seit vielen Jahren international tätig sind. Die Interviews mit zurückgekehrten Expatriates und mit Personalmanagern dokumentieren eine Vielfalt von Wissen. Sie zeigen aber auch, daß die vier in der Literatur zu Organisationslernen zentralen Kategorien von Wissen (declarative, procedural, conditional und axiomatic) in der Literatur zum Organisationslernen nicht ausreichen, um diese Vielfalt zu erfassen. Eine fünfte Kategorie muß ergänzend hinzugefügt werden: relational knowledge. Die Untersuchung zeigt, daß zwischen dem vielfältigen individuellen Wissen und dem Wissen der Organisation eine große Lücke bleibt. Bei der Transformation ihres Individualwissens in organisatorisches Eigentum erleben die Expatriates wenig Unterstützung. Viele der von den Expatriates angesprochenen Probleme bei der Umsetzung von Wissen können als organisationstypisch angesehen werden. Die Autoren erarbeiten daher nicht nur Empfehlungen für eine auf Organisationslernen besser abgestimmte Gestaltung der Entsendungspolitik, sondern auch Vorschläge für die Feststellung der Lernbedürfnisse der jeweiligen Organisation sowie für die Schaffung eines lernfreundlichen Rahmens.

Drawing on the knowledge of returned expatriates for organizational learning: case studies in German multinational companies

"In order to explore the potential contributions that returned expatriates can make towards helping their organizations to better understand and manage culturally diverse and changing conditions, a pilot study was conducted in two German-based companies with a long tradition of international operations. The interviews generated insights not only into the four categories of knowledge used in the organizational learning literature (declarative, procedural, conditional, and axiomatic) but also into a fifth (relational). The analysis indicates that a large gap remains between individual and organizational learning. The barriers encountered by the expatriates in transforming their knowledge into an organizational property lie more in the absence of supportive factors and conditions than in the actual presence of impediments. The authors suggest that many of the problems encountered by returned expatriates are not limited to this specific subgroup but rather serve to highlight those experienced by other employees who seek to introduce new ideas and practices into an organization. The study therefore concludes not only with recommendations for improving expatriation processes, but also with suggestions for identifying the learning needs of an organization and for creating a supportive framework for organizational learning from all employees." (author's abstract)"International tätige Unternehmen investieren viel in die Entsendung von Führungskräften ins Ausland. Was und wie können Unternehmen von diesen Führungskräften nach ihrer Rückkehr lernen? Um dieser Frage nachzugehen, wurde eine Pilotstudie in zwei deutschen Unternehmen durchgeführt, die beide seit vielen Jahren international tätig sind. Die Interviews mit zurückgekehrten Expatriates und mit Personalmanagern dokumentieren eine Vielfalt von Wissen. Sie zeigen aber auch, daß die vier in der Literatur zu Organisationslernen zentralen Kategorien von Wissen (declarative, procedural, conditional und axiomatic) in der Literatur zum Organisationslernen nicht ausreichen, um diese Vielfalt zu erfassen. Eine fünfte Kategorie muß ergänzend hinzugefügt werden: relational knowledge. Die Untersuchung zeigt, daß zwischen dem vielfältigen individuellen Wissen und dem Wissen der Organisation eine große Lücke bleibt. Bei der Transformation ihres Individualwissens in organisatorisches Eigentum erleben die Expatriates wenig Unterstützung. Viele der von den Expatriates angesprochenen Probleme bei der Umsetzung von Wissen können als organisationstypisch angesehen werden. Die Autoren erarbeiten daher nicht nur Empfehlungen für eine auf Organisationslernen besser abgestimme Gestaltung der Entsendungspolitik, sondern auch Vorschläge für die Feststellung der Lernbedürfnisse der jeweiligen Organisation sowie für die Schaffung eines lernfreundlichen Rahmens." (Autorenreferat

Use of freeze-cracking in ontogenetic research in Macrostomum lignano (Macrostomida, Rhabditophora)

A method for studying whole mount flatworm embryos based on freeze-cracking of the eggs is described. This method allows successful immunohistological and immunocytological studies of whole mount embryos. It does not require the use of sharpened needles or a microinjection system to puncture the eggshell. Moreover, this method is more practical and less time-consuming than classical puncturing and much cheaper than the use of a microinjection system. The advantages of this method are illustrated by results of several immunolocalisation experiments in the macrostomid flatworm Macrostomum lignano. The optimal procedure and crucial steps for this method are discussed

Unique health care utilization patterns in a homeless population in Ghent

Background: Existing studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary care by homeless people compared to the general population. Homeless people are importantly hindered and/or steered in their health care use by barriers directly related to the organisation of care. Our goal is to describe the accessibility of primary health care services, secondary care and emergency care for homeless people living in an area with a universal primary health care system and active guidance towards this unique system. Methods: Observational, cross-sectional study design. Data from the Belgian National health survey were merged with comparable data collected by means of a face-to-face interview from homeless people in Ghent. 122 homeless people who made use of homeless centres and shelters in Ghent were interviewed using a reduced version of the Belgian National Health survey over a period of 5 months. 2-dimensional crosstabs were built in order to study the bivariate relationship between health care use (primary health care, secondary and emergency care) and being homeless. To determine the independent association, a logistic model was constructed adjusting for age and sex. Results and Discussion: Homeless people have a higher likelihood to consult a GP than the non-homeless people in Ghent, even after adjusting for age and sex. The same trend is demonstrated for secondary and emergency care. Conclusions: Homeless people in Ghent do find the way to primary health care and make use of it. It seems that the universal primary health care system in Ghent with an active guidance by social workers contributes to easier GP access

A qualitative interpretation of challenges associated with helping patients with multiple chronic diseases identify their goals

Background Patients with multiple chronic diseases are usually treated according to disease-specific guidelines, with outcome measurements focusing mostly on biomedical indicators (e.g. blood sugar levels or lung function). However, for multimorbidity, a goal-oriented approach focusing on the goals defined by the individual patient, may be more suitable. Despite the clear theoretical and conceptual advantages of including patient-defined goals in clinical decision-making for multimorbidity, it is not clear how patients define their goals and which aspects play a role in the process of defining them. Objective To explore goal-setting in patients with multimorbidity. Design Qualitative analysis of interviews with 19 patients diagnosed with chronic obstructive pulmonary disease and comorbidities. Results Patients do not naturally present their goals. Their goals are difficult to elicit, even when different interviewing techniques are used. Four underlying hypotheses which may explain this finding were identified from the interviews: (1) patients cannot identify with the concept of goal-setting; (2) goal-setting is reduced due to acceptation; (3) actual stressors predominate over personal goal-setting; and (4) patients may consider personal goals as selfish. Conclusions Our findings advocate for specific attention to provider skills and strategies that help patients identify their personal goals. The hypotheses on why patients may struggle with defining goals may be useful to prompt patients in this process and support the development of a clinical method for goal-oriented care

Erratum:The behavioral and psychological symptoms of dementia in down syndrome scale (BPSD-DS II): Optimization and further validation

BACKGROUND: People with Down syndrome (DS) are at high risk to develop Alzheimer's disease dementia (AD). Behavioral and psychological symptoms of dementia (BPSD) are common and may also serve as early signals for dementia. However, comprehensive evaluation scales for BPSD, adapted to DS, are lacking. Therefore, we previously developed the BPSD-DS scale to identify behavioral changes between the last six months and pre-existing life-long characteristic behavior. OBJECTIVE: To optimize and further study the scale (discriminative ability and reliability) in a large representative DS study population. METHODS: Optimization was based on item irrelevance and clinical experiences obtained in the initial study. Using the shortened and refined BPSD-DS II, informant interviews were conducted to evaluate 524 DS individuals, grouped according to dementia status: no dementia (DS, N = 292), questionable dementia (DS + Q, N = 119), and clinically diagnosed dementia (DS + AD, N = 113). RESULTS: Comparing item change scores between groups revealed prominent changes in frequency and severity for anxious, sleep-related, irritable, restless/stereotypic, apathetic, depressive, and eating/drinking behavior. For most items, the proportion of individuals displaying an increased frequency was highest in DS + AD, intermediate in DS + Q, and lowest in DS. For various items within sections about anxious, sleep-related, irritable, apathetic, and depressive behaviors, the proportion of individuals showing an increased frequency was already substantial in DS + Q, suggesting that these changes may serve as early signals of AD in DS. Reliability data were promising. CONCLUSION: The optimized scale yields largely similar results as obtained with the initial version. Systematically evaluating BPSD in DS may increase understanding of changes among caregivers and (timely) adaptation of care/treatment