The experiences and perspectives of overseas trained speech and language therapists working in the United Kingdom

There is a growing body of research which has investigated the experience of the migrant health worker. However, only one of these studies has included speech and language therapists thus far, and then only with extremely small numbers. The aim of this study was to explore the experiences and perspectives of migrant speech and language therapists living in the UK. Twenty-three overseas qualified speech and language therapists living in the UK completed an online survey consisting of 36 questions (31 closed question, 5 open-ended questions). The majority of participants came from Australia or the USA and moved to the UK early in their careers. Participants reported a range of benefits from working in another country and more specifically working in the UK. The findings were consistent with other research on migrant health workers regarding known pull factors of travel, finance, and career. This study suggests additional advantages to working in the UK were realised once participants had started working in the UK, such as the UK job lifestyle. Finally, the migrant speech and language therapists were similar in profile to other migrant health workers in terms of age and country of origin previously reported in the literature

Productivity, Quality, and Cost Relationships in a Healthcare Foodservice System

A pilot study was conducted in a 165-bed combination hospital-nursing home with a conventional food production system to develop a system to measure productivity, quality, and cost of meals and service and to determine the relationship among those variables. Measurement of these variables was made from December, 1988 to September, 1989. Historical productivity and cost data were obtained from departmental records for the time period from January, 1986 through November, 1988. The mean productivity was 14.4 ± 1.5 labor minutes paid per meal equivalent. The mean total cost per meal was $1.59 ± .23. The mean overall percent quality index was 88 ± 5. Major quality problems related to temperature control of food at point of service and delivery and cleanliness and orderliness of equipment and work areas. Simple linear regression analysis showed no significant relationship between Quality Index and Productivity Indexes, between Productivity Indexes and Cost per meal Index, and between Quality Index and Cost per meal Index. Multiple linear regression showed that Productivity Index and Quality Index do not predict Cost per meal Index. This provides a comprehensive system that could be used by other dietitians to set standards for productivity, cost, and quality variables and to monitor performance related to these variables in their operations

What difference does ("good") HRM make?

The importance of human resources management (HRM) to the success or failure of health system performance has, until recently, been generally overlooked. In recent years it has been increasingly recognised that getting HR policy and management "right" has to be at the core of any sustainable solution to health system performance. In comparison to the evidence base on health care reform-related issues of health system finance and appropriate purchaser/provider incentive structures, there is very limited information on the HRM dimension or its impact. Despite the limited, but growing, evidence base on the impact of HRM on organisational performance in other sectors, there have been relatively few attempts to assess the implications of this evidence for the health sector. This paper examines this broader evidence base on HRM in other sectors and examines some of the underlying issues related to "good" HRM in the health sector. The paper considers how human resource management (HRM) has been defined and evaluated in other sectors. Essentially there are two sub-themes: how have HRM interventions been defined? and how have the effects of these interventions been measured in order to identify which interventions are most effective? In other words, what is "good" HRM? The paper argues that it is not only the organisational context that differentiates the health sector from many other sectors, in terms of HRM. Many of the measures of organisational performance are also unique. "Performance" in the health sector can be fully assessed only by means of indicators that are sector-specific. These can focus on measures of clinical activity or workload (e.g. staff per occupied bed, or patient acuity measures), on measures of output (e.g. number of patients treated) or, less frequently, on measures of outcome (e.g. mortality rates or rate of post-surgery complications). The paper also stresses the need for a "fit" between the HRM approach and the organisational characteristics, context and priorities, and for recognition that so-called "bundles" of linked and coordinated HRM interventions will be more likely to achieve sustained improvements in organisational performance than single or uncoordinated interventions

Nitro-fatty acid formation and metabolism

Nitro-fatty acids (NO 2 -FA) are pleiotropic modulators of redox signaling pathways. Their effects on inflammatory signaling have been studied in great detail in cell, animal and clinical models primarily using exogenously administered nitro-oleic acid. While we know a considerable amount regarding NO 2 -FA signaling, endogenous formation and metabolism is relatively unexplored. This review will cover what is currently known regarding the proposed mechanisms of NO 2 -FA formation, dietary modulation of endogenous NO 2 -FA levels, pathways of NO 2 -FA metabolism and the detection of NO 2 -FA and corresponding metabolites.Fil: Buchan, Gregory J.. University of Pittsburgh; Estados UnidosFil: Bonacci, Gustavo Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Fazzari, Marco. University of Pittsburgh; Estados Unidos. Fondazione Ri.Med; ItaliaFil: Salvatore, Sonia Rosana. University of Pittsburgh; Estados UnidosFil: Gelhaus Wendell, Stacy. University of Pittsburgh; Estados Unido

Understanding Class-level Testability Through Dynamic Analysis

It is generally acknowledged that software testing is both challenging and time-consuming. Understanding the factors that may positively or negatively affect testing effort will point to possibilities for reducing this effort. Consequently there is a significant body of research that has investigated relationships between static code properties and testability. The work reported in this paper complements this body of research by providing an empirical evaluation of the degree of association between runtime properties and class-level testability in object-oriented (OO) systems. The motivation for the use of dynamic code properties comes from the success of such metrics in providing a more complete insight into the multiple dimensions of software quality. In particular, we investigate the potential relationships between the runtime characteristics of production code, represented by Dynamic Coupling and Key Classes, and internal class-level testability. Testability of a class is consider ed here at the level of unit tests and two different measures are used to characterise those unit tests. The selected measures relate to test scope and structure: one is intended to measure the unit test size, represented by test lines of code, and the other is designed to reflect the intended design, represented by the number of test cases. In this research we found that Dynamic Coupling and Key Classes have significant correlations with class-level testability measures. We therefore suggest that these properties could be used as indicators of class-level testability. These results enhance our current knowledge and should help researchers in the area to build on previous results regarding factors believed to be related to testability and testing. Our results should also benefit practitioners in future class testability planning and maintenance activities

Tracking the leavers: Towards a better understanding of doctor migration from Ireland to Australia 2008-2018

© 2019 The Author(s). Background: The recession of 2008 triggered large-scale emigration from Ireland. Australia emerged as a popular destination for Irish emigrants and for Irish-trained doctors. This paper illustrates the impact that such an external shock can have on the medical workforce and demonstrates how cross-national data sharing can assist the source country to better understand doctor emigration trends. Method: This study draws on Australian immigration, registration and census data to highlight doctor migration flows from Ireland to Australia, 2008-2018. Findings: General population migration from Ireland to Australia increased following the 2008 recession, peaked between 2011 and 2013 before returning to pre-2008 levels by 2014, in line with the general economic recovery in Ireland. Doctor emigration from Ireland to Australia did not follow the same pattern, but rather increased in 2008 and increased year on year since 2014. In 2018, 326 Irish doctors obtained working visas for Australia. That doctor migration is out of sync with general economic conditions in Ireland and with wider migration patterns indicates that it is influenced by factors other than evolving economic conditions in Ireland, perhaps factors relating to the health system. Discussion: Doctor emigration from Ireland to Australia has not decreased in line with improved economic conditions in Ireland, indicating that other factors are driving and sustaining doctor emigration. This paper considers some of these factors. Largescale doctor emigration has significant implications for the Irish health system; representing a brain drain of talent, generating a need for replacement migration and a high dependence on internationally trained doctors. This paper illustrates how source countries, such as Ireland, can use destination country data to inform an evidence-based policy response to doctor emigration

Nurses in expanded roles to strengthen community-based health promotion and chronic care: Policy implications from an international perspective; A commentary

© 2018 The Author(s). Chronic conditions and health inequalities are increasing worldwide. Against this backdrop, several countries, including Israel, have expanded the roles of nurses as one measure to strengthen the primary care workforce. In Israel, community nurses work in expanded roles with increased responsibilities for patients with chronic conditions. They also work increasingly in the field of health promotion and disease prevention. Common barriers to role change in Israel are mirrored by other countries. Barriers include legal and financial restrictions, resistance by professional associations, inflexible labor markets and lack of resources. Policies should be revisited and aligned across education, financing and labor markets, to enable nurses to practice in the expanded roles. Financial incentives can accelerate the uptake of new, expanded roles so that all patients including vulnerable population groups, benefit from equitable and patient-centered service delivery in the communities