An unsafe environment: the reflection of a clinical manager

This reflection considers of the actions of the author, a junior ward sister working on a cardiology ward. The reflection is triggered by the unsafe environment found when arriving on the ward unexpectedly, and the report from a staff member. It explores the actions taken in relation to the staff involved, considers the implications of being an advocate for both patients and staff in practice, and focuses on creating an environment where staff feel they can speak out.     

Oncology nursing: professional development as a clinical specialty in Hong Kong

Cancer is a major health problem world-wide. Therefore, it is not surprising that cancer is identified as the top priority disease group for an improvement programme by the Hospital Authority in Hong Kong. Laser therapy for patients with nasopharyngeal carcinoma, for example, is evidence of the advancement of the scientific and technological developments for cancer treatment. Furthermore, the establishment of the Cancer Centre has provided ample opportunities for clinical practices and research studies. In response to the proclamation of the 'urgent need for the establishment of a cancer society in every country' by Searle in 1990, the Oncology Care Society of Hong Kong, which aims to promote both cancer education and cancer research, was established in 1993. Adopted from the core curriculum of the European Oncology Nursing Society, the specialist course of cancer nursing care was first implemented in Hong Kong in 1993 and the nurse specialist is now a permanent part of nursing career structure in Hong Kong. This paper attempts to review the development of oncology nursing in Hong Kong according to these factors and to find ways to improve the current situation.     

The effect of ocular dominance on the performance of professional baseball players

OBJECTIVE: The purpose of the study was to determine whether a performance difference exists between baseball players with "same" (right-right) and "crossed" (right-left) hand-ocular dominance. DESIGN: A cohort study design was used. PARTICIPANTS: Four hundred and ten major and minor league members of the Los Angeles Dodgers professional baseball team. INTERVENTION: Measurement of ocular dominance. MAIN OUTCOME MEASURES: Batting average and earned run average (ERA). RESULTS: Same/crossed dominance (with P values in parentheses) are as follows: Batting averages: major league-0.271/0.251 (0.20); minor league-0.274/0.270 (0.57); ERA: major league-3.34/3.56 (0.66); minor league-4.00/4.20 (0.54). CONCLUSIONS: Hand-ocular dominance patterns do not have an effect on batting average or ERA.     

Satisfaction and morale of foremen as a function of middle manager's performance.

Investigated the relationship between satisfaction and performance from the viewpoint of middle managers' performance and their subordinates' satisfaction, in 2 samples. Analysis of the 1st sample, with 111 department heads, revealed the existence of 2 satisfaction item referents, individual and group. Relating these 2 types of items to supervisor's performance revealed positive correlations with group items but little relation with items individualistic in reference. Results of the cross-validation sample with 72 Ss provide moderate support for the main results of the validation sample. Explanations and data which all seem to indicate that cohesiveness of work groups varied across samples are presented. Implications of results for the job satisfaction literature and industrial morale programs are discussed. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The private psychiatric hospital as a crucible for innovative models of professional practice.

Discusses the development of an interdisciplinary vehicle for the delivery of mental health services that is based in a private psychiatric hospital. It offers an example of ways psychologists can develop innovative service programs that (1) preserve a professional rather than give a labor identity for providers; (2) maintain high-quality services; (3) develop, implement, and evaluate innovative ideas; and (4) provide for financial security in a rapidly changing professional/economic climate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of clinical trials on hospital admission for stroke

OBJECTIVE: To analyze the contribution of clinical trials in the hospital treatment of acute ischaemic cerebrovascular disease. DEVELOPMENT: In recent studies many trials have been designed for the treatment of the acute phase of this illness. Based on experimental studies, the drugs used in the trial need to be given within a 'therapeutic window' of less than six hours from the onset of the illness. This time factor has led to a radical change in the organization of hospital services dealing with this illness. In order to run clinical trials the medical staff have had to be organized into functional stroke units for the swift protocolized diagnosis of the condition. Also information has to be given to health workers regarding the need for urgent specialized treatment. Several studies have shown that early, specialist treatment reduces morbi-mortality, time spent in hospital and financial cost in these patients. CONCLUSION: Clinical trials in acute cerebrovascular pathology have formed the basis for the creation of stroke units, led to the drawing up of protocols for the diagnosis and guidelines for treatment. It has also made the medical profession more aware of the importance of early diagnosis and specialized treatment in acute cerebral ischaemia.     

Perceived performance norm as a mediator in the effect of assigned goal on personal goal and task performance.

We conducted two experiments to test the hypothesis that assigned goals affect personal goals and task performance, in part, by providing normative information about the task. Normative information inferred from the goal was expected to influence performance expectancy and performance valence, which, in turn, would affect personal goal and, ultimately, performance. In Experiment 1, 60 undergraduate students were assigned performance goals of varying difficulty on a brainstorming task, and measures of perceived norm, performance expectancy, performance valence, personal goal, and task performance were obtained. Results of analyses of covariance and path analysis were generally consistent with the proposed cognitive mediation model. In Experiment 2, information about the performance norm was manipulated independently of goal difficulty for 135 undergraduates working on the same brainstorming task. Results of similar analyses revealed that (a) the effects of goal difficulty observed in Experiment 1 were attenuated by the presentation of normative information and (b) performance norm had significant effects on all of the dependent variables. The findings have implications for the integration of motivation theories and for the use of goal setting as a motivational technique. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cesarean section rates: effects of participation in a performance measurement project

BACKGROUND: According to previous studies, postdialysis urea rebound (PDUR) is achieved within 30-90 min, leading to an overestimation of Kt/V of between 15 and 40% in 3- to 5-hour dialysis. The purpose of the study was to assess the impact of PDUR on the urea reduction ratio (URR), Kt/V and normal protein catabolic rate (nPCR) with long 8-hour slow hemodialysis. METHODS: This study was performed in 18 patients (13 males/5 females), 62.5 +/- 11.7 years of age, hemodialyzed for 3-265 months. Initial nephropathies were: 3 diabetes; 2 polycystic kidney disease; 3 interstitial nephritis; 2 nephrosclerosis; 3 chronic glomerulonephritis, and 5 undetermined. Residual renal function was negligible. The dialysis sessions were performed using 1- to 1.8-m2 cellulosic dialyzers during 8 h, 3 times a week. Blood flow was 220 ml/min, dialysate flow 500 ml/min, acetate or bicarbonate buffer was used. Serial measurements of the urea concentration were obtained before dialysis, immediately after dialysis (low flow at t = 0), and at 5, 10, 20, 30, 40, 60, 90 and 120 min, and before the next session. The low-flow method was used to evaluate the access recirculation, second-generation Daugirdas formulas for Kt/V, and Watson formulas for total body water volume estimation. The difference between the expected urea generation (UG) and urea measured after dialysis (global PDUR) defines net PDUR (n-PDUR). RESULTS: The n-PDUR usually became stable after 58 +/- 25 (30-90) min. Its mean value was 17 +/- 10% of the 30-second low-flow postdialysis urea (3.9 +/- 2 mmol/l). This small postdialysis urea value and the importance of UG in comparison with shorter dialysis justify the use of n-PDUR. Ignoring n-PDUR would lead to a significant 4% overestimation (p < 0.001) of the URR (79 +/- 7 vs. 76 +/- 8%), 12% of Kt/V (1.9 +/- 0.4 to 1.7 +/- 0.38) and 4% of the nPCR (1.1 +/- 0.3 to 1.05 +/- 0.3). n-PDUR correlated negatively with postdialysis urea (r = 0.45 p = 0.05), positively with URR (r = 0.31 p = 0.01) and Kt/V (r = 0.3 p = 0.03) but not with K, and negatively with the urea distribution volume (r = 0.33 p = 0.05). Mean total recirculation, ultrafiltration rate, predialysis urea levels and urea clearance did not correlate with n-PDUR. CONCLUSION: We found a significant PDUR in long-slow hemodialysis after a mean of 1 h after dialysis. This PDUR has a less important impact upon dialysis delivery estimation than short 3- to 5-hour hemodialysis, especially for the lower Kt/V or URR ranges. This is explained by the low-flux, high-efficiency, and long-term dialysis. Its inter-individual variability incites us to calculate PDUR on an individual basis.     

Effect of a clinical case manager/clinical nurse specialist on patients hospitalized with congestive heart failure

The purpose of this study was to evaluate the effect of case management by a Clinical Case Manager/Clinical Nurse Specialist (CCM/CNS) on hospitalized length of stay and hospital charge throughout a 12-month period for patients with congestive heart failure. A total of 491 patients were discharged during 1997 with a diagnosis-related group code of 127. Of this number, 88 were case managed by a CCM/CNS. The remaining 403 received the usual management of their care. The group who were case managed by the CCM/CNS demonstrated significantly shorter length of stay (t = 5.40, P < 0.00) and lower hospital charges (t = 4.26, P < 0.00) than the patients with congestive heart failure who were not case managed. Secondary analysis indicated a significant interaction between case management and involvement of a cardiologist in the care of the patient. Patients whose care involved a cardiologist without case management by a CCM/CNS demonstrated significantly greater (alpha = 0.01) length of stay and hospital charges than patients who were case managed by a CCM/CNS or patients whose care did not involve a cardiologist.     

Conference on the professional preparation of clinical psychologists: A summary.

Presents a summary of the conference on the professional preparation of clinical psychologists. Without countenancing the lowering of standards as such, the conferees have sought for a responsible position in the face of the dilemma presented by the foregoing combination of circumstances. Brought together for the purpose were not only clinical psychologists and their colleagues in applied areas, but experimental and social psychologists as well, together with representatives of such other disciplines as psychiatry and social work, a group including both suppliers of clinical psychologists and consumers. Topics discussed at the conference include: professional preparation; clinical training; research training; curricula; alternative models of doctoral training; and so forth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does a structured free recall intervention reduce the effect of stereotypes on performance ratings and by what cognitive mechanism?

The purpose of this article was to extend previous work on the effect of racial biases on performance ratings. The 1st of 2 studies examined whether a structured free recall intervention decreased the influence of negative racial biases on the performance ratings of Black men. Results indicated that without the intervention, raters who endorsed a negative stereotype of Black men as managers evaluated Black men more negatively. However, the structured free recall intervention successfully reduced these effects. The second study examined in more detail the cognitive mechanisms underlying the success of the intervention. Results are consistent with the assumption that the reduction of the influence of racial biases under structured free recall conditions is a consequence of a modified strength threshold for retrieval of behaviors from memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conference on the professional preparation of clinical psychologists: Progress report II.

The conference will begin an August 27 and end September 1 in Chicago prior to the APA meetings. "It is expected that a total of approximately 80 participants and Os will attend. The major work of the conference will be carried out in 8 groups of about 10 persons each." The 80 participants and 8 recorders are listed; also listed are the "Psychology Groups" invited to send Os. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conference on the professional preparation of clinical psychologists: A progress report.

Preconference planning has been carried out by a Division 12 Conference Committee and its associates; the Committee is issuing a preconference report for wide distribution and discussion. The report "includes a statement on the nature of the profession, a historical survey and review of previous conferences on graduate education in psychology, and a section on manpower." The report includes 22 invited position papers reflecting different points of view in the general area of training as well as on specific issues. Titles of the papers are listed. The Executive Committee of Division 12 has made a final selection of 60 participants; observers will be limited to official representatives from organizations such as NIMH, the VA, the E&T Board, etc. "Much of the work of the Conference will be carried out in small discussion group meetings interspersed with plenary sessions. It will begin in the afternoon on August 26 or 27 and run for 5? consecutive days." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work attitudes and decisions as a function of manager age and employee age.

Research has shown the importance of employee age relative to coworker age in determining attitudes, performance, and career-related opportunities. The authors used chronological and subjective measures of employee and manager age to determine whether employee age relative to the manager has an impact on these same outcome variables. One hundred eighty-five managers and 290 employees completed surveys. The strongest and most consistent age effects were observed for interactions between employee and manager chronological age. Both the magnitude and pattern of the employee-manager age interactions varied by self- and manager-rated outcome measures of work attitudes, performance and promotability assessments, and developmental experiences. Results are discussed in light of the relational demography and career timetable literatures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Degradation of organics using LaFeO3 as a persulfate activator under low-intensity ultra-violet-light irradiation: Catalytic performance and mechanism

ABO₃-type perovskite oxides with abounding defect structures and diverse physical chemistry attributes have been extensively studied in heterogeneous catalysis. Semiconductor LaFeO₃ perovskites fabricated via the sol–gel method were used as peroxydisulfate (PDS) activators for methylene blue (MB) degradation under low-intensity ultra-violet (UV)-light to evaluate the degradation efficiency of organic pollutants and mechanism. The results indicate that under low-intensity UV irradiation, the developed UV/LaFeO₃/PDS system shows excellent degradation ability of organic pollutants in a wide pH range. Electron spin resonance and radical quenching experiments verify that SO₄^·?, ?OH, h⁺ and ¹O₂ are generated during the activation process, and ¹O₂ plays a dominant role in MB degradation. Reduction of low oxidation state Fe(II) and O₂^2?/O^? on the LaFeO₃ surface shows that oxygen vacancy, as the electron transfer mediator, enhances the redox cycle efficiency of Fe(II)/Fe(III). Photogenerated electrons of LaFeO₃ involved in the cyclic transformation of Fe(II)/Fe(III) and PDS activation further increase the number of active radicals and thus promote the synergistic effect of photocatalytic coupled with sulfate radical-based advanced oxidation processes.     

Store manager performance and satisfaction: Effects on store employee performance and satisfaction, store customer satisfaction, and store customer spending growth.

Based on emotional contagion theory and the value–profit chain literatures, the present study posits a number of hypotheses that show how managers in the small store, small number of employees retail context may affect store employees, customers, and potentially store performance. With data from 306 store managers, 1,615 store customer-contact employees, and 57,656 customers of a single retail chain, the authors examined relationships among store manager job satisfaction and job performance, store customer-contact employee job satisfaction and job performance, customer satisfaction with the retailer, and a customer-spending-based store performance metric (customer spending growth over a 2-year period). Via path analysis, several hypothesized direct and interaction relations among these constructs are supported. The results suggest implications for academic researchers and retail managers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of posttraining administration of insulin on retention of a habituation response in mice: participation of a central cholinergic mechanism

Male Swiss mice were allowed to explore a novel environment, provided by an open-field activity chamber for a 10-min period. The procedure was repeated twice within a 24-h interval. The difference in the exploratory activity between the first (training) and the second exposure (testing) to the chamber was taken as an index of retention of this habituation task. Posttraining intraperitoneal administration of insulin (8, 20, or 80 IU/kg) impaired retention in a dose-related manner, although only the dose of 20 IU/kg of insulin produced significant effects. Thus, the dose-response curve adopted a U-shaped form. Insulin (20 IU/kg) given to untrained mice did not modify their exploratory performance when recorded 24 h later. The effects of insulin on retention were time dependent, suggesting an action on memory storage. An ineffective dose (8 IU/kg) of insulin given together with an ineffective dose of a central acting muscarinic cholinergic antagonist atropine (0.5 mg/kg) or with a central acting nicotinic cholinergic antagonist mecamylamine (5 mg/kg) interacted to impair retention. In contrast, neither methylatropine (0.5 mg/kg), a peripherally acting muscarinic receptor blocker, nor hexamethonium (5 mg/kg), a peripherally acting nicotinic receptor blocker, interacted with the subeffective dose of insulin on retention. The impairing effects of insulin (20 IU/kg) on retention were reversed by the simultaneous administration of physostigmine (70 microg/kg) but not neostigmine (70 microg/kg). We suggest that insulin impairs memory storage of one form of learning elicited by stimuli repeatedly presented without reinforcement, probably through a decrement of brain acetylcholine synthesis.     

The effect of WIC participation on small-for-gestational-age births: Michigan, 1992

Portal thrombectomy with extended hepatectomy for extensively progressive primary liver cancer (Vp 3), in which the tumor thrombus has spread beyond the first portal branches, will make other non-surgical treatments possible and improve patients quality of life. We have performed extensive resections in 15 cases of such Vp 3 liver cancer. One patient with huge HCC involving retrohepatic IVC underwent in situ extended left hepatectomy without reconstruction of IVC, resulting in postoperative renal failure because of thrombosis in the bilateral renal veins, but 14 other patients' postoperative courses were uneventful. Ten of 14 patients relapsed within one year, but these patients underwent non-surgical treatments, resulting in improvement in the quality of life. The 1-, and 3-year survival rates were 55.6% and 32.5%, respectively.