scholarly journals “Multimorbidity Plus”: a secondary analysis exploring GP work in areas of high socioeconomic deprivation

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0117
Author(s):  
Marianne McCallum ◽  
Sara MacDonald
Keyword(s):  
Social Complexity ◽  
Personal Values ◽  
Management Strategies ◽  
Secondary Analysis ◽  
Socioeconomic Deprivation ◽  
Everyday Work ◽  
Emotional Work ◽  
Different Types ◽  
Illness Model ◽  
Depth Interviews

BackgroundThere is a GP workforce crisis, particularly in areas of high socioeconomic deprivation where multimorbidity, and social complexity, is higher. How this impacts GP work, and how they manage workload has not been fully explored.AimTo explore GP work in areas of high socioeconomic deprivation, and the strategies GPs employ using Corbin and Strauss’s ‘Managing Chronic Illness’ model as an analytical lens.MethodSecondary analysis of in-depth interviews, with GPs working in areas of high socio-economic deprivation (n=10).ResultsAll three types of work defined by Corbin and Strauss (everyday, illness, biographical) were described, and one additional type: emotional (work managing GPs’ own emotions). The context of socioeconomic deprivation influenced GP work, increased multimorbidity PLUS social complexity (“Multimorbidity plus”). Healthcare systems, and self-management strategies, did not meet patients’ needs; meeting the resulting gap created extra hidden everyday work, often unrecognised (source of frustration). GPs also described taking on “illness work” for patients who were either overwhelmed, or unable to do it. Some GPs described biographical work asserting their professional role against demands from patients, and other professionals. Work aligning with personal values was important in sustaining motivation; strong teams and outside professional appeared to build resilience.ConclusionGPs working in areas of high socioeconomic deprivation experience different types of work; much unrecognised and not resourced. Current strategies to reduce burnout could be more effective if the complexity of different types of work was addressed, personal values supported, practice teams and outside professional interests were supported.

Palliative care clients' and caregivers' notion of fear and their strategies for overcoming it

2014 ◽  
Vol 13 (3) ◽  
pp. 777-785 ◽  
Author(s):  
Joy Penman ◽  
Bronwyn Ellis
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Secondary Analysis ◽  
Human Relationships ◽  
Department Of Health ◽  
Different Types ◽  
One Step ◽  
Depth Interviews ◽  
Australian Department

AbstractObjective:This paper aims to clarify our understanding of fear and explore the strategies employed by people with life-limiting conditions and their caregivers in addressing the emotion of fear as they journey through the dying process. The role of fear is discussed: different kinds of fear, the tangible and intangible measures by which people manage their fear, and the ways of transcending fear.Method:The findings of a larger research project funded by the Australian Department of Health and Ageing are drawn upon. In-depth interviews were conducted with clients and caregivers relating to the psychosocial and emotional issues in palliative care. Secondary analysis was utilized to examine the perceptions of fear in this cohort.Results:While there were many other findings, the results highlighted in this paper relate to the notion of fear among interview participants. Interview data showed that people with life-limiting conditions and their caregivers had different types of fear and employed a variety of strategies to deal with fear. Four themes emerged embodying these strategies: calling on their own resilience and inner resources, maintaining human relationships, gaining the ability to “keep one step ahead” in the dying process, and engaging in spirituality and religion.Significance of results:The implications of the findings for healthcare professionals are highlighted. The recognition of emotions is embedded in palliative care; healthcare professionals should view the management of emotions as an integral part of professional practice. Addressing fear is essential because unresolved fear can impinge on one's ability to cope. Our paper brings together different perspectives on fear and how vulnerable individuals attempt to cope with it while at the same time providing a view of the challenges confronting healthcare professionals who are engaged with them and committed to optimizing health outcomes for palliative care clients and their caregivers.

scholarly journals Secondary Analysis of an Electronic Surveillance System Combined with Multi-focal Interventions for Early Detection of Sepsis

2017 ◽  
Vol 26 (01) ◽  
pp. 47-66 ◽  
Author(s):  
Bonnie Westra ◽  
Sean Landman ◽  
Pranjul Yadav ◽  
Michael Steinbach
Keyword(s):  
Early Detection ◽  
Surveillance System ◽  
Point Of Care ◽  
Management Strategies ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Separate Analysis ◽  
Electronic Surveillance ◽  
Predictive Values ◽  
Sensitivity Specificity

SummarySummary: To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveil-lance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application. Methods: Propensity score matching was used to select subsets of the cohorts with balanced covariates. Bootstrapping was performed to build distributions of the measured difference in rates/ means. The effect of the sepsis intervention was evaluated for all patients, and High and Low Risk subgroups for illness severity. A separate analysis was performed patients on the intervention and non-intervention units (without the electronic surveillance). Sensitivity, specificity, and the positive predictive values were calculated to evaluate the accuracy of the alerting system for detecting sepsis or severe sepsis/ septic shock.Results: There was positive effect on the intervention units with sepsis electronic surveillance with an adjusted mortality rate of –6.6%. Mortality rates for non-intervention units also improved, but at a lower rate of –2.9%. Additional outcomes improved for patients on both intervention and non-intervention units for home discharge (7.5% vs 1.1%), total length of hospital stay (-0.9% vs –0.3%), and 30 day readmissions (-6.6% vs –1.6%). Patients on the intervention units showed better outcomes compared with non-intervention unit patients, and even more so for High Risk patients. The sensitivity was 95.2%, specificity of 82.0% and PPV of 50.6% for the electronic surveillance alerts. Conclusion: There was improvement over time across the hospital for patients on the intervention and non-intervention units with more improvement for sicker patients. Patients on intervention units with electronic surveillance have better outcomes; however, due to differences in exclusion criteria and types of units, further study is needed to draw a direct relationship between the electronic surveillance system and outcomes.

scholarly journals The survival of school financing management in COVID-19 pandemic

2021 ◽  
Vol 15 (4) ◽  
pp. 563-570
Author(s):  
Sujasan Sujasan ◽  
Udik Budi Wibowo
Keyword(s):  
Financial Management ◽  
Teaching And Learning ◽  
School Quality ◽  
Management Strategies ◽  
Education Financing ◽  
School Financing ◽  
Good Schools ◽  
School Finances ◽  
Depth Interviews

This study aimed to explore the survival of school financing management during the COVID-19 pandemic, to assure the quality of teaching and learning continuously. This study used a qualitative design, and data collection is carried out by observing resource persons and in-depth interviews, analysis or analysis of documentation and a combination of the three as triangulation method. The collected data were analyzed using an interactive model. The results showed that financial management strategies in managing school finances effectively and efficiently, through transparency, accountability and responsibility, are considered to have contributed to the prospects, quality, progress and sustainability of education in the midst of the COVID-19 pandemic. This is based on the fact that many quality and good schools eventually experience setbacks due to the lack of transparency, accountability and responsibility in the management of education funds. Openness in schools can promote accountability and fight corruption in education, if it is implemented effectively and any malpractice is dealt with clear consequences. The implication is the strategies of education financing management in terms of transparency, accountability and accountability need to be carry out consistently to ensure the improvement of school quality runs in a sustainable manner.

scholarly journals Analysis of Related Technologies Used in Fuel Cell Vehicles

2021 ◽  
Vol 2125 (1) ◽  
pp. 012011
Author(s):  
Ziyi Du ◽  
Hongxu Zhan
Keyword(s):  
Fuel Cells ◽  
Fuel Cell ◽  
Automotive Industry ◽  
High Efficiency ◽  
Management Strategies ◽  
Production Model ◽  
Hydrogen Energy ◽  
Fuel Cell Vehicles ◽  
Energy Applications ◽  
Different Types

Abstract Nowadays, many types of fuel cells have made significant progress. In 2014, they were applied to the production model Toyota’s FCHV-Adv. With their high efficiency and low pollution, fuel cells have gradually started to replace some traditional technologies in many energy applications and production industries and have become a hot topic of interest in recent years. Depending on the type of fuel, there are various types, and different fuel cells work on different principles, leading to differences in their performance. This paper lists the different fuel cells and their application scenarios in the automotive industry. In addition, the use of hydrogen in fuel cell vehicles is also a major concern. This paper briefly discusses the current hydrogen production and four different types of fuel cell vehicles and their energy management strategies. All the technical advantages of fuel cells and hydrogen energy are ultimately reflected in fuel cell vehicles, and this paper describes the current challenges and future possibilities.

scholarly journals Managerial strategies of the personal values, used to improve engineers communication

2019 ◽  
Vol 290 ◽  
pp. 07004
Author(s):  
Mihaela Laura Bratu ◽  
Lucian-Ionel Cioca
Keyword(s):  
Employee Performance ◽  
Personal Values ◽  
Management Strategies ◽  
Well Being ◽  
Workplace Communication ◽  
Individual Values ◽  
Internal Standards ◽  
The Everyday ◽  
Managerial Strategies ◽  
The Individual

Every person can be described by his behavior in certain situations, but also by the motivation of his actions, a motivation that reflects the individual values. The set of values of each individual is reflected in the everyday tasks, the way of communication, the degree of success of his actions. The higher the values apply in a wider area of life, the higher the personal satisfaction of the individual. Personal values are the internal standards and, at the same time, the inner force that determines us to learn, work and live in a certain way. The paper presents a study of a group of 116 engineers from different fields who sought to identify personal values in order to improve communication at the workplace. It was used The Inventory of Personal Values that measured the analyzed variable. The findings of the research are that management strategies that value the practical and organizational spirit of engineers improve workplace communication, increase employee performance and improve their well-being.

The ‘grey area’ of employment relations in the Polish videogame industry

2019 ◽  
Vol 22 (2) ◽  
pp. 298-314 ◽  
Author(s):  
Anna M Ozimek
Keyword(s):  
Civil Law ◽  
Employment Relations ◽  
Economic Risk ◽  
Self Employment ◽  
Grey Area ◽  
Regulatory Systems ◽  
Different Types ◽  
Videogame Industry ◽  
Depth Interviews ◽  
Code Provisions

This article discusses fraudulent contracting of work in the Polish videogame industry by addressing its relation to workers’ understanding of their insecure employment and the economic risk associated with it. Fraudulent contracting of work is understood as misuse of civil law contracts/self-employment to disguise different types of employment relations. The article draws upon in-depth interviews with Polish videogame workers and key sector organisations to examine their understanding of the prevalence of employment relations not covered by the labour code in the videogame industry. The interviewees presented polarised opinions about engagement with civil law contracts ranging from celebratory approaches to their flexibility to discussing their use by companies in order to circumvent the labour code provisions. This article argues that the understanding of work precarisation needs to be further investigated in relation to national regulatory systems and workers’ understanding of their own employment arrangements.

Managing Smokefree Momentum: Young RYO Smokers’ Responses to Tobacco Endgame Strategies

2020 ◽  
Vol 40 (2) ◽  
pp. 250-265
Author(s):  
Shelagh Ferguson ◽  
Jan Brace-Govan ◽  
Janet Hoek ◽  
Matthew Mulconroy
Keyword(s):  
Public Policy ◽  
Environmental Changes ◽  
Management Strategies ◽  
Population Level ◽  
Sense Making ◽  
Consumer Resistance ◽  
Policy Initiatives ◽  
The Social ◽  
Depth Interviews ◽  
Tobacco Endgame

As more countries set smoking endgame goals and introduce measures to denormalize smoking, smokers’ experience of stigma may intensify and require new management strategies. Probing the tension between environmental changes that support population-level behaviour change and individuals’ sense making, which occurs at a micro, everyday level, provides unique insights into reactance, agency and stigma. Using a Foucauldian informed approach, we analyze how young RYO (roll-your-own tobacco) smokers internalize neoliberal marketplace economic norms and create positions of resistance. Experience-based videographies and in-depth interviews with 15 New Zealand young adults aged 20-30 illustrate how participants resist stigma and the social disapproval they experience. This analysis identifies how smoking denormalization affects practices and pleasures, and generates four discernible positions of resistance: Socialized, Comfort, Status and Pleasure Orientated Resistances. These highlight intersections between policy initiatives and consumer resistance, offering new insights relevant to public policy.

Exploration of Relationships among Individual and Organizational Characteristics, Nurse Leader Fatigue, and Turnover Intention

2018 ◽  
Vol 62 (1) ◽  
pp. 627-631 ◽  
Author(s):  
Sarah Brzozowski ◽  
Jessica G. Rainbow ◽  
Barbara Pinekenstein ◽  
Élise Arsenault Knudsen ◽  
Linsey Steege
Keyword(s):  
Turnover Intention ◽  
Secondary Analysis ◽  
Chronic Fatigue ◽  
Nurse Leaders ◽  
Organizational Characteristics ◽  
Individual Factors ◽  
Significant Relationships ◽  
Nurse Leader ◽  
Different Types ◽  
Mediating Factor

Understanding nurse leader fatigue and its relationship with turnover intention is essential for maintaining a viable leadership workforce. This secondary analysis of a national survey of nurse leaders explored the relationships of organizational and individual factors with nurse leader fatigue and turnover intention. A nurse leader’s membership in individual and organizational classes is associated with differences in acute and chronic fatigue levels. There were significant relationships between acute and chronic fatigue states and turnover intention. Acute fatigue was a mediating factor between individual and organizational classes and turnover intention. Future interventions to decrease nurse leader turnover intention could be tailored for different types of organizations, individual classes and fatigue type.

From Necropraxis to Necroresistance: Transgender Experiences in Latin America

2020 ◽  
pp. 088626052098039
Author(s):  
Sheilla L. Rodríguez Madera
Keyword(s):  
Latin America ◽  
Social Interactions ◽  
Management Strategies ◽  
State Policies ◽  
Sociocultural Context ◽  
Multiple Forms ◽  
Trans People ◽  
Small Doses ◽  
Political Economic ◽  
Depth Interviews

Latin America is one of the deadliest regions for trans communities. Scientific research generated in the region has reported that trans people live through a complicated panorama shaped by multiple forms of oppression, extreme violence, and micro-aggressions. Although necropolitics, as a theoretical approach, has been useful to understand how State policies negatively affect trans individuals, it does not fully account for informal dynamics within groups and among individuals that are potentially lethal for this population in Latin America. To account for this gap, the author proposes two novel concepts: necropraxis (a pattern that manifest itself in everyday social interactions, through which gradual small doses of death are delivered to eliminate, symbolically and/or literally, trans people); and necroresistance (the ways in which trans people defy the threats imposed by necropraxis through “ordinary” acts manifested in their everyday life). The main objective of this article is to put forth definitions for these two concepts and identify how they apply in the context of trans communities in three countries of the region: Guatemala, Argentina, and Chile. To achieve the latter, the author relies on her ethnographic work in these contexts. Data were gathered through parcipant observation, in-depth interviews with trans persons ( N = 11) and informal conversations with individuals during the site visits. A deductive qualitative analysis was conducted. Results evidence how the manifestation of necropraxis and necroresistance were highly influenced by the historical, political, economic and sociocultural context of each country. This study provides valuable information to help both policymakers and other stakeholders understand the problem’s magnitude in the region and the ways necropraxis is experienced in everyday relations between trans individuals and others. Similarly, through the understanding of what constitutes necroresistance and its value, the proposed framework could help them outline prevention and management strategies to strengthen trans communities in different countries.

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