Implementation and Evaluation of a Digitally Enabled Precision Public Health Intervention to Reduce Inappropriate Gabapentinoid Prescription: Cluster Randomized Controlled Trial

Background Digital technologies can enable rapid targeted delivery of audit and feedback interventions at scale. Few studies have evaluated how mode of delivery affects clinical professional behavior change and none have assessed the feasibility of such an initiative at a national scale. Objective The aim of this study was to develop and evaluate the effect of audit and feedback by digital versus postal (letter) mode of delivery on primary care physician behavior. Methods This study was developed as part of the Veterans’ Medicines Advice and Therapeutics Education Services (MATES) program, an intervention funded by the Australian Government Department of Veterans’ Affairs that provides targeted education and patient-specific audit with feedback to Australian general practitioners, as well as educational material to veterans and other health professionals. We performed a cluster randomized controlled trial of a multifaceted intervention to reduce inappropriate gabapentinoid prescription, comparing digital and postal mode of delivery. All veteran patients targeted also received an educational intervention (postal delivery). Efficacy was measured using a linear mixed-effects model as the average number of gabapentinoid prescriptions standardized by defined daily dose (individual level), and number of veterans visiting a psychologist in the 6 and 12 months following the intervention. Results The trial involved 2552 general practitioners in Australia and took place in March 2020. Both intervention groups had a significant reduction in total gabapentinoid prescription by the end of the study period (digital: mean reduction of 11.2%, P=.004; postal: mean reduction of 11.2%, P=.001). We found no difference between digital and postal mode of delivery in reduction of gabapentinoid prescriptions at 12 months (digital: –0.058, postal: –0.058, P=.98). Digital delivery increased initiations to psychologists at 12 months (digital: 3.8%, postal: 2.0%, P=.02). Conclusions Our digitally delivered professional behavior change intervention was feasible, had comparable effectiveness to the postal intervention with regard to changes in medicine use, and had increased effectiveness with regard to referrals to a psychologist. Given the logistical benefits of digital delivery in nationwide programs, the results encourage exploration of this mode in future interventions.

DEONTOLOGICAL COMPONENT OF EVALUATION-ANALYTICAL COMPETENCE OF A TEACHER

With the approval of teachers’ professional standard there is a need for a qualitatively different teacher training, which allows to combine the fundamentals of professional basic knowledge with innovative thinking and practice-oriented research approach to the implementation of a new evaluation format. Modernization of the system of education in Ukraine has radically changed the «portrait» of the modern teacher and the requirements for his work. There is a demand for professionals who not only know their subject well, but also have a flexible professional self-awareness, emotional intelligence and communication skills focused on creativity, innovation, entrepreneurship. There is a need to create a route map for the development of teachers` professionalism in Ukraine. The analysis of the teacher’s professional standard encourages to more detailed definition and comprehension of the value sphere of teacher`s professional activity. It is here, in our opinion, that the achievements of a relatively new field of scientific knowledge − pedagogical deontology − should be used. The purpose of the article is to identify and determine the place of the deontological component within the teacher`s evaluative-analytical competence in the formulation of teacher`s professional standard. Based on the comparative analysis of literature sources, the author's conclusions are formulated. Motivational-value (personal) component of the structure of evaluative-analytical competence clearly reveals the personal traits of the teacher, which gives the opportunity to reveal students` motives and aspirations. This gives grounds to define the motivational-value (personal) component as a deontological component of the teacher’s evaluative-analytical competence. It should be a trigger for fair and motivating assessment that enables the student to feel valued and find meaning in learning. The teacher forms certain models of professional behavior, which are a manifestation of the formation of his evaluative-analytical competence.

Development and Validation of an Unethical Professional Behavior Tendencies Scale for Student Teachers

Teacher’s unethical professional behaviors affect students’ physical and mental health. Prevention should start with student teachers, but empirical research is lacking in China. This study surveyed over 2,000 student teachers from China to examine the psychometric properties of a student teachers’ unethical professional behavior tendencies scale which revised by primary and secondary school teachers’ unethical professional behavior tendencies scale. Exploratory and confirmatory factor analysis confirmed that a bi-factor model fit the data best. The final student teachers’ unethical professional behavior tendencies scale comprised four subscales, including a general factor (unethical professional behaviors) and four special factors (perfunctory attitude and carelessness, insults and discrimination, unfairness, and using power for personal gain). The student teachers’ unethical professional behavior tendencies scale correlated negatively with their professional ethical values and positively with perceived frequency of unethical professional behaviors of college teachers around them. The data supported the scale’s measurement invariance across gender, and male student teachers scored significantly higher on unethical professional behavior tendencies than female student teachers. The findings suggest that the student teachers’ unethical professional behavior tendencies scale is a useful instrument for assessing student teachers’ unethical professional behaviors in China.

The centrality of ethical utterances within professional narratives

This study examines the centrality of ethics within editorials published in the Canadian Institute of Chartered Accountants’ professional journal, CA Magazine, over the 1912 to 2010 period. Starting from the twin assumptions that editorials speak about appropriate professional behavior using a variety of words such as ‘ethics,’ ‘conduct,’ and ‘codes,’ and that appropriate professional behavior is situational, we use topic modeling techniques to identify these dimensions of ethical discourse. We then use social network analysis methods to map the position and centrality of ethics within the editorials across time. The results show that enunciations about appropriate professional conduct are broader than simply enunciations using the word ‘ethics’. The results also highlight that ethical utterances become more central, not less central, over time.

Implementation and Evaluation of a Digitally Enabled Precision Public Health Intervention to Reduce Inappropriate Gabapentinoid Prescription: Cluster Randomized Controlled Trial (Preprint)

BACKGROUND Digital technologies can enable rapid targeted delivery of audit and feedback interventions at scale. Few studies have evaluated how mode of delivery affects clinical professional behavior change and none have assessed the feasibility of such an initiative at a national scale. OBJECTIVE The aim of this study was to develop and evaluate the effect of audit and feedback by digital versus postal (letter) mode of delivery on primary care physician behavior. METHODS This study was developed as part of the Veterans’ Medicines Advice and Therapeutics Education Services (MATES) program, an intervention funded by the Australian Government Department of Veterans’ Affairs that provides targeted education and patient-specific audit with feedback to Australian general practitioners, as well as educational material to veterans and other health professionals. We performed a cluster randomized controlled trial of a multifaceted intervention to reduce inappropriate gabapentinoid prescription, comparing digital and postal mode of delivery. All veteran patients targeted also received an educational intervention (postal delivery). Efficacy was measured using a linear mixed-effects model as the average number of gabapentinoid prescriptions standardized by defined daily dose (individual level), and number of veterans visiting a psychologist in the 6 and 12 months following the intervention. RESULTS The trial involved 2552 general practitioners in Australia and took place in March 2020. Both intervention groups had a significant reduction in total gabapentinoid prescription by the end of the study period (digital: mean reduction of 11.2%, <i>P</i>=.004; postal: mean reduction of 11.2%, <i>P</i>=.001). We found no difference between digital and postal mode of delivery in reduction of gabapentinoid prescriptions at 12 months (digital: –0.058, postal: –0.058, <i>P</i>=.98). Digital delivery increased initiations to psychologists at 12 months (digital: 3.8%, postal: 2.0%, <i>P</i>=.02). CONCLUSIONS Our digitally delivered professional behavior change intervention was feasible, had comparable effectiveness to the postal intervention with regard to changes in medicine use, and had increased effectiveness with regard to referrals to a psychologist. Given the logistical benefits of digital delivery in nationwide programs, the results encourage exploration of this mode in future interventions.

Managing Street-Level Bureaucrats’ Performance by Promoting Professional Behavior Through HRM

This article connects human resource management (HRM) research to studies of street-level bureaucracies and public professionals. It investigates the intermediary role of professional behavior in the HRM–individual performance link in the context of public human service organizations. The article hypothesizes that human resources (HR) practices, aimed at enhancing street-level workers’ abilities, motivation, and opportunities, strengthen these workers’ professional behavior; that professional behavior and individual performance are positively related; and that professional behavior mediates the relationship between HR practices and individual performance. The analysis of findings from a survey study of street-level workers in local welfare agencies implementing welfare-to-work policies in the Netherlands shows support for the mediating role of professional behavior in the HRM–individual performance chain. Based on this evidence, the article concludes that the professional behavior of street-level workers in public human service organizations deserves scrutiny of both HRM scholars and HR practitioners who are interested in promoting the performance of public professionals.

The art of hospitality

The textbook describes the basics of the art and culture of hospitality, hospitality as part of modern business, modern models of hospitality, hospitality as a component of everyday life, hospitality in everyday life, the technology of meeting and greeting guests, the rules of greeting in the premises, on the street, the norms and rules of professional behavior and business etiquette, the basics of departmental etiquette, relations in professional activities, communication by phone, methods of holding various events, presentations and receptions, culinary art of different peoples and much more. Nine practical works are described in detail, as well as independent work in the study of the discipline of MDK. 01.01 "The art of hospitality". For students of secondary vocational education institutions. It can be used when mastering the module PM. 01 "Management of household management" for the specialty 43.02.08 "Service of household and communal services".

Cognitive Dissonance in the Professional Activity of an Accountant

Th e article focuses on the issue of increasing the activity of members of the professional community in the field of accounting science and practice regarding the methodological component of accounting knowledge. Based on the fundamental approaches of the logic of scientifi c research and the postulates of social psychology, the author identifi es the problem and comes to the conclusion that there is a psychological background to the professional behavior of colleagues, as a result, a contradiction is revealed between the true attitude of accountants to the ongoing reformation changes and their publicly expressed position. Th e very awareness of the causes of what is happening is an indispensable condition for restoring the atmosphere of free scientifi c and practical discussions.

De quem é a culpa? Os narradores suspeitos de Divórcio e Dom Casmurro / Who is the guilty? Suspicious narrators in Divórcio and Dom Casmurro

Resumo: Em Divórcio, romance do escritor Ricardo Lísias, após uma separação dolorosa, o narrador, em primeira pessoa, dá início a um processo de desconstrução da imagem da mulher a partir de fragmentos, cada vez menores, de um diário íntimo que ele encontra por acaso. Para ele, tal diário é uma prova indiscutível de que ela o traiu e da falta de ética também profissional da sua companheira, uma jornalista. A história segue, desse modo, uma trama muito semelhante à de Bentinho e Capitu em Dom Casmurro, de Machado de Assis, mas seus instrumentos de deslegitimação da companheira acompanham questões e formas pertinentes aos novos tempos.Palavras-chave: literatura brasileira; Machado de Assis; Ricardo Lísias; literatura comparada.Abstract: In Divórcio (Divorce), a novel by Ricardo Lísias, the first-person narrator begins, after a very painful separation, a process of deconstructing his wife’s image using small fragments of a diary left by her that he read by chance. The diary, he claims, is an evidence of her betrayal and of her unethical professional behavior as journalist. This jealous narrator reminds other character of a well known Brazilian novel, Bentinho, from Dom Casmurro, by Machado de Assis. In his book, Lísias rethinks Machado’s novel and uses new questions and literally instruments to tell his history of adultery, passion and betrayal.Keywords: Brazilian literature; Machado de Assis; Ricardo Lísias; comparative literature