Institutional governance and responsiveness to antimicrobial resistance: a qualitative study of Australian hospital executives

ObjectivesDespite escalating antimicrobial resistance (AMR), implementing effective antimicrobial optimisation within healthcare settings has been hampered by institutional impediments. This study sought to examine, from a hospital management and governance perspective, why healthcare providers may find it challenging to enact changes needed to address rising AMR.DesignSemistructured qualitative interviews around their experiences of antimicrobial stewardship (AMS) and responsiveness to the requirement for optimisation. Data were analysed using the framework approach.SettingTwo metropolitan tertiary-referral hospitals in Australia.ParticipantsTwenty hospital managers and executives from the organisational level of department head and above, spanning a range of professional backgrounds and in both clinical and non-clinical roles, and different professional streams were represented.ResultsThematic analysis demonstrated three key domains which managers and executives describe, and which might function to delimit institutional responsiveness to present and future AMR solutions. First, the primacy of ‘political’ priorities. AMR was perceived as a secondary priority, overshadowed by political priorities determined beyond the hospital by state health departments/ministries and election cycles. Second, the limits of accreditation as a mechanism for change. Hospital accreditation processes and regulatory structures were not sufficient to induce efficacious AMS. Third, a culture of acute problem ‘solving’ rather than future proofing. A culture of reactivity was described across government and healthcare institutions, precluding longer term objectives, like addressing the AMR crisis.ConclusionThere are dynamics between political and health service institutions, as well as enduring governance norms, that may significantly shape capacity to enact AMS and respond to AMR. Until these issues are addressed, and the field moves beyond individual behaviour modification models, antimicrobial misuse will likely continue, and stewardship is likely to have a limited impact.

The readiness of dentists to use the autofluorescence method

Background. Head and neck squamous cell carcinoma are the sixth most common cancer in prevalence rate. Early diagnosis significantly reduces morbidity and mortality. Autofluorescence facilitates diagnosis the disease at the early stages, but it depends on the doctor’s skill in interpreting images. The aim of the study: to analyze the results of reading autofluorescence images of the oral mucosa by dentists.Materials and methods. The results of reading 10 autofluorescence images of potentially malignant diseases of the oral mucosa and 10 images of benign lesions and conditions were evaluated. The study involved 308 dentists. The assessment of the ability to recognize autofluorescence images was carried out with respect to gender, age, length of service, qualification category, academic degree, position of the head of the department.Results. On the average, dentists correctly differentiated the results of visualization of potentially malignant diseases of the oral mucosa in 3.85 ± 2.47 cases, benign lesions together with other benign conditions – in 4.56 ± 2.47 cases. Images of benign lesions and conditions were identified by dentists better than images of potentially malignant diseases of the oral mucosa (t = –17.0; p < 0.001). There is a direct correlation between the correct differentiation of visualization of potentially malignant diseases of the oral mucosa with the correct interpretation of benign lesions and conditions (r = 0.956; p < 0.001). The interpretation of potentially malignant diseases of the oral mucosa is not related to gender (t = –1.62; p = 0.306), work experience (r = –0.002; p = 0.977), department head (t = –0.11; p = 0.910), qualification category (t = –0.50; p = 0.574), academic degree (t = –0.34; p = 0.731).Conclusion. Dentists cannot recognize diseases of the oral mucosa well in autofluorescence images. The recognition skill is not related to general professional development.

Crew endurance training in the united states navy: Lessons learned from senior leadership, prospective commanding/executive officers, and department heads

The Crew Endurance Team at the Naval Postgraduate School led a 3-year project to develop and deliver crew endurance and sleep hygiene training to support the US Navy’s implementation of circadian-based watchbills. As part of this effort, 16 training sessions were delivered to 362 active-duty service members (ADSMs) of the USN, including senior Navy leaders (n=249), prospective commandingIexecutive officers (PCOIPXOs) (n=30) at the Surface Warfare Officers School (SWOS) and students (n=83) attending SWOS Department Head School. Overall, responses from all audiences were positive indicating a high level of satisfaction with the training. We identified the need to expand two parts of the training: stimulants and sleep-promoting medications, and tips for sleeping in military environments. We will continue to tailor the training to the specific needs of ADSMs. We continue to train military audiences to increase awareness of the critical importance of sleep for operational performance and resilience.

Forced Leadership as a Social Psychological Phenomenon in Professionally Successful Women Scientists

In today's world, women are increasingly taking the place of leaders, so they have to be active, focused, resistant to stress, have a high level of self-regulation, and be able to work in a team. So, we can see how women are sometimes forced to become leaders in difficult life circumstances. Due to persistence, self-education, determination, they work in leadership positions and demonstrate masculine personality traits. The study aimed to study the psychological characteristics of women scientists who hold high positions in educational establishments - vice-rector, dean, and department head. We hypothesized that the professional success of women scientists depends on the level of their potential leadership skills. The study involved 75 women from higher education institutions who successfully work as vice-rectors, deans, heads of departments. All of them have the degree of doctors of philosophy from various scientific fields and combined scientific activity with managerial activity. Analysis of the results of empirical research showed that a high level of leadership skills determines the professional success of 37% of women studied, but 63% of women scientists have other determinants of professional success. Differences in indicators were identified, and three groups of women were characterized depending on the level of development of their leadership abilities. In groups of women with a medium and low level of leadership skills, the main determinants of professional success are the focus on real-life circumstances, high level of development of stable emotional and volitional sphere, voluntary self-regulation, self-control in difficult situations, emotional stability. Women who have achieved professional success, not on the basis of potential leadership abilities, form a socially determined personal quality - forced leadership, which we tend to consider as a social psychological phenomenon, which is based on the ability to adapt to living conditions in situations requiring a person to choose against own individual psychological features, namely to become a leader, to cultivate the traits inherent in a true leader.

Leading the Challenge: Leader Support Modifies the Effect of Role Ambiguity on Engagement and Extra-Role Behaviors in Public Employees

The assumption of new challenges and services to provide, and the evolution of new technologies in public administration, give employees an important perception of ambiguity when carrying out their work. Role ambiguity has been conceptualized as one of the main impeding demands at work with negative consequences. The objective of the present study is to analyze the moderating effect of the support by the department head in the negative influence of the role ambiguity on the engagement and the extra-role performance behaviors of the employees. The hypothesis is proposed that the support of the department head will mean the transformation of role ambiguity into a challenging job demand with positive results. A total of 315 public employees with administrative staff have participated in this study. Results confirmed that the support of the leader moderates the effects of role ambiguity. The inclusion of this variable as a moderator transforms the influence of role ambiguity on the employees’ engagement into a positive one and reduces their negative effect on extra-role performance behaviors. These results reinforce the role of leader support as a protective element against job demands in public administrations. Theoretical and practical implications and future lines of research are discussed at the end of the work.

Evaluation of Department Head Person Based on Gender, Gender Role Orientation, and Attachment of Labels in Dire Dawa University

The study, designed to find out the gender outcome, gender roles, and labeling of labels in the department's head examination, was conducted using 194 study participants recruited from lecturers at Dire Dawa University in Ethiopia 116 female and 78 were males aged 29.23. The following five labels are used: Department head in general, efficient male Department head, efficient female Department head, inefficient male Department head, and inefficient female Department head) were responded to by the research participants. Seven different hypotheses were tested using ANOVA. Findings revealed that gender role orientation had a significant effect on the evaluation of the Department head. Furthermore, there were no significant effects of gender, and attachment of labels on the evaluation of Department head and no interaction effects of gender and gender role orientation, gender and attachment of labels and gender, gender role orientation, and attachment of labels on the evaluation of Department head.

The implementation of nutrition improvement programs for underweight children, wasting and stunting in the Department of Health, Central Buton district, Southeast Sulawesi

Background: Health status can affect the Human Development Index (HDI) of a country. To improve the quality of human resources, the Indonesian Government has applied various policies, such as the nutrition improvement program, since there are still lots of toddlers suffering from underweight, wasting dan stunting. Even one out of three toddlers in Indonesia were detected stunting.Objectives: This study described the implementation of a nutrition improvement program for toddlers in the Central Buton District Health Office.Materials and Method: This was a qualitative study that involved ten informants. Three of those informants are nutritionists in the District Health Office, Head of Public Health Department, Head of NutritionDepartement. Also, two nutrition workers in primary healthcare centers and two mothers of malnourished toddlers.Results: These findings showed that in terms of input, trained human resources on nutrition were lacking, and the budget for the nutrition improvement program was inadequate. While, in the process, all implementors had done very well, although they still had no collaboration across sectors. In the output aspect, the health status of underweight, wasting, and stunting toddlers improved. Also, monitoring and evaluation were conducted on toddlers registered at the integrated service posts in 2018.Conclusions: There were still constraints on the input, process, and output aspects, even though there was an increase in the nutritional status of children under five, but nutrition problems for children under five in Central Buton Regency were still high.

Editorial

Yorgos Photis was my spiritual son, my student, my advisee, my helper, my colleague, my friend, my confidant and regrettable the sack of box to relieve my anxieties and worries. He suddenly left this world to meet his maker, who I am certain will show His mercy on such a fine man. Once I read a father's eulogy for his son, which fits exactly how I feel about Yorgos "The sunflowers, the lilies and the lush green grass looked cheery, so long as you were around. Do you think they will ever look green again, once the meaning in life I have lost is found?" Yorgos I wished I had remembered that passage more often and mainly practiced it when you were around me! But I remember the first time I called you in my office, as a young professor who care about his students, trying to deciphered the unkind remarks of a fellow professor about you. I am so proud that you have proved him so wrong. We worked together and you finished your undergraduate thesis, your PhD, and you climbed all the academic grades. You followed my steps in a more successful manner and became a professor of Geographical Analysis and Locational Planning, a department head, associated editor of the European Journal of Geography, president of the Hellenic Geographical society, and member of the board of EUROGEO- the European Association of Geography. I want to declare that I will continue to show my feelings for you, so that I will talk about you because I am proud of you. I will talk about you, because you deserve to be remembered. I will talk about you, because even though you not physically with me, you are never from my mind. I will talk about you, because you are part of me, a part that I could never ignore or disown. I will talk about you because I love you still and always will. Nothing will ever change that. The passing of Yorgos Photis has been a great loss to his family, the university, the department and the lab he was serving, as well as the Hellenic Geographical society, the European Journal of Geography and EUROGEO he was committed to their advancements. My sincere condolences