Behaviour Of Healthcare Professionals Research Articles

P1557EFFECTIVENESS OF INTERVENTION FOR SAFETY CONFIRMATION OF HEMODIALYSIS PREPARATION PROCESS

Abstract Background and Aims It has been determined that more than half of the medical errors related to haemodialysis treatment are due to the preparation process at the initial stage of treatment, and that the errors are mainly caused by insufficient confirmation behaviour of healthcare professionals. Pointing confirmation and double check have been proven effective as safety treatments, but no specific strategy has been established to verify these insufficient confirmation behaviours. This study clarified the actual behaviour of healthcare professionals engaged in haemodialysis during the preparation process at the initial stage of treatment and defined the confirmation behaviour necessary to start safe haemodialysis based on the results. Moreover, the aim was to assess the effectiveness of an intervention program for enhancing adherence to confirmation practice. Method A first study was conducted to investigate the actual state of behaviour, and a second study to verify the effectiveness of an intervention program. In the first study, we monitored and analysed the actual behaviours of 23 clinical engineering technicians and 14 registered nurses at a dialysis centre during the preparation process (218 steps) at the initial stage of treatment, and calculated their adherence rates. In the second study, the final confirmation process at the initial stage of treatment was determined (13 steps), and an intervention program aimed at adherence was devised. To verify its effectiveness, 18 clinical engineering technicians and 8 registered nurses were randomly divided into an experimental group (E) and a control group (C). The intervention program for Group E comprised baseline without intervention, intervention 1 (verbal explanation of confirmatory behaviour), intervention 2 (adding graphic feedback), intervention 3 (adding video feedback), and follow-up without intervention. That of Group C comprised only baseline and intervention 1. The adherence rate to the final confirmation process in both groups was calculated. Results In the first study, the adherence rate to the preparation process at the initial stage of treatment was 67.2%, and the adherence rate in the confirmation process immediately after the start of dialysis was 21.0%, which was remarkably low. In the second study, the adherence rate to the final confirmation process in Group E was 17.1% at baseline, 45.5% after intervention 1, 65.5% after intervention 2, 90.4% after intervention 3, and 93.9% at follow-up. In contrast, the adherence rate in Group C was 8.6% at baseline and 50.4% after intervention 1. Conclusion The adherence rate to the preparation process at the initial stage of treatment was less than 70%. Furthermore, the intervention program using graphic feedback and video feedback increased the adherence rate to the final confirmation process. Intervention programs aimed at the behaviour modification of healthcare professionals involved in haemodialysis have increased the adherence rate to confirmation actions in the final confirmation step of haemodialysis, and it has become clear that verbal teaching and visualized feedback are effective.

Clinical Factors, Preventive Behaviours and Temporal Outcomes Associated with COVID-19 Infection in Health Professionals at a Spanish Hospital

The novel coronavirus disease (COVID-19) outbreak has quickly spread around the world, with Spain being one of the most severely affected countries. Healthcare professionals are an important risk group given their exposure. The aims of this study were to determine the prevalence of symptoms, main concerns as patients, preventive behaviours of healthcare professionals, and the different temporal outcomes associated with the negativization of PCR results. A total of 238 professionals were analysed and follow-up was conducted from 11 March to 21 April 2020 through clinical records, in-depth surveys, and telephone interviews. Symptoms, concerns, and preventive measures were documented, and temporal outcomes (start and end of symptoms, first positive PCR, and negativization of PCR) were analysed through survival analyses. A high prevalence of gastrointestinal symptoms (especially in women and older professionals), fever, cough, and fatigue were reported. The main concern was contagion in the work and home environment. Professionals (especially men) reported low use of face masks before the pandemic. Our analysis indicates that the median times for the negativization of PCR testing to confirm the resolution of infection is 15 days after the end of symptoms, or 25 days after the first positive PCR test. Our results suggest that these times are longer for women and for professionals aged ≥55 years, therefore follow-up strategies should be optimized in light of both variables. This is the first study we are aware of to report factors associated with the time to negativization of PCR results. We present the first rigorous estimates of time outcomes and hope that these data can be valuable to continue feeding the prediction models that are currently being developed. Similar studies are required to corroborate our results.

The relationship between leadership styles and organisational citizenship behaviour of healthcare professionals: Case of Mus State Hospital


 This study was conducted to investigate the effect of leadership behaviours of health administrators on the citizenship perception of health staff. The study was conducted at Mus State Hospital and the sample consisted of 237 health staff who are volunteered to participate in the study. A survey consisting of three parts, demographic information, leadership styles and organisational citizenship, was used to collect data. Research data was coded and analysed by researchers. Frequency, percentage distributions and mean values were calculated. Also, to investigate the relationship between leadership styles and organisational citizenship, regression analysis was implemented. According to the results of the research, significant differences were found between leadership behaviours of health managers on organisational citizenship perception of health staff according to their occupations. In addition, a significant (p < α = 0.05), positive but weak relationship was found between leadership behaviours of health managers and organisational citizenship perception of health staff.
 
 Keywords: Director, health, hospital, leadership, organisational citizenship, perception.

A feasibility, acceptability and fidelity study of a multifaceted behaviour change intervention targeting free-living physical activity and sedentary behaviour in community dwelling adult stroke survivors

BackgroundDespite the benefits of physical activity for walking ability, balance, and mood, less than 30% of stroke survivors engage in recommended levels of physical activity with high levels of sedentary behaviour observed. This study aims to assess the feasibility, acceptability and fidelity of a theory- and evidence-based multifaceted behaviour change intervention targeting free-living physical activity and sedentary behaviour after stroke.MethodsThis study will be set in community stroke services in the North East of England and will assess the feasibility of a behaviour change intervention targeting free-living physical activity and sedentary behaviour of stroke survivors and consultation behaviour of the healthcare professionals to support stroke survivors to make these lifestyle changes. Up to 35 stroke survivors currently receiving stroke rehabilitation within the study catchment area with capacity and no contraindications to increasing physical activity/reducing sedentary behaviour will be recruited. Stroke survivors will receive a supported self-management physical activity/sedentary behaviour programme incorporating provision of information, goal setting, action planning, barrier identification, coping planning, self-monitoring and feedback on physical activity and sedentary behaviour. The programme will be supported by up to 12 healthcare professionals (HCPs) recruited from the community stroke services taking part in the study. The HCPs will deliver at least two face-to-face sessions (baseline, review and subsequent reviews if necessary) and provide a range of personalised tools to support each individual stroke survivor (e.g. workbook, self-monitoring tools, information on local resources). The consultation behaviour of the HCPs will be targeted via a training programme incorporating face-to-face training, a training manual and individual feedback on intervention programme delivery from the study research team. The feasibility, acceptability and fidelity of the study protocol will be assessed.DiscussionThe most effective methods of supporting stroke survivors to alter physical activity and sedentary behaviour have yet to be established. This study will establish the feasibility of delivering a complex theory- and evidence-based intervention targeting the behaviour of both stroke survivors and HCPs and assess whether it is acceptable to the target populations. Findings will inform the iterative development of the intervention before a larger scale evaluation.Trial registrationTrial register: Trial identifier: ISRCTN35516780, date of registration: 24/10/2018

Efficacy of a knowledge translation approach in changing allied health practitioner use of evidence-based practices with children with cerebral palsy: a before and after longitudinal study

Purpose To investigate the effect of a knowledge translation intervention on knowledge and frequency of routine evidence-based assessment behaviours of healthcare professionals working with children with cerebral palsy. Methods A before-and-after longitudinal study was conducted in five disability organisations. Four organisations (Commencing Knowledge Translation group) implemented a multifaceted intervention: knowledge brokers, targeted education, electronic-evidence library, and clinical outcomes database. These strategies were already in place at the fifth organisation (Comparison group). Outcomes evaluated at 0, 6, 12, and 24 months were health-professional knowledge and routine assessment behaviours (self-report and “completeness” of clinical assessment). Generalised estimating equations determined longitudinal changes. Results Four hundred and forty-seven professionals involved 861 children in the study. The Comparison group had higher knowledge and routine assessment behaviours at baseline. Professional knowledge in both groups remained stable (differences in change from baseline to 24 months: 0.3 units, 95%CI: −0.76 to 1.36). Assessment completeness of the Comparison group was stable (baseline mean 68 units, 95%CI: 65–71); the Commencing Knowledge Translation group improved from baseline mean 35 units (95%CI: 33–36), peaking at 12 months (mean 68 (95%CI: 65–71). Conclusions Multifaceted organisational support improved health-professional routine evidence-based assessment behaviours with children with cerebral palsy, despite no change in knowledge. Trial registration This trial was not a controlled health care intervention and was registered retrospectively: ACTRN12616001616460. The protocol of the trial was published in 2015 as follows: Imms et al. [6]. Implications for rehabilitation A multifaceted knowledge translation intervention increased allied health professionals’ assessment behaviours. Knowledge translation strategies can be chosen to target change in knowledge and/or change in behaviour. Knowledge translation interventions should be designed to address organisational barriers and enhance organisational supports. Interventions that target healthcare professionals’ behaviour directly can be effective even if their knowledge does not change.

An analysis on the relationship between safety awareness and safety behaviors of healthcare professionals, Ankara/Turkey.

ObjectivesThis descriptive study aims to examine the relationship between the safety awareness of healthcare professional and their safety behaviors.MethodsThe study was carried out on 418 healthcare professionals working in a training and research hospital in Ankara/Turkey. The survey method was used as data collection tool. The questionnaire consisted of 3 sections and 18 questions. First section consisted of questions on sociodemographic characteristics and, second section consisted of the awareness scale and third section consisted of safety behaviors scale.ResultsThe safety awareness and safety behaviors are scored on a scale from 1 (completely disagree) to 5 (completely agree). The safety awareness and safety behaviors has an average score of 3.85 ± 0.81 and 3.56 ± 0.82, respectively. The safety awareness and safety behavior levels of healthcare professionals were found to be high.ConclusionA significant positive correlation was found between safety awareness and safety behaviors and it was concluded that the increase in safety awareness led to an increase in safety behavior.

Real-World Data and Randomised Controlled Trials: The Salford Lung Study.

Traditional efficacy double-blind randomised controlled trials (DBRCTs) measure the benefit a treatment produces under near-ideal test conditions in highly selected patient populations; however, the behaviour of patients and investigators in such trials is highly controlled, highly compliant and adherent, and non-representative of routine clinical practice. Pragmatic effectiveness trials measure the benefit a treatment produces in patients in everyday “real-world” practice. Ideally, effectiveness trials should recruit patients as similar as possible to those who will ultimately be prescribed the medicine, and create freedom within the study design to allow normal behaviours of patients and healthcare professionals (HCPs) to be expressed. The Salford Lung Study (SLS) was a world-first, prospective, phase III, pragmatic randomised controlled trial (RCT) programme in patients with chronic obstructive pulmonary disease and asthma to evaluate the effectiveness of a pre-licensed medication (fluticasone furoate/vilanterol) in real-world practice using electronic health records and through collaboratively engaging general practitioners and community pharmacists in clinical research. The real-world aspect of SLS was unique, requiring careful planning and attention to the goals of maximising the external validity of the trials while maintaining scientific rigour and securing suitable electronic processes for proper interpretation of safety data. Key learnings from SLS that may inform the design of future pragmatic effectiveness RCTs include: (1) ensuring the trial setting and operational infrastructure are aligned with routine clinical care; (2) recruiting a broad patient population with characteristics as close as possible to patients in routine clinical practice, to maximise the generalisability and applicability of trial results; (3) ensuring that patients and HCPs are suitably engaged in the trial, to maximise the chances of successful trial delivery; and (4) careful study design, incorporating outcomes of value to patients, HCPs, policymakers and payers, and using pre-planned analyses to address scientifically valid research hypotheses to ensure robustness of the trial data.Electronic supplementary materialThe online version of this article (10.1007/s12325-019-01192-1) contains supplementary material, which is available to authorized users.

Moderating Role of Violence by Patients and Their Relatives on the Behaviors of Healthcare Professionals.

Studies examining violent behaviors occurring in health settings emphasize direct effects of the variables, and the findings are collected in a limited area. This study aimed to investigate the role of the moderator in the relationship between organizational citizenship behavior (OCB) and job satisfaction in the setting of violent behavior by the patients and their relatives toward healthcare professionals. Research data were collected by face-to-face questionnaire method by interviewing the participants. The study included 512 healthcare workers, physicians, nurses, midwives, and health technicians, working in different units of 13 public hospitals in Ankara and providing health services directly to the patients. According to the results of the regression analysis, a significant and direct effect of the general level of OCB that predicts the general level of job satisfaction has emerged (β = 0.284, t = 6.68, P < .001). It has been determined that violent behaviors toward healthcare professionals explain approximately 12.5% of the variance with its differentiating role reducing this effect (R2 = 0.125, F = 25.30, P = .001). This study showed that the positive contribution of OCB to job satisfaction is higher in healthcare workers who are not exposed to violent behavior. The results of this study also revealed that the relationship between variables regarding the attitudes and behaviors of healthcare professionals may differ owing to the violence perpetrated by the patients and their relatives.

An Exploration of the Gross National Happiness Approach to Assure Patient Safety and Healthcare Quality in Bhutan

Although the principles of Gross National Happiness (GNH) are currently being used as the overall framework for Bhutan’s development programs (including healthcare services), little is known about how Bhutanese healthcare professionals perceive the relationship between GNH and patient safety or how the GNH principles could help in improving patient safety in Bhutan’s healthcare system. The aim of this study was to explore how Bhutanese healthcare professionals, educators, managers, and policy makers perceive the relationship between GNH and patient safety and what they believe should be done to improve patient safety in Bhutan. A qualitative exploratory descriptive study using in-depth interviews was undertaken. All audio-recordings were transcribed verbatim and analyzed using content and thematic analysis strategies. Four major themes were identified: patient safety being important for GNH; incorporating the concept of GNH in healthcare; adopting the GNH values, whereby everyone believes that “someone’s happiness would be our happiness”; and educating healthcare professionals about GNH. Incorporation of the concept of GNH in healthcare could help transform the attitudes and behaviors of healthcare professionals toward patient care by producing a “Bhutanized” doctors and healthcare professionals and creating a Bhutanized healthcare system.

Physical Activity Prescription Among Healthcare Professionals in Hospital Setting: In the Application of the Theory of Planned Behavior

Introduction: Regular physical activity can achieve greater effects on non-communicable diseases (NCDs) than those achieved with drugs. The healthcare setting has been recognized as an appropriate and promising venue for prescribing physical activity. Aim of the study: To assess physical activity prescription behavior (PAPB) of Ethiopian healthcare professionals and determine if the theory of planned behavior explain this behavior. Methods: A cross-sectional survey design was used to assess healthcare professionals’ physical activity counseling and prescription behavior for non-communicable diseases (NCDs) in hospital setting. The survey includes self-reported physical activity prescription behavior, and the tenets of theory of planned behavior (attitude (ATT), subjective norm (SUN), perceived behavioral control (PBC), and intention (INT) to prescribe physical activity). Structural equation modeling was used to estimate the relationship of theoretical constructs to prescribe physical activity. Amos and SPSS software were applied to estimate the predictive utility of the theory. Results: A total of 442 healthcare professionals from 7 government hospitals in Addis Ababa city participated in the study. From these hospitals 387 healthcare professionals (physicians=135,34.9%, nurses=218,56.3% and physiotherapist=34,8.8%) completed the questionnaire. 21.4% of healthcare professionals very frequently provide verbal prescription, 5.4% provide written prescription of physical activity for the purpose of treating and preventing NCDs. The fit of the TPB model was well fit (RMSEA=0.072, CFI=.926, TLI=.910, GFI=.902). The PBC (β=.25, p<.05) and INT (β =.17, p<.05) explained physical activity prescription behavior and PBC (β=.39, p<.05), ATT (β=.16, p<.05) explained intention to prescribe physical activity. Conclusion: HCPs's physical activity prescription practice was low. The findings of this study were supported the theory and the TPB have the predictive utility in describing and predicting physical activity prescription behavior among healthcare professionals in hospital setting. The TPB confirmed to be a useful theoretical framework that should be used for understanding healthcare professionals' physical activity prescription behavior in hospital setting. The present study found that perceived behavioral control was the strongest predictor of intention followed by attitude and subjective norm. Also not only for intention it was a strong predictor followed by intention for physical activity prescription behavior and had a direct effects on healthcare professionals' PAP behavior Recommendation: Interventions/strategies focused on improving healthcare professionals' perceived ability to provide physical activity prescription and the willingness or motivation of healthcare professionals to prescribe physical activity for their patients are important. For instance, facilitating fitness centers or gyms in hospitals can encourage healthcare professionals to prescribe physical activity for their patients as well as to make active HCPs.

Impact of educational intervention on health-care professional's behaviors toward adverse drug reactions reporting - A study of tribal belt of central India

Background: Adverse drug reactions (ADRs) are one of the most significant causes of mortality; hence, it must be reported. Very few studies were done, including educational intervention and even fewer in a tribal area of world, especially in India. Aims and Objectives: We planned this study to assess the knowledge, attitude, and practice (KAP) of pharmacovigilance (PVG) and ADR reporting of health-care professionals (HCPs) of tertiary care hospital of the central tribal belt in India before and after an educational intervention. Materials and Methods: A cross-sectional descriptive KAP pre- and post-questionnaire based study was conducted on a total of 164 participants, including doctors and nurses working in Tertiary Care Hospital, Ratlam, India. A predesigned structured questionnaire with multiple-choice questions was used for pre-test and post-test along with the intermediate educational session. Furthermore, the practice of ADR reporting was assessed over a month’s time. The data were analyzed using descriptive statistics and Fisher’s exact test was done to compare the difference in correctness for each question. Results: In the pre-test, about 73.77% of the doctors and 11.65% of the nurses knew what is PVG, while the post-test response rocketed to 100% in doctors and 98.06 % in nurses (P < 0.001). The overall knowledge and attitude of doctors and nurses were low initially and it improved significantly (P < 0.001) after the educational intervention. Furthermore, ADRs reported increased from 0 to 10 (P < 0.001) during the follow-up practice of 1 month of the study. Conclusions: Educational intervention is a reinforcement tool to improve the KAP of the ADR reporting of HCPs. Furthermore, more awareness and cooperation by the HCPs are required to deal with the prevalent under-reporting of the ADRs in tribal region of India.

During COVID-19, which is more effective in work accident prevention behavior of healthcare professionals: Safety awareness or fatalism perception?

As the pandemic process, COVID-19 has a serious occupational safety risk for healthcare professionals. Therefore, determining their health and safety perceptions and attitudes in the pandemic process is very important. This study aims to determine which is more effective in work accident prevention behavior: safety awareness and competencies of healthcare professionals or perception of fatalism. For this purpose, a questionnaire was applied to 326 healthcare professionals. The questionnaire consists of four parts: (1) demographic information of the employees, (2) scale of preventing occupational accidents, (3) fatalism perception scale in occupational health and safety, and (4) security awareness and competency scale. Descriptive statistical methods, multiple regression and correlation analysis were used in the analysis of the data. It was determined that the participants' safety awareness and competencies were at the high level and their fatalism perceptions were at the low level. The average of the responses given by the participants to the scale of preventing work accidents was above the middle level. According to the study, the safety awareness and competencies of health workers were found to be about three times more effective on the behavior of preventing work accidents than the perception of fatalism. In conclusion, it is important to recommend managers to take the step to increase the safety awareness and competencies of those working in their institutions.

Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy: A grounded theory study.

Childhood cancer invades the child's daily life and has a strong influence on their living conditions and lifestyle. The treatment is an unpleasant experience and the children often perceive the treatment as worse than the actual disease. The aim of the present study was thus to explore the process of how healthcare professionals improved care for children undergoing sedation for intrathecal chemotherapy. A constructivist grounded theory approach was applied and qualitative interviews with paediatricians (n=2), anaesthetists (n=2), paediatric nurses (n=3) and nurse anaesthetists (n=5). The theory of creating a shielding place emerged and conceptualized the pattern of behavior of healthcare professionals throughout the procedure of sedation for intrathecal chemotherapy for pediatric leukaemia. The theory explains the core category 'shielding' and the process of how healthcare professionals developed strategies to resolve their main concern: a striving to reduce discomfort and suffering induced by the procedure and the treatment. These strategies, used throughout the procedure, were; de-dramatizing, de-exposing and minimizing trespassing. The theory of creating a shielding place offers a greater understanding of how healthcare professionals included the child's perspective in their work and thereby enabled a more sensitive and supportive care that had an impact on both quality of care and patient safety. The results from the study contributes with theoretical knowledge that can be used for developing evidence-based care guidelines for the procedure of sedating a child with leukaemia for intrathecal chemotherapy.

Acceptability of dietary or nutritional supplementation in pregnancy (ADONS) – Exploring the consumer's perspective on introducing creatine monohydrate as a pregnancy supplement

BackgroundPre-clinical studies suggest maternal dietary creatine supplementation during pregnancy could protect babies against hypoxic intrapartum events, however creatine has not been used as a supplement in pregnancy. The aim of this study was to explore pregnant women and healthcare professional's general knowledge, behaviours, and attitudes toward nutritional supplements, and their thoughts on introducing creatine as a pregnancy supplement. MethodsPregnant women (n = 42) and partners (n = 23), attending a tertiary care pregnancy service in Melbourne, Australia, participated in focus groups or semi-structured interviews. Health professionals (n = 100), completed a semi-structured online survey. Descriptive data were analyzed using SPSS 25.0 and qualitative data was managed using NVivo 22.0. ResultsUse of branded nutritional supplements in pregnancy was commonplace and acceptable. All primary healthcare respondents discussed supplements with their patients at first consultation. Supplements consumed corresponded closely to those recommended. Women had good general awareness of commonly recommended nutritional supplements, however, were less aware of the rationale for supplement use. This aligned with health professional's perceptions. Women would consider taking creatine if recommended by their health professional. Health professionals would require detailed safety, beneficence, and efficacy information before recommending creatine supplementation. They would also be more likely to recommend a new supplement in higher-risk pregnancies, where benefits may outweigh any perceived side-effects. ConclusionThere is high acceptance of current recommended nutritional supplements in pregnancy. Implementing creatine as a new supplement will require substantive empirical evidence and changes to clinical guidelines. Public awareness and education would also be essential to consumer acceptability of creatine.

Exploring the provision of diabetes nutrition education by practice nurses in primary care settings.

High-quality nutrition education is recommended as an essential component of diabetes care. In the UK, there has been a gradual shift of inter-professional boundaries with respect to providing nutritional care for people with type 2 diabetes. Only a minority now regularly receive advice from a dietitian. Instead, increased demands for nutrition education are being absorbed by practice nurses. The present study seeks to explore this situation through the views of practice nurses on the services that they provide and the issues they face. A qualitative approach using semi-structured interviews was employed. Practice nurses were recruited using purposive sampling, and nine were interviewed. Data were analysed using the Framework Method. The Theoretical Domains Framework from the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model of behaviour change, as increasingly employed to explore the behaviour of healthcare professionals, was used to further frame the findings. Practice nurses reported that ongoing diabetes nutrition education only took place at annual review appointments and was limited to 5-10min. They described how they are expected to take on a more advanced role in diabetes nutrition education than they can provide and are becoming increasingly isolated in this role as a result of a lack of time, practical and informational support, and training standards and provision. A range of service improvements led by dietitians, which focus on strengthening the working environment and enhancing professional support available for practice nurses who provide diabetes nutrition education, could improve quality of care and health outcomes in people with diabetes within current time restraints.

Key factors for overcoming psychological insulin resistance: an examination of patient perspectives through content analysis

ObjectiveTo understand participant perceptions about insulin and identify key behaviors of healthcare professionals (HCPs) that motivated initially reluctant adults from seven countries (n=40) who had type 2 diabetes (T2D) to...

Establishing and Evaluating an ASCO Learning Cohort: a Longitudinal Project Assessing the Learning Needs and Behaviors of Oncology Professionals.

In 2013, the American Society of Clinical Oncology (ASCO)'s Continuing Education Committee recommended establishing an interprofessional, longitudinal cohort pilot project. The main goals of the cohort were to gain feedback from oncology providers on how they use resources to address their learning needs and gain insights into the utility of different ASCO educational activities. The ASCO Learning Cohort Pilot Project included 49 ASCO members that were representative of the overall Society membership demographics and ran from November 2015 through August 2016. Participants documented monthly learning needs and completed monthly feedback activities focused on specific ASCO educational resources. The Learning Cohort Pilot Project proved a viable and innovative cohort model for analyzing the learning process for oncology healthcare professionals. The development, operations, and compliance required unique infrastructure to accomplish this project. Relationships between participant demographic variables and learning preferences are reported elsewhere. The ASCO Learning Cohort Project is a unique educational project that demonstrated feasibility and has met its goals. This paper outlines the processes of establishing a learning cohort, including participant selection, project design, and participant feedback. We evaluate the project model as a means to better understand the learning needs and behaviors of oncology healthcare professionals.

Exploring public perspectives of e-professionalism in nursing.

E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses' e-professionalism. To explain what, how and why the public make decisions about the acceptability of nurses' online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. This was a mixed-method critical realist study. Participants in a survey ( n =53) and two focus groups ( n =8) discussed and rated the acceptability of five vignettes related to nurses' online behaviours based on real-life examples. The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. The public make decisions on the acceptability of nurses' online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can 'tag' and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based.

Red meat and processed red meat consumption behaviour of healthcare professionals: do they participate in the World Health Organization's view of red meat carcasses and red meat carcinogens?

This study investigated the consumption behaviours of healthcare professionals in relation to red meat and processed red meat products. This study included a questionnaire conducted through face-to-face interviews with 149 health professionals. The purpose of the questionnaire was to determine the extent to which health professionals agreed with the WHO classification of red meat and processed red meat on their list of carcinogenic products. This research was carried out in İzmir, which is Turkey's third largest city. The survey was conducted in 2016 by holding face to face interviews with forty-three specialist doctors, sixteen doctors, twelve dentists, sixty-four nurses and fourteen pharmacists. Nationally representative sample of healthcare professionals in Turkey. People educated in healthcare are especially cautious about the consumption of processed red meat products. The results of the research revealed the importance of processing and cooking patterns in red meat consumption preferences. The consequences of the research, in terms of breaking down prejudices and overcoming the anxieties of those with health concerns who do not consume red meat, are important. In fact, the results show that healthcare professionals consume red meat, but they are more careful in their consumption of processed red meat products. This result is in line with the WHO report.

Sponsorship of national and regional professional paediatrics associations by companies that make breast-milk substitutes: evidence from a review of official websites

ObjectivesProfessional paediatrics associations play an important role in promoting the highest standard of care for women and children. Education and guidelines must be made in the best interests of patients....