Client Interactions Research Articles

Weight management: insights from the science of human behaviour change

Helping animal owners to recognise and manage obesity in their animals is a particularly complex area of communications in veterinary medicine. Several studies have outlined the difficulty veterinary professionals face in such discussions, including frustration with the client, embarrassment (particularly if the owner is also overweight), and a sense of inevitable failure. However, obesity continues to be a serious and prevalent welfare problem in dogs, cats, and probably other companion animals as well — hence those discussions will only continue. This review considers veterinary surgeon–client interactions around obesity from the perspective of behaviour change psychology and motivational interviewing, in order to determine how veterinary surgeons and nurses can best assist owners. We consider how an approach based on a supportive and empathetic conversational style could be best suited to these discussions, leading to tailored weight management solutions. Nurses are ideally placed to work with owners in this way.

Barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities: A theory-informed qualitative study.

BackgroundCare institutions are recognised to be a high-risk setting for the emergence and spread of infections and antimicrobial-resistant organisms, which stresses the importance of infection prevention and control (IPC). Accurate implementation is crucial for optimal IPC practice. Despite the wide promotion of IPC and research thereof in the hospital and nursing home setting, similar efforts are lacking in disability care settings. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDD), as well as to identify professional-reported recommendations to improve IPC.MethodsThis qualitative study involved semi-structured interviews (before COVID-19) with twelve professionals from five Dutch RCFs for people with IDD. An integrated theoretical approach was used to inform data collection and analysis. Thematic analysis using inductive and deductive approaches was conducted. This study followed the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines.ResultsOur findings revealed barriers and facilitators at the guideline, client, professional, professional interaction, professional client interaction, client interaction, organisational, community, and societal level. Six main themes covering multiple barriers and facilitators were identified: (1) guidelines’ applicability to (work)setting; (2) professionals’ cognitions and attitude towards IPC (related to educational background); (3) organisational support and priority; (4) educational system; (5) time availability and staff capacity; and (6) task division and change coaches. The main professional-reported recommendations were the introduction of tailored and practical IPC guidelines, structural IPC education and training among all professionals, and client participation.ConclusionsTo promote IPC, multifaceted and multilevel strategies should be implemented, with a preliminary need for improvements on the guideline, professional, and organisational level. Given the heterogeneous character, i.e., different professionals, clients and care needs, there is a need for a tailored approach to implement IPC and sustain it successfully in disability care. Our findings can inform future IPC practice improvements.

Allergic rhinitis self-care advice in community pharmacies: A simulated patient study

BackgroundPharmacists and pharmacy assistants can support consumers by identifying minor ailments and providing evidence-based advice about treatment options. In the Netherlands, advice is based on national minor ailment guidelines and structured WWHAM questions (Who, What, How long, Action, Medication). ObjectivesTo study whether pharmacy assistants provide guideline-compliant advice for allergic rhinitis based on WWHAM and condition-specific questions (When and Familiarity) and their association with appropriate self-care advice. MethodsA retrospective study of the assessments of simulated patient (SP) visits regarding one condition- and two symptom-based cases of allergic rhinitis in Dutch community pharmacies. Pharmacies that participated in 2014, 2016 and 2018 were selected. SPs documented their observations of the problem analysis, dispensing and client interaction on a standardized scoresheet. Dispensing of an oral antihistamine according to the guideline recommendation was considered as the correct outcome. Chi-square tests were used to analyze differences in scores for problem analysis of pharmacies with correct and incorrect advice provision in 2014 and 2018. Predictors for correct outcome were identified by univariate and multivariate logistic regression analysis. ResultsData from 673 pharmacies were available for all three years. In 2014 and 2018, problems were presented as a symptom (running nose), and 41.2% and 21.1% of pharmacies dispensed an antihistamine. For the condition-based problem (allergy) in 2016, 96.0% of participating pharmacies dispensed an antihistamine. Both in 2014 and 2018, each additional problem analysis question increased the odds ratio of providing correct advice. Questions asked about ‘hay fever symptoms’, ‘medication’, ‘when symptoms occurred’, and ‘familiar symptoms’ were significant predictors of correct advice provision. ConclusionsMost pharmacies provided appropriate advice for a condition-based request but less than half of them provided appropriate advice for a symptom-based request. More questions asked was associated with an increased chance of providing correct advice. Addition of condition-specific questions may improve the WWHAM-method.

Outcomes from the Adaptation of an Evidence-Based Peer Linkage & Re-Engagement Intervention for Women of Color with HIV in Three Urban Clinics.

Peer interventions have demonstrated efficacy with improving HIV health outcomes. Yet, little is known about factors associated with their uptake into the clinic setting. Three urban sites in the US were funded to adapt, implement and evaluate a peer intervention to improve HIV health outcomes for 173 out of care and newly diagnosed women of color. Peers worked with cis and transgender women of color for four months to achieve the goals of linkage and retention in HIV case management and medical care. Results were 96% of women were linked to medical care, 73% were retained in care and 81% were virally suppressed post 12months. The average duration of the peer intervention was seven months. Women who received four peer encounters had a 10% increase in retention in care and viral suppression. The findings highlight key elements such as dose and duration of client interaction for peer staff as part of the health care team.

‘Between a rock and a hard place’: Challenging encounters between disability service clients and workers

ABSTRACT Professional relationships in the health and welfare sector involve many challenging client encounters. This study aims to describe what kind of client interaction social service workers in disability services find challenging and how they rationalise and manage these challenges. The study investigates disability service workers’ perceptions of challenging client interactions using data from 22 interviews with disability service workers in two hospital districts. Interviewees highlighted lack of mutual trust and lack of shared understanding as two issues arising in challenging communicative behaviours that disability service workers find burdensome and miserable. The interviewees’ accounts referred to four aspects of these challenges: 1) individual, 2) third-party, 3) structural and 4) experiential. In addition, six different management strategies were identified: 1) adjusting interaction, 2) listening, 3) negotiating, 4) problem solving, 5) withdrawing and 6) encounter interruption.

Teaching the Design Process in a HyFlex Environment

This paper addresses how one instructor redesigned a face-to-face design course - Introduction to Engineering Design (IED) - known for its collaborative and experiential learning focus to accommodate a synchronous hybrid flexible (HyFlex) delivery. In semesters prior to spring 2020, students in IED learned the design process by practicing it using a project supported by clients and customers in the local community. Due to Covid19, however, students during the 2020 spring and fall semesters and the 2021 spring semester could not physically meet with traditional clients, which is integral to the experiential aspect of the course. It was also difficult for students to physically meet consistently in teams. These alterations had the ability to negatively affect the learning experience. Thus, the collaborative nature of the class and the client identification and interaction structure was revised. This paper describes the course design process focus, project and client identification, and team collaboration process used in the HyFlex delivery to aid learning of the design process.

The economic logic of OR consulting practice: Towards a foundational view

AbstractThe establishment of foundations for operational research (OR) enables OR academic researchers to ground their theoretical research. As OR consultants, we compete for commercial contracts with clients based on our practical expertise. The paper seeks to identify the economic foundations of this contracting process, to separate those aspects most likely to endure from those that are more ephemeral. The focus of the analysis is on the behaviour of the players in the consulting services market. The market for consultancy thrives despite the fact that it is difficult for both consultants and clients to understand what is being sought and what is being offered. A key question for everyone concerned is how this problem is resolved in practice. The paper distils existing theories into a set of foundational statements that inform OR research aimed at improving the practice of OR consultants and client interactions. Eight economic foundational statements are derived.

A Case Study of Publishing Internal APIs to External Users

External service integration and adherence to industry standards has become ever more important for collections data management platforms. External APIs (Application Programming Interfaces), allow for the development of bi-directional data flows critical to service integration. In contrast to service-oriented backend APIs, public APIs must have continually up-to-date, comprehensive documentation that covers common use cases, on-the-fly request validation, and meaningful error messages. OpenAPI (OpenAPI Initiative 2021), a machine-readable API documentation specification can help significantly with testing and maintenance, and libraries can be used to automate common maintenance tasks. Specify 7 is a biological collections data management platform developed by the Specify Collections Consortium (Specify Software Consortium 2021). This presentation summarizes the challenges and lessons learned with publishing the existing backend Specify 7 API to a public-facing external API. Each Specify 7 API is composed of 200 resources. A standard set of CRUD (Create, Read, Update, Delete) operations is provided for each resource for client interaction with a group of service-based endpoints for bulk operations such as file uploads, file-based data imports, and attachment manipulation. To support the migration, we developed a custom library to enhance request validation. Parameter validation is extended through a real-time comparison against the existing schema and data. The library is available to the community under a MIT license on GitHub (https://github.com/specify/open_api_tools/). In this presentation, we will close with an overview of the next steps for the Specify 7 public API. These include: An update to the latest OpenAPI specification, version 3.1. The latest version aims to increase compatibility with the Javascript Object Notation (JSON) Schema specification, and thus would allow us to use JSON Schema (IETF Trust 2021) validation frameworks. An in-depth evaluation of GraphQL for its ability to force all endpoints to be strongly typed and automatic validation of request parameters and response objects. An update to the latest OpenAPI specification, version 3.1. The latest version aims to increase compatibility with the Javascript Object Notation (JSON) Schema specification, and thus would allow us to use JSON Schema (IETF Trust 2021) validation frameworks. An in-depth evaluation of GraphQL for its ability to force all endpoints to be strongly typed and automatic validation of request parameters and response objects.

Personalized Robo-Advising: Enhancing Investment Through Client Interaction

Automated investment managers, or robo-advisors, have emerged as an alternative to traditional financial advisors. The viability of robo-advisors crucially depends on their ability to offer personalized financial advice. We introduce a novel framework in which a robo-advisor interacts with a client to solve an adaptive mean-variance portfolio optimization problem. The risk-return tradeoff adapts to the client’s risk profile, which depends on idiosyncratic characteristics, market returns, and economic conditions. We show that the optimal investment strategy includes both myopic and intertemporal hedging terms that reflect the dynamic risk profile of the client. We characterize the optimal portfolio personalization via a tradeoff faced by the robo-advisor between receiving information from the client in a timely manner and mitigating behavioral biases in the communicated risk profile. We argue that the optimal portfolio’s Sharpe ratio and return distribution improve if the robo-advisor counters the client’s tendency to reduce market exposure during economic contractions when the market risk-return tradeoff is more favorable. This paper was accepted by David Simchi-Levi, stochastic models and simulation.

Australian Social Workers’ Understandings of Technology in Practice

ABSTRACT Existing international research that tracks technology use in social work practice often focuses on specific forms of technology. The study outlined in this article explored Australian social workers’ understanding and use of technology related to their practice experiences more broadly. With a sample of 100 participants who had less than 12 months to 20+ years of social work experience, the study found that Australian social workers utilise technology without clear boundaries, policies, or professional access. It found that organisations prioritise technological resources for outcomes measurement rather than finding ways technology could benefit service user relationships. Social workers attempt to mediate practice tensions and complexities by understanding client-centred approaches rather than specific theories or social work models with technology. This study suggests that guidelines and conceptualisations for social work practice with technology require further development. This article argues for a social work–based understanding of technology as a context of practice, requiring social workers to navigate profession-specific knowledge, skills, and values to contribute to social work–led technology. IMPLICATIONS Technology in social work practice is yet to fully support client connection, engagement, advocacy, and interaction. Organisational contexts shape and often limit technology use by social workers, thus minimising the potential for social work–led conceptualisations and practice. Social workers individually navigate limitations presented by practice contexts without drawing on social work–specific knowledge of technology, inhibiting the profession from contributing to practice-led technology.

A Competitive Analysis of BitTorrent-like Algorithms for Interactive Video-on-Demand Streaming over MANETs

This article carries out a competitive analysis between BitTorrent-like algorithms for interactive video-on-demand streaming over mobile ad hoc networks. To this end, we herein mainly delve into five recent proposals of this kind, and assess the operational download (DO) and the discontinuity-time (DT) performance metrics in different scenarios by means of simulations, considering two client interactivity profiles, two mobility models, and various network sizes. Although final results indicate that all five proposals may provide suitable system quality of service and client quality of experience in certain scenarios, the one named as BitTorrent Interactive Broadcast - Network is overall the most competitive one. For instance, compared to other literature proposals, it may provide optimizations of up to 106% and 86% at the DO and DT metrics, respectively, thus confirming its attractive performance.

Home‐ and Community‐Based Work at the Margins of Welfare: Balancing between Disciplinary, Participatory and Caring Approaches

By the end of the 20th century, deinstitutionalisation had become a pervasive trend in the Western world. This thematic issue discusses how successful deinstitutionalisation has been in enabling dignified and safe living with necessary services in local communities. It contributes to an understanding of the history and phases of deinstitutionalisation and ‘home turn’ policies, and sheds light on the grassroots‐level of home‐ and community‐based work at the margins of welfare, hitherto little researched. The latter includes grassroots work to implement the Housing First approach to homelessness, commonly portrayed as a means of social inclusion, worker–client interactions during home visits and in the local community, as well as close inspections of what ‘housing support’ may actually entail in terms of care, discipline and service user participation.

Transforming Worker–Client Identities: From Shelters to Housing First

The Housing First (HF) approach to counteracting homelessness, stemming from the USA, is advocated as a blueprint for homelessness policy change in Europe, including the Nordic countries. In contrast to traditional homelessness policies based on shelters as the first step towards ending homelessness, the HF policy discourse regards access to one’s own housing as a basic human right that should not be conditional upon good or acceptable behaviour. Building on ethnographic research in a Swedish HF unit striving to implement the HF approach ‘by the book,’ which includes both focus group interviews with workers and observations of worker–client interactions during home visits, we show how the new HF policy challenges both workers and clients, who used to encounter each other in shelters but now meet in clients’ own homes, transforming their identities. We demonstrate how workers account for transformations in worker–client identities by referring to how they and their clients used to think, talk and act, thus contrasting their new identities with their former selves. Moreover, in their efforts to accomplish their actual work tasks within the framework of the new HF policy discourse in the homes of formerly homeless clients, we show how workers struggle with their identities when they encounter clients in practice. In their accounts of policy change, the workers embraced their new identities with pleasure, but in practice, they were hesitant when dealing with issues of concern, such as their clients’ use of tobacco, alcohol and drugs. In sum, it becomes complicated in practice.

Separating symbolic and active representation: a mixed methods study of gender and education in China

ABSTRACT Bureaucracies representative of the public can affect programme outcomes either through active representation by bureaucrats or symbolic representation via changes in client behaviour. Separating out these different aspects of representation requires understanding the interaction of bureaucrats and clients which is difficult using only quantitative data. Using individual-level quantitative analysis of Chinese education data, we find gender representation exists. Qualitative interviews of teachers, students and school principals, however, indicate that the effects are most likely not from active representation but rather via the symbolic representation through role-model effects.

THE IMPACT OF MOBILE BANKING APPLICATION ON CLIENT INTERACTION WITH YEMEN BANKS

Purpose: The purpose of the study is to analyse the impact of a mobile banking application on client interactions with banks in Yemen.
 Methodology: Data were collected using structured questionnaires. The Statistical Package for the Social Sciences (SPSS) was used for statistical analysis. Descriptive statistics and correlation values were used to report the results. This paper coverers the barriers and the factors that might affect badly on the performance of the mobile banking services in the Yemen banks industry.
 Findings: The findings of this study show that the traditional method of banks is changing; the entire system of banks has been changed from the traditional old way to the advanced way, and The traditional way is a paper-based banking provider while the new way is to use the technology as a method to enhance the performance of the banks such as the usage of mobile banking. In addition, the result of this paper is that there is a link between the user stratification and supportive access factor, and they are related to mobile banking. However, recently mobile banking is being adopted scientifically in recent years as most of the systems are become computerized and mobile phones are being in the market more than computers. Although, the emerging new technology to the banks' services market is exposed to barriers to the adoption of mobile banking services. The results of this current study will provide insights into the factors that affect the successful uptake of mobile banking services among clients of Yemeni banks.

Impact of Occupational Therapy Education on Students' Disability Attitudes: A Longitudinal Study.

Discrimination based on disability-ableism-is pervasive and affects the opportunities of people with disabilities to fully engage in society. The aim of this study was to explore the impact of occupational therapy graduate education on students' explicit and implicit disability attitudes throughout their graduate education. Longitudinal observational study, measuring occupational therapy students' attitudes on an annual basis. Three Midwestern graduate occupational therapy programs. Occupational therapy students (N = 67). Outcomes and Measures: Participants completed the Symbolic Ableism Scale (to measure their explicit disability attitudes) and the Disability Attitude Implicit Association Test (to measure their implicit disability attitudes) on an annual basis, from when they entered their occupational therapy program to when they graduated. The students' explicit attitudes decreased (i.e., became more favorable) throughout their education; however, their implicit attitudes did not change. In fact, most students (68%) were implicitly ableist at graduation. Occupational therapy education programs have an important role to play in terms of intervening with students' beliefs and preconceived assumptions about disability. Our finding suggests that occupational therapy programs may fail to intervene with students' ableist attitudes. What This Article Adds: Little longitudinal research has examined how students' implicit disability bias may be affected by their academic experience. Our findings about ableism among occupational therapy students should open the door for further dialogue on the existence of ableism in program content, its potential impact on future client interactions, and the development of approaches to address it.

Home-care workers' experiences of assisting people with dementia with their personal care: A qualitative interview study.

Home-care workers are increasingly caring for clients living with dementia. Workers usually have limited dementia training and are low paid and often lone working. Little is known about how home-care workers assist people with dementia with their personal care. We aimed to explore the experiences of home-care workers and the knowledge and skills they rely on when providing personal care to people with dementia. In 2020, we conducted 17 semi-structured, face-to-face interviews with home-care workers in the East of England. Analysis was inductive and thematic. Two key themes were present in the data: 'structural conditions' and 'clients' dementia-related characteristics'. For each of these, we examined the challenges faced by home-care workers and the strategies they used to manage these challenges. Challenges included time allocation for visits, completing care plan tasks, lone working, communication and understanding, refusals of care, and client behaviours. To mitigate these challenges, home-care workers utilised system support, time management, training and experience and enacted a caring relationship, thought about their approach, and used distraction and communication skills. Workers relied on skills such as, relationship building, team working, observation, communication, decision making and interpersonal sensitivity. They drew on knowledge about the person, the person's needs, their own abilities, company policies and procedures and their role and responsibilities as a home-care worker. Home-care workers had more scope to mitigate client-based challenges by adapting care within client interactions, than to manage structural challenges where there was a limit to what workers could do. Despite a commissioning focus on time- and task-based care, when caring for people with dementia, home-care workers used interaction as a way to bring the person along and complete care activities. Home-care services should acknowledge the importance of interactions with people with dementia within home care and support their workers to develop interpersonal sensitivity.

Microhabitats of sharknose goby (Elacatinus evelynae) cleaning stations and their links with cleaning behaviour

Coral reefs are renowned for the complexity of their habitat structures and their resulting ability to host more species per unit area than any another marine ecosystem. Dedicated cleaner fish, which acquire all their food resources through client interactions, rely on both the habitat structures (by using topological cleaning stations) and the wide diversity of fish species available on coral reefs, to function. As a result of natural and anthropogenic threats, coral reef habitat structures and their complexity are being lost—despite this threat it is unclear how important reef geometry is to key ecological interactions, like cleaning. Using an established Caribbean reef study site, three-dimensional constructions of discrete coral heads were used to investigate how fine-scale structural complexity traits (structural complexity—measured by rugosity and vector dispersion—height, volume, surface area, percentage live coral cover and refuge availability) relate to cleaner occupancy, abundance and their cleaning interactions with clients. Coral height was a particularly important trait for cleaning, correlating with both the occurrence of cleaning stations on a reef, and with increased cleaning durations and reduced cleaning frequencies/rates. Cleaning stations were also more structurally complex than non-cleaning coral heads, and the increased availability of uneven surfaces (creating cracks and crevices) and refuge availability linked with increased cleaning durations/rates. By understanding habitat features important to cleaner fish on a typical Caribbean fringing reef, we can gain a better understanding of how important reef geometry might be for governing the occurrence and dynamics of such mutualisms.

Factors associated with midwives’ job satisfaction and experience of work: a cross-sectional survey of midwives in a tertiary maternity hospital in Melbourne, Australia

BackgroundSignificant factors affecting the Australian maternity care context include an ageing, predominantly part-time midwifery workforce, increasingly medicalised maternity care, and women with more complex health/social needs. This results in challenges for the maternity care system. There is a lack of understanding of midwives’ experiences and job satisfaction in this context. AimTo explore factors affecting Australian midwives’ job satisfaction and experience of work. MethodsIn 2017 an online cross-sectional questionnaire was used to survey midwives employed in a tertiary hospital. Data collected included characteristics, work roles, hours, midwives’ views and experiences of their job. The Midwifery Process Questionnaire was used to measure midwives’ satisfaction in four domains: Professional Satisfaction, Professional Support, Client Interaction and Professional Development. Data were analysed as a whole, then univariate and multivariate logistic regression analyses conducted to explore any associations between each domain, participant characteristics and other relevant factors. FindingsThe overall survey response rate was 73% (302/411), with 96% (255/266) of permanently employed midwives responding. About half (53%) had a negative attitude about their Professional Support and Client Interaction (49%), and 21% felt negatively about Professional Development. The majority felt positively regarding Professional Satisfaction (85%). The main factors that impacted midwives’ satisfaction was inadequate acknowledgment from the organisation and needing more support to fulfil their current role. ConclusionFocus on leadership and mentorship around appropriate acknowledgement and support may impact positively on midwives’ satisfaction and experiences of work. A larger study could explore how widespread these findings are in the Australian maternity care setting.

Job Design to Extend Working Time: Work Characteristics to Enable Sustainable Employment of Older Employees in Different Job Types

Due to an aging workforce and an increasing structural labor shortage across Western economies, it is important to design jobs for older workers that support their continued employability. The aim of this qualitative study was to investigate how job type (operational, professional and managerial jobs) influences work characteristics older workers need to continue working. Semistructured interviews were conducted with 21 older (55+) Dutch employees working in the health and education sector. A full thematic analysis of interview transcripts was performed, and work characteristics were identified, coded, categorized and compared to discover patterns of similarities and differences between job types. The results show that job types have a number of work characteristics in common: operational job types share autonomy with managers and client interaction with professionals, and professionals and managers share mentorship. Unique work characteristics for operational roles are supervisor support and comfortable workspace. Professionals especially want to use their expertise and flexible working hours, and managers are different because they value personal development and contact with colleagues. In conclusion, the results show that certain work characteristics have a different impact on the design of future jobs for older workers, depending on the type of job of the employee.