Ordinary Staff Research Articles

The Current Status of the Use of Internet Hospitals for Outpatients With Pain: Retrospective Study.

The national "Internet +" policies and the emergence of internet hospitals have created a new direction for the management of pain outside of the hospital. Nevertheless, there are no consolidated studies conducted by pain physicians on the current state of internet hospital-based online medical services used by patients with pain outside of a hospital setting. In this retrospective study, we aimed to examine the status of the use of internet hospitals by patients who experience pain. Moreover, we identified the factors that influenced patients' decisions to make an online visit through the internet hospital. Detailed information was collected online and offline from outpatients with pain at the information technology center of West China Hospital of Sichuan University from February 2020 to April 2022. Binary logistic regression analysis was conducted to identify the determinants that influenced patients' decisions to make an online visit to the internet hospital. Over a 2-year period, 85,266 pain-related clinic visits were recorded. Ultimately, 39,260 patients were enrolled for the analysis, with 12.9% (5088/39,260) having online visits. Both online and offline clinics had a greater number of visits by women than men. The average age of patients attending the online clinic was 46.85 (SD 16.56) years, whereas the average age of patients attending the offline clinic was 51.48 (SD 16.12) years. The majority of online clinic visitors (3059/5088, 60.1%) were employed, and one of the most common occupations was farming (721/5088, 14.2%). In addition, 51.8% (2635/5088) of patients who participated in the online clinics lived outside the hospital vicinity. Young (odds ratio [OR] 1.35, 95% CI 1.01-1.81; P=.045) and middle-aged (OR 1.98, 95% CI 1.81-2.16; P<.001) patients, employed patients (OR 1.11, 95% CI 1.04-1.18; P=.002), nonlocal patients (OR 1.57, 95% CI 1.48-1.67; P<.001), and the ordinary staff (OR 1.19, 95%CI 1.01-1.39; P=.03) were more likely to have the intention to choose online visits through the internet hospitals. Internet hospitals are flourishing as a more efficient and promising method of pain management and follow-up for patients with pain outside the hospital. People with pain who are young, working, and not in the vicinity of hospitals are more likely to visit internet hospitals.

Gaya Kepemimpinan Kepala Distrik Heram Kota Jayapura

The importance of leadership in managing organized human groups, so the role of leaders in improving organizational performance is very significant. This article aims to describe and analyze the leadership style of the Heram District of Jayapura City. The research method is descriptive qualitative. The research site is Heram District, Jayapura City. The informants were purposively selected by determining the categories of informants, district heads and Waena district staff. Data collection techniques used were observation and interview. The data analysis techniques include stages of data reduction, data presentation, and drawing conclusions. The results of the research show that there are three characteristics of the leadership model of the Heram District Head of Jayapura City, namely first, the rational-legal leadership model, meaning leadership is achieved based on appointment from the Jayapura Municipal Government Authority based on laws and regulations, second, communicative-coordinative, meaning leadership that is open, listening and directing and protecting all the people he leads, namely employees and residents in his leadership area, and the three models of exemplary leadership, because he shows this from his work experience, rising from ordinary staff to district head. In carrying out this leadership, the participation of the employees is needed to move the organization so that when communication and coordination work well, the goals of the organization can be achieved.

Соціально-побутові умови та продовольче забезпечення науково-педагогічних працівників СРСР у 20-х рр. ХХ століття

У статті розглянуто один із актуальних напрямів в історичних студіях щодо особливостей соціально-побутових умов та продовольчого забезпечення науково-педагогічних працівників СРСР у 20–30-х рр. ХХ століття. Мета роботи полягає у висвітленні діяльності російських центральних та місцевих органів влади з покращення соціально-побутового, матеріального та житлового забезпечення наукових та педагогічних працівників, зокрема створення та діяльність ПетроКУБУ та ЦеКУБУ. Методологія дослідження включає принципи наукової об’єктивності, історизму, системності, а також методи аналізу та синтезу, узагальнення, історико-порівняльний, історико-типологічний. Висновки. Характеризуючи становище вчених у 20-х рр. ХХ ст., необхідно зазначити, що наукова інтелігенція, як і загалом радянське післяреволюційне суспільство, знаходились у складній суспільно-політичній та економічній ситуації. Наукова інтелігенція належала до тих верств суспільства, які особливо гостро відчули погіршення якості життя. Закриття низки вищих навчальних закладів і факультетів, затримки з виплатою заробітних плат, що і без того знецінювалися через розгул інфляції, позбавляли науковців стабільного доходу. Цей важкий у побутовому плані період співпав у часі з болісною трансформацією соціальної структури населення країни, що зачепило і наукову інтелігенцію. Матеріальне становище вчених було досить хитким, характеризувалося відсутністю житла, низьким рівнем заробітної плати, відсутністю умов для проведення науково-дослідної роботи, завантаженістю партійно-політичною роботою. Змінилося й ставлення до вчених та їх ролі в житті суспільства, побутувала думка про неприпустимість керівної ролі інтелігенції в будь-якій галузі народного господарства та культури, зведення становища представників інтелігенції до рядових виконавців. До того ж радянське керівництво розуміло, що науковий потенціал країни потрібно зберегти для будівництва соціалістичного суспільства. Тому одним із головних був пошук можливостей порятунку вчених від вимирання і надзвичайного виснаження. Влада починає вибудовувати співпрацю з інтелектуальною системою, залучаючи її на свою сторону, створюючи для неї сприятливі умови для життя та роботи.

КОНКУРЕНЦІЯ УКРАЇНСЬКИХ МОРЯКІВ НА СВІТОВОМУ РИНКУ ПРАЦІ

The article highlights the importance of the sea industry in the world, which takes one of the first places in the international transport and trade system. An annual increasing in the international commercial fleet needs more intensive training of marine industry. Particular attention is paid to the preparation of officers and ordinary members of the sea vessels in different countries of the world, which are the main suppliers of highly skilled maritime staff. Among the main countries of the world who take part in the preparation and thesis of officers and ordinary members of the sea vessels include such countries of the world as China, Philippines, India, Indonesia, Russian Federation, Ukraine, Poland, Vietnam, Japan, Turkey and United States. Marine institutions of higher education of these countries are constantly looking for and implementing new methods for encouraging young people to enter marine educational institutions, providing training and graduates. The aforementioned educational institutions are constantly improving and upgrading the training base with the help of the investments of shipping and Crewing companies, which allows to develop the necessary skills for obtaining appropriate qualifications. An in-depth study of sea English is provided to improve linguistic communications in mixed crews. Due to fruitful cooperation of marine educational institutions with shipping and Crewing companies, the possibility of proper practical training of young specialists at sea vessels and providing them necessary skills and experience for further work in the sea. Organization of studing and practical training in the educational institutions of the above-mentioned countries is designed for providing work places for cadets and contribute to their rapid career growth in the marine industry, which in turn leads to an increasing in both officer and ordinary staff members of the marine vessels. Key words: certification of seafarers, officers of sea-going ships, ratings of sea-going ships, STCW Convention, maritime higher educational institutions, employment of seafarers.

Handheld transabdominal ultrasound, after limited training, may confirm first trimester viable intrauterine pregnancy: a prospective cohort study

Objectives Handheld point-of-care abdominal ultrasound (POCUS) may be used by primary care physicians while vaginal ultrasound is limited to use in specialist care. We aimed to compare abdominal handheld ultrasound to vaginal ultrasound in determining first trimester viable intrauterine pregnancy and estimate gestational length. Design Prospective cohort study. Setting Gynaecologic outpatient clinic; women referred from GPs during early pregnancy. Handheld ultrasound using VscanExtend® was performed by fourth-year medical students with limited training. Transvaginal ultrasound using high-end devices was performed by ordinary hospital staff. Subjects Women in the first trimester of pregnancy referred for termination of pregnancy or with symptoms of early pregnancy complications. Main outcome measures Rate of confirming vital intrauterine pregnancy (visualizing foetal heart beats) and measurement of crown-rump length (CRL) using handheld abdominal versus vaginal ultrasound. Results In all 100 women were included; 86 confirmed as viable intrauterine pregnancies and 14 pathological pregnancies (miscarriages/extrauterine pregnancies). Handheld abdominal ultrasound detected fetal heartbeats in 63/86 (73% sensitivity) of healthy pregnancies and confirmed lack of fetal heartbeats in all pathological pregnancies, total positive predictive value (PPV) 100% and total negative predictive value (NPV) 38%. From gestational week 7, handheld abdominal ultrasound confirmed vitality in 51/54 patients: PPV 100% and NPV 79%. CRL (n = 62) was median 1 mm shorter (95% confidence interval 1–2 mm) measured by handheld abdominal versus vaginal ultrasound. Conclusion Handheld ultrasound has an excellent prediction confirming viable intrauterine pregnancy from gestational week 7. Validation studies are needed to confirm whether the method is suitable in primary care assessing early pregnancy complications. KEY POINTS When early pregnancy vitality needs to be confirmed, women will traditionally be referred to secondary care for transvaginal comprehensive ultrasonography performed with high-end devices by imaging specialists. In this study personnel with limited former training (fourth-year medical students) performed transabdominal POCUS using a handheld device, investigating 100 first trimester pregnancies for confirmation of viability. Using handheld ultrasound viable pregnancy was confirmed from gestational week 7 with 79% positive and 100% negative predictive value. If handheld ultrasound used in primary care confirms vital intrauterine pregnancy, the need for specialist referral could be reduced.

TRAINING, RE-TRAINING AND CERTIFICATION TRAINING OF RESCUERS OF UKRAINE

The article reveals the content of the concepts of professional training, professional training of ordinary and senior staff. It is noted that the professional training of ordinary and managerial staff involves obtaining professional (vocational) higher, pre-higher, postgraduate education. Professional training of newly appointed members of the rank and file and junior management may be carried out by obtaining professional (vocational) education in the relevant profession. Persons admitted to the civil defense service are sent to study in educational programs of professional (vocational) education after appointment.Training of specialists with professional higher education is carried out in institutions of professional higher education of civil defense according to accredited educational and professional programs developed on the basis of standards of professional pre-higher education.Professional training of ordinary and senior staff can be carried out by obtaining an educational degree at a certain level of higher education and the relevant specialty. Training of specialized specialists with higher education is carried out in institutions of higher education of civil defense, which provide training for accredited educational and professional (educational and scientific) programs developed on the basis of higher education standards.Postgraduate education includes obtaining a second (next) higher education, advanced training, specialization, retraining and internship.Taking into account the analysis of guiding documents and scientific literature, we found the need for conceptual justification and development of a system of professional training of rescuers, their preparation for successful activities during the service, firefighting, emergency response and their consequences.

The effect of two types of minimal acupuncture on stooling, sleeping and feeding in infants with colic: secondary analysis of a multicentre RCT in Sweden (ACU-COL).

BackgroundEvidence for the effect of minimal acupuncture in infants with colic is limited.AimTo compare the effect of standardized minimal acupuncture, individualized acupuncture (where traditional acupuncture points were chosen according to the infant’s symptoms) and no acupuncture on objective measures of stooling, feeding and sleeping in infants with colic (based on diaries) and perceived changes in these parameters (based on parental questionnaires).MethodsThis was a secondary analysis of a multicentre randomized controlled three-armed trial conducted in four counties in Sweden between January 2013 and May 2015 (ACU-COL). The effect on crying has already been published and showed a decrease in crying time for the acupuncture groups. Infants, 2–8 weeks old, who cried and fussed for more than 3 h/day for more than 3 days/week, and thereby fulfilled the criteria for infantile colic, received four extra visits to their ordinary child health centre. The infants (n = 147) were randomly allocated via a computer-generated list to standardized minimal acupuncture at LI4 for 5 s (group A, n = 48), semi-standardized individual acupuncture with a maximum of five insertions for up to 30 s (group B, n = 49), or no acupuncture (group C, n = 48). The parents and the ordinary staff were blinded. Data were collected using: (1) diaries at baseline, during the two intervention weeks and 1-week follow-up; and (2) questionnaires with quantitative and qualitative components used at the second and fourth visits and during a follow-up telephone call. Outcomes were the changes in frequency of stooling and in hours of sleep per day.ResultsThere were no differences between groups for stooling, feeding, or sleeping at any time point according to data from the diaries. At the follow-up phone call, more parents in groups A and B (compared to group C) perceived that feeding and sleep had changed and that the symptoms of colic had improved.

СУЧАСНІ ПІДХОДИ ДО ПРОБЛЕМ РЕФОРМУВАННЯ АНТИКОРУПЦІЙНИХ ДЕРЖАВНИХ ОРГАНІВ В УКРАЇНІ

Problems of prevention and fight against corruption are important priorities in the state policy of Ukraine. This phenomenon, like corruption, impedes the reform of modern Ukrainian society, worsens the socio-economic situation of the state, affects negatively all spheres of the life of a national society. One of the priority directions and strategies in the state anti-corruption policy is the creation and development of innovative anti-corruption institutions. One of the important foundations for the formation of such innovative institutions is their independence, professionalism, systemicity, legitimacy, legality, etc. The National Anti-Corruption Bureau of Ukraine, the National Anti-Corruption Bureau of Ukraine, the Specialized Anti-Corruption Prosecutor, the State Investigation Bureau, the National Agency for the Detection, Investigation and Asset Recovery of Corruption and Other Crimes, and the Highest Anticorruption Court were established during 2015-2018. At the same time, the effectiveness of anti-corruption policy is not yet. According to experts, the anti-corruption authorities have a selective approach to the identification of suspects and political interdependence, a certain dependence on the influence of representatives of financial-industrial groups and political-ruling elites and, accordingly, the possibility of their use to persecute political opponents. Among other shortcomings of the fight against corruption in Ukraine, foreign experts point out the lack of professionalism, inexperience and lack of independence in the decision-making of the leaders and ordinary staff of NABU and SAP. Serious doubts raise the justification for replacing the criterion of professionalism with the criterion of new faces in the formation of the state of NABU and other anti-corruption bodies, their excessive activity in the media, to hide the lack of real results, public scandals and corporate wars between the old (primarily the Prosecutor General's Office) and new Anti-corruption institutions, which leads to a conflict of jurisdiction and worsens the performance of activities. The problem of streamlining and optimizing the subjects of prevention and counteraction to corruption in order to implement the effective and effective state anti-corruption policy, reducing the manifestations of corruption in Ukraine, is being activated today. In our opinion, rationalization and optimization of anti-corruption bodies of state power should be carried out according to the following algorithm: formation of a problem field - in particular, raising the level of anti-corruption culture, forming preventive mechanisms for the prevention of corruption; carrying out reengineering of anti-corruption bodies of state power; reforming anti-corruption bodies of state power. Equally important is the problem of the formation of a professional corps of anti-corruption bodies of state power on the one hand, and the impartial and transparent formation of the leadership of anti-corruption bodies, regardless of the policy of the state - on the other hand. The analysis provides the basis for determining the following clusters of problems of the formation and development of anti-corruption institutions of state power. First, there is no single concept for the formation and development of anti-corruption bodies in Ukraine. Secondly, the lack of specially trained specialists, who would be knowledgeable not only in law issues but also in the formation and development of public policy, were able to conduct financial audits, collate and analyze data. That is, there was an urgent need to form a generation of specialists of anti-corruption bodies of state power. Thirdly, there is no system for auditing the effectiveness and effectiveness of the anti-corruption institutions itself. Thus, the state spends a lot of money and resources on the creation and development of anti-corruption institutions than the funds and resources provided by such bodies of state power. Fourthly, there are no real mechanisms for punishing corruption offenses. Fifthly, there is no institution of voluntary confiscation of funds provided that it is impossible to explain the origin of the stakes. This would allow offenders to avoid or mitigate criminal liability. Sixth, the Highest Anticorruption Court does not work so far, dampening all the efforts of other anti-corruption institutions.

The importance of museum presentation in activating the museum culture

Museums are peoples’ memory and an effective tool for preserving identity, much more they are considered as space where the remnants of time and the treasures of the ancestors are gathered. Preventing this memory from being destroyed or let to forgetting, it must be revitalized by inventing effective ways to attract more visitors allowing them to be in touch with what their ancestors have left as exploits that reflect their way of living and narrate their heroisms. If antiques and collectibles are the only way to allow visitor to enter such spaces and getting the pleasure to see them, and if the exhibition hall is the only space to be visited among other spaces, how will it be possible, then, for the administration to take advantage of this opportunity to effectively invest in the museum and to devote its culture. Are there any specific rules that should be followed to make the museum exhibition a success, or is it a matter of routine procedures that any ordinary staff member can do it without recourse to experts, technicians or artists. Museum of all kinds are seeking to collect more collectibles either by buying, exchanging, offering as a gift or on loan, all this in order to fill the exhibition gallery, hence owning a great number of these collectibles is not enough to bring significant number of visitors, more than that; the value of such masterpiece will diminish if it remains isolated and maybe it will be damaged. For that, it’s the department duty to work hard for applying a set of scientific and studied rules which will add an aesthetic to the collectibles and to the space as a whole and thus it’ll raise the curiosity of viewers. Based on this, we will try to show the importance of the museum presentation in activating the museum's culture.

“Seeing the patient as a human is their priority” – Patients’ experiences of being cared for by pairs of student nurses

Background: A Developing and Learning Care Unit (DLCU) is a model used in the clinical practice of student nurses that aims at bridging the gap between theory and praxis, by supporting nursing students’ learning through supervision in pairs. The aim of this study is to describe how patients experience being cared for by pairs of student nurses.Methods: The study is based on a reflective lifeworld research (RLR) approach founded on phenomenological traditions. Data was collected in lifeworld interviews of 17 patients cared for by pairs of student nurses. The data was explored and analysed for meaning.Results: To be cared for by student nurses, supervised in pairs entails being involved in the students’ learning and being met with responsibility and a willingness to care and learn. This means being made the centre of attention, being seen, taken seriously and being listened to as a valuable human being. The students’ care is shown to be more flexible and has a more open approach, in comparison to that of the ordinary staff, and they ‘do something extraordinary’ and give of their time.Conclusions: Pairs of students, who are supervised within a learning model that support students’ learning through reflection, can contribute to patient experiences of being given good care.

Internationally educated nurses' descriptions of their access to structural empowerment while working in another country's health care context.

To examine internationally educated nurses' experiences of empowerment structures using Kanter's theory of structural empowerment. There has been an increase in the number of nurses working in other countries worldwide and concerns have been raised regarding their working conditions. Semi-structured interviews were conducted with a purposive sample of 11 internationally educated nurses. Directed content analysis was used to analyse the data and Kanter's theory of empowerment was used as a framework. Access to information was generally good. Access to support for their relationship with their managers varied. Regarding access to resources, nurses unfamiliar with clinical leadership found team leadership challenging. Access to in-house learning opportunities were reported as good. Access to informal power was more common than access to formal power. The findings support Kanter's theory and demonstrate that internationally experienced nurses encountered varying degrees of access to empowering structures. Access to information and formal power was more general and related to the unit. Access to resources, support, opportunities and informal power were related to both the unit and the informants' specific situation as IENs. Managers need to support IENs when having a team leadership role, facilitate encounters between IENs and ordinary staff, and establishing mentorship for IENs.

Status of the Science and Technology Award of the Chinese Nursing Association and analysis of the development trend of nursing research

Aims and objectiveThis study focuses on the status quo and development trend of nursing research in our country to provide a reference for nursing research workers and improve the development of nursing research in China. MethodsThe official website of the Chinese Nursing Association was searched to obtain the total number, category, geographical distribution, and job of project leaders of winning projects of the Chinese Nursing Association Technology Award. Findings were analyzed using webometrics and content analysis approach to understand the “study hotspots,” “study level,” and “development trend” of nursing research in China. ResultsThe total number of winning projects was 144. Among them, the number of first, second, and third prizes were 8, 36, and 100, respectively. Beijing is the area with the largest number of winners (21), followed by Shanghai (17) and Jiangsu (13). Among the winning projects, the top 3 research areas were specialty nursing, nursing management, and nursing education, with percentages of 50%, 27%, and 18%, respectively. Among the 144 project leaders, 96% were academic or hospital directors and only 4% were ordinary staff. ConclusionsThe geographical distribution of winning projects presented a regional concentration trend. The categories of winning projects are diverse, and our country has made great achievements in every category, particularly in specialty nursing. Most of the project leaders were academic or hospital directors. The stumbling block to nursing research is the lack of high-quality research projects with international influence. Future research should learn from the experiences of developed countries, focus on the in-depth refinement of specialty nursing, and highlight the importance of collaboration to coordinate and promote nursing development in all regions.

Les ambivalences de la démarche participative dans l’administration. Le cas de la fusion au sein de la Direction générale des finances publiques (2007-2012)

This article analyses the forms and effects of participative management when it is used to support large-scale reform within a government department. The case of the merger between France's Central Taxation Department and Central Public Accounts Department shows that, for the reformers, the encouragement to participate is a way to increase the acceptance of change, in an institution where the capacities for internal resistance are greater than in the private sector. This encouragement to participate takes different forms for senior executives, management and ordinary staff. Depending on their position in the division of labour and their career path in the organisation, civil servants take a different view of this manner of being enrolled into the ongoing reforms.

Hygrometry of Oil and Petroleum Products: Ways of Evaluating the Accuracy of Measurements

Existing standard measurement techniques in the area of oil hygrometry are analyzed with respect to interferences. Ways of estimating the accuracy of these methods are examined. The need for a new generation of reference materials and for measurement techniques that take the various interferences into account by methods accessible to ordinary technical staff are pointed out.

Assessment of Facilities Management (FM) Performance in International Islamic University Malaysia (IIUM)

Performance management has a strong relationship with facilities management practices. The unclear information of the method of managing performance in higher education properties is emerged the research to be undertaken. IIUM Properties Facilities Management Services (IPFMS) has been entrusted to lead the new concept of out-sourcing on higher learning institution facilities management. Initially, IIUM Properties Sdn Bhd (IPSB) is a wholly owned subsidiary of IIUM Holdings Sdn Bhd was established in 2001 has team up with external company Global Facilities Management Sdn Bhd (GFM) as a technical partner to manage the operation and maintenance of the IIUM. In order to identify the relationship and the implementation of FM performance in IIUM by using the outsourcing concept, this research has been carried out. The objective of doing this research is to identify the method FM performance management in IIUM as the public university that promotes their subsidies self managed. The findings revealed that performance management practices is systematically established, implemented and enforced as part of their quality objectives achievements by introduced the performance indicators and using the four tested research variables which are flexibility, effectiveness, efficiency and creativity. The opinions gathered from respondents are very encouraging. The information is obtained from FM personnel in multiple disciplines and customer (students, ordinary staff and public) where the results are thoroughly analyzed. From the findings, the author anticipate that this paper would provide better understanding and perception to the readers as part of the FM performance management in higher education properties and the extent of its benefits as well.

Relationship between office workers’ staying and workstation attributes in a non-territorial office using ultra wide band sensor network

This paper investigates the staying and moving characteristics of office workers in a non-territorial office using an ultra wide band (UWB) impulse radio sensor network. The differences between office workers’ staying and moving are clarified according to the individual workstation type that they select. The study determines the characteristics of each type of workstation. By clarifying office workers’ preference for staying and moving with regard to individual workstation types and office worker post, the reasons why office workers in different posts tended to select different types of workstations were revealed. Specifically, leaders tended to select workstations at the “inner meeting corner side” most frequently, as they had a greater need to stay in other areas. In contrast, ordinary staff needed to visit office workers in other areas less often, and as such, they tended to select individual workstations at the “middle meeting corner side.” Barring this, they tended to select individual workstations at the “middle corridor side” or “outer-meeting corner side.” Temporary staff members had little need to visit or stay at other places so they tended to select individual workstations at the “window side,” which is seldom visited or stayed at by other office workers and they could be disturbed less often from their solo work.

Behavior Concerning Choosing Workstations in Non-territorial Offices

This paper attempts to clarify how employees choose individual workstations in a non-territorial office, in which they may locate themselves anywhere as they wish. The authors ascertained the preference of employees with regard to the positions of their workstations and the consistency of choosing the same workstations. The results are as follows: for all the investigated employees, there was a tendency to choose workstations that were adjacent to the main corridors and close to the meeting corners. More than 70% of the employees either chose the same workstation every time or nearly every time. In total, 90% of the employees were found to locate in the same or in adjacent areas. Analysis by group showed that while employees in the engineering groups, the renovation design group (Architecture Group 3), and the competition team were inclined to locate in specific areas and use such areas consistently, employees in the other architecture groups were much more open to choosing workstations far away from each other. Further, the analysis showed that leaders were inclined to occupy workstations beside the main corridor in the center of the office while ordinary staff members preferred workstations near the entrance.

Does a physical activity referral scheme improve the physical activity among routine primary health care patients?

Physical activity referral (PAR) schemes or concepts occur in varying forms. Because few physical activity intervention studies have been carried out in routine health care settings, it is difficult to translate research findings into daily practice. The aim of this study was to analyze the effectiveness of a PAR scheme implemented in routine primary health care. The study did not include a control group and was based on the ordinary staff's work efforts and follow-up measures. During a 2-year period, 6300 PARs were issued. Effectiveness was measured by an increase in self-reported physical activity. Half of the patients reached reported increased physical activity both at 3 months (49%) and at 12 months (52%). The proportion of inactive patients decreased from 33% at baseline to 17% at 3 months and 20% at 12 months. The proportion of patients who were physically active on a regular basis increased from 22% at baseline to 33% at 3 months and 32% at 12 months. Neither the patient's age nor the profession of the prescriber was associated with differences in effectiveness. The patient's activity level at baseline, the type of physical activity as well as the reason for the prescription were associated with increased physical activity.

Psychoeducational family interventions for schizophrenia in the last decade: from explanatory to pragmatic trials

A number of explanatory RCT studies published since the 1980s have demonstrated the clinical efficacy of Psychoeducational Family Interventions (PFI) for schizophrenia when provided in combination with drug therapy. In recent years, there has been a shift from efficacy to effectiveness studies and great attention by the researchers in developing training programmes in these interventions for ordinary staff. In this paper, we will provide an overview of the studies on PFI for schizophrenia which have been carried out in the last decade in routine clinical settings or with at least a partial involvement of ordinary staff. These studies have been grouped into: (a) studies comparing PFI with standard care; (b) studies comparing PFI with individual integrated interventions; (c) studies comparing different PFI strategies; (d) implementation studies. The results of these studies reveal that, when provided in clinical settings, PFI have positive middle-term effects on patients' clinical status and disability, and limited impact on family burden. From a methodological viewpoint, these studies had several similarities, such as homogeneity of PFI models and mid-term follow-up assessments, and several differences, mainly in the intensity and duration of the family exposure to the intervention. Future studies are needed to identify the "best dose" at which PFI can be provided in routine conditions at the most convenient cost-benefit ratio.

Reorganization of a hospital catering system increases food intake in patients with inadequate intake

Background: Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases the energy and protein intake of the patients. Design: Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served, eaten and wasted was measured, and energy and protein intake calculated. Results: The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79-178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489-631 kJ) on the first occasion, and 1021 kJ per patient (95% CI 939-1104 kJ) on the second occasion. With the old system, the wastage was on average 276 g per patient (48% of the total amount produced) compared with 118 g per patient (30%) and 78 g (21%) on the two test occasions with the new system. Conclusions: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially. Keywords: hospital food; nutritional risk; undernutrition