Profession Of Participants Research Articles

Accessibility of Elementary School-Based Assistive Technology: A Descriptive and Associational Survey

The purpose of this quantitative survey design study was to better understand the perceived barriers of accessibility of elementary school-based assistive technology (AT) from the perspective of parents, teachers and occupational therapists. Furthermore, the purpose of this study was to quantify parent, teacher and occupational therapist perceptions on the benefit of AT training, frequency of AT use, and the efficacy of AT use in the school and home environments. This 13 question survey collected a combination of nominal and ordinal data on participant profession, benefit of AT training, frequency of AT use, level of support by elementary school institution, method of payment for acquiring AT, and the efficacy of AT use in the school and home environments. 33 participants responded to the survey, however only 27 met inclusion criteria (<i>n = </i>27). Participants reported the frequencies of which specific forms of AT they observe children using in both the school and home environments. The amount of training one received on operating AT was moderately correlated with feelings of support for the child from the IEP team regarding AT, <i>rs</i>(27) =.429, <i>p</i> =.013, Fisher’s<i> z</i> =.459, CI 95% [0.12, 1.00], VS-MPR = 6.64. The frequency of use of AT by a child was moderately correlated with feelings of support for the child from the IEP team regarding AT,<i> rs</i>(27) =.392, <i>p</i> =.022, Fisher’s<i> z </i>=.414, CI 95% [0.08, 1.00], VS-MPR = 4.38. The perceived benefits from AT for students were moderately correlated with the feelings of support for the child from the IEP team regarding AT, <i>rs</i>(27) =.438, <i>p</i> =.011, Fisher’s <i>z</i> =.470, CI 95% [0.13, 1.00], VS-MPR = 7.35. The level of support one feels from their IEP team can significantly predict perceived benefit from AT, <I>F</I>(3, 23) = 3.897, <i>p</i> =.022. The results of this study indicate that participants universally believe that for AT to be at its most beneficial, training is vital for teachers, parents, and therapists to become confident in utilizing AT, alongside strong elementary education institutional support. Further research is indicated to improve understanding of AT access and AT compliance strategies in the elementary education setting.

Legalised active assistance in dying: palliative care stakeholders’ national e-consultation

ObjectivesThere is a growing debate surrounding the legalisation of medical assistance in dying (MAID). MAID is currently prohibited by the French law; however, the debate has recently been reinvigorated in...

Certainty and systematicity of practice-derived evidence matter for its relative importance in professional decision-making: Survey results on the role of proven experience in Swedish medicine, nursing, OT, dentistry, and dental hygiene.

High-quality healthcare decisions need to balance input from science and clinical practice. When two sources of evidence - such as scientific and practice-derived evidence - are compared, integrated, or need to stand-in for one another, they need to be comparable on similar dimensions. Since 1891, Swedish physicians have been operating under a legal requirement to base their healthcare decisions on science and "proven experience" (approximately clinical expertise), and today all healthcare personnel in Sweden fall under this legal requirement. We investigated the dynamics between these two kinds of evidence with respect to importance, systematicity, and certainty by studying Swedish healthcare professionals. Survey to professionals; document studies of political discourse. In this study, a survey was sent to simple random samples of Swedish professionals in medicine, nursing, occupational therapy, dentistry, and dental hygiene, asking about the roles of science and proven experience in medical decision making. Outcome measures were how important, certain, and systematic science and proven experience are for successful medical decision making. The sampling frame was each profession's most recent occupational registry accessed by the Swedish federal statistical agency. 3500 surveys were distributed. 1626 surveys were returned. 26 participants were removed prior to analysis (exclusion criteria: more than one profession indicated, missing certificate, and mistake in stratum). The final sample consisted of 295 physicians, 300 nurses, 365 occupational therapists, 339 dentists, and 301 hygienists. 162 responses in questions used as variables in the analyses were either uninterpretable or empty; those were replaced with the modal response for a given participant's profession on a given question. In the study, proven experience's perceived importance for clinical decision making is positively correlated with its certainty and systematicity, and an increased certainty and systematicity is positively correlated with a diminished difference in importance between science and proven experience for almost all professions surveyed in this study. Proven experience has an evidentiary role in clinical decision making, and this role depends in part on its certainty and systematicity. Notably, this makes the EBM-based perspective that practice-derived knowledge is primarily of implementation value less plausible.

An online randomised controlled trial of prognosticating imminent death in advanced cancer patients: Clinicians give greater weight to advice from a prognostic algorithm than from another clinician with a different profession.

A second opinion or a prognostic algorithm may increase prognostic accuracy. This study assessed the level to which clinicians integrate advice perceived to be coming from another clinician or a prognostic algorithm into their prognostic estimates, and how participant characteristics and nature of advice received affect this. An online double-blind randomised controlled trial was conducted. Palliative doctors, nurses and other types of healthcare professionals were randomised into study arms differing by perceived source of advice (algorithm or another clinician). In fact, the advice was the same in both arms (emanating from the PiPS-B14 prognostic model). Each participant reviewed five patient summaries. For each summary, participants: (1) provided an initial probability estimate of two-week survival (0% 'certain death'-100% 'certain survival'); (2) received advice (another estimate); (3) provided a final estimate. Weight of Advice (WOA) was calculated for each summary (0 '100% advice discounting' - 1 '0% discounting') and multilevel linear regression analyses were conducted. NCT04568629. A total of 283 clinicians were included in the analysis. Clinicians integrated advice from the algorithm more than advice from another clinician (WOA difference=-0.12 [95% CI -0.18, -0.07], p< 0.001). There was no interaction between study arm and participant profession, years of palliative care or overall experience. Advice of intermediate strength (75%) was given a lower WOA (0.31) than advice received at either the 50% (WOA 0.40) or 90% level (WOA 0.43). The overall interaction between strength of advice and study arm on WOA was significant (p< 0.001). Clinicians adjusted their prognostic estimates more when advice was perceived to come from a prognostic algorithm than from another clinician. Research is needed to understand how clinicians make prognostic decisions and how algorithms are used in clinical practice.

HEALTH PROMOTION BEHAVIOUR FOR NON-COMMUNICABLE DISEASES AMONG HEALTHCARE WORKERS IN KAKAMEGA COUNTY, KENYA

Introduction: The rising burden of non-communicable diseases poses a great health system challenge in Kenya. Healthcare workers have a critical role to play in health promotion, in addressing patients’ lifestyle risk factors. However, their own lifestyle habits can influence their attitude and practices towards patient care. Opportunistic counselling of patients by health professionals signifies one of the most cost-effective medical interventions in combatting non-communicable diseases. Objective: To determine the attitudes and practice of health promotion for the prevention and management of non-communicable diseases among healthcare workers In Kakamega county. Methods: A cross-sectional mixed method study was carried out from June to July 2018 at Kakamega county referral hospital. For the quantitative method, one hundred and eighty-five doctors and nurses were recruited through stratified sampling. Data on healthcare workers; socio-demographic characteristics, lifestyle practice, attitude, and practice of health promotion was collected through self- administered questionnaires. Frequency and percentage distributions tables were used to initially describe the study population while, Chi- square test of significance was used to evaluate the association between healthcare workers attitudes and practice of health promotion and their socio-demographic features. Secondly, a total of 12 doctors and nurses were purposively selected based on age, gender and profession of participants for the qualitative method. Data on healthcare workers perspective on health promotion and organizational support factors were collected through in-depth interviews. The recorded interviews were transcribed and data analysis was done using content analysis of thematic areas. A verbatim approach was used to describe study findings. Results: 69.2% of the respondents were females, mean age was 36 years and the median years in profession was 12 years. The respondents exhibited good lifestyle practices with alcohol and tobacco prevalence at 30.8 %and 3.8% respectively. 72% of the respondents demonstrated a positive attitude towards health promotion while, 31% showed good health promotion practices. Less than half of the respondents inquired about a patient’s lifestyle practices during routine visit. The study found that healthcare workers with a positive attitude were four times more likely to have good health promotion practices (OR = 3.54, p&lt;0.001). Lastly findings from the in-depth interviews revealed that staff had no written guidelines on health promotion and that the hospital management had abolished the health promotion unit. Conclusion: The results indicated that a positive health professional attitude is a precursor to good health promotive practices. Recommendation: Efforts to build capacity and support for health promotion in health services should be encouraged. Additionally, health Promotion programs for non- communicable disease should not only target the health of general population but also the health of health care workers.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0720/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Fetal physiology cardiotocography training, a regional evaluation

IntroductionCardiotocography (CTG) has its limits in detecting fetal acidosis and intrapartum asphyxia. Our aim was to evaluate a CTG training programme based on fetal physiology in the Mediterranean perinatal network. MethodsProfessionals from 41 maternity units of the Mediterranean network were invited to participate in a CTG masterclass based on fetal physiology in March 2019 and October 2019. They were asked to react to three practical cases by a physiological approach before the training course (T0), one month after (T1) and six to seven months after (T2). The mean scores were compared by using a mixed model including lapse of time to evaluation, profession of participants and level of the maternity unit as fixed effects. ResultsA total of 248 professionals from 32 maternity units finally participated in the organizational audit. By using a mixed model, we found a significant improvement of the mean score at T1=6.44/10 compared to T0=4.97/10 (p<0.0001), and a significant improvement of the mean score obtained at T2=6.17/10 compared to T0 (p<0.0001). T2 scores were not significantly different from T1 scores (p=0.143). DiscussionA CTG training programme based on fetal physiology showed a significant improvement in the professionals’ interpretation of CTG at short term and stable results at long term. Continuing medical education could help maintain and improve knowledge to ensure neonatal safety.

Multiprofessional perspectives on the identification of latent safety threats via in situ simulation: a prospective cohort pilot study

ObjectivesTo describe the association between participant profession and the number and type of latent safety threats (LSTs) identified during in situ simulation (ISS). Secondary objectives were to describe the association...

Informal coercion as a neglected form of communication in psychiatric settings in Germany and Switzerland

AimsInformal coercion is a frequently used form of communication among mental health professionals to influence treatment outcomes.This study investigates the recognition, attitude, and application of different forms of informal coercion by mental health professionals. MethodsMental health professionals of five psychiatric institutions in Germany and Switzerland (n = 424) took part in an online survey assessing the recognition of, attitudes towards, and application of different forms of informal coercion. ResultsMental health professionals did not recognize the extent of informal coercion adequately; especially stronger forms were underestimated. Recognition and application of informal coercion was predicted by attitudes towards coercion. Furthermore, there were differences between profession of participants regarding the recognition and application of informal coercion. ConclusionsIt is important to realize that the extent of applied informal coercion in therapeutic communication is often not recognized by practitioners, although it might interfere with a sound therapeutic relationship.

The postoperative handover: a focus group interview study with nurse anaesthetists, anaesthesiologists and PACU nurses

ObjectivesTo investigate different professionals’ (nurse anaesthetists’, anaesthesiologists’, and postanaesthesia care unit nurses’) descriptions of and reflections on the postoperative handover.DesignA focus group interview study with a descriptive design using qualitative...

Variation in risk judgment on radiation contamination of food: Thinking trait and profession

Through a large-scale web-based experiment (n=538), we examined variation in risk judgments on radiation contamination of food from the following two perspectives and discussed psychological factors that would be related to such variation. First, we examined how thinking trait (i.e., intuitive or deliberate) would affect risk judgments. Second, we examined whether risk judgments varied by participant profession. Large variation in risk judgments were observed in the latent psychological factor representing risk aversion about radiation contamination, and this variation was explained by the thinking traits and professions of participants. However significant variation was not observed in the factor representing risk tolerance for radiation contamination. These results show that thinking trait and profession play important roles in risk judgments on food contamination by radioactive materials.

Educating health care professionals on human trafficking.

The US Department of State estimates that there are between 4 and 27 million individuals worldwide in some form of modern slavery. Recent studies have demonstrated that 28% to 50% of trafficking victims in the United States encountered health care professionals while in captivity, but were not identified and recognized. This study aimed to determine whether an educational presentation increased emergency department (ED) providers' recognition of human trafficking (HT) victims and knowledge of resources to manage cases of HT. The 20 largest San Francisco Bay Area EDs were randomized into intervention (10 EDs) or delayed intervention comparison groups (10 EDs) to receive a standardized educational presentation containing the following: background about HT, relevance of HT to health care, clinical signs in potential victims, and referral options for potential victims. Participants in the delayed intervention group completed a pretest in the period the immediate intervention group received the educational presentation, and all participants were assessed immediately before (pretest) and after (posttest) the intervention. The intervention effect was tested by comparing the pre-post change in the intervention group to the change in 2 pretests in the delayed intervention group adjusted for the effect of clustering within EDs. The 4 primary outcomes were importance of knowledge of HT to the participant's profession (5-point Likert scale), self-rated knowledge of HT (5-point Likert scale), knowledge of who to call for potential HT victims (yes/no), and suspecting that a patient was a victim of HT (yes/no). There were 258 study participants from 14 EDs; 141 from 8 EDs in the intervention group and 117 from 7 EDs in the delayed intervention comparison group, of which 20 served as the delayed intervention comparison group. Participants in the intervention group reported greater increases in their level of knowledge about HT versus those in the delayed intervention comparison group (1.42 vs -0.15; adjusted difference = 1.57 [95% confidence interval, 1.02-2.12]; P < 0.001). Pretest ratings of the importance of knowledge about HT to the participant's profession were high in both groups and there was no intervention effect (0.31 vs 0.55; -0.24 [-0.90-0.42], P = 0.49). Knowing who to call for potential HT victims increased from 7.2% to 59% in the intervention group and was unchanged (15%) in the delayed intervention comparison group (61.4% [28.5%-94.4%]; P < 0.01). The proportion of participants who suspected their patient was a victim of HT increased from 17% to 38% in the intervention group and remained unchanged (10%) in the delayed intervention comparison group (20.9 [8.6%-33.1%]; P < 0.01). A brief educational intervention increased ED provider knowledge and self-reported recognition of HT victims.

Differences between observers in interpreting double-blind placebo-controlled food challenges: a randomized trial.

Interpretation of double-blind placebo-controlled food challenges (DBPCFC) can be difficult, particularly with ambiguous subjective symptoms. Early opening of the challenge key (which day is verum and which placebo) may influence the clinician's interpretation of the DBPCFC result. Fifty-one clinicians reviewing results of 19 DBPCFCs with ambiguous clinical symptoms were randomized into a key first strategy (opening the DBPCFC key before reviewing the symptoms on both challenge days and deciding on the DBPCFC result) or a symptoms first strategy (reviewing symptoms and interpreting both test days as positive or negative before opening the key and deciding on the DBPCFC result). The proportion of DBPCFCs considered inconclusive was comparable between the two strategy groups (p = 0.791). Participants in the symptoms first group were more likely to consider a DBPCFC as positive (in 14 tests, 73.7%) than subjects in the key first group (four tests, 21.1%). The number of positive tests was higher in the symptoms first group (median 50.0%, interquartile range [IQR] 23.1-76.9%) than in the key first groups (44.0%, IQR 12.0-68.0%, p = 0.031). This was independent of the participant's profession (pediatrician or other), age, gender, or years of experience (p > 0.3). Clinicians differ in their interpretation of DBPCFC results when symptoms are ambiguous. Opening the key of a DBPCFC before reviewing and interpreting symptoms significantly reduces the likelihood of the challenge being interpreted as positive. Guidelines for performing DBPCFCs should standardize the moment of opening the challenge key.

Restraints as nurse's aides see them

Informal coercion is a frequently used form of communication among mental health professionals to influence treatment outcomes.This study investigates the recognition, attitude, and application of different forms of informal coercion by mental health professionals.Mental health professionals of five psychiatric institutions in Germany and Switzerland (n = 424) took part in an online survey assessing the recognition of, attitudes towards, and application of different forms of informal coercion.Mental health professionals did not recognize the extent of informal coercion adequately; especially stronger forms were underestimated. Recognition and application of informal coercion was predicted by attitudes towards coercion. Furthermore, there were differences between profession of participants regarding the recognition and application of informal coercion.It is important to realize that the extent of applied informal coercion in therapeutic communication is often not recognized by practitioners, although it might interfere with a sound therapeutic relationship.