Office Practice Research Articles

Knowledge, attitudes, and practices of paediatric medical officers and registrars on the developmental origins of health and disease in a tertiary women’s and children’s hospital

BackgroundTo mitigate the growing burden of non-communicable diseases, doctors training to become paediatricians should be equipped with concepts and knowledge regarding Developmental Origins of Health and Disease (DOHaD).MethodsWe assessed the knowledge, attitudes, and practices (KAP) of medical officers, resident physicians, as well as junior and senior residents practising in the paediatric department of a tertiary women’s and children’s hospital. This was done through a cross-sectional online survey, with questions developed after focused group discussions with domain experts, and responses based on a 5-point Likert scale.ResultsA total of 95 physicians met the inclusion criteria, grouped into Medical Officers (MOs) and Registrars (REGs), and we received a 100% response rate. Results showed that few physicians (n = 22, 23.2%) knew the term DOHaD, and majority rated their colleagues to be inadequately informed (n = 84, 88.4%). Among the physicians, one third (n = 32, 33.7%) were not confident in their ability to counsel patients about initiating healthy feeding practices to prevent future metabolic diseases in their children. However, there was a readiness to be better equipped with DOHaD principles and knowledge, and 95.8% (n = 91) strongly acknowledged the physician’s responsibility to optimise early life determinants of cardiometabolic health.ConclusionIn conclusion, the findings suggest a poor translation of DOHaD concepts, indicating that bridging the gap between DOHaD research knowledge and clinical application represents an unmet need. These principles should be inculcated early in the professional training of all healthcare providers.

Factors Influencing Professional Associations' Member Engagement Online: An “Information Practices” Approach

ABSTRACTMember engagement can benefit professional associations, their members, and the profession. Rarely any studies adopt the “information practices” approach to identify the factors influencing professional associations' member engagement. The experiences, epiphanies, and the frequency of 11 information practices of six SIG‐III officers and volunteers when planning and implementing 184 activities of eight initiatives from 2020 to 2023 helped this autoethnography study identify 99 sub‐factors and 18 factors influencing the member engagement online. Information production, dissemination, recording, use, and discovery emerge as the top 5 information practices of officers and volunteers, in the same order, for influencing the SIG member engagement. Managing member attendance, Sharing knowledge, Managing member attention, Meeting member needs, and Building trust serve as the top 5 factors, in the same order, for affecting the member engagement. We propose a theoretical model and provide guidance to associations to enhance and sustain member engagement.

Reducing healthcare waste by eliminating exam table paper in a primary care practice: a sustainable quality improvement initiative.

Climate change is now the greatest threat to human survival. The healthcare system contributes significantly to global pollution and greenhouse gas emissions. Individual practitioners play an important role in helping to reduce these impacts in day-to-day practice. Deimplementation of unnecessary processes and products, such as exam table paper, in medical offices is one simple approach to incorporating principles of planetary health into practice. All quality improvement (QI) projects must start to consider environmental impacts to fully evaluate change ideas. We designed a single Plan-Do-Study-Act cycle using the Institute for Health Improvement Model for Improvement. We removed the exam table paper from our primary care office and measured changes in staff time, laundry, financial costs, paper use and carbon dioxide (CO2) emissions. Eliminating exam table paper in our clinic resulted in modest annual cost savings of $C718 and improved staff efficiency and motivation to introduce other green office practices. In our clinic alone, this change will save 8.2 km of exam table paper, 10 trees and 148 kg of CO2e (equivalent to driving 1233 km) every year. There were no negative consequences or feedback. This simple QI project demonstrates the feasibility of implementing a small change in a primary care clinic that can improve environmental sustainability with multiple co-benefits. If all family physicians in Canada eliminated exam table paper in their offices, it would result in savings of approximately 95 940 km of paper, 121 680 trees, $C8 400 600 and 3054 T CO2 emissions, equivalent to driving around the world 360 times.

Associations of Racial Equity Training, Policies, and Practices With Routine Supervision Strategies in Community Corrections

Community corrections agencies across the United States are adopting racial equity as a priority in their polices, practices, and staff training, though how racial equity can be translated into the routine practices of probation and parole officers has not been widely discussed. This study examines the associations of perceived racial equity priorities on the supervision strategies reported by probation and parole officers in an online survey ( N = 1054). Approximately one-third of officers reported that their agencies prioritized racial equity. Racial equity scores were stronger in juvenile agencies and in agencies that prioritized evidence-informed practices. Racial equity was associated with reduced accountability-oriented case management practices. Results of this study suggest that racial equity policies and practices may impact client outcomes through changes in general supervision strategies. More research is needed to identify race-conscious strategies that community corrections officers can employ to meet the needs of people involved in the legal system.

Insurance Status, Language, and Access to Care for Pediatric Anterior Cruciate Ligament Injury.

Patients with public insurance (PUBs) face more difficulty obtaining orthopaedic appointments and have longer wait times than privately insured patients (PVTs). These delays are associated with greater injury severity at the time of surgery, which affects sports injuries such as anterior cruciate ligament tears where early surgical stabilization leads to better outcomes. Additionally, previous evidence showed that patients with limited English proficiency often must rely on informal translation services, such as family members or friends, to communicate with their orthopaedic surgeons, which may represent a disparity in the care provided. It was hypothesized that PUBs would be less likely to obtain an appointment compared with PVTs and that most providers would not offer professional translation services to Spanish-speaking patients. Cross-sectional study. The authors called 50 randomly selected orthopaedic surgeons' offices in California specializing in sports medicine to request an appointment. Each office was called 4 times in random order for the hypothetical patient having either private or public insurance and speaking either Spanish or English. The hypothetical PUB had significantly decreased access to an appointment (19% of offices offered an appointment) when compared to the PVT (73.8% offered an appointment). Independent private practice (IPP) offices were less likely to accept public insurance (13.3%) compared with offices at academic medical centers (57.1%). There was no difference in access to an appointment for the Spanish- versus English-speaking patient. Translation services were offered at 73.8% of the orthopaedic offices. Overall, the data illustrated disparities in access to pediatric orthopaedic care for PUBs compared to those with private insurance. Disparities were most prominent in IPP settings, which were less likely than academic offices to accept public insurance. Additionally, it was found that 73.8% of the offices the authors contacted offered Spanish translation services. Interventions should focus on increasing acceptance of public insurance and translation services in IPP settings. Future studies should expand this analysis to other languages and investigate the potential impacts of language on the quality of care provided.

Office Practice Customer Service Plan

Quint Studer revolutionized the hospital environment with his programs in customer service and excellence. Although some of Studer’s initiatives can be used in the office practice environment, overall application is not ideal. The information here should complement the Studer standards and provide best-practice components for customer service in the office practice environment.

What are the ideal metrics for assessing the quality of long-term stabilized "perfect" 24-h BP control after renal denervation?

A significant number of individuals being treated for hypertension still have uncontrolled blood pressure (BP). In Japan, renal denervation (RDN) is being introduced into clinical practice as an adjunctive treatment for hypertension that is uncontrolled despite adequate lifestyle changes and maximal antihypertensive drug therapy. The pivotal SPYRAL ON-MED trial showed that there was a significant reduction in trough office and nighttime ambulatory BP values in the RDN group compared with sham control group, although 24-h and daytime BP values were not significantly different between the two groups. The trough office BP measurement (taken before morning antihypertensive dosing) is similar to guideline recommendations for taking morning home BP before taking the morning antihypertensive drug dose. Recent guidelines recommend the measurement of nighttime BP because nighttime BP is a stronger predictor of cardiovascular event risk than daytime BP. It is particularly important to assess nighttime BP in medicated individuals with hypertension because the up- or down-titration of antihypertensive drug dosing is primarily based on office and daytime BPs in clinical practice. This means that there may be significant risk relating to nocturnal hypertension during longer follow-up. Because RDN results in persistent, "always-on" 24-h BP-lowering effects, the best BP metrics to assess the potential benefit of RDN are nighttime BP (determined using home or ambulatory BP monitoring) and morning BP (determined using home BP monitoring or morning trough office BP measurement). The variability of office, home, and ambulatory BP values is another important metric to assess the quality of RDN-related BP lowering.

Automating modular open-plan office layouts with performance-based generative design

Space planning, a crucial phase of architectural design, has significantly benefited from recent performance-based generative methods, enabling early discovery of innovative layouts among a wide range of alternatives. The application of generative design in open-office layout, where flexibility to support different work styles is essential, should become more practical. This paper fills gaps in automated space planning for office buildings, presenting a generative algorithm for robust circulation in multi-story modular geometries. By inputting a modular 3D model, the algorithm generates multiple interior configurations using a library of predefined modules adaptable to cube dimensions and client preferences. This facilitates extensive layout options, streamlining decision-making for efficient workstation and corridor designs. The use of a user-friendly visualization platform allows standard drawing modifications by architects with no programming knowledge. The algorithm's effectiveness is proven through application on various 3D geometries, showcasing its potential to improve practical office design.

The Practices of Chief Sustainability Officers in Orchestrating Strategy Formation

The Practices of Chief Sustainability Officers in Orchestrating Strategy Formation

Palliative care in dermatooncology - Current practice in German dermatooncological centers and specialist offices.

Dermato-oncology patients are often treated in certified skin cancer centers or dermato-oncological specialist offices. Especially in higher tumor stages, patients develop symptoms, either disease-related or due to therapy-related side effects, requiring treatment. Despite a markedly improved prognosis since the introduction of targeted therapies and immunotherapies, advance care planning is required in progressive disease. It is unclear how palliative care of skin cancer patients is currently organized in dermato-oncology. In a nationwide survey, all certified skin cancer centers and dermato-oncological specialist offices in Germany were contacted and asked to participate in this anonymized survey. Overall, 45 responses (42%) were received. The majority (98%) of the respondents screen the patients on a regular basis for distressing symptoms, and all centers are connected to palliative medical care providers. Only 5% of the medical staff members have the additional qualification "palliative medicine". In 68% of the participating institutions, the opportunity for care planning is offered to patients. For 89%, palliative care is relevant for everyday work, and 82% desire more research opportunities on this topic. This survey has shown that palliative care plays a major role in dermato-oncological work. Given that only a small proportion of the staff have received specialized training in palliative care, however, an increase of this proportion would be desirable for comprehensive care.

Standard Versus Step Burs for Implant Site Preparation: A Randomized Controlled Clinical Trial.

There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes. The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement. In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups. Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.

Small‐ and medium‐sized enterprises' carbon footprint reduction initiatives as a catalyst for green jobs: A systematic review and comprehensive business strategy agenda

AbstractMotivated by the growing attention on climate change, this study provides an up‐to‐date and comprehensive systematic literature review (SLR) on small‐ and medium‐sized enterprises (SMEs) carbon footprint reduction initiatives and green jobs. Based on datasets from databases that include Web of Science, Scopus, ProQuest and Google Scholar, we conducted a SLR of 70 published articles spanning 2012 to 2022. Using VOSviewer and InfraNodus, bibliographic cluster analysis revealed the existence of three clusters namely; the role of green job initiatives and green human resource management in SMEs (cluster 1); green innovation, green Initiatives, green strategy and circular economy in SMEs (cluster 2); carbon footprint reduction initiatives, carbon performance, carbon management and carbon emission in SMEs (cluster 3). We found that SMEs adopt green supply chain, employing energy‐saving strategies, eco‐friendly waste reductions and recycling, circular economy, and green office practices. The study results indicate that these carbon footprint initiatives can lead to green job creation since green competences are required to implement green initiatives. However, value propositions relating to carbon reduction initiatives within SMEs need to be integrated with employee engagement. Additionally, the SLR identifies future research areas that include exploring the association among SMEs carbon footprint, green innovation and green jobs, and strategies to enhance climate change initiatives. Consequently, we call for future research to focus on the design of green jobs tracking and carbon footprint reduction reporting framework to support SMEs' green initiatives. The findings have key policy implications for SME owners, policymakers, practitioners and future researchers.

Street office and care practices: emerging conceptions and reflexivities

Objective: To understand the perceptions of users of the "street office" about care practices. Methods: Mixed approach study carried out through semi-structured individual interviews with users of the "street office", with their reports analyzed through the Iramuteq software. Results: The general corpus of the reports consisted of 188 text segments (TS), with 178 TSs (94.68%), with three classes emerging: Class 1 – "Care understood by homeless people", with 85 TS (47.75%); Class 2 – "Satisfaction with access to health actions and services", with 40 TS (22.47%) and Class 3 – "Causes and coping with life on the street", with 53 TS (29.78%). The most recurrent word in the word cloud and in the analysis of similarity was “street”, showing reflections on social inequality and health disparities. Conclusion: The narratives revealed the needs of users regarding their conceptions of care practices, constituting reflectivities emerging from this service instrument.

Pengimplementasian Perkantoran Modern di Madrasah Tsanawiyah Al-Wasliyah Tembung

This study aims to evaluate the implementation of modern office practices at Madrasah Tsanawiyah Al-Wasliyah Tembung, encompassing staff training, procurement of hardware and infrastructure, document digitization, system integration, and the application of technology-based communication systems. A qualitative approach using a case study method was employed to gain an in-depth understanding of the processes and outcomes of the implementation. Data were collected through in-depth interviews, direct observations, and document analysis. The study also identifies the challenges faced, such as resistance to change and technical issues, and the strategies used to address them. The study concludes that the implementation of modern office practices significantly impacts the efficiency and effectiveness of madrasah operations and enhances the quality of educational services. This study recommends continuous staff training, investment in hardware and infrastructure, and a focus on document digitization and system integration for the successful implementation of modern office practices in other educational institutions.

Knowledge and perception of cereal farmers and extension agents on fungicide use in northern Ghana.

Agricultural pesticide use in sub-Saharan Africa has doubled over the past three decades, with a greater relative increase for fungicides. As pesticide inputs continue to rise, so does the potential for the development of resistance. Here, we report on a survey conducted to understand pesticide resistance awareness, pesticide-use knowledge and practices of growers and agricultural extension officers (AEOs) in the cereals growing-belt of northern Ghana, with emphasis on fungicides. The results may inform development of strategies for improving pesticide literacy including resistance awareness, extension services and crop protection outcomes. The survey revealed a low level of pesticide-use knowledge for AEOs and growers. This was more so for growers with low education, predominantly women. Education level (and indirectly gender) influenced perceived effectiveness of fungicides and levels of adoption of cultural and agrochemical best practices. Only 28% of growers and 11% of AEOs practiced crop and fungicide rotations, respectively. More than half (53%) of the respondents indicated that fungicides used in northern Ghana are not effective. Given the low level of pesticide literacy of AEOs and growers, training programs on best practice for the use of pesticides, with targeted initiatives for female growers, would improve crop protection outcomes and safety. The limited adoptions of crop rotation and repeated use of fungicides with the same active ingredients, along with >50% of respondents reporting 'fungicides not working' suggest the potential presence of fungicide resistance cases in growers' fields in the Northern region of Ghana. Further work is needed to determine the incidence of resistance in the region. It is recommended that a key policy priority should focus on understanding broader agrochemical-use practices, crop losses and household-level food security in the presence of resistance risks. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

An Improvement Project in Reducing After-Visit Phone Calls in a Community Pediatric Neurology Clinic: Too Much Communication?

Physicians strive to provide high-quality clinical care, yet after-visit patient telephone calls create extra demands on a clinician's time. Pediatric neurologists are particularly affected by this challenge given the number of patients with chronic illnesses they serve and the volume of worried parents they support. Added workload coupled with a busy office practice increases the likelihood of early physician burnout, which can have downstream effects on the quality of patient care and patient satisfaction. Using the IHI model for quality improvement (abbreviated QI moving forward), QI methodology was used to determine volume and key drivers of patient/family communications after a visit to a pediatric neurology clinic. Interventions aimed at reducing telephone messages by 15% over a 6-month period were put into place. A baseline audit of clinic phone calls was completed in 2019 to develop an overview of after-visit communications. After-visit telephone calls and web-based portal messages were then tracked for 3-week periods in 2019, 2020, and 2021 to understand key trends. A key driver diagram of patient/family communications after a clinic visit was created, and interventions aimed at reducing telephone messages were discussed. These interventions included optimizing MD-RN workflows, synchronous and asynchronous educational initiatives, and changes to our clinic's voicemail phone tree. Our primary outcome measure was the average monthly telephone call volume, and this measure was tracked monthly from November 2020 through December 2022. Similarly, electronic portal message volume was tracked and served as our balancing measure. Physicians, nurses, and patients were primary drivers of phone call volume. After interventions were in place, the average monthly call volume decreased by 30% from a baseline of 293 calls to 203 calls. This change was sustained for at least 1 year. The average monthly portal message volume remained consistent throughout the study period at 359 messages. Both physicians and nurses agree that after-visit patient communication affects their workload. This study illustrates that QI methodology can be used to plan and implement interventions aimed at decreasing after-visit telephone calls.

Prevalence of risk factors for development of cardiovascular diseases in urban and rural areas of Eastern Croatia: a cross-sectional study.

Cardiovascular diseases are the leading global cause of death. Due to the disparities in cardiovascular risk factors between rural and urban populations, this study aims to assess the differences in the prevalence of risk factors in urban and rural areas of eastern Croatia. The cross-sectional study included 280 participants (140 from urban and 140 from rural areas) registered at studied general practice offices. Methods included e-health records, questionnaire, physical examination methods, and blood sampling for laboratory tests. The most common risk factors among participants were elevated total cholesterol (83.6%), elevated LDL cholesterol (81.8%), increased body mass index (75.0%), increased waist-hip ratio (82.9%), increased waist circumference (63.2%), and arterial hypertension (70.1%). The rural participants had a significantly higher prevalence of arterial hypertension (p = 0.023), increased body mass index (p = 0.004), increased waist circumference (p = 0.004), increased waist-hip ratio (p < 0.001), and increased LDL cholesterol (p = 0.029), while the urban participants had a significantly higher prevalence of insufficient physical activity (p < 0.001). In the examined sample, the prevalence of cardiovascular risk factors is generally high. Participants from rural areas are significantly more susceptible to cardiovascular risk factors than participants from urban areas.

How Police Officers Experience Suspect Interviews: Beliefs and Practices in the Belgian Interview Room

AbstractThe current study focuses on the beliefs and practices of Belgian police officers (N = 177) concerning suspect interviews. Enhancing and safeguarding the quality of suspect interviews can prevent miscarriages of justice, and a comprehensive understanding of the process is crucial. While prior research has explored suspects’ perspectives on this issue, there has been no comprehensive study on European police officers’ beliefs and practices. This study aims to fill this gap by investigating the attitudes of Belgian officers in two studies. Study 1 included Flemish-speaking police officers (N = 130), and Study 2 included French and German-speaking officers (N = 47). Using a self-report survey, officers were questioned about the duration, frequency, and recording of suspect interviews, suspects’ use of legal rights, deception detection ability, (false) confession rates, and the use of various interviewing techniques. The findings suggest a positive shift in the Belgian approach to suspect interviewing, with more adherence to guidelines for minimizing false confessions. However, some officers still reported using accusatorial tactics, indicating that interviewing training in Belgium could benefit from more uniformity. By understanding the beliefs and practices of police officers, we can work towards developing effective interviewing techniques that protect the rights of suspects and promote justice.

Knowledge, Attitudes and Practices among Medical Officers on Disaster Preparedness: Study from Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH), Panadura in Western Province

&#x0D; &#x0D; &#x0D; Climate change is contributing to increased disasters in the world. As the disaster events are rising, health, socio-economic and political consequences are inevitable. Therefore, managing disasters to reduce the risk and impacts is given high priority in any development agendas. In this context, emergency and disaster preparedness have become a vital element in disaster management. To manage disaster induced health impacts that include deaths and injuries, hospitals play a major role. The objective of this study was to investigate the knowledge, attitudes, and practices of medical officers on disaster preparedness in two key hospitals in the country. The present study focused on the medical officers in Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH) regarding disaster preparedness. Cross-sectional research was designed to collect data from the health personnel working in two hospitals through a questionnaire which was prepared and distributed online. Data were collected from 95 and 17 doctors, who were randomly chosen, from BHP and KMH respectively. The majority of the respondents (93%) stated that hospital disaster preparedness plans could assist in reducing morbidity and mortality during an event of a disaster. In both hospitals, 40% of respondents were familiar with the disaster preparedness (DP) programs and 60 % were aware that such programs exist in their hospital. Around 67% and 65% of the medical officers from BHP and KMH respectively had stated that the prior experience of the medical officers is the key to handling a post disaster health management. The statistical analysis indicated that knowledge and practices of the medical officers were significantly linked to DP while the attitudes of the participants did not demonstrate any link to the DP programs. In summary, enhancing knowledge and good practices aiming at post disaster medical care as well as enhanced disaster preparedness activities among the medical officers contribute to disaster risk reduction.&#x0D; Keywords: Disaster preparedness, Knowledge, Attitudes, Practices, Medical officers&#x0D; &#x0D; &#x0D;

In-Office Needle Arthroscopy: Indications, Surgical Techniques, Tips, and Tricks.

In-office needle arthroscopy (IONA) has gained increased attention as a minimally invasive alternative to standard arthroscopy performed in the operating room (OR) setting. IONA uses instrumentation that is markedly smaller in size and diameter making arthroscopy less invasive. Less OR equipment and less OR staff are required resulting in procedures that may be more accessible and less expensive. IONA is typically performed using local intra-articular blocks, thereby reducing the need for regional anesthesia or general anesthesia along with its associated risks. Using a clinic setting rather than an OR reduces the cost and increases the efficiency of the procedure. This article will present the indications for IONA in upper and lower extremity injuries and will describe the best practice office setup. Technical pearls and pitfalls will also be discussed.