Recruitment Problems Research Articles

Can Nursing Students Gain Person-Centred Skills while Supporting Citizen Contacts to use the Internet for Health?

Introduction: Service users may benefit from digital health services by having access to reliable health information and ways to communicate health issues, thus fostering greater engagement in self-care. The University of Plymouth’s nursing students study ‘Digital Professionalism’ as part of an introduction to e-health in their curriculum. The University seeks to benefit local communities through direct community action. This study aims to explore the feasibility of implementing a model for students to enhance citizens’ knowledge and use of the Internet for health, and to provide an opportunity for students to understand citizens in their social context. Theory/Method: A collaborative action research approach has been used to develop and trial a citizen contact model. This study has two iterative cycles using mixed methods; a third will be undertaken. The first cycle explores the proposed activity with academics, health professionals, the public, and students. The second and third cycle’s trial the model, exploring its feasibility with stakeholders. Results: First cycle: Six workshops were undertaken. There was general consensus introducing a citizen contact model into the nursing curriculum was a good idea. An online survey further explored the thoughts of workshop participants and stakeholders. All 57 survey respondents agreed that the proposed activity would give students a better understanding of the thoughts and experiences of citizen contacts, and the majority 52/57 agreed citizen contacts would learn about health services. However, a number of concerns were raised including recruitment of citizen contacts, safeguarding of participants, and workloads. In October 2017, 473 first year students were invited to demonstrate one of five health websites to a friend, relative or neighbour as part of an assessment. The benefits were explored without confronting the problems of recruitment, safeguarding, and workloads. Second cycle: The recruitment of citizen contacts unknown to students and the organisation of visits has been addressed with volunteer second year adult nursing students. Three students and five citizen contacts participated in the implementation phase. Citizen contacts were recruited via a service user organisation. Reflective logs from students and questionnaires from citizen contacts are currently being collected. All participants are invited to explore their experiences in a follow-up. The model offers students the chance to visit a carer or someone living with a long-term health condition in pairs, to support them in using the Internet for health in a non-clinical setting. Discussion: Although a third cycle of collaborative action research will be undertaken offering child nursing students a similar opportunity, the model has not yet achieved unanimous support and routine implementation. However, stakeholders seem to accept the model. If we can implement the model for routine use, it could improve student and citizen learning. Collaborative action research, through a number of cycles, appears an appropriate methodology. Lessons Learned: Working with stakeholders is key to developing a feasible approach. Limitations: The model is being developed within one Higher Education Institute HEI, we cannot be sure the findings will transfer across to other HEIs. Suggestions for Future Research: Future research would trial this model at other HEIs.

Communal roosts of the Blue-fronted Amazons (Amazona aestiva) in a large tropical wetland: Are they of different types?

Psittacidae species are among the most threatened birds in the world. Approximately one-half of the 390 parrot species are experiencing population declines. The Blue-fronted Amazon (Amazona aestiva) is the most traded parrot worldwide and suffers from poaching and habitat loss. Many species of parrots, including the Blue-fronted Amazon, form communal roosts where they spend the night. Under certain circumstances, roost surveys can be a rapid and cost-effective way to obtain information about the demography of parrots or the consequences of threats. We surveyed an area of 2,700 km2 in a large wetland in mid-western of Brazil and located five Blue-fronted Amazon roosts. We conducted monthly counts of the birds arriving at these roosts for 28–61 months and stratified the counts into flock sizes. We used this information to estimate the number of parrots using these roosts to determine whether the roosts follow seasonal patterns and whether they have different flock-size structures and different dynamics throughout the year, as well as to determine the trends of the roosting parrots, which are stratified by flock size. The roosts were different, as they followed different seasonal patterns and had different flock-size structures, which could be interpreted in relation to the parrot breeding cycle. The trends of singletons, which index the number of reproductive couples each year, and the number of pairs parrots increased or fluctuated around a baseline, but the number of fledged young in the year declined throughout the study. This is of concern, as it indicates problems in population recruitment, which could have been unnoticed by the management authorities, as the total numbers were not decreasing. Although every monitored roost had birds of each age or reproductive condition strata, the fact that the roosts were different could be important in terms of management, as it will be more effective for the conservation of the Blue-fronted Amazon to protect a carefully chosen set of complementary roosts.

Vehicle-Based Bi-Objective Crowdsourcing

Mobile crowdsourcing is an emerging complex problem solving paradigm that makes use of pervasive mobile devices equipped with multi-functional sensors. Recently, vehicles have also been increasingly adopted for mobile crowdsourcing, as the vehicles, as well as drivers, can provide diverse sensing capability and predictable mobility. Existing mobile crowdsourcing algorithms mostly recruit workers to complete one kind of sensing tasks, i.e., location-based query tasks or automatic sensing tasks. In this paper, we investigate the possibility of recruiting a set of vehicles to simultaneously complete these two categories of tasks, so as to maximize the sensing utility of each participant. We first model the worker recruitment for vehicle-based crowdsourcing as a bi-objective optimization problem with respect to the sensing capability and predictable mobility of vehicles. The recruitment problem is proven to be NP-hard, and we design two heuristic algorithms based on the bi-objective greedy strategy and the multi-objective genetic algorithm to find the solutions. The experimental results with a real-world traffic trace data set show that the proposed algorithms outperform some existing algorithms in finding solutions that maximize both objectives.

Проблема радикализации и вербовки террористов в тюрьмах

Проблема радикализации и вербовки террористов в тюрьмах

A need for a paradigm shift in focus: From Kt/Vurea to appropriate removal of sodium (the ignored uremic toxin).

Hemodialysis for chronic renal failure was introduced and developed in Seattle, WA, in the 1960s. Using Kiil dialyzers, weekly dialysis time and frequency were established to be about 30 hours on 3 time weekly dialysis. This dialysis time and frequency was associated with 10% yearly mortality in the United States in 1970s. Later in 1970s, newer and more efficient dialyzers were developed and it was felt that dialysis time could be shortened. An additional incentive to shorten dialysis was felt to be lower cost and higher convenience. Additional support for shortening dialysis time was provided by a randomized prospective trial performed by National Cooperative Dialysis Study (NCDS). This study committed a Type II statistical error rejecting the time of dialysis as an important factor in determining the quality of dialysis. This study also provided the basis for the establishment of the Kt/Vurea index as a measure of dialysis adequacy. This index having been established in a sacrosanct randomized controlled trial (RCT), was readily accepted by the HD community, and led to shorter dialysis, and higher mortality in the United States. Kt/Vurea is a poor measure of dialysis quality because it combines three unrelated variables into a single formula. These variables influence the clinical status of the patient independent of each other. It is impossible to compensate short dialysis duration (t) with the increased clearance of urea (K), because the tolerance of ultrafiltration depends on the plasma-refilling rate, which has nothing in common with urea clearance. Later, another RCT (the HEMO study) committed a Type III statistical error by asking the wrong research question, thus not yielding any valuable results. Fortunately, it did not lead to deterioration of dialysis outcomes in the United States. The third RCT in this field ("in-center hemodialysis 6 times per week versus 3 times per week") did not bring forth any valuable results, but at least confirmed what was already known. The fourth such trial ("The effects of frequent nocturnal home hemodialysis") too did not show any positive results primarily due to significant subject recruitment issues leading to inappropriate selection of patients. Comparison of the value of peritoneal dialysis and HD in RCTs could not be completed because of recruitment problems. Randomized controlled trials have therefore failed to yield any meaningful information in the area of dose and or frequency of hemodialysis.

NHS Scotland’s community GP fellowship – a qualitative study of the first year

ABSTRACTNHS Scotland faces the challenges of an ageing population and a GP recruitment problem. Research has shown that hospital admissions can be reduced if community services can offer enhanced support, in keeping with the Scottish Government’s 2020 Vision for healthcare. This study presents the findings of an evaluation of the first year of a three-year community GP fellowship which included working in primary care and secondary care and an educational programme. A grounded theory approach was adopted with data collected from GP fellows and key stakeholders using focus groups and individual interviews. A total of 12 fellows were interviewed at various times in the first year and 22 key stakeholders were interviewed once. The main themes were: aspirations for the fellowship, career choices of recently-qualified GPs, perceptions of primary care and secondary care components, planning and preparation of educational events, the creation of community hubs and identity and status of fellows. The fellowship showed potential for a change in practice and was a good foundation for further collaboration between health care sectors. Physical hubs need to be constructed and resourced to allow fellows to demonstrate a reduction in hospital admissions. More research is needed throughout the lifetime of the fellowship.

RESPONDER \u2013 diagnosis of pathological complete response by vacuum-assisted biopsy after neoadjuvant chemotherapy in breast Cancer - a multicenter, confirmative, one-armed, intra-individually-controlled, open, diagnostic trial

BackgroundNeoadjuvant chemotherapy (NACT) is a standard approach of the multidisciplinary treatment of breast cancer. Depending on the biological subtype a pathological complete response in the breast (bpCR) can be achieved in up to 60% of the patients. However, only limited accuracy can be reached when using imaging for prediction of bpCR prior to surgery. Due to this diagnostic uncertainty, surgery after NACT is considered to be obligatory for all patients in order to either completely remove residual disease or to diagnose a bpCR histologically. The purpose of this trial is to evaluate the accuracy of a vacuum-assisted biopsy (VAB) to diagnose a bpCR after NACT prior to surgery.MethodsThis study is a multicenter, confirmative, one-armed, intra-individually-controlled, open, diagnostic trial. The study will take place at 21 trial sites in Germany. Six hundred female patients with breast cancer after completed NACT showing at least a partial response to NACT treatment will be enrolled. A vacuum-assisted biopsy (VAB) guided either by ultrasound or mammography will be performed followed by histopathological evaluation of the VAB specimen before standard, guideline-adherent breast surgery. The study is designed to prove that the false negative rate of the VAB is below 10%.DiscussionAs a bpCR is becoming a more frequent result after NACT, the question arises whether breast surgery is therapeutically necessary in such cases. To study this subject further, it will be crucial to develop a reliable test to diagnose a bpCR without surgery.During the study we anticipate possible problems in patient recruitment as the VAB intervention does not provide participating patients with any personal benefit. Hence, a proficient informed consent discussion with the patient and a detailed explanation of the study aim will be crucial for patient recruitment. Another critical issue is the histopathological VAB evaluation of a non-tumorous specimen as this may have been taken either from the former tumor region (bpCR) or outside of the (former) tumor region (non-representative VAB, sampling error).Trial registrationThe trial has been registered at clinicaltrials.gov with the identifier NCT02948764 on October 28, 2016 and at the German Clinical Trials Register (DRKS00011761) on February 20, 2017. The date of enrolment of the first participant to the trial was on March 8, 2017.

Physiotherapy plus conventional treatment versus conventional treatment only in the treatment of functional constipation in children: design of a randomized controlled trial and cost-effectiveness study in primary care

BackgroundOur aim was to design a study to evaluate the effectiveness and cost-effectiveness of adding physiotherapy to conventional treatment for children with functional constipation in primary care. Physiotherapy is focusing on improving the coordination between the pelvic floor and abdominal musculature during bowel movement, while conventional treatment is mainly focusing on symptomatic relief of symptoms, therefore, we expect the effects of physiotherapy will be more sustainable than the effects of conventional treatment. In this paper we describe the final study design and how the design was adapted, to overcome recruitment problems.MethodsWe designed a randomized controlled trial of children aged 4–17 years with functional constipation diagnosed by a general practitioner or pediatrician. Children in the intervention group received physiotherapy plus conventional treatment, and those in the control group received conventional treatment only. Follow-up measurements took place at 4 and 8 months. The primary outcome was treatment success defined according to the Rome-III criteria as the absence of functional constipation, with no laxative use. Secondary outcomes were absence of functional constipation irrespective of laxative use, quality of life, global perceived effect, and costs.Children were recruited from September 2014 to February 2017. Initially, we aimed to include children with recent symptom onset. However, in the first phase of enrollment we were confronted with an unforeseen recruitment problem: many children and their parents refused randomization because physiotherapy was considered too burdensome for the stage of disease. Therefore, we decided to also include children with a longer duration of symptoms. In total 134 children were included.DiscussionThe target number of participants is achieved. Therefore, the results may change thinking about the management of functional constipation in children.Trail registrationNetherlands Trial Register (NTR4797), registered 8 September 2014.

Underestimating the importance of expressing intrinsic motivation in job interviews

Across five studies (N = 1428), we documented an important prediction problem in recruitment: Job candidates mispredicted how much recruiters valued expressions of intrinsic motivation (e.g., learning that a candidate desired meaningful work). In contrast, candidates more accurately predicted how much recruiters valued expressions of extrinsic motivation (e.g., learning that a candidate desired opportunities for career advancement). Social distance produced this discrepancy: People failed to realize others cared about intrinsic motivation as much as they did; therefore, they underestimated how much expressing that they valued intrinsic motivation mattered to others. Indeed, recruiters giving recruitment pitches also mispredicted how much admitted candidates valued learning that a company emphasized intrinsic motivation. As a consequence of the misprediction, candidates chose suboptimal pitches that failed to express their intrinsic motivation during job interviews, unless explicitly encouraged to take the recruiters’ perspective.

Randomized pilot study on probiotic effects on recurrent candidiasis in oral lichen planus patients.

To study whether probiotic intervention reduces recurrent OC in patients with OLP. Twenty-two patients with symptomatic OLP were enrolled in the double-blinded, randomized, placebo-controlled intervention study. Lozenges containing Lactobacilli reuteri (DSM 17938 and ATCC PTA 5289) or placebo were dissolved intra-orally three times daily for 16weeks, after which patients were followed up for 36weeks. Mucosal symptoms, VAS pain, OLP severity score, plaque index (PI) and gingival index (GI), Candida count/carriage, and OC and/or need for symptomatic treatment were registered. Statistical significance was set at p<.05. No difference was observed between the groups during the intervention or follow-up in terms of recurrent OC (p=.966) or need for symptomatic treatment (p=1.000). There was no difference in terms of Candida count (p=.96) or carriage over time (p=.511). GI decreased in the probiotic group and increased in the placebo group (p=.046). OLP severity score decreased in both groups during the study period (p=.039). Across the entire study period, the placebo group had higher VAS pain score (p=.037). Probiotic intervention did not reduce recurrent OC or Candida count/carriage, but the study experienced recruitment problems, which may have influenced results.

Cooperation Between Vocational Schools and Business in Poland: Schools’ vs. Employers’ Perspective

Purpose – The aim of the article is to identify the barriers to cooperation between vocational schools and employers. Design/Methodology/Approach – The main data source are the results of two surveys (CAWI): on vocational schools in Lublin, and on employers cooperating with those schools. Findings – The results show the asymmetry of schools’ and enterprises’ objectives, which should be regarded as an important barrier to the development of cooperation between the two. Employers are set on increasing the number of hours of students’ practical vocational training in the workplace, but are reluctant to undertake more costly and more demanding forms of cooperation with schools, like participating in vocational exams, training teachers or providing equipment for school workshops. Meanwhile, schools primarily indicate the need to improve their own resources, especially workshop equipment. They often consider the present state of cooperation with business as satisfactory. Employers’ limited willingness to cooperate stems i.a. from fragmentation of the enterprise sector in Poland, poorly developed cooperative bonds between enterprises, and the small scale of recruitment problems during most of the last two decades. Practical implications – The results allow for the identification of these forms of cooperation between schools and employers, which should be supported by EU structural funds. Value – The research is based on information of high substantive value from the employers who already have experience in cooperation with vocational schools. Results contribute to the formulation of the view on the effects of the reform of vocational education in Poland.

A leadership recruitment challenge

Much is said about the recruitment and retention problems when it comes to teachers, but similar problems are emerging for headteachers as well…

Discontinuation of the PACE Plus trial: problems in patient recruitment in general practice

BackgroundThe PACE Plus trial was a multi-center, double-blinded, superiority randomized controlled trial (RCT) conducted in patients from Dutch general practice to investigate the efficacy of paracetamol and NSAIDs in acute non-specific low back pain (LBP). Because insufficient numbers of patients could be recruited (only four out of the required 800 patients could be recruited over a period of 6 months), the trial was prematurely terminated in February 2017, 6 months after the start of recruitment. This article aims to transparently communicate the discontinuation of PACE Plus and to make recommendations for future studies.MethodsGeneral Practitioners (GPs) from 36 participating practices received a one-question survey in which they were asked to give the three most important factors that in their opinion contributed to failure of patient recruitment.ResultsGPs of 33 out of 36 (92%) participating practices sent a response. A total of 81 factors were reported. These have been categorized into patient factors (26 out of 81 comments, 32%), GP factors (39 out of 81 comments, 48%) and research factors (16 out of 81 comments, 20%).DiscussionPatient recruitment in the PACE Plus trial may have failed due to inefficient medication distribution, recruitment of incident rather than prevalent cases, a design that was too complicated, adequate self-management of LBP, patient expectations different from the trial’s scope and lack of time of participating GPs. Substantial differences in design may explain why the preceding PACE trial did manage to successfully complete patient recruitment.ConclusionAlthough the PACE Plus trial was terminated as a result of insufficient patient inclusion, the research questions addressed in this trial remain relevant but unanswered. We hope that lessons learned from the discontinuation of PACE Plus and corresponding recommendations may be helpful in the design of upcoming research projects in LBP in general practice.Trial registrationDutch Trial Registration NTR6089, registered September 14th 2016.

Mobility-Aware Participant Recruitment for Vehicle-Based Mobile Crowdsensing

Nowadays, vehicles have been increasingly adopted in mobile crowdsensing applications. Due to their predictable mobility trajectories, vehicles as participants bring new insight in improving the crowdsensing quality. The predictable mobility of vehicles provides not only the current locations of the vehicles, but also their future mobility trajectory. In this context, the existing participant recruitment solutions, which are mainly based on the current locations of the participants, cannot be directly used in vehicle-based mobile crowdsensing. Utilizing the predicted mobility trajectory of vehicles, this paper aims to propose efficient vehicle recruitment algorithms for mobile crowdsensing, so as to minimize the overall recruitment cost. Specifically, we study two mobility trajectory models of the vehicles, named deterministic and probabilistic models. We first prove that the vehicle recruitment problem under both models is NP-hard. Then, for the deterministic trajectory model, an efficient LP-relaxation-based heuristic algorithm is proposed, and an approximation ratio is analyzed. For the probabilistic trajectory model, we propose a greedy algorithm and analyze its performance with a guaranteed approximation ratio. Finally, we evaluate the performance of the proposed schemes through simulations.

Factors influencing nurses' intentions to leave adult critical care settings.

The shortage of critical care and specialist nurses has been an ongoing issue for many decades. Although all areas of nursing are affected, critical care areas are especially vulnerable to recruitment and retention problems. High nursing turnover in critical care areas is evident; however, research into the factors that influence nurses' intentions to leave adult critical care areas is limited. To explore factors that may influence nurses' intentions to leave adult critical care areas. To appraise existing evidence and highlight gaps in knowledge regarding factors that may influence nurses' intentions to leave adult critical care areas. A systematic mixed-method literature review was conducted. The search strategy was developed using the List, Keep and Delete approach, a framework used to identify search terms for systematic health care reviews. The following key words were used: intentions to leave, nurses, adult and critical care. The databases searched were BNI, CINAHL, PubMed, PsycINFO, Embase and Health B Elite from 2005 to 2016. Primary data from non-critical care areas and neonatal and paediatric critical care areas were excluded. Comprehensive supplementary searching was performed. Papers were critically appraised using the NICE (2012) checklists. Data were analysed using the Braun and Clarke (2006) thematic framework. A total of 15 studies, including 13 cross-sectional studies and 2 qualitative studies, were reviewed. Three main themes emerged following data analysis. These themes were quality of the work environment, nature of working relationships and traumatic/stressful workplace experiences. The literature review highlighted the need for further research and greater understanding of how these themes may impact critical care nurses. Nurse managers and leaders should consider these findings when developing strategies to improve nurse retention. The shortage of critical care nurses is currently a global issue impacting costs and quality of patient care.

Accounting and finance in UK universities: Academic labour, shortages and strategies

This paper contributes to the literature on change in the higher education sector arising from massification, increased political control, international mobility and competition. Drawing on various data sources and labour shortage models, it considers academic labour in UK accounting and finance academia over the period 2000 to 2012. A disequilibrium between supply and demand is evidenced through the identification of recruitment problems, unfilled vacancies, and retirements. The impact of research assessment on faculty backgrounds is shown to result in inadequate supply of faculty with the required skills. Strategic responses to labour shortages include: increased recruitment efforts, early promotions, enhanced remuneration and reducing restrictions on occupational entry. The consequences and future implications of shortages and strategies are considered. In particular, the decoupling of research and teaching in accounting is challenging the future existence of accounting as an academic discipline. The current generation of accounting academics is also under threat – if they neither excel at research nor are professionally-qualified they risk becoming undesirable.

Detailed Literature Review: Antecedents Affecting the Flight Risk or Turnover Intention of Professionals

Employee turnover has attracted significant research worldwide because of the high cost it entails. These costs include recruitment, selection, training, adjustment time, possible product, and/or service quality problems which often exceed hundred percent of the annual salary for the position being filled. Understanding the factors that influence the turnover gives organisations the opportunity to reduce selection and training costs, increase employee morale and customer satisfaction and enhance organisational productivity. This paper traces the work done by researchers in understanding the flight risk or Turnover Intention behaviour of professionals and thus helps understand and curtail turnover thereby curtail costs for organisations.

DEVELOPMENT OF ADVANCED TRAINING SYSTEM OF TEACHERS IN THE USA

The history of the formation and development of the American system for improving the qualifications of school teachers is analyzed in the article. It is stated that from the very beginning continuous education has developed in two directions: as a pedagogical concept, a paradigm and as a phenomenon of practice. It was determined that the development of the teacher training system was not equal and straightforward, but was a process full of real changes that included different stages. Among them, it is possible to conditionally distinguish three stages: from the 40s to 60s; from the 60s to 80s years of the XX century; from the 80s to the present. On the basis of the analysis of scientific sources, it was concluded that within this system there were two main forms of teacher training: training in courses (long-term or short-term) at universities and colleges and advanced training that was organized at schools, namely, at the teachers’ work place. It has also been proved that the formation of modern teacher training system was greatly facilitated by studies conducted under the auspices of the National Institute of Education. It has been established that the National Council for the Accreditation of Teacher Education (USA) has developed standards that the applicants for the position of teacher must meet. It is determined that solving problems of recruitment and preservation of perspective pedagogical staff, comprehensive support of young teachers, and effective administrative and pedagogical support for their professional development are key areas of US educational policy in recent decades.

How can the NHS become a millennial friendly employer?

With the NHS facing serious recruitment and retention problems, The BMJ hosted a round table at the Nuffield health policy summit asking how the NHS can do more to attract,...

Identifying trial recruitment uncertainties using a James Lind Alliance Priority Setting Partnership \u2013 the PRioRiTy (Prioritising Recruitment in Randomised Trials) study

BackgroundDespite the problem of inadequate recruitment to randomised trials, there is little evidence to guide researchers on decisions about how people are effectively recruited to take part in trials. The PRioRiTy study aimed to identify and prioritise important unanswered trial recruitment questions for research. The PRioRiTy study - Priority Setting Partnership (PSP) included members of the public approached to take part in a randomised trial or who have represented participants on randomised trial steering committees, health professionals and research staff with experience of recruiting to randomised trials, people who have designed, conducted, analysed or reported on randomised trials and people with experience of randomised trials methodology.MethodsThis partnership was aided by the James Lind Alliance and involved eight stages: (i) identifying a unique, relevant prioritisation area within trial methodology; (ii) establishing a steering group (iii) identifying and engaging with partners and stakeholders; (iv) formulating an initial list of uncertainties; (v) collating the uncertainties into research questions; (vi) confirming that the questions for research are a current recruitment challenge; (vii) shortlisting questions and (viii) final prioritisation through a face-to-face workshop.ResultsA total of 790 survey respondents yielded 1693 open-text answers to 6 questions, from which 1880 potential questions for research were identified. After merging duplicates, the number of questions was reduced to 496. Questions were combined further, and those that were submitted by fewer than 15 people and/or fewer than 6 of the 7 stakeholder groups were excluded from the next round of prioritisation resulting in 31 unique questions for research. All 31 questions were confirmed as being unanswered after checking relevant, up-to-date research evidence. The 10 highest priority questions were ranked at a face-to-face workshop. The number 1 ranked question was “How can randomised trials become part of routine care and best utilise current clinical care pathways?” The top 10 research questions can be viewed at www.priorityresearch.ie.ConclusionThe prioritised questions call for a collective focus on normalising trials as part of clinical care, enhancing communication, addressing barriers, enablers and motivators around participation and exploring greater public involvement in the research process.