Regular Duties Research Articles

Managing fraud risk: A study of the private hospital sector of South Africa

Ethical and legal decisions are made daily by healthcare professionals and personnel in the performance of their regular duties. However, fraud risk has become a threat to the sustainability of industries and organisations, including the healthcare sector. In the South African healthcare sector, losses due to fraud risk amounted to R13 billion during 2015(Bateman, 2015). The purpose of the study on which this article reports, was to assess whether private hospitals managed fraud risk effectively and in a cohesive manner. Failure to manage fraud risk threatens the sustainability of any hospital. Primary data was collected by means of a survey, which involved management staff at head office level and at hospital level. The findings suggested that South African private hospitals appreciate the significance of the management of fraud, but there is room for improvement. It is recommended that private hospitals follow a decentralised business model and decentralising risk ownership in order to manage fraud risk more effectively. Risk management training should be provided to staff members on a regular basis and a King-type regime should be adopted by private hospitals with regard to the management of risks.

Clinical holding with children who display behaviours that challenge.

Nurses hold children to administer treatment, prevent treatment interference and undertake clinical assessments, which can sometimes be invasive, as part of their regular duties. Clinical holding ensures this treatment or assessment is carried out safely, however, it has been reported that there is little training available in this area. This article explores the prevalent clinical holding techniques used by nursing staff when caring for children with behaviours that challenge. As an initial insight into what the researchers hope will become a more in-depth 2-year study, this investigation looks to explore current practice when holding children and the factors influencing this. It is hoped that this will inform the development of a training package offered to nurses when caring for these children. Thirteen semi-structured interviews took place with a small group of nurses, which were given thematic analysis. The overarching themes influencing holding practice were the nursing role itself along with intrinsic and external factors.

Spanish songs for Christmas Eve from the early 16th century

A tradition for singing songs in the vernacular on Christmas Eve, whether as an integral part of the Officium pastorem or paraliturgical celebrations related to it, in Spanish churches, chapels and convents dates from at least the end of the 14th century, and possibly even earlier. Certainly, by the first decades of the 15th century such songs began to be written down, although it seems likely that these notated versions would not have been used in performances where the actor-musicians were often dressed or masked as shepherds or other persons present at the Nativity scene. Rather, it seems that the notating of the songs served at least two other purposes: as a record of an ecclesiastical institution’s ceremonial practice and/or for the rehearsal and memorization of the songs to be performed on Christmas Eve. The recent discovery of four (incomplete) Christmas villancicos in two 16th-century leaves that originally formed part of a substantial volume of sacred songs in the vernacular is of particular interest as witness to the increased institutionalization of this repertory. The songs themselves also reflect the final stages in the transition from a semi-improvised tradition to a more formal act of creation that would, in the course of the 16th century, become one of the most regular and important duties of the chapel masters of Spanish cathedrals.

Looking forward to looking back

Looking forward to looking back

Examining outcome of early physician specialist assessment in injured workers with shoulder complaints.

BackgroundThere is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems. The purposes of this study were: 1) to document the demographics of patients with shoulder complaints referred to an Early Shoulder Physician Assessment (ESPA) Program and to describe the recommended management, and 2) to examine the relationship between patient characteristics and their subjective complaints of pain and functional difficulty.MethodsThis study involved a retrospective review of electronic files of injured workers mostly seen within the first 16 weeks of injury or recurrence. Measures of functional difficulty and pain were the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Numeric Pain Scale (NPS).ResultsFiles of 550 consecutive patients, 260 females (47%), 290 men (53%) were examined. The average age was 49 (SD = 11, range 22–77), with 28 (5%) patients being 65 years of age or older. Patients who were not working were the most disabled group based on Quick DASH (F = 49.93, p < 0.0001) and NPS (F = 10.24, p = 0.002). Patients who were working full time performing regular duties were the least disabled according to both measures, the QuickDASH (F = 10.24, p = 0.002) and NPS (F = 7.57, p = 0.006).Patients waiting more than 16 weeks were slightly older (53 years of age vs. 49, p = 0.045) than those who met the criteria for early assessment with similar levels of pain and functional difficulty. Biceps pathology had the highest prevalence (37%). Full thickness tear had a prevalence of 14%. Instability, labral lesions and osteoarthritis of glenohumeral joint were uncommon conditions (3, 2 and 1% respectively). Fifty-five patients (10%) were surgical candidates and had higher scores on QuickDASH (F = 7.16, p = 0.008) and NPS (F = 4.24, p = 0.04) compared to those who did not require surgery.ConclusionsThis study provides information on characteristics and prevalence of important variables in injured workers with shoulder problems and highlights the impact of these characteristics on pain and disability.

The extraboard operator scheduling and work assignment problem

An instance of the operational fixed job scheduling problem arises when open work caused by unplanned events such as bus breakdowns, inclement weather, and driver (operator) absenteeism need to be covered by reserve (extraboard) drivers. Each work-piece, which is referred to as a job, requires one operator who must work continuously between specified start and end times to complete the job. Each extraboard operator may be assigned up to w hours of work, which may not to be continuous so long as the total work time is within a s-hour time window of that operator’s shift start time. Parameters w and s are called allowable work-time and spread-time, respectively. The objective is to choose operators’ shift start times and work assignments, while honoring work-time and spread-time constraints, such that the amount of work covered as part of regular duties is maximized. This paper argues that the extraboard operator scheduling problem is NP-hard and three heuristic approaches are presented for the solution of such problems. These include a decomposition-based algorithm whose worst-case performance ratio is proved to lie in [1 − 1/e, 19/27], where e ≈ 2:718 is the base of the natural logarithm. Numerical experiments are presented that use data from a large transit agency, which show that the average performance of the decomposition algorithm is good when applied to real-world data.

From the Sidelines to the Front Lines - Mathew Ahmann Leads American Catholics into the Civil Rights Movement

THE FIFTY YEAR-OLD PHOTO shows twelve men dark suits standing around President John F. Kennedy. The occasion is the White House reception following the 1963 March on Washington. The camera captures Dr. Martin Luther King, Jr., and then-Vice-President Lyndon B. Johnson. Also pictured are the African American labor leader, A. Philip Randolph; Whitney Young, head of the National Urban League; United Auto Workers president, Walter Reuther; and future Congressman John Lewis. But who is the tall, skinny white fellow wearing a bow tie? Few people could identify the mystery man as Mathew Ahmann, executive director of the National Conference for Interracial Justice (NCCIJ).It is said that every person is entitled to fifteen minutes of fame. Ahmann's moment the media spotlight came on August 28,1963, when he stood on the steps of the Lincoln Memorial, one of nine speakers delivering brief speeches prior to King's unforgettable Have a Dream oration. This was the public highlight of a career spent mostly the background. Yet, during the 1960s, Ahmann guided the civil rights efforts of the United States' largest religious body and, more than any other individual, brought Roman Catholics from the sidelines to the front lines of the struggle for racial equality.Early YearsMathew Hall Ahmann was born on September 10,1931, to a middle class family St. Cloud, Minnesota. His father, Norbert T. Ahmann, was a dentist and his mother, Clotilde Hall, worked as a nurse before she married. Mathew was educated at St. John's Prep nearby Collegeville where he played drums the band and rose to Eagle the Boy Scouts. The Ahmanns were deeply religious, attending retreats and other religious rites at Saint Johns Abbey Collegeville. According to his wife, Mathew always was compassionate about people who were marginalized.1 One revealing event his youth occurred at a gathering of young people that included Janet, a Jewish refugee from Nazi Germany. During the evening some children began singing an all too ubiquitous anti-Semitic song, oblivious to its possible effect on her. Matt stopped it short no uncertain terms.Mathew enrolled at St. Johns University, his fathers alma mater, 1949. There he was influenced by Emerson Hynes, a popular young sociology professor. also joined the Young Christian Students (YCS), an association of high school and college students who applied the observe, judge, act inquiry method to social issues.2 His friend and YCS associate, Vaile Scott, described Mathew as a serious student: He wasn't a party boy.3 In 1952 Ahmann enrolled the graduate sociology program at the University of Chicago. His brother David recalled: Matt announced he was going on to the University of Chicago the family promptly held a prayer meeting so that Matt wouldn't lose his faith. In fact, he found his faith.4 When not on campus he helped out at the YCS national headquarters. There he met Margaret Cunningham, a Wilmette resident and graduate of the College of St. Teresa Winona, Minnesota, who worked full-time for the Young Christian Students. Much later Matt told his granddaughter, in Chicago I met some of my closest friends, and my wife Margaret.... These were people with whom I shared deep religious interests social justice. Together we worked to improve race relations.5 Matt and Margaret married September of 1954.Chicago during the 1940s and 1950s was the center for Catholic Action, the name given to lay organizations employing the Church's teachings to improve the lives of families, students, workers, the poor, and racial minorities. A trio of dynamic young priests, Daniel Cantwell, William Quinn, and John Egan, guided these programs. Cardinal Samuel Stritch, Archbishop of Chicago, released these men from regular parish duties to work full-time the various Action ministries.6Ahmann withdrew from the University of Chicago without completing his Master's thesis and accepted a social work position with the Cook County Department of Public Aid. …

2, 6, heave! Sail training’s influence on the development of self-concept and social networks and their impact on engagement with learning and education. A pilot study

Introduction Youth disengaged with learning are at risk of not fulfilling their potential and often become very difficult to be provided with the social support necessary to remain active contributors to society. Similarly, disengaged youth who do return to study are more likely to fail and drop out greatly reducing the prospect of creating constructive productive community members (Henry, Knight & Thornberry, 2012; Kirjansson, 2007). Consequently there is a need to identify strategies to promote engagement with learning and education. One such strategy is the use of experiential education. Successful experiential learning is described by Priest (1993) as an approach to training and development utilising activities involving some form of perceived physical or emotional risk to bring about positive changes in individuals. Here learning is based in real world situations with both a social element and immediate consequences that in turn allows for future learning to occur (Wojcikiewicz & Zachary, 2010) Among many experiential learning proposals that might be useful to reengage students with education--such as sports, project-driven programs, outdoor education - this paper analyses sail training as one potential avenue to provide disengaged youth students with tools to pursue further learning. An experiential learning voyage aboard Australia's national sail training ship STS Young Endeavour requires youth aged 16 to 23 to live at sea in close confines with up to 36 other people they have previously never met, aboard a 33 meter tall ship for 11 days. During this time they engage in a number of experiential activities including; climbing a 30 meter mast, participating in teamwork activities such as sail-handling, conducting regular ship duties, steering the vessel and taking control of daily operations. 2,6, Heave! is a common call requiring all members of a sailing team to heave together to complete a task one person cannot accomplish alone. This becomes synonymous with the ethos of a sail training voyage which is - working together achieves more than working alone. Participants are also involved in a number of targeted debriefing scenarios which provide opportunities for both reflections on behaviours, feelings and attitudes, as well as how these informed thoughts can be related to life beyond the voyage. This paper shows how, by increasing opportunities to 2'6' heave together, sail training is likely to transform young people's lives in ways they could not imagine at first. We use the term experiential education rather than outdoor education in this paper as the ship and the marine environment appear to provide a context for the experiential elements of the program participants identified as being influential in their learning. Burns, Collin, Blanchard, De-Freitas and Lloyd (2008) argue engaging and connecting young people in the broader social life is one of the key issues for Australian contemporary society. The authors believe that engaged young people are better prepared to become healthy adults with a greater potential to contribute to the society. They affirm that "young people, who are provided with opportunities to participate, experience a better quality of life and contribute to creating and building better communities" (p. 4). In this paper we offer insights about a sail training experience from five young Australians who participated in a voyage with Young Endeavour and how this impacted their engagement with learning and education upon their return. We engaged in qualitative conversations both pre and post voyage, in order to have the participants reflecting on how their sail training voyage might impact their further involvement with education. By looking at behavioural, affective and cognitive aspects of the participants' engagement, we aim to provide a better understanding of aspects where sail training seems to be a potentially good strategy to reengage youth in education. …

The effectiveness of codetermination laws in cooperative and adversarial employment relations: When does regulation have bite?

The German Codetermination Law grants workers of establishments with 200 or more employees the right to have a works councillor who is fully exempted from his or her regular job duties while still paid a regular salary. This article analyses theoretically and empirically how this de jure right to exemption translates into de facto practice, and explicitly takes into account the nature of the employment relations participation regime. It is found that the right of exemption has no effect in cooperative employment relations because exemptions are granted even in the absence of legal rights, but does make a difference in adversarial relations when exemptions are only granted above the threshold where legal rights force employers to do so, i.e. legal rights do make a decisive difference in exactly those situations where the legislators’ intent would not be realized without the right to legal enforcement.

Predictors of declining levels of physical activity among adult survivors of childhood cancer.

10062 Background: Childhood cancer survivors are at increased risk of developing obesity-related diseases, yet many survivors do not meet established guidelines for physical activity. We aimed to identify demographic and health-related predictors of declining physical activity among participants in the Childhood Cancer Survivor Study (CCSS). Methods: Analyses included 6617 &gt;5 year childhood cancer survivors diagnosed between 1970-86 who completed the CCSS 2003 and 2007 follow-up questionnaires, and1992 siblings. Participants were classified as active if they reported engaging in any physical activity other than their regular job duties in the prior month. Generalized linear models using a log-link and Poisson distribution were used to compare participants whose physical activity levels fell from active to inactive over the study interval to those who remained active or whose activity levels improved. In addition to analyses comparing survivors to siblings, selected demographic factors and chronic conditions (CTCAE v4.0 Grade 3 and 4) were evaluated as risk factors in an analysis among survivors alone. Risk ratios (RR) with 95% confidence intervals (CI) are reported. Results: The median age at last follow-up among survivors and siblings was 36 (range: 21-58) and 38 (range: 21-62) years, respectively. Approximately 14% of survivors and 9% of siblings reported declines in physical activity across the study interval (p&lt;0.01). Factors that predicted declining levels of physical activity included BMI≥30kg/m2 (RR=1.4, 95% CI=1.3-1.7, p&lt;0.01), BMI&lt;18.5kg/m2 (RR=1.4, 95% CI=1.0-1.8, p=0.03), not completing high school (RR=1.7, 95% CI=1.2-2.2, p&lt;0.01), and black race (RR=1.6, 95% CI=1.2-2.1, p&lt;0.01). In a model limited to survivors, declining levels of physical activity were more likely among survivors who reported the presence of Grade 3 or 4 neurological (RR=1.5, 95% CI=1.2-1.8, p&lt;0.01) or cardiac conditions (RR=1.5, 95% CI=1.3-1.9, p&lt;0.01). Conclusions: Childhood cancer survivors are at increased risk of becoming inactive over time compared to siblings. Interventions targeting survivors at highest risk of decline are required to reduce the risk of chronic diseases associated with an inactive lifestyle.

Blake, Joseph Johnson, and "The Gates of Paradise"

Previous articleNext article No AccessThe Wordsworth-Coleridge Association, 2013: Ed. Toby BenisBlake, Joseph Johnson, and "The Gates of Paradise"Joseph ByrneJoseph Byrne Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The Wordsworth Circle Volume 44, Number 2-3Spring-Summer 2013 Article DOIhttps://doi.org/10.1086/TWC24044236 Views: 12Total views on this site © 2013 by The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

Internet startups look to reinvent higher education

Massive open online courses promise a convenient, low-cost experience, but high dropout rates threaten to slow their growth.

Covey's 7 Habits Can Guide Working Mothers

There can be a huge difference between what's urgent and what's important. It all hinges on what you value. Pulled in endlessly by their families, their bosses and their own needs and desires, working mothers can be forgiven for getting confused between the two. Speaking at the National Association of Student Personnel Administrators (NASPA) conference held in Phoenix in March 2012, Dr. Michelle Pickett and Dr. Susana Das Neves discussed Stephen Covey's The 7 Habits of Highly Effective People from the perspective of working mothers. Both work at Northern Illinois University, where Pickett is director of the academic advising center and Das Neves is an academic advisor and counselor. “Being a mother doesn't define me at work,” said Das Neves. “Working doesn't define me as a mother.” It helps to have a boss who understands her two roles. “Discussing work/life balance and actually practicing it are two different things,” said Pickett. “It takes time to find a way to do it.” Habits are defined as the intersection of knowledge (what to do), skill (how to do it) and desire (want to do it). Applying Dr. Stephan R. Covey's seven habits along with our skills/ knowledge/desires ensures that we focus on what's important to us, not just urgent. Proactive responses result from carefully considered values, not by a “circle of concerns.” To gain more control, we need to increase our circle of influence. Feelings that are influenced by circumstances, conditions and environment lead to a reactive response. Being proactive means having a plan that stops you from responding to situations based on only your feelings. This habit is based on your principle of personal leadership. Whatever is at the center of your life is your source for security, guidance, wisdom and power. Family? Education? Career? Balance is based on your personal vision statement. Visualize your potential and develop your talents and strengths to get there. Getting there requires you to examine five dimensions: character, relationships, courtesy and respect, agreements and goals, support with a reward system that works and the process. Identify the concerns, points of view and results of others and adapt to them. It's not all about you! Covey followed up his seven habits with an eighth one: “from effectiveness to greatness,” essentially finding your voice and inspiring others to find theirs. The best greatness is to accept our choices as mothers and professionals. Accept being a “good enough” mother without needing perfection. Still having trouble deciphering urgent from important? A time management matrix divides tasks into four quadrants. In Quadrant I, urgent/important, are the crises, pressing problems and deadline-driven projects. Quadrant II, not urgent/important, contains no drama and no crises. You can concentrate on prevention, building relationships, recognizing new opportunities and planning and cooperation. The danger is in ignoring Quadrant II. Quadrant III, urgent/not important, includes interruptions, some calls, mail, reports and meetings, as well as proximate and pressing matters along with regular duties. Quadrant IV, not urgent/not important, contains trivial tasks, busy work, some mail and phone calls, time wasters and pleasant activities. We have many organizational tools for success at work. How about using them for home and personal lives? Contacts: mpickett@niu.edu or 815.753.2533 dasneves@niu.edu or 815.753.5908

Health Information Technology Happenings in 2011: Part 2

With this installment, we explore items 6 through 10 in Dr. Farzad Mostashari's list of the 10 most important developments related to health information technology from 2011. We covered items 1 through 5 in March 2012 and close out the list with this installment. Readers are encouraged to consider which topics they come in contact with during regular practice and administrative duties.

Elimination of leprosy &amp; possibility of eradication - the Indian scenario

Elimination of leprosy &amp; possibility of eradication - the Indian scenario

Zukunftschance Pflege - von der Professionalisierung zur Restrukturierung des Aufgabenfeldes

Demographic trends and expected changes regarding future health care require substantial structural reforms of the German health care system. It is generally assumed that nursing education and training as well as curriculum development and also the competencies of professional nurses must adapt to the changing demands of health care supply. Moreover, the expected shortage of general practitioners demands solutions for easing their growing workload, which will include the assignment of certain services to health care professionals which perform these services autonomously or in behalf of the practitioner. Consequently, nurses have to expand their scope of skills and expertise. In order to prepare nurses for their new and extended roles, different curricula for professional and academic educational programmes are currently developed. If nurses are to perform additional tasks, it is essential to delegate some of their regular duties to health care assistants. Consequently the latter must be included in the reform process since their current range of duties will be modified as well.

Developing Educators, Investigators, and Leaders During Internal Medicine Residency: The Area of Distinction Program

Professional organizations have called for individualized training approaches, as well as for opportunities for resident scholarship, to ensure that internal medicine residents have sufficient knowledge and experience to make informed career choices. To address these training issues within the University of California, San Francisco, internal medicine program, we created the Areas of Distinction (AoD) program to supplement regular clinical duties with specialized curricula designed to engage residents in clinical research, global health, health equities, medical education, molecular medicine, or physician leadership. We describe our AoD program and present this initiative's evaluation data. METHODS AND PROGRAM EVALUATION: We evaluated features of our AoD program, including program enrollment, resident satisfaction, recruitment surveys, quantity of scholarly products, and the results of our resident's certifying examination scores. Finally, we described the costs of implementing and maintaining the AoDs. AoD enrollment increased from 81% to 98% during the past 5years. Both quantitative and qualitative data demonstrated a positive effect on recruitment and improved resident satisfaction with the program, and the number and breadth of scholarly presentations have increased without an adverse effect on our board certification pass rate. The AoD system led to favorable outcomes in the domains of resident recruitment, satisfaction, scholarship, and board performance. Our intervention showed that residents can successfully obtain clinical training while engaging in specialized education beyond the bounds of core medicine training. Nurturing these interests 5 empower residents to better shape their careers by providing earlier insight into internist roles that transcend classic internal medicine training.

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial

The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. Time to RTW sustained for ≥4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.

Deployment to Afghanistan: Perioperative Nursing Outside the Comfort Zone

Multiple missions are assigned to the Bagram Airfield in Afghanistan, including providing combat medical and medical support services to US and coalition forces and providing resources to strengthen security and build a solid health care infrastructure. Craig Joint Theater Hospital located at Bagram Airfield is staffed primarily with Air Force personnel serving a six-month tour of duty. The three-suite OR is in operation 24 hours a day, seven days a week, as is the rest of the hospital. In 2009, health care providers at Craig Joint Theater Hospital treated the highest number of casualties in the history of the US involvement in the Afghanistan conflict. They assessed and categorized patients using the Injury Severity Score to evaluate the number and acuity of patients treated. During one nurse's deployment in 2009, practice challenges occurred daily and personnel quickly learned how to adapt using the resources available. In addition to regular perioperative duties, Bagram Airfield perioperative nurses mentored a number of Afghan physicians and nurses.

Embedded academic librarian experiences in online courses

PurposeThis paper seeks to determine common and unique activities, promotional methods, time management strategies, and best practices of academic librarians embedded in online courses at six institutions.Design/methodology/approachThis is a mixed methods study using both interviews and quantitative data to study the activities and experiences of embedded librarians at six institutions.FindingsThe librarians and faculty involved in the embedded services reported unexpected benefits to the service. However, experiences with managing the time required for embedding along with regular reference duties varied, and scaling up the service from a few courses to a regular library service caused staffing issues for a few institutions.Research limitations/implicationsThis study was exploratory by nature and thus its scope was limited. Because only six institutions were studied, it is difficult to determine the true state of embedded librarianship in the USA. Future research should build on the foundation to determine outcomes for which embedded service is best suited and perform cost‐benefit analyses.Practical implicationsBecause embedded services can become popular quickly, individual librarians should work with library administrators to determine whether staffing a full‐scale service will be possible and plan accordingly. If a full‐scale service is not feasible, the service scope may need to be limited (for instance, to core courses or to specific academic departments).Originality/valuePast research on embedded librarianship has been limited to single institutions or to purposes and outcomes of the service. This paper provides a comparative study of embedded librarians at six institutions, and concentrates on the librarian's experience at each.