Staff Volunteers Research Articles

Moving On: Voluntary Staff Departures at Small Colleges and Universities

Although voluntary departures are frequent among new professional student affairs staff members at small colleges and universities, there is little systematic study of the processes involved in departing a job at one campus to accept a student affairs position at another. Potentially awkward dynamics surrounding staff departures can complicate professional relationships and reputations, and unanticipated staff departures often result in increased work demands for staff members who remain. This study explored professional and developmental dimensions of voluntary departures of student affairs staff members at small colleges and universities using aspects of the transitions model (Schlossberg, Waters, & Goodman, 1995) and the synergistic supervision model (Winston & Creamer, 1997) as principal theoretical frameworks. Findings indicate that supervisors and graduate faculty members can assist new professionals and junior colleagues to regard voluntary departures as predictable occurrences related to career advancement and/or personal fulfillment that, in cooperation with dedicated supervisors, can be professionally managed. Ideally, supervisors and supervisees should have early discussions about departure expectations and processes.

Iterative Design, Implementation and Evaluation of a Supplemental Feeding Program for Underweight Children Ages 6–59 Months in Western Uganda

In this paper we describe the development, implementation, evaluation, and subsequent improvements of a supplemental feeding program that provides community-based care to underweight children in a rural East African setting, using a locally-sourced and produced ready-to-use food (RUF). Production teams were trained to grind soybeans and groundnuts (peanuts), which were then mixed with moringa oleifera leaf powder to form an energy-dense supplemental food, designed for use as an RUF. Eligible children (based on low weight-for-age or mid-upper-arm circumference < 12 cm) received RUF of approximately 682 kcal per day for five weeks. Weekly growth monitoring and caregiver education were provided by trained health center staff and community volunteers. The program was evaluated by examining RUF nutrient composition, weight gain velocity, and qualitative data from key-informant interviews and home feeding observations. Locally-produced RUF had similar energy density but higher protein content than commercial RUTF (ready-to-use therapeutic food). Mean weight gain of children was 2.5 g/kg/day (range 0.9-6.0). Feeding observations revealed that caregivers were diluting the RUF fed to children. Production team members desired increased financial compensation for their work but were enthusiastic about the program as helpful to malnourished children. Locally-produced RUF is a promising strategy for community-based care of moderately malnourished children. Through the production team's entrepreneurship, a small business was formed, whereby financial incentives encouraged continued RUF production. Future efforts are needed to educate caregivers on correct RUF use and improve commercial viability in local markets.

When a graph is poorer than 100 words: A comparison of computerised natural language generation, human generated descriptions and graphical displays in neonatal intensive care

AbstractVolunteer staff from a Neonatal Intensive Care Unit (NICU) were presented with sets of anonymised physiological data recorded over approximately 45 minute periods from former patients. Staff were asked to select medical/nursing actions appropriate for each of the patients whose data were displayed. Data were shown in one of three conditions (a) as multiple line graphs similar to those commonly shown on the ward, or as textual descriptions generated by (b) expert medical/nursing staff or (c) computerised natural language generation (NLG). An overall advantage was found for the human generated text, but NLG resulted in decisions that were at least as good as those for the graphical displays with which staff were familiar. It is suggested that NLG might offer a viable automated approach to removing noise and artefacts in real, complex and dynamic data sets, thereby reducing visual complexity and mental workload, and enhancing decision‐making particularly for inexperienced staff. Copyright © 2008 John Wiley &amp; Sons, Ltd.

Dissemination and implementation of suicide prevention training in one Scottish region

BackgroundAs part of a national co-ordinated and multifaceted response to the excess suicide rate, the Choose Life initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service (NHS), Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM (Skills-based Training On Risk Management), we set out to explore not only the outcomes of training, but key factors involved in the processes of diffusion, dissemination and implementation of the educational intervention.MethodsParticipants attending STORM training in Highland Region provided by 12 trained facilitators during the period March 2004 to February 2005 were recruited. Quantitative data collection from participants took place at three time points; immediately before training, immediately post-training and six months after training. Semi-structured telephone interviews were carried out with the training facilitators and with a sample of course participants 6 months after they had been trained. We have utilized the conceptual model described by Greenhalgh and colleagues in a Framework analysis of the data, for considering the determinants of diffusion, dissemination and implementation of interventions in health service delivery and organization.ResultsSome 203 individuals completed a series of questionnaire measures immediately pre (time 1) and immediately post (time 2) training and there were significant improvements in attitudes and confidence of participants. Key factors in the diffusion, dissemination and implementation process were the presence of a champion or local opinion leader who supported and directed the intervention, local adaptation of the materials, commissioning of a group of facilitators who were provided with financial and administrative support, dedicated time to provide the training and regular peer-support.ConclusionFeatures that contributed to the success of STORM were related to both the context (the multi-dimensional support provided from the host organisation and the favourable policy environment) and the intervention (openness to local adaptation, clinical relevance and utility), and the dynamic interaction between context and the intervention.

Second Life: A Tool for Reference and International Understanding

ABSTRACT The challenges that virtual reference staff volunteers in Second Life (SL) are facing are opportunities at the same time. There are a lot of differences between doing reference work in Real Life (RL) and in SL, but for the most part reference work in-world is quite the same as in the daily life of any reference specialist. In essence, that is. Of course new skills are needed, but this is just for now. In the end, working at a virtual reference desk, especially as one member on a team of international pioneers, is as exciting as it is new!

Editorial: New Horizons and New Responsibilities: PubMed Central indexes the JCE

Editorial: New Horizons and New Responsibilities: PubMed Central indexes the JCE

A Broader Vision of Advocacy

A Broader Vision of Advocacy

Availability of Tobacco Cessation Services in Free Clinics

This study sought to determine the availability of tobacco cessation services in free clinics. In fall 2007, a survey was e-mailed to free clinics that asked respondents to indicate the availability of13 different services recommended as part of the Treating Tobacco Use and Dependence guidelines set by the United States Public Health Service (USPHS). Seventy-two percent (n=51) of clinics responded to the survey. The majority of clinics enforce a "no tobacco use" policy inside the clinic (98%), encourage health care providers to advise patients to quit (90%), ask patients about tobacco use behavior on intake (78%), provide self-help materials (70%), and offer pharmacotherapy (e.g., bupropion) for quitting (60%). Fewer clinics offer fee nicotine replacement therapy (35%), display counter-advertisements in waiting areas and patient rooms (35%), have a designated staff person or volunteer to help patients quit (26%), evaluate whether health care providers offer tobacco cessation advice (30%), or have onsite tobacco cessation classes (22%). One out of 3 free clinics offer comprehensive (at least 9 of 13) tobacco cessation services using the USPHS Treating Tobacco Use and Dependence guidelines. Small sample size limits analytical techniques that can be applied, as well as interpretation of results. Free clinics offer an excellent opportunity to reach the uninsured population for tobacco cessation. Although 1 in 3 clinics is comprehensive in its approach to reduce tobacco use among their patients, many have yet to undertake the breadth of clinic-based strategies that can promote quitting. This study serves as an opportunity and a challenge to free clinics to expand their service delivery into the area of behavioral health.

User Perceptions of In-Home Medication Dispensing Devices

The purpose of this study was to characterize patient and clinician perceptions of programmable medication devices (dispensers and timers) being marketed to consumers to improve medication adherence. Using principles of usability testing, 33 volunteer staff and clinic patients rated seven devices. Raters scored devices on cueing and alarms, storage and dispensing, machine characteristics, potential to improve adherence, and cost. Medication dispensers ranked highest overall. However, even if the Department of Veterans Affairs paid for them, patient participants would be unlikely to use them. No significant differences were found across the devices in the perceived likelihood that the device would improve medication adherence. In this article, we provide a set of criteria for patients who might choose such a device and clinicians who may recommend these kinds of devices. More work is needed in the design and deployment of these devices if they are to be part of a successful medication adherence plan.

Value considerations in an information ecology: Printed materials, service providers and homeless young people

We demonstrate how value considerations can be used to analyze an information ecology that has emerged to help homeless young people. We studied the information ecology of service agencies that assist homeless young people, age 13 to 25. We focused on printed materials used at the agencies and employed surveys and semi-structured interviews to gather data. Of the printed materials considered, a flier with a map of all programs was reported to be most important and distributed most frequently. Future work would further investigate distribution and usability of these portable information sources and the values they embody.

Greening Healthcare: 21st Century and Beyond

WE ARE INUNDATED with news reports, advertising campaigns, and media blitzes about the need to go green. Going has become the buzz phrase of the new millennium. If manufacturers aren't green, then their product just isn't in. Healthcare hasn't been left out of this trend. We have been steadily making changes to protect the health and safety of patients, as well as provide for a healthier planet. Many hospitals started by making small changes that ultimately led to a big difference. Others, such as the two hospitals profiled in this issue, began greening their hospitals from the very start. By taking a good operational look at how care is delivered, enlisting staff volunteers to serve on green teams, and working with suppliers, Boulder Community Hospital in Colorado and St. Mary's Hospital Medical Center in Green Bay, Wisconsin, are outstanding examples of how more and more hospitals are going green-from design and construction of their buildings to greener operations and more sustainable purchasing. These two hospitals have been at the forefront of the greening healthcare movement and have incorporated an environmental mind-set in their planning and decision-making. As we move ahead in the 21st century, what future steps will other hospitals need to take to protect not only patients and staff, but the planet? GREENING THE SUPPLY CHAIN Healthcare providers always face the challenge of providing high-quality care in an ever-changing industry. Many of the key changes these days deal with the environment. For example, research has long linked chemical contaminants in the environment with a high incidence of disease. And now increasing scientific evidence shows that chemical exposure in healthcare products and devices is having an impact on the health of patients and healthcare providers (Healthcare Environmental Resource Center 2008). Consider the number of items in a hospital that contain potentially harmful chemicals: cleaners and disinfectants, medical devices with phthalates, furniture with flame retardants and formaldehyde, solvents in labs, and countless others. Patients and staff are exposed daily to a stew of chemicals. Hospitals purchase thousands of different products each day, and often may not know which products and devices contain toxic components. And product toxicity is only the beginning. Other green purchasing issues include the amount of pollution created and the energy consumed in the manufacture of the product and how recyclable it is. Boulder Community and St. Mary's have implemented environmentally preferable purchasing (EPP) practices to help identify safe and environmentally smart products. Environmentally preferable products are generally: * less toxic; * minimally polluting; * more energy efficient; * safer and healthier for patients, workers, and the environment; * high in recycled content; * packaged more efficiently; and * fragrance-free. Boulder Community's EPP program clearly demonstrated that purchasing green supplies meant selecting items that use less wasteful packaging. The hospital successfully collaborated with manufacturers to modify their process in order to eliminate bulky packaging. In doing so, the hospital achieved its first big cost reduction. The Sterile Processing department switched to hard, reusable containers instead of plastic wrap-reducing expenses in excess of $100,000 per year. From eliminating unnecessary packaging to seeking substitutes for mercury-and polyvinyl chloride (PVC)-containing products, it's clear the hospital purchasing decisions do have a major impact in providing healthcare without harm as well as positively impacting the bottom line. MANAGING THE WASTE STREAM Hospitals on average generate more than 5 million tons of waste each year (Brannan 2006). In the past, many hospitals simply dumped all waste together, from reception area trash to operating room waste, and burned it in incinerators. …

Displacement of Black Flying-foxesPteropus alectofrom Batchelor, Northern Territory

This paper reports upon an operation to displace camps of Black Flying-foxes Pteropus alecto using non-lethal methods from the town of Batchelor. The flying-foxes showed a preference for camping in African Mahogany trees Khala senegalensis. Flying-foxes were dispersed by a team of Parks and Wildlife staff and community volunteers using a combination of smoke, non-lethal plastic shot and noise. The flying-foxes ceased roosting in the town during the operation but continued efforts were required to ensure that flying-fox camps did not re-establish within the town. The use of methods for dispersal, the removal of camp trees and public relations are discussed.

A day in the life of a training excavation: teaching archaeological fieldwork in the UK

This paper considers current issues in the teaching of archaeological fieldwork skills, using a British university's summer excavation as a case study. Analysing diary accounts submitted by participants – including members of staff, undergraduate students and local volunteers – on an hourly basis throughout one working day provides a unique insight into the training process. Key issues such as the hierarchy and structure of the project itself can be seen in the light of their impact on the effective teaching of field skills. The different needs of students and local volunteers are discussed, and the extent to which these needs are addressed is also considered. The backdrop to this paper is the current debate in British archaeology between those who favour field schools/training excavations and those who believe that students learn more when placed on pure research excavations.

Getting serious about Canadian health research

<h3>Background</h3> Patients with life-limiting illnesses should have opportunities to contribute to medical education so that professional learning is relevant to their needs and priorities. The potential contribution of children and parents using hospice services to medical education has not been fully explored. <h3>Aims</h3> 1. To explore perceptions of a ‘good doctor’ amongst children/parents using hospice services 2. To collaborate with children/parents and staff to develop materials for educating medical students about living with life-limiting illnesses 3. To assess feasibility of student-led action research projects in a children9s hospice <h3>Methods</h3> An INSPIRE Award from the Academy of Medical Sciences funded an undergraduate medical student to undertake this work with clinical and academic supervision. Prospective ethical approval was received. Children (n=7), parents (n=5), and staff (n=6) volunteers were recruited from a hospice to participate in audio-recorded semi-structured focus groups, individual interviews or activity workshops. Participants discussed what newly qualified doctors needed to know about caring for children with life-limiting conditions and what makes a ‘good doctor’. Data were transcribed for qualitative thematic analysis. Findings were refined by participant feedback. <h3>Results</h3> Key themes among participants included the importance of treating children as individuals, communicating honestly and sensitively, ensuring two-way dialogue between clinicians and families and actively listening to all involved in children9s care. Staff, parents and children in the hospice were willing and able to make valuable contributions to undergraduate medical education by sharing their knowledge and experiences. This paper will present methodological insights, thematic findings, and educational materials (for undergraduate medical students and service development) created from the project. <h3>Conclusions</h3> Parents, children and staff in hospices are willing to participate in action research. This project provided the student researcher with transferable qualitative research skills. Further work is required to fully explore and understand opportunities for collaboration between children9s hospices and medical schools.

The costs of unpaid labour: the use of voluntary staff in the King's Mill Hospice

This paper provides an analysis of the costs and benefits of employing voluntary staff in a single hospice unit. It forms part of a evaluation of the hospice by a multi-disciplinary research team guided by the methodological principles of formative, qualitative evaluation. Voluntary staff working at the Hospice contributed over 2000 h of unpaid labour in each calendar month. A conservative estimate places the potential cost of the free labour of voluntary staff at the hospice in excess of $108 000 in 1993. Once administrative and training costs have been taken into account the potential savings for the hospice of using voluntary labour was approximately $81 000. It is suggested employing voluntary staff at the hospice is cost effective and that the voluntary staff contribute significantly to the quality of services which patients and their relatives receive at the hospice.

Med &amp; Ren 2006

The 2006 Medieval and Renaissance Music Conference was held in Cambridge from 17 to 20 July. While the city sweltered in record-breaking heat, a packed programme of 56 papers, two round-table sessions and two keynote speeches offered delegates some compelling reasons to stay indoors in the relative cool of the Faculty of Music. With so many of papers on offer, most sessions ran in parallel; it was sometimes difficult deciding which papers to miss. Med & Ren conferences are known for their friendly, constructive atmosphere, and this gathering was no exception: stimulating post-paper discussions spilled out into break times and continued over the appetizing lunch buffet. Personal and professional connections were renewed, and—best of all—senior scholars and junior academics shared platforms and ideas. The convivial atmosphere was much helped by the exemplary conference organization: under the leadership of Edward Wickham, friendly staff and helpful student volunteers ensured that everything ran smoothly.

A novel resource model for underprivileged health support: Community &#x0D; Medical Outreach

Community Medical Outreach is a student-run organization that provides healthcare access to medically underprivileged farm workers. The program exploits the substantial energy, enthusiasm and organizational capacity of pre-medical students as they prepare to apply for medical school. All of the partners benefit from the interchange. The students gain from a unique first-hand medical experience that demonstrates their leadership, management skills, commitment to a healthcare team, and focus on care at the community level. Those in most need gain healthcare access. Volunteer staff and physicians are inspired by the students and are energized by caring for those most in need of health care. The companies, agencies, and organizations donating supplies, drugs, expertise, and sponsorship benefit from enhanced public relations. The article describes the initiation, the lessons learned, the critical importance of linkages, and the essential components such as individual and institutional liability. Community Medical Outreach is an important vehicle for shaping students in the process of becoming physicians, shaping those involved with the process of admitting students, shaping training experiences, and shaping new models of health care.

Evaluation of a mass dispensing exercise in a Cities Readiness Initiative setting

The effectiveness of a point of dispensing (POD) used in a mass dispensing exercise was evaluated. Public Health-Seattle & King County (PHSKC), in conjunction with the University of Washington, conducted a functional exercise of mass dispensing plans to test the effectiveness of a POD. Specifically, the organization and maintenance of patient flow, staffing model, signage, and dissemination of public information were evaluated. A data collection application using cellular telephones was used to record time and patient flow data to evaluate patient flow. Questionnaires distributed to staff and volunteer patients at the end of the exercise obtained feedback regarding the setup, organization, and operations of the POD. The POD was operational for approximately 68 minutes. The majority of POD staff reported feeling comfortable with their specific job tasks and duties within 15 minutes of opening the doors to the POD to the public. Staff questionnaires also revealed a high level of self-reported confidence in their ability and in the ability of their colleagues to perform the job-specific responsibilities required of them or respond to this hypothetical event. The majority of volunteer patients found the signs helpful and easy to follow and the check-in form easy to complete. Despite efforts to provide patients with oral and written information about the medications being dispensed, only 80% indicated that they knew how to take the medication, and only 73% reported understanding the medication instructions for all the individuals for whom they picked up medication. The majority of volunteer patients and staff who participated in a functional exercise of mass dispensing plans found the POD to be effective. Time-flow analysis provided preliminary estimates of the total amount of time needed to complete the dispensing process for each head of household.

Discussion to the Article: Teaching Pediatric Hand Surgery in Vietnam

The admirable efforts of the surgeons, anesthesiologists, nurses, paramedical staff, and other volunteers offer a tremendous service to unfortunate individuals in underdeveloped countries. The authors have eloquently described their experience abroad, treating patients afflicted with a variety of ailments. Many patients in underdeveloped countries must bear the burden of living throughout their lives with various deformities. These deformities may result in functional loss that significantly impairs their activities of daily living. In fact, afflicted patients may be ostracized from their own community because of their deformity. There are many implications and ramifications of these medical problems not only for the patient, but also for their families and the local society. I too have traveled overseas for volunteer work, performing surgery on patients with burn contractures, nomas, congenital deformities, and other acquired disorders that impair function. The experience offers a multitude of benefits to these patients, their families, and the local community. These patients are extremely grateful and return to productive lives. Such trips require significant commitment and can actually be quite tiring. Depending on the location, the travel can be long and grueling, often involving various flights, bus rides, or other modes of transportation. Jet lag and fatigue are not uncommon during these trips. As the surgical team arrives, the equipment must be checked, calibrated, and/or repaired prior to performing any surgery. The instruments and supplies are removed from boxes and the operating rooms are set up to permit safe, reliable, and efficient surgery. The patients often arrive from miles around with the hope that they might be lucky enough to be operated upon by experienced, knowledgeable surgeons. The patients are usually screened by the surgeons, anesthesiologists, and staff to prioritize those who would be candidates for surgery. The short amount of time that the surgical team has at any given destination unfortunately limits the number of procedures that can be performed during each visit. The surgical team must therefore look to perform procedures that would have the greatest impact on patients, focusing primarily on restoring function. Following the surgical screening, the patients are assessed for operative risk factors, as safety is foremost in the minds of the entire team. In fact, the partnership and communication between the surgeons, anesthesiologists, and nurses are often more intense and constructive than at our own surgical theatres. The many surgeries can include cleft lip and palate repair, contracture release, free tissue transfer, skin grafting, and flap reconstruction. The patients therefore require surgeons with expertise in reconstruction of the head and neck, hand, lower extremity, and trunk. Postoperatively, nurses and paramedical staff care for the patients to aid in safe recovery. It is amazing to witness the care that the families provide in the recovery process of these patients. The surgical team uses the resources it has brought with them, as well is what is locally available, to provide adequate rehabilitation. The daily rounds on the patients after surgery are for caring and education. It is often astonishing to witness the makeshift dressings, splints, and wound care that are available from the local surgeons and HAND (2007) 2:25–26 DOI 10.1007/s11552-006-9020-4

Personal Dosimeter Use In Australian Nuclear Medicine Practice

Introduction: Anecdotally, Australian Nuclear Medicine staff wear a single thermoluminescent dosimeter (TLD) for monitoring purposes and tend to wear their TLD in a variety of body positions including but not limited to the chest, waist and shoulder. There is a paucity of published data directly relating to the effect of placement of the TLD on whole body dose measurements. Methodology: A survey was undertaken of current protocol and procedures employed for personal radiation monitoring of occupationally exposed staff in Nuclear Medicine departments across Australia. The study design utilised a self-administered questionnaire to provide participant confidentiality. The experimental study utilised a quasi-experimental, repeated measure (within subjects) design of eight Nuclear Medicine staff volunteers. TLD data was collected for two consecutive monitoring periods of two months duration each. All participants wore two TLDs simultaneously, one positioned on the chest and the second positioned at the waist. Results: The position for the primary TLD of staff was predominantly at the waist (92.8%) with the remainder (7.2%) placing their primary TLD at the chest. A further 34.8% use a second TLD on the chest, 15.9% on the finger, 5.8% on the collar and 1.4% each for the pocket, umbilicus and under the apron. The mean x-ray / gamma ray dose for TLDs positioned at the chest was 287.5 μSv while the corresponding waist dose records had a mean of 178.8 μSv. The matched pairs t test demonstrated a statistically significant difference between matched pairs (P = 0.001) with a mean decrease in recorded doses for the waist of 108.8 μSv (95% CI of 50.2 to 167.3 μSv). Conclusion: Comparing occupational radiation doses within Nuclear Medicine departments and amongst Nuclear Medicine departments is fraught with danger. There is a need for the development of uniform policy and practice in relationship to TLD position.