[Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study]. / Zusammenhang der Patientenzufriedenheit mit der Anwesenheitszeit Pflegender am Patientenbett.

Correlation of patient satisfaction with nurses' time spent at the bedside: A prospective observational study Abstract. Background: Patient satisfaction is of high importance in quality assurance in many hospitals. The existing shortage of nursing staff and the resulting additional workload for individual nurses reduce the time available for patient care. Aim: The aim of this study is to explore a possible relationship of patient satisfaction with the time spent by nurses at the bedside and the influence of other influencing predictors. Methods: In this observational study, nursing attendance time was collected using attendance records which were verified by digital call light logs, and then evaluated using a linear regression model including patient satisfaction. Results: The nursing attendance time showed no significant influence on "patient satisfaction" (p = 0.155). The most important variables influencing "patient satisfaction" were: "no previous hospital experience" (p = 0.001), "importance of care" (p < 0.001) and "Gender" (form male) (p = 0.001). Conclusions: The time spent by nurses at the patient's bedside is not considered decisive enough to have a clear positive influence on patient satisfaction. Adaptations in nursing care are recommended, which enable a holistic relationship building and goal-oriented nursing care that favours patient satisfaction.

The physiotherapy workforce in the Brazilian Unified Health Care System.

BACKGROUND: Maintaining sufficient health care workforce is a global priority to achieve universal health coverage. Therefore this study addresses the availability of physiotherapists in Brazil. OBJECTIVE: To describe secular trends of the physiotherapy workforce-to-population ratio in the Unified Health System, considering public and private sector and care level (primary, secondary, tertiary) in Brazil and its regions. METHOD: Descriptive exploratory quantitative study based on secondary sources. All data related to the distribution of physiotherapists between August 2007 and September 2016 regarding facilities types, location and public and private sectors was obtained from the Brazilian National Registry of Health Care Facilities. Data related to the population of Brazil was extracted from Brazilian Institute of Geography and Statistics. The physiotherapy workforce-to-population ratio was calculated by the number of physiotherapists per 1000 population (public and private sector and care level) by ANOVA test. The distribution trends are represented on maps. Annual growth rates were estimated with Prais-Winsten linear regression models, with a significance level of 0.05, autocorrelation was checked by the Durbin-Watson test. RESULTS: The physiotherapists ratio in Brazil was 0.22/1000 population in 2007 and 0.41 in 2016, showing growth of 86%, with an increasing trend of 0.5% on an annual average. The public sector had the biggest physiotherapy workforce in the country in 2007 and 2016. The primary health care had the smallest physiotherapy workforce-to-population ratio (2007: p > 0.001 and 2016: p = 0.003), even though it had the largest growth trend in annual average (0.9% p > 0.001), followed by public and private tertiary health care sectors (0.8% p > 0.001). The workforce in secondary health care was bigger in the private sector than in the public sector (0.6% p > 0.001 vs. 0.2% p = 0.004). Overall, all regions had greater growth of physiotherapy workforce-to-population ratio in public primary and tertiary health care sectors, and private secondary health care sector, mainly the Southeast, South and Central-West regions. CONCLUSION: Although the physiotherapy workforce in Brazil is relatively small, there was a trend towards growth with differences among care levels, and public and private sectors. The physiotherapy workforce-to-population ratio is bigger in the private secondary health care sector, followed by public tertiary, secondary and primary health care sectors. Sub-national regions show similar trends to the national estimates, with minor variations by region.

Early identification of palliative care needs by family physicians: A qualitative study of barriers and facilitators from the perspective of family physicians, community nurses, and patients.

BACKGROUND: There is a growing recognition that a palliative care approach should be initiated early and not just in the terminal phase for patients with life-limiting diseases. Family physicians then play a central role in identifying and managing palliative care needs, but appear to not identify them accurately or in a timely manner. AIM: To explore the barriers to and facilitators of the early identification by family physicians of the palliative care needs. DESIGN, SETTING, AND PARTICIPANTS: Six focus groups (four with family physicians, n = 20, and two with community nurses, n = 12) and 18 interviews with patients with cancer, chronic obstructive pulmonary disease, heart failure, and dementia were held. Thematic analysis was used to derive themes that covered barriers and facilitators. RESULTS: Key barriers and facilitators found relate to communication styles, the perceived role of a family physician, and continuity of care. Family physicians do not systematically assess non-acute care needs, and patients do not mention them or try to mask them from the family physician. This is embedded within a predominant perception among patients, nurses, and family physicians of the family physician as the person to appeal to in acute and standard follow-up situations rather than for palliative care needs. Family physicians also seemed to pay more often attention to palliative care needs of patients in a terminal phase. CONCLUSION: The current practice of palliative care in Belgium is far from the presently considered ideal palliative care approaches. Facilitators such as proactive communication and communication tools could contribute to the development of guidelines for family physicians and policymakers in primary care.

Peripherization of immigrant professionals: Korean physicians in the United States.

Using data on the characteristics of 1043 physicians who graduated from a medical school in Korea, the authors analyze the effects of immigrant status, gender, and year of graduation on their choice of medical practice specialty. The specialty areas are categorized into 2 groups, "core" and "periphery," on the basis of the reported median income of practitioners in each specialty. The results of log-linear model analyses indicate that female physicians are more likely to immigrate to the United States than male physicians, although the general trend of immigration does not notably change over time. In the main equation, immigration status shows a significant peripheral effect as immigrant physicians are much more likely to practice in peripheral areas than their home-staying counterparts. Gender status is also found to have a significant peripheral effect. When these Korean immigrant physicians are compared with the US-educated physicians in regard to their areas of practice, the same pattern of peripherization is observed among the immigrants. The findings suggest that, despite their secular image of "success," immigrant professionals in the United States carry on the same kind of marginal economic activities within the professional labor market as unskilled immigrant workers do within the nonprofessional labor market.

Immigration and the earnings of youth in the U.S..

"This article reports findings that have emerged from an effort made at statistically measuring the effects of immigration on the earnings of U.S.-born youth. The presence of immigrants arriving before 1965 has a positive impact on youth earnings. Recently arrived immigrants impact negatively, however. These results are consistent with recent findings that the skill level of immigrants arriving within the last two decades is lower relative to that of immigrants arriving earlier. The results also show that the negative effects diminish as the youth ages, reflecting skill acquisition and job mobility of the young worker into jobs less vulnerable to competition from immigrant workers."

Prior geographic mobility and job search length.

The effect of previous geographic mobility on the length of an unemployed person's job search in the United States is examined. "This study proposed that knowledge of regional wage differentials and other market conditions give a worker with prior geographic mobility experience a better stock of information than one who has worked all of his or her work life in the same geographical location. It is proposed that this superior stock of information has a significant impact on the amount of time it takes an unemployed worker to locate and accept a job." Data are from the 1981 Panel Study of Income Dynamics.

Rapid implementation of inpatient electronic physician documentation at an academic hospital.

Electronic physician documentation is an essential element of a complete electronic medical record (EMR). At Lucile Packard Children's Hospital, a teaching hospital affiliated with Stanford University, we implemented an inpatient electronic documentation system for physicians over a 12-month period. Using an EMR-based free-text editor coupled with automated import of system data elements, we were able to achieve voluntary, widespread adoption of the electronic documentation process. When given the choice between electronic versus dictated report creation, the vast majority of users preferred the electronic method. In addition to increasing the legibility and accessibility of clinical notes, we also decreased the volume of dictated notes and scanning of handwritten notes, which provides the opportunity for cost savings to the institution.

Demographic waves and labor resources.

PIP: The author examines the causes, nature, and socioeconomic consequences of medium-term fluctuations in the sizes of age groups in the Soviet Union, with particular attention to the impact on the dynamics of the nation's labor resources. Developments since World War I are outlined, and projections through the end of the twentieth century are summarized. Changes over time in the age distribution of a small population in a Kama River community are used as an example.^ieng

[Changes in patterns of behavior toward work of mothers who gave birth to their children in the 1980s (results of a survey conducted in 1988 by the Institute of Social Economy)]. / Przemiany wzorow zachowan matek wobec pracy po urodzeniu dziecka w latach 80-tych (wyniki badania IGS z 1988 r.).

PIP: The results of a 1988 survey of 5,382 young Polish mothers concerning employment following the birth of a child are presented. They show that 83 percent of mothers return to work following maternity leave, that educational and salary levels are the primary factors affecting return to work, and that women are taking increasing lengths of time away from work to care for children. (SUMMARY IN ENG AND RUS)^ieng

Women's transitions in the labour market: a competing risks analysis on German panel data.

"This paper analyses the transitions between the three states of non-employment, part-time and full-time work of a sample of married women living in West Germany....A non-parametric duration analysis shows that women have a similar attachment to full-time and part-time work in terms of survival, and that survival in non-employment is shorter than in the other two states. Estimates of a parametric discrete-time competing risks duration model show that wives of retired husbands go into full-time work, children under 3 years have a disincentive effect on part-time work and that part-time work is a state that German women prefer to stay in and not a first step to full-time employment, whereas foreign women living in West Germany prefer full-time jobs."

The floating population: an informal process of urbanisation in China.

"This paper attempts to employ substantial source materials to shed light on the characteristics of population migration in a centrally planned society that is in the process of transforming to a market economy. In order to compare rural-urban migration in China with that in other developing countries, the data on 1985-1990 interprovincial population migration have been analysed. Some demographic research techniques on population migration, such as the impact on the place of origin and the place of destination, have been employed to assess the influence of rural-urban migration on China's long-term economic development. Economic betterment appears to be the sole motivation of rural population migration in China."

Arab labour migration: a review of trends and issues.

"The objectives set for this paper are to: provide an analysis of volume and trends in labour migration within the Arab region; discuss the major characteristics of the migrants, including demographic features, types of economic activity, wage levels and duration of stay in host countries; [and] outline and discuss the major issues in labour migration both from the sending and receiving countries. The time period covered by the study is from the mid 1970s to the present." (SUMMARY IN FRE AND SPA)

Changing patterns of migration in Kuwait.

PIP: The economic boom and accelerated development programs in Kuwait in recent years have created a labor market that native Kuwaitis have been unable to fill, with the result that a majority of jobs have been filled by non-nationals from other countries. The paper reveals that in 1985 migrants constituted over 60% of the total population and more than 80% of the labor force. Quinquennial censuses provide the main source for this in-depth study on changing migration patterns in Kuwait from 1957-1985.^ieng

[American policy (1986-1989): results and limits]. / La politique de regularisation americaine (1986-1989): resultats et limites.

PIP: Although the American program to legalize illegal immigrants succeeded in giving legal status to over 3 million foreigners between 1987-88, the experience contributes to understanding of the limitations in a state's ability to control illegal immigration. Some part of the illegal population entitled to legalization failed to apply to 1 of the 110 offices opened for the purpose, but the proportion is debatable because in the US as elsewhere the exact numbers and characteristics of the illegal population are unknown. As elsewhere, political and legislative constraints limited the scope of the program. The duration of the program and the access to it of illegal migrants both might have been increased. The major legalization program began on May 5, 1987. There were 6 specific component programs each with its own terms of eligibility, advantages, expsense, and duration. The principal programs concerned illegal immigrants residing continuously in the US since January 1, 1982, and illegal immigrants working in agriculture. Both groups were expected to pay $185 per applicant to cover expenditures. The program got underway slowly due to financing problems and an unexpected bypassing by most applicants of the voluntary agencies trained to assist them. The relevance of the legalization to family members of applicants residing elsewhere is a serious question. A survey in late 1987 indicated that around 90% of the illegal aliens interviewed were aware of the legalization policy. Lack of information, inability to pay the fee, and erroneous perception of ineligibility were the 3 reasons cited to explain why eligible individuals failed to apply. The obligation of proving continuous presence posed a problem for many and helped explain the large number of last-minute applicants. Data from applications should be a rich source of information on the illegal immigrant population, but to date only a few characteristics have been analyzed in provisional and incomplete form. Some 95.9% of requests for legalization were approved as of May 1989. An estimated 100,000 requests for legalization by agricultural workers were believed to be fraudulent. Over 70% of applicants were Mexican, and over 1/2 of applicants resided in California. 7/8 of all candidates lived in just 5 states: California, Texas, Illinois, New York, and Florida. Candidates in the agriculture program conformed to the stereotype of the illegal immigrant as a young, single male but other applicants were more diverse. Like the majority of industrial democracies adopting a legalization policy in this period, the US had a tradition of legal and permanent immigration. Modern governments appear to have only a limited ability to reduce their illegal populations through legalization policies. The American case clearly illustrates that this capacity may be determinted primarily by the legal and administrative requirements for legalization.^ieng

[The evolution of employment in Mexico: 1895-1980]. / Evolucion del empleo en Mexico: 1895-1980.

PIP: Employment figures from the Mexican national census are the basis for this analysis of employment changes in Mexico between 1895-1980. The work identifies longterm trends in the volume and composition of employment and distinguishes 3 main periods in the evolution of employment. The first period, from 1895-1930, marked the end of a stage of development lasting until about 1907 in which sufficient internal stability was achieved to support Mexico's entrance into the world market. Export of agricultural products and metals was the principal focus of economic growth. Construction of roads and railroads was a central element of progress. But economic and social problems manifested in regional disparities, concentration of wealth, conflicts between economic sectors, low pay for agricultural workers, and fierce social and political control characterized the period and culminated in the Mexican Revolution. After the first decade of the 20th century the ability of the economy to absorb new workers began to decline, and the falling of crude activity rates was not reversed until the 1940s. During the 1920s, total employment increased less than 6%, reflecting a net increase of 403,000 male workers and a decrease of 110,000 female workers. The second major period of employment from 1930-1970 saw the change from an economy based on export of primary products to one based on manufacturing for the internal market. There were 2 subperiods, a stage of transition from 1930-50, the economy registered marked fluctuations, but by the 1940s the consolidation of state power and important reforms permitting expansion of the internal market were factors in an accelerated growth of employment relative to the preceding intercensal period. Despite considerable increases in agricultural employment, the relative share of the agricultural sector in total employment was beginning a decline. Employment registered the highest growth rates of the century in the 1940s and exceeded population growth. The increased employment was explained by accelerated growth and accumulation in manufacturing along with increases in commerce, services, construction, and agriculture. From 1950-70, industrial development was consolidated, and there was a generalized expansion in employment in manufacturing as well as in the secondary and tertiary sectors. The economy was less able to absorb new labor, primarily because the agricultural sector had reached the limits of expansion in both the commercial and peasant sector by 1965, at just the time that population growth was most rapid. During the 1970s, manufacturing employment grew less rapidly because of modernization, almost exclusive orientation to the internal market which limited expansion, and scarcity of funds for importing capital goods. A new model of growth will be needed if Mexico is to escape its present stagnation, and a significant share of economic activity will need to be oriented to export. Until this process is consolidated, the national economy is unlikely to show signs of sustained recuperation.^ieng

Implementing a quality improvement programme in a family planning centre in Monastir, Tunisia

We aimed to improve the quality of family planning and reproductive health services in a family planning centre though implementation of a quality improvement programme. Clients were surveyed to identify quality-related problems. Health care teams then analysed the causes of the problems, developed solutions for 3 selected ones and established a quality assurance framework. The selected issues were: long waiting time at the centre; insufficient integration of family planning and reproductive health services; and lack of a holistic approach. The final phase was aimed at testing and implementing corrective measures