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Laboratory animal facility managers must ensure that animal experiments can be carried out under optimal scientific conditions, that all legal requirements are met, and that animal welfare is maximized. Animal experimentation is stressful not only for the animals involved but also for the people who maintain these animals or carry out the experiments. Many of those involved find themselves in a constant conflict between scientific necessity, care, and harm. Under the term Culture of Care, procedures have been developed to reduce the burden of animal experimentation on the animals and the staff involved. The focus here is on what laboratory animal facility managers can do to improve the welfare of laboratory animals and the people working with them. Exemplary measures are the improvement of the housing conditions of laboratory animals, the introduction of uniform handling measures, clear and transparent structures via a quality management system, implementation of a no-blame culture of error (e.g., via Critical Incident Reporting System in Laboratory Animal Science [CIRS-LAS]), and open and respectful communication with all parties involved in animal experimentation, including the public and representatives of the authorities (public webpage, open house policy). The 6 Rs must be considered at all times: replacement, reduction, refinement, respect, responsibility, and reproducibility. We are writing this article from the perspective of laboratory animal facility managers in Germany.
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Providing care is central to the operations of health care organizations. This article discusses how organizations can create a culture of care. It also identifies key elements that health care organizations can implement to build a culture that nurtures both patients and employees. Additionally, the article examines the benefits of implementing practices that demonstrate compassion toward both employees and patients. This article explores the significance of creating and supporting a culture of care for both patients and employees in health care organizations. Finally, the article identifies prevalent practices that contribute to a culture of care.
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Atenção à Saúde , Cultura OrganizacionalRESUMO
Taking a compassionate approach to the non-human animals used in biomedical research is in line with emerging ideas around a "culture of care". It is important to expose biomedical sciences students to the concept of a culture of care at an early stage and give them opportunities to explore related practices and ideas. However, there is no simple tool to explore biomedical sciences students' attitudes towards laboratory animals. Accordingly, there is little understanding of students' feelings towards these animals, or a means of quantifying potential changes to these feelings. We developed a 12-item questionnaire designed to explore compassion (the Laboratory Animal Compassion Scale; LACS) and used it with UK-based and China-based samples of undergraduate biomedical sciences students. In the same samples, we also explored a harm-benefit analysis task and students' beliefs regarding some mental characteristics of laboratory animals, then drew correlations with the quantitative measure of compassion. Compassion levels were stable across years of study and were not related to students' level of experience of working with laboratory animals. We observed a higher level of compassion in females versus males overall, and a higher level overall in the UK-based versus China-based sample. In a task pitting animal suffering against human wellbeing, students' compassion levels correlated negatively with their acceptance of animal suffering. Compassion levels correlated positively with a belief in animals being conscious and possessing emotions. These data are in line with studies that show compassion is gender- and nationality/culture-dependent, and points to links between compassion, beliefs, and choices.
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In this proposal we present a feminist critical analysis of the importance that nurses haveplayed, being the life story of the nurse Águeda Medina Soto an example of her relevance in Jaén.In this sense, the methodology that facilitates the study of our recent past is life history, this beingpart of a critical-reflective intergenerational analysis, establishing cause-effect between personal experiences, society and Nursing. In addition, linking it with the gender perspective, it provides uswith another necessary analysis to reflect on how society was formed, the access and limitationsthat were presented to women of the time for incorporation into the nursing branch, in addition tothe difference structural and recognition of sex-gender roles between women and men who exercised these trades (nurses and interns respectively). The results obtained show the usefulness offered by the life history, to make visible the differences both structural, academic and sex-genderdifferentiated practices associated with nurses and practitioners. In turn, make visible the socialrelevance of nurses within the health field in the culture of care, through the case of nurse Águeda.(AU)
En esta propuesta presentamos un análisis crítico feminista de la importancia que hanjugado las enfermeras, siendo la historia de vida de la enfermera Águeda Medina Soto un ejemplo de su relevancia en Jaén. En este sentido, la metodología que nos facilita el estudio de nuestro pasado reciente es la historia de vida, siendo esta, parte de un análisis intergeneracional crítico-reflexivo, estableciendo causa-efecto entre las experiencias personales, la sociedad y la Enfermería. Además, enlazándolo con la perspectiva de género, nos presta otro un necesario análisis para reflexionarsobre cómo se conformaba la sociedad, el acceso y limitaciones que se presentaban a las mujeres dela época para la incorporación en la rama de enfermería, además de la diferencia estructural y dereconocimiento de los roles sexo-genéricas entre las mujeres y hombres que ejercían dichos oficios(enfermeras y practicantes respectivamente). Los resultados obtenidos muestran la utilidad queofrece la historia de vida, para visibilizar las diferencias tanto estructurales, académicas y prácticasdiferenciadas sexo-genéricas asociadas a las enfermeras y los practicantes. A su vez, visibilizar larelevancia social de las enfermeras dentro del ámbito sanitario en la cultura de los cuidados, a travésdel caso de la enfermera Águeda.(AU)
Nesta proposta apresentamos uma análise crítica feminista da importância que os enfermeiros têm desempenhado, sendo a história de vida da enfermeira Águeda Medina Soto um exemplo da sua relevância em Jaén. Nesse sentido, a metodologia que facilita o estudo do nosso passadorecente é a história de vida, fazendo parte de uma análise intergeracional crítico-reflexiva, estabelecendo causa-efeito entre experiências pessoais, sociedade e Enfermagem. Além disso, articulando-acom a perspectiva de gênero, nos fornece mais uma análise necessária para refletir sobre como seformou a sociedade, os acessos e limitações que se apresentavam às mulheres da época para incorporação ao ramo da enfermagem, além da diferença estrutural e reconhecimento dos papéis sexogênero entre mulheres e homens que exerciam esses ofícios (enfermeiros e estagiários, respectivamente). Os resultados obtidos mostram a utilidade oferecida pela história de vida, para tornar visíveis as diferenças estruturais, acadêmicas e práticas diferenciadas de gênero associadas a enfermeiros e profissionais. Por sua vez, visibilizar a relevância social dos enfermeiros da área da saúde nacultura do cuidado, através do caso da enfermeira Águeda.(AU)
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Humanos , Feminino , Escolas de Enfermagem , Estudantes de Enfermagem/história , Feminismo , Papel do Profissional de Enfermagem , Relações Interpessoais , Perspectiva de Gênero , Enfermagem , Bacharelado em Enfermagem , História da Enfermagem , EspanhaRESUMO
Culture of Care has been an integral part of Sanofi's policy on animal protection for more than 15 years. Culture of Care goes beyond compliance with regulations and standards, since it relates to the attitudes of staff and to caring for research animals, as well as to the company's commitment to an active animal protection policy. However, the concept of Culture of Care remains subjective. Via two anonymous and voluntary surveys conducted in 2018 and 2021, it was possible to understand the level of staff engagement and the perception of company efficiency. Based on key questions, it was possible to assess individual engagement (animal welfare knowledge, pride, engagement, recognition) and company commitments (oversight body efficiency, level of transparency, Sanofi policy on animal protection). The institutional scores were 7.7/10 and 7.9/10 obtained in 2018 and in 2021, respectively. The individual score obtained for 2018 was 6.7/10 compared to 6.9/10 obtained in 2021. The combination of these two criteria helps to determine a Culture of Care score and thus make it a performance indicator. The scores are CoC2018 (7.7; 6.7) and CoC2021 (7.9; 6.9). Being able to quantify this level of engagement and the perception that employees have of the company encourages the organisation of an improvement programme and helps measure the benefits.
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Bem-Estar do Animal , Animais , Preparações FarmacêuticasRESUMO
As researchers, institution-wide regulatory and organisational cultures guide our work. Over the past two decades, University Research Ethics Committees have been formally established across social science disciplines. However, the functioning of these committees has not been without critique. It is often argued that established ethical procedures informed by the medical sciences do not fit well with the more iterative epistemologies and unpredictable practices of doing social fieldwork. In this paper, I contribute to these discussions by considering what a further framework, a 'culture of care', might offer to university research ethics. A culture of care has evolved in contexts like the National Health Service (NHS) and animal research, and makes central claims around support, openness, collaboration and relationships. Bringing this to research ethics, I explore experiences of care through moments of friction in doing fieldwork with people living with Motor Neurone Disease. Identifying gaps between the institutional, personal and relational, I tentatively suggest some key features that a culture of care for research ethics might seek to develop. These discussions are also timely. Wider conversations emerging around reimagining research cultures in higher education provide an opportune moment to consider what a reimagined research ethics might look like and offer too.
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Communication between scientists and animal technicians is considered important for creating a 'culture of care' in facilities that use animals in scientific research. For example, the Brown report, which investigated alleged failures of animal care at Imperial College London, noted the physical and social separation between animal technicians and scientists as a problem that delimited a culture of care. This paper seeks to better understand the communicative relationships between scientists and animal technicians in this context. We conducted a survey of scientists working in the UK who use animals in their research (n = 230), asking who they spoke with about various aspects related to using animals in research. We found that scientists communicated with technicians about operational issues, while they spoke with other scientists about experimental design as well as moral questions and concerns. We probe the meaning of these communicative relationships using narrative analysis of semi-structured, qualitative interviews conducted with consenting survey respondents (n = 14). Analytically, this paper seeks to bridge social network analysis with geographies of care through a shared concern with relations of power.
La comunicación entre científicos y técnicos en animales se considera importante para crear una 'cultura del cuidado' en las instalaciones que utilizan animales en la investigación científica. Por ejemplo, el informe Brown, que investigó supuestos fallos en el cuidado de los animales en el Imperial College de Londres, señaló la separación física y social entre técnicos animales y científicos como un problema que delimitaba una cultura del cuidado. Este artículo busca comprender mejor las relaciones comunicativas entre científicos y técnicos en animales en este contexto. Realizamos una encuesta a científicos que trabajan en el Reino Unido y que utilizan animales en su investigación (n = 230), y les preguntamos con quién hablaron sobre varios aspectos relacionados con el uso de animales en la investigación. Descubrimos que los científicos se comunicaban con los técnicos sobre cuestiones operativas, mientras hablaban con otros científicos sobre el diseño experimental, así como sobre cuestiones e inquietudes morales. Investigamos el significado de estas relaciones comunicativas mediante el análisis narrativo de entrevistas cualitativas semiestructuradas realizadas con encuestados que dieron su consentimiento (n = 14). Analíticamente, este artículo busca unir el análisis de las redes sociales con las geografías del cuidado a través de una preocupación compartida por las relaciones de poder.
Les sciences de l'animal de laboratoire représentent un aspect complexe et sujet à controverses dans les relations entre les humains et les animaux, parce que sa pratique implique la souffrance ou la mise à mort d'animaux, délibérément ou accidentellement. Par conséquent, la recherche sur les animaux a fait l'objet de fortes préoccupations et réglementations sur le plan éthique dans le Royaume-Uni, afin de réduire les épreuves et les douleurs subies par ces bêtes dont les corps vivants modèlent entre autres les maladies humaines. Cette communication s'appuie sur des recherches ethnographiques longitudinales et des entrevues détaillées entreprises avec des techniciens animaliers de laboratoire débutants dans des universités du Royaume-Uni entre 2013 et 2015, ainsi que des perspectives venant d'entretiens avec des acteurs principaux du bien-être animal. Dans notre analyse, nous étudions quatre dimensions essentielles des soins dans la recherche animale de laboratoire. (i) les compétences et les affinités spécifiques qui sont nécessaires ; (ii) l'importante d'expériences préalables en soins animaliers (iii) l'influence des cadres institutionnel et affectif et (iv) l'expérience nécessaire pour mettre fin à des vies animales. Nous suggérons que des notions de soins différentes se déroulent en parallèle, pas seulement les seuils de douleur autorisés à être infligés aux animaux de recherche suivant les protocoles de recherche, mais aussi la douleur des techniciens animaliers dans les processus de soins et de mise à mort des animaux. Pour conclure, nous nous prononçons en faveur d'une meilleure concertation dans la coexistence des soins et des souffrances à travers les débats au sein de la géographie sur les soins, le care et les relations entre les humains et les animaux.
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A good culture of care, empowering individuals within organisations to care and reflecting wider social expectations about care, is now a well-documented aspiration in managing practices of laboratory animal research and establishing priorities for patient and public health. However, there is little attention to how different institutional cultures of care interact and what happens to the accountabilities of caring roles and the entanglements of caring practices when institutional cultures meet. Drawing on research exploring the increasing practices of patient and public involvement (PPI) within animal research in the UK, we identify three ways in which cultures of care are changing in encounters between biomedical researchers and people affected by health conditions. Firstly, patient involvement in animal research brings additional bodies to care for within research facilities. Secondly, patient and public groups are seen as an increasingly important group to convey a culture of care to. Thirdly, involvement brings opportunities for patients and publics to connect care for both human and animals. However, more attention is required to understand how shifts towards cultures of care distribute power and responsibility to care within institutions and at their boundaries, where responsibilities to care may be disconnected from the power to effect meaningful changes.
Une culture du care de qualité, qui donne aux personnes au sein des organisations les moyens de prodiguer des soins et reflète des attentes sociales plus larges concernant la notion de care, est maintenant une aspiration bien documentée dans les pratiques de gestion de la recherche sur les animaux en laboratoire et l'établissement des priorités pour les patients et la santé publique. On accorde cependant peu d'attention à la manière dont les différentes cultures institutionnelles du care interagissent et ce qu'il advient des responsabilités des rôles de soins et des intrications des pratiques de care quand les cultures institutionnelles se rencontrent. En nous appuyant sur des recherches explorant l'augmentation de la pratique de participation des patients et du public (patient and public involvement PPI) dans la recherche sur les animaux au Royaume-Uni, nous identifions trois manières dont les cultures du care sont en train de changer dans les rencontres entre des chercheurs biomédicaux et des personnes touchées par des problèmes de santé. Premièrement, la participation des patients dans la recherche sur les animaux amène plus d'êtres vivants à qui prodiguer des soins dans les centres de recherche. Deuxièmement, on considère que les groupes de patients et du public forment une cohorte à qui il est de plus en plus important de communiquer une culture du care. Troisièmement, cette participation donne aux patients et au public des opportunités de lier le care pour les humains et pour les animaux. Il faudra cependant du travail plus approfondi pour comprendre comment les changements vers les cultures du care distribuent les pouvoirs et les responsabilités dans les institutions aussi bien qu'à leurs frontières, où les responsabilités du care peuvent être déconnectées du pouvoir pour engendrer des changements significatifs.
Una buena cultura de la atención, que empodera a las personas en organizaciones hacia el cuidado y que refleja expectativas sociales más amplias sobre la atención, es ahora una aspiración bien documentada en la gestión de prácticas de investigación con animales de laboratorio y el establecimiento de prioridades para la salud pública y del paciente. Sin embargo, se presta poca atención a cómo interactúan las diferentes culturas institucionales de cuidado y qué sucede con los roles de cuidado y los enredos de las prácticas de cuidado cuando las culturas institucionales se encuentran. Basándonos en la investigación que explora las prácticas de participación del paciente y del público (PPI) dentro de la investigación con animales en el Reino Unido, identificamos tres formas en las que las culturas del cuidado están cambiando en los encuentros entre investigadores biomédicos y personas afectadas por problemas de salud. En primer lugar, la participación de los pacientes en la investigación con animales aporta organismos adicionales que cuidar dentro de las instalaciones de investigación. En segundo lugar, los grupos de pacientes y públicos se consideran un grupo cada vez más importante al que transmitir una cultura de cuidado. En tercer lugar, la participación brinda oportunidades para que los pacientes y el público conecten el cuidado tanto para humanos como para animales. Sin embargo, se requiere más atención para comprender cómo los cambios hacia las culturas del cuidado distribuyen el poder y la responsabilidad del cuidado dentro de las instituciones y en sus límites, donde las responsabilidades del cuidado pueden estar desconectadas del poder de efectuar cambios significativos.
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Resumen: Introducción: a diario en Colombia mueren 60 mujeres por enfermedad cardiovascular y las mujeres de raza negra tienen mayor riesgo. Según la Organización Mundial de la Salud (OMS) estas muertes son, en su mayoría, prevenibles. El cuidado como estilo de vida es una intervención del programa "Actúa con corazón de mujer" de la Sociedad Colombiana de Cardiología y Cirugía Cardiovascular (SCC) y la Fundación Colombiana del Corazón (FCC). Objetivo: formar líderes para promover la adopción de comportamientos saludables. Método: se seleccionaron municipios con población de raza negra y compromiso de las autoridades locales. 395 mujeres fueron elegidas. La percepción del riesgo se midió con un instrumento adaptado por la FCC. La intervención educativa se dividió en cuatro sesiones en cada municipio durante cinco meses. Las participantes fueron formadas en toma de presión arterial; se utilizó la automonitorización de presión arterial (AMPA) para confirmar hipertensión y se incluyeron mediciones antropométricas y fisiológicas para calcular el riesgo cardiovascular y de diabetes. Resultados: Los resultados consolidados de los instrumentos y mediciones aplicados demostraron significativos aportes en reducción de riesgo cardiovascular, en razón de una nueva percepción de los peligros y de la incorporación de comportamientos saludables. Conclusiones: las mujeres aprendieron del cuidado. 90% reportaron percepción "ideal" del riesgo, hicieron promesas y adoptaron comportamientos tomando acción frente a sus factores de riesgo y más del 50% evidenciaron cambios en las medidas antropométricas. Los resultados demuestran que estrategias de educación, especialmente con líderes comunitarias, pueden ser de gran relevancia para la salud pública.
Abstract: Introduction: every day in Colombia 60 women die from cardiovascular disease and black women are at higher risk. According to the World Health Organization (WHO) these deaths are preventable. Care as a lifestyle is an intervention of the "Actúa con corazón de mujer" program of the Colombian Society of Cardiology and Cardiovascular Surgery (SCC) and the Colombian Heart Foundation (FCC). Objective: Train leaders to promote the adoption of healthy behaviors. Method: Municipalities with a black population were selected with the commitment of the local authorities. 395 women were elected. Risk perception was measured with an instrument adapted by the FCC. The educational intervention was divided into four sessions in each municipality for five months. Participants were trained in blood pressure measurement, blood pressure self-monitoring (AMPA) was used to confirm hypertension, and anthropometric and physiological measurements were included to calculate cardiovascular and diabetes risk. Results: The consolidated results of the instruments and measurements applied showed significant contributions in reducing cardiovascular risk, due to a new perception of the dangers and the incorporation of healthy behaviors Conclusions: the women learned about care. 90% reported "ideal" perception of risk, made promises and adopted behaviors taking action against their risk factors and more than 50% showed changes in anthropometric measurements. The results show that education strategies, especially with community leaders, can be of great relevance for public health.
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Culture of care in Laboratory Animal Science (LAS) refers to a commitment toward improving animal welfare, scientific quality, staff wellbeing, and transparency for all stakeholders, ensuring that the animals and personnel involved are treated with compassion and respect. A strong culture of care can be established by the proactive implementation of the Three Rs, sharing best practices, caring for and respecting animals and colleagues, empowering staff, taking responsibility for our actions, and having a caring leadership. Culture of care, when established, should be evaluated continuously, in order to foster its progress and persistence. Even though several tools for assessing the culture of care within an institution have been proposed, an ultimate standard for measuring the concept is lacking. Here, we review the culture of care concept and propose the 'Capability Maturity Model' as a means of quantifying culture of care in the laboratory animal setting.
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Experimentação Animal , Ciência dos Animais de Laboratório , Animais , Animais de Laboratório , Bem-Estar do AnimalRESUMO
Research on animals is essential for science and medical progress. While it is still necessary to conduct this research, it is essential to apply the highest standards in animal welfare, including animal husbandry and care. Furthermore, it is important to recognize the special relationship between research animals and the people who care for them. Caring for research animals can be extremely fulfilling and meaningful, but it also comes with challenges, particularly when caring for animals experiencing pain or distress. These challenges can lead to work-related mental stress. To get more insight into the challenges of working in animal research, we organized a panel discussion at the GV-SOLAS (German Society for Laboratory Animal Science) and IGTP (Interest Group Animal Caretakers) conference 2021 about work wellbeing. This discussion was the first of its kind in Germany. The active panel contributions included the view of an ethical philosopher, a scientist, a lecturer for laboratory animal science, an animal facility manager and an animal caretaker. They gave insights from their perspective into key factors that can affect human wellbeing in animal research. Keys ideas included stigmatization of work, tension between research aims and animal wellbeing, and the importance of supportive culture to overcome work-related strains, as well as lack of education and supportive environments to cope with emotional stress in the workplace. Overall, the discussion has shown that we must also promote human wellbeing when promoting culture of care in animal research, because there is strong relationship between culture of care and individual performance.
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Experimentação Animal , Animais , Humanos , Bem-Estar do Animal , Criação de Animais Domésticos , AlemanhaRESUMO
AIMS: The aim of this study is to examine the psychometric properties of the Chinese version of the Culture of Care Barometer in health care organizations. BACKGROUND: There is a lack of tools to gauge the caring culture in Chinese hospitals. The Culture of Care Barometer is a psychometrically sound measure for caring culture developed in Western settings. METHODS: This study was guided by Sousa and Rojjanasrira's methodological approach. A total of 2365 staff were recruited from two tertiary hospitals. The Barometer was administered with the Hospital Culture Evaluation Index and Minnesota Satisfaction Questionnaire. RESULTS: The content validity index was calculated as 0.99. The goodness-of-fit indices, apart from the model chi-square, which was statistically significant, all exceeded established thresholds for adequate fit. The internal consistency was very satisfactory. Pearson's correlation indicated that the tool has good concurrent and convergent validity. CONCLUSIONS: The Barometer is a reliable and valid instrument to assess front-line staff perspectives on a caring culture in Chinese hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can use the Barometer to gauge the caring culture in China. Tailored interventions can be designed to address specific domains, and additional support can be provided to more vulnerable departments or staff groups.
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Hospitais , China , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Adolescents and young adults have unique needs which differ from those of children or adults. In the United Kingdom, we have dedicated services, which are diverse in how they are managed and delivered. A multiple-case study was conducted in young people's cancer services in four geographical regions of England. Data collection included: semi-structured interviews with healthcare professionals (n = 41) and young people (n = 29); and observation (total = 120 hours). Thematic analysis was used to synthesize and interpret five emerging themes describing the way a culture of adolescent and young adult-specific care developed. To develop a cultural attitude which embraced and promoted core values, leadership was needed, as well as high patient volume accessing a service. Time was essential, an adolescent and young adult-centered culture of care does not happen overnight, it needs time and dedicated staff to evolve, but once in place, services have a significant impact on the experience of care.
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Neoplasias , Adolescente , Criança , Coleta de Dados , Inglaterra , Humanos , Reino Unido , Adulto JovemRESUMO
The structural dialectic model of care provides a data analysis method that facilitates the identification of beliefs and structural and functional characteristics. To demonstrate the relevance of the structural dialectic model of care for data analysis integrating beliefs, scenarios and social actors. The characteristics and functions of the model are described and explained through an analysis of its application in fifteen doctoral theses (2009-2017). This model has three structures, the functional unit (beliefs), the functional element (social agents), and the functional framework (scenarios). The Structural Dialectic Model of Care constitutes a useful methodological tool for studies of nursing, organizing analysis of the data according to the dynamic and dialectical nature of their structures.
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Pesquisa em Enfermagem , HumanosRESUMO
Identification marking mice commonly involves ear-punching with or without anaesthetic, or tail-marking with ink. To identify which is most humane, we marked weanling male BALB/c mice using ear-punching (EP), ear-punching with anaesthetic EMLATM cream (EP+A), or permanent marker pen (MP). We compared marked mice, unmarked cagemates, and control mice (n = 12-13/group) for 5 weeks, reapplying MP weekly. Treatment-blind observations following marking showed that EP and EP+A mice were allogroomed (p < 0.001) and sniffed (p < 0.001) by their cagemates more than MP and control mice were. EP+A mice groomed themselves (p < 0.001) and their ears (p < 0.001) ~5 times more than most other mice; their cagemates also increased self-grooming (p < 0.001). Unmarked MP cagemates (p = 0.001), and possibly EP+A mice (p = 0.034; a nonsignificant trend), grimaced the most. The following day, half the EP+A mice showed hyponeophagia versus no MP and control mice (p = 0.001). Over the 5 weeks, EP mice approached the handler significantly less than unmarked cagemates did (p < 0.001). Across weeks, defecation during marking of MP mice decreased (p < 0.001). Treatment showed no effects on immediate responses during marking, aggression, bodyweight, plus-maze behaviour or corticosterone. MP mice showed no differences from controls, whilst EP and EP+A mice showed altered behaviour, so ink-marking may be the more humane identification method.
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The term Culture of Care, within the scientific community using laboratory animals, is being used more and more frequently after it was introduced in the EU Directive 2010/63/EU, where it is phrased as a 'climate of care', which became effective in national legislation from January 2013. However, there is a risk that the term could become a meaningless phrase if no agreed local definition of the term exists at the animal facility (called establishment in the EU Directive). This paper presents a comprehensive survey tool that provides a means to describe what the Culture of Care in an establishment looks like. The tool is one of the elements that can contribute to the overall picture of the culture; however, it cannot stand alone. Together with an evaluation of the effectiveness of the Culture of Care (e.g. key performance indicators) and a description of the outcomes and achievements in terms of animal welfare and the 3Rs (Replace, Reduce, Refine), the survey tool will constitute a comprehensive picture. The survey tool offers a multilevel and comprehensive view of different subcultures, presenting details on mindset and behaviour of the employees and the different relations within the culture, thus enabling the initiation of improvement projects if required. The tool addresses essential elements of a co-operative culture in terms of what we think, what we do and how we work together.
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Bem-Estar do Animal , Animais de Laboratório , Animais , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Since its introduction in 2007, the quality of care in specialized palliative home care (SAPV) is being measured using the patients' perspective. The perception of beneficial or inhibiting factors on the quality of care from the perspective of care providers received only little attention. OBJECTIVE: To investigate the factors that promote or impede the quality of care in SAPV from the care providers' perspective. METHODS: Within the framework of a transregional qualitative study, 113 problem-centered interviews were conducted on-site at 10 SAPV providers with their staff as well as their network partners. Grounded theory methodology was used for data curation and analysis. RESULTS: The factors that are perceived as either enhancing or inhibiting the quality of care largely depends on the culture of care of the individual SAPV provider. For participating doctors, nurses and psychosocial professionals, successful performance is associated with good symptom control, participation of relatives and the achievement of certainty of action and of interpretation by means of 'good' decision-making procedures. Problematic performances are linked to a lack of time resulting in restlessness and especially in disagreement between the parties involved in the provision of care as well as to the denial of death. CONCLUSIONS: The results of the study show that the perceived strategies, interpretations and evaluation categories, which are associated with good quality of care, are very heterogenous. On the basis of qualitative data, they do, however, follow three typical patterns in terms of cultures of care: proceduralism, holism and dualism.
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Serviços de Assistência Domiciliar , Cuidados Paliativos , Alemanha , Humanos , Pesquisa Qualitativa , Qualidade da Assistência à SaúdeRESUMO
Múltiples factores de tipo individual y contextual condicionan la calidad de la relación terapéutica en unidades de salud mental. El objetivo fue describir las características de estructura, de equipo, de normativa y de dinámica de cuidados que intervienen en el establecimiento de la relación terapéutica en las unidades de salud mental de Cataluña. El estudio forma parte un proyecto multicéntrico que incluye 18 unidades de salud mental de Cataluña y que pretende mejorar la relación terapéutica a través de una Investigación-Acción Participativa. Este trabajo es la primera etapa en la cual se realizó un análisis del contexto de estudio. Los datos se recogieron a través de guías observacionales cumplimentadas por las enfermeras coordinadoras de cada centro. Los resultados se agruparon en 3 temas: i) estructura de las unidades y dimensión de las plantillas, ii) normativa y dinámica de las unidades y iii) indicadores de calidad de los cuidados. La principal conclusión del estudio es la gran variabilidad observada en las unidades en relación con su estructura, ratios y normativas. Debido a estos factores del entorno, los cuidados que se brindan y, en consecuencia, la relación terapéutica; es considerablemente distinta en función del área en la que reside cada paciente.(AU)
Multiple individual and contextualfactors influence the quality of thetherapeutic relationship in mental healthunits. The objective was to describe the characteristics of structure, teamwork, wardrules and care dynamics that intervene in theestablishment of the therapeutic relationshipin mental health units in Catalonia. Thestudy is part of a multi-centre project thatincludes 18 mental health units in Catalonia,and which aims to improve the therapeuticrelationship through Participatory Action-Research. This work is the first stage inwhich an analysis of the study context wascarried out. The data were collected throughobservational guides filled in by thecoordinating nurses of each centre. Theresults were grouped into 3 themes: i)structure of the units and size of theteamworks, ii) rules and dynamics of theunits and iii) indicators of quality of care.The main conclusion of the study is the greatvariability observed in the units in relation totheir structure, ratios and rules. Due to theseenvironmental factors, the care providedand, consequently, the therapeuticrelationship, is considerably differentdepending on the area in which each patientresides.(AU)
Vários fatores individuais econtextuais condicionam a qualidade darelação terapêutica nas unidades de saúdemental. O objetivo foi descrever ascaracterísticas da estrutura, trabalho emequipa, regulamentação e dinâmica decuidados que intervêm no estabelecimentoda relação terapêutica em unidades de saúdemental na Catalunha. O estudo faz parte deum projeto multicêntrico que inclui 18unidades de saúde mental na Catalunha e quevisa melhorar a relação terapêutica atravêsda Investigação-Ação Participativa. Estetrabalho é a primeira etapa em que foirealizada uma análise do contexto do estudo.Os dados foram recolhidos através de guias observacionais preenchidos pelosenfermeiros coordenadores de cada centro.Os resultados foram agrupados em 3 temas:i) estrutura das unidades e tamanho dosgabaritos, ii) regulamentação e dinâmica dasunidades e iii) indicadores de qualidade daatenção. A principal conclusão do estudo é agrande variabilidade observada nas unidadesem relação á sua estrutura, relações eregulamentos. Devido a estes fatoresambientais, os cuidados prestados e,consequentemente, a relação terapêutica, sãoconsideravelmente diferentes dependendoda área em que cada paciente reside
Assuntos
Humanos , Saúde Mental , Pesquisa Participativa Baseada na Comunidade , Cuidados de Enfermagem , Relações Médico-Paciente , Espanha , PsiquiatriaRESUMO
Hospital-acquired pressure ulcers (HAPUs) negatively affect patients during hospitalisation, putting patients at risk for further complications. HAPUs are one of the hospital quality key performance indicators (KPIs) that necessitate quality initiatives and/or programmes to minimise its occurrence and consequences. When quality initiatives are put into place and proven effective, the next important focus is sustainability of the effects. The original Saudi Arabian study based on data collected from 50 441 patients, showed that implementation of the pressure ulcer prevention programme (PUPP) was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value <.001). The aim of this follow-up check of the original study was to assess if the PUPP's effectiveness success was retained. Also, to try and determine why the implemented quality improvement programme to prevent HAPUs was so successfully retained. Designed and conducted as a systemic review, it tracked the outcomes of pressure ulcer rates during and post PUPP implementation that mostly focused on evidence-based staff education, concentrating on years 2016 to 2018. Statistically significant reductions were captured by data that have been presented through Pearson Chi squares. HAPU decline was notable between year 2017 and 2018. This was followed by a further reduction in year 2018. The results determine retention effect sustainability of the initial positive results achieved. By doing so, the study was further able to establish that the PUPP had been integrated into the hospital system's care culture as evidenced by the reduction of HAPUs despite a large inpatient growth. Consideration of what contributing factors led to this successful integration of new knowledge into the care culture are also examined. KPIs can be used as indicators to help reinforce staff education. Culture of care (support of values and interventions taught during the PUPP) offer hope that these may be duplicated in future improvement projects. The supportive nature of a given culture of care may in fact be just as important as the practical education provided to staff members.
Assuntos
Úlcera por Pressão , Hospitais , Humanos , Úlcera por Pressão/prevenção & controle , Melhoria de Qualidade , Arábia Saudita , Higiene da PeleRESUMO
Scientific excellence is a necessity for progress in biomedical research. As research becomes ever more international, establishing international collaborations will be key to advancing our scientific knowledge. Understanding the similarities in standards applied by different nations to animal research, and where the differences might lie, is crucial. Cultural differences and societal values will also contribute to these similarities and differences between countries and continents. Our overview is not comprehensive for all species, but rather focuses on non-human primate (NHP) research, involving New World marmosets and Old World macaques, conducted in countries where NHPs are involved in neuroimaging research. Here, an overview of the ethics and regulations is provided to help assess welfare standards amongst primate research institutions. A comparative examination of these standards was conducted to provide a basis for establishing a common set of standards for animal welfare. These criteria may serve to develop international guidelines, which can be managed by an International Animal Welfare and Use Committee (IAWUC). Internationally, scientists have a moral responsibility to ensure excellent care and welfare of their animals, which in turn, influences the quality of their research. When working with animal models, maintaining a high quality of care ("culture of care") and welfare is essential. The transparent promotion of this level of care and welfare, along with the results of the research and its impact, may reduce public concerns associated with animal experiments in neuroscience research.