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The paper-and-pencil Rey-Osterrieth Complex Figure (ROCF) copy task has been extensively used to assess visuo-constructional skills in children and adults. The scoring systems utilized in clinical practice provide an integrated evaluation of the drawing process, without differentiating between its visuo-constructional, organizational, and motor components. Here, a tablet-based ROCF copy task capable of providing a quantitative assessment of the drawing process, differentiating between visuo-constructional, organizational, and motor skills, is trialed in 94 healthy children, between 7 and 11 years of age. Through previously validated algorithms, 12 indices of performance in the ROCF copy task were obtained for each child. Principal component analysis of the 12 indices identified spatial, procedural, and kinematic components as distinct dimensions of the drawing process. A composite score for each dimension was determined, and correlation analysis between composite scores and conventional paper-and-pencil measures of visuo-constructional, procedural, and motor skills performed. The results obtained confirmed that the constructional, organizational, and motor dimensions underlie complex figure drawing in children; and that each dimension can be measured by a unique composite score. In addition, the composite scores here obtained from children were compared with previsions results from adults, offering a novel insight into how the interplay between the three dimensions of drawing evolves with age.
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Destreza Motora , Humanos , Criança , Feminino , Masculino , Fenômenos Biomecânicos , Destreza Motora/fisiologia , Desempenho Psicomotor/fisiologia , Computadores de Mão , Análise de Componente PrincipalRESUMO
Critical nursing shortages and experiences of burnout present a significant challenge in the home and community care (HCC) health sector. Determining what factors influence resiliency could inform HCC organizations in developing recruitment and retention resources and strategies. This scoping review identified factors that influence professional resilience in nurses working in the HCC sector. From 1819 documents identified from database searches, using a librarian-informed strategy, eight articles were included. Two domains emerged for HCC nurses, that is, i) professional and work-related characteristics of being resilient; and ii) strategies to promote professional nurse resilience. One domain emerged addressing organizational infrastructure, policy and practices contributing to professional nurse resilience in the HCC sector. The findings revealed that resiliency in HCC nurses extends beyond individual characteristics as nurse professionals, and their personal "self-care" strategies as individual people. Further research is needed to disentangle personal and professional resilience in nurses working in the HCC sector.
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Many companies have been implementing strategies in recent years to increase employee happiness, which has become one of their primary corporate objectives. Research has explored which initiatives are effective in promoting employee happiness, the extent to which happiness affects employee performance, and the importance of numerical evidence in this regard. Studies have found a positive correlation between employee happiness and organizational performance, making employee happiness rate a crucial indicator for measuring the health and sustainability of an organization. The aim of this research was to examine the connection between performance scores and happiness, drawing on Fisher's "happy-super worker" hypothesis proposed in 1980. Data analysis was conducted on seven quarters (21 months) of information from 4,277 employees, and the results confirmed that happiness and performance are positively correlated. The study revealed that happiness had a beneficial impact on performance at both low- and high-performance score levels, albeit with a gradual effect. In contrast, happiness had a more rapid impact on success at medium-performance levels. However, a positive association was found between happiness and success across all performance scores, including low, medium, and high performance. The study revealed a curvilinear relationship between happiness and performance. Furthermore, panel data modeling showed that an increase of 1 unit in individual happiness at any given time led to an average increase of 3.41 units in their performance score.
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AIM: The aim was (1) to explore organizational factors influencing the use of low-value care (LVC) as perceived by primary care physicians and (2) to explore which organizational strategies they believe are useful for reducing the use of LVC. DESIGN: Qualitative study with semi-structured focus group discussions (FGDs) analyzed using qualitative content analysis. SETTING: Six publicly owned primary health care centers in Stockholm. SUBJECTS: The participants were 31 primary care physicians. The number of participants in each FGD varied between 3 and 7. MAIN OUTCOME MEASURES: Categories and subcategories reporting organizational factors perceived to influence the use of LVC and organizational strategies considered useful for reducing the use of LVC. RESULTS: Four types of organizational factors (resources, care processes, improvement activities, and governance) influenced the use of LVC. Resources involved time to care for patients, staff knowledge, and working tools. Care processes included work routines and the ways activities and resources were prioritized in the organization. Improvement activities involved performance measurement and improvement work to reduce LVC. Governance concerned organizational goals, higher-level decision making, and policies. Physicians suggested multiple strategies targeting these factors to reduce LVC, including increased patient-physician continuity, adjusted economic incentives, continuous professional development for physicians, and gatekeeping functions which prevent unnecessary appointments and guide patients to the appropriate point of care. . CONCLUSION: The influence of multiple organizational factors throughout the health-care system indicates that a whole-system approach might be useful in reducing LVC.KEY POINTSWe know little about how organizational factors influence the use of low-value care (LVC) in primary health care.Physicians perceive organizational resources, care processes, improvement activities, and governance as influences on the use of LVC and LVC-reducing strategies.This study provides insights about how these factors influence LVC use.Strategies at multiple levels of the health-care system may be warranted to reduce LVC.
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Médicos de Atenção Primária , Médicos , Humanos , Suécia , Cuidados de Baixo Valor , Relações Médico-Paciente , Pesquisa Qualitativa , Atenção Primária à SaúdeRESUMO
BACKGROUND: Obsessive Compulsive Disorder (OCD) is characterized by the presence of executive dysfunctions. As organizational strategies may play an important role as a possible endophenotype of the disorder, we decided to investigate non-verbal memory and organizational abilities in OCD. We also investigated how organization and non-verbal memory differ between responder and non-responder patients to pharmacological treatment, to test whether cognitive functions can predict the response to pharmacological treatment. METHODS: In Study 1, executive and clinical functioning measures were applied to 162 OCD and 95 controls. In Study 2, clinical, intelligence and executive functioning measures were applied to 72 OCD responders and 63 OCD non-responder patients. RESULTS: OCD patients and controls from Study 1 differed in copy organization (p < 0.01) and delayed recall (p = 0.048). In Study 2, the OCD responders displayed better copy organization (p = 0.013) and lower depressive, anxious and OCD symptoms (p < 0.01 in the three cases). Scores in the following instruments were found to predict the response to pharmacological treatment: HDRS, Y-BOCS, Raven progressive matrices, and Direct digit subtest from the Wechsler's scale (p < 0.01 in all four cases). LIMITATIONS: In Study 1, the imbalance of the sample can be considered a limitation, whilst in Study 2, some of the levels of pharmacological resistance were not represented. CONCLUSIONS: In this study, non-verbal memory and organization was affected in OCD. Responder patients also displayed better executive functioning and fluid intelligence. Organizational ability is a predictor of pharmacological response to SSRI monotherapy in a predictive model controlling for anxious symptoms.
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Disfunção Cognitiva , Transtorno Obsessivo-Compulsivo , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/tratamento farmacológico , Função Executiva , Humanos , Testes Neuropsicológicos , Transtorno Obsessivo-Compulsivo/psicologiaRESUMO
New concerns have emerged during the COVID-19 pandemic that greatly impact employees and many other aspects in organizations. We have highlighted the major organizational issues during COVID-19 and classified the relevant research findings based on 45 recent articles. Main themes identified include (1) work setting, (2) perceptions of COVID-19, (3) employee wellbeing, (4) organizational strategies, and (5) influences on career behaviors. Employees have faced challenges due to work conditions that have shifted from traditional commuting to telework. Employees have also become aware of the negative current situation, so their overall wellbeing has been threatened. In response, organizations have strived to promote positive psychological capital for employees as they attempt to cope with this crisis. Organizations have tried to maintain and manage both their employees and their business. People tended to adjust their career-related behaviors based on how they perceived their own wellbeing and organizational strategies.
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BACKGROUND: Engagement of academic faculty in research remains low. While barriers to research have been explored, there are no data on how national organizations can help overcome these barriers. Our study explored faculty satisfaction and motivational drivers for engagement with research opportunities offered by the Council on Medical Student Education in Pediatrics (COMSEP), an organization of pediatric medical educators, and characterize strategies perceived by faculty to promote the use of these opportunities. METHODS: In 2021, 5 survey questions were administered to faculty members of COMSEP to explore satisfaction with COMSEP's research offerings, the perceived value of educational research, and the facilitators, barriers and potential opportunities for COMSEP to promote research. Clark's Commitment and Necessary Effort model on motivation served as the theoretical framework for our study, which explores motivation, self-efficacy and contextual factors influencing an individual's pursuit of goals. Chi-square analysis and Wilcoxon Signed Ranks Test were used to compare categorical and scaled variables among groups who did and did not avail of COMSEP's research offerings. RESULTS: 90 (25%) of 360 recipients responded. 61% expressed satisfaction with COMSEP's research offerings. 68% indicated research was an expectation of their academic appointment, that education was their primary research focus (74%) and that they did not have other research opportunities that met their needs (58%). Of respondents, 75.7% of females had submitted a proposal compared to 60% of non-responders who were females. The comparison by gender was not statistically significant. Exploration by academic rank revealed that 35% of instructor/assistant professors had submitted a proposal compared to 65% of associate professors/professors (p =.05). Barriers leading to non-submission to any of the offerings included having too much other work, lack of enjoyment in writing and inability to find mentors. Respondents endorsed the importance of several strategies to promote engagement in research-skill building opportunities, personalized consultations and increased funding. CONCLUSIONS: Faculty educators value the importance of educational research and recognize that research opportunities offered by COMSEP address an unmet need, but express ambivalence in the enjoyment of writing (reflecting their mood), and endorse structural barriers, that are amenable to change, affecting their personal agency.
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Estudantes de Medicina , Criança , Docentes , Docentes de Medicina , Feminino , Humanos , Mentores , Motivação , Inquéritos e QuestionáriosRESUMO
The verbal fluency task is a measure of cognitive flexibility and search strategy within the lexicon and semantic topic. The use of organizational strategies was tested in healthy Spanish children divided in two groups: group 1 of younger children and group 2 of older children introducing different letters and semantic categories. Semantic fluency was greater than phonological fluency in both age groups. In addition, older children showed better performance of both fluencies than younger children. From the phonological analyses, younger children evoked more word with the PMR letter group than with the FAS one. Moreover, an improvement of semantic fluency associated with the animal's category faced to meals and drink was observed only in the younger children group. In respect to organizational strategies, older children used more switches specifically in FAS group and more clusters for the meals or drinks category compared with the older children group. The relationships between the number of words evoked and the number of clusters and switches for both VF tasks were significant and positive. These data suggest that the type of letter and the semantic category employed in the VF evaluation modulate the verbal fluency performance in both groups of age.
La tarea de fluidez verbal es una medida de flexibilidad cognitiva y estrategia de búsqueda dentro del contenido léxico y semántico. Se evaluó el uso de estrategias organizativas en niños españoles sanos divididos en dos grupos: grupo 1 de niños más pequeños y grupo 2 de niños mayores introduciendo diferentes letras y categorías semánticas. La fluidez semántica fue mayor que la fluidez fonológica en ambos grupos de edad. Además, los niños mayores mostraron un mejor rendimiento de ambas fluencias que los niños más pequeños. A partir de los análisis fonológicos, los niños más pequeños evocaron más palabras con el grupo de letras PMR que con el de FAS. Además, se observó una mejora de la fluidez semántica asociada con la categoría animales frente a la categoría comidas y bebidas únicamente en el grupo de niños más pequeños. Con respecto a las estrategias organizativas, los niños mayores utilizaron más cambios, específicamente en el grupo FAS y más agrupamientos para la categoría de comidas o bebidas, en comparación con el grupo de niños mayores. Las relaciones entre el número de palabras evocadas y el número de agrupamientos y cambios para ambas tareas de VF fueron significativas y positivas. Estos datos sugieren que el tipo de letra y la categoría semántica empleada en la evaluación de la VF modulan el rendimiento en fluidez verbal en ambos grupos de edad.(AU)
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Humanos , Masculino , Feminino , Criança , Semântica , Comportamento Verbal , Aprendizagem Verbal , Transtornos da Articulação , Espanha , FonoaudiologiaRESUMO
PURPOSE: A growing waitlist for Mindfulness in Motion (MIM), an evidence-based worksite mindfulness-based intervention, necessitated a training system with built in fidelity assurance to meet program demand. MIM was delivered as part of an organizational strategy in a large academic health center to enhance Health Care Professional (HCP) well-being. In order to ensure that the intervention was being delivered the same way to each cohort, a process to ensure intervention fidelity was developed for MIM. METHOD: The core components of MIM informed the development of a detailed fidelity monitoring system to ensure consistent intervention delivery. Each MIM cohort was conducted with both trained facilitators and trained intervention fidelity monitors. RESULTS: Across 11 cohort offerings of MIM, each 8 weeks in length, there was a mean adherence rate of 0.9886, SD = 0.0012. CONCLUSION: The fidelity monitoring system allowed for a reliable expansion of MIM offerings to HCPs and for a seamless pivot to fully virtual MIM delivery, necessitated by COVID-19.
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BACKGROUND: Knowledge translation (KT) is an important means of improving the health service quality. Most research on the effectiveness of KT strategies has focused on individual strategies, i.e., those directly targeting the modification of allied health professionals' knowledge, attitudes, and behaviors, for example. In general, these strategies are moderately effective in changing practices (maximum 10% change). Effecting change in organizational contexts (e.g., change readiness, general and specific organizational capacity, organizational routines) is part of a promising new avenue to service quality improvement through the implementation of evidence-based practices. The objective of this study will be to identify why, how, and under what conditions organizational KT strategies have been shown to be effective or ineffective in changing the (a) knowledge, (b) attitudes, and (c) clinical behaviors of allied health professionals in traumatology settings. METHODS: This is a realist review protocol involving four iterative steps: (1) Initial theory formulation, (2) search for Evidence search, (3) knowledge extraction and synthesis, and (4) recommendations. We will search electronic databases such as PubMed, Embase, CINHAL, Cochrane Library, and Conference Proceedings Citation Index - Science. The studies included will be those relating to the use of organizational KT strategies in trauma settings, regardless of study designs, published between January 1990 and October 2020, and presenting objective measures that demonstrate change in allied health professionals' knowledge, attitudes, and clinical behaviors. Two independent reviewers will select, screen, and extract the data related to all relevant sources in order to refine or refute the context-mechanism-outcome (CMO) configurations developed in the initial theory and identify new CMO configurations. DISCUSSION: Using a systematic and rigorous method, this review will help guide decision-makers and researchers in choosing the best organizational strategies to optimize the implementation of evidence-based practices. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020216105.
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Pesquisa Translacional Biomédica , Traumatologia , Pessoal Técnico de Saúde , Atenção à Saúde , Humanos , Organizações , Literatura de Revisão como Assunto , Revisões Sistemáticas como AssuntoRESUMO
The COVID-19 pandemic significantly impacted the labor market and multiple aspects of work and workers' life. The present rapid review analyzes this impact considering the effects that COVID-19 pandemic had on employment and work-related aspects across different age groups. A comprehensive literature search was performed on scientific contributions published between 2019 and March 2021, resulting in 36 papers pertinent to the scope of this review. Findings were grouped according to different topics, all linked to age: occupational risk, implications on the labor market (i.e., job loss and reemployment, job insecurity, turnover intentions and retirement, and healthcare workers' return-to-work phase), remote work, and key individual and organizational resources and strategies. Overall, the review revealed variability across age groups in the impact this pandemic had on employment and several work-related aspects (i.e., occupational risk, remote work). Findings supported an age-differential effect of normative history-graded events such as the current pandemic, highlighting different responses and consequences depending on workers' age.
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COVID-19 , Pandemias , Emprego , Humanos , Reorganização de Recursos Humanos , SARS-CoV-2RESUMO
PURPOSE: Hospitals and healthcare organizations are today operating in an extremely competitive environment, with increasing pressure to improve quality while reducing costs. In responding to this dynamic situation, transformation of any organization requires the will to organize delivery around the needs of patients. RECENT FINDINGS: Providing palliative care to the many who require it needs the value agenda to be formulated based on mutually reinforcing components. Here we present an overview of the framework for a palliative care department in a comprehensive cancer center, which includes different levels that are embedded within a comprehensive system. Detailed information on each level is presented, followed by a discussion of quality of care, as an integrating theme for the framework. The chapter concludes by detailing the benefits that a comprehensive cancer palliative care center provides to a country's healthcare efforts through service, education, research, and advocacy.
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Neoplasias/terapia , Cuidados Paliativos/organização & administração , Recursos em Saúde , Cuidados Paliativos na Terminalidade da Vida , Humanos , Tecnologia da Informação , Cuidados Paliativos/economia , Cuidados Paliativos/normas , Planejamento de Assistência ao Paciente , Guias de Prática Clínica como Assunto , Qualidade da Assistência à SaúdeRESUMO
The main purpose of the paper is to identify the outcomes for employers and employees indicated in research related to workplace health promotion interventions (WHPIs). We investigated what methods are used and what types of organization this type of research is most often carried out in. In addition, the authors attempted to assess to what extent the methods used in the previous research prove the effectiveness of the implemented WHPIs. A systematic review of English-language papers (2000-2020) focused on types of health-promoting interventions in the workplace, and outcomes for employers and employees were conducted using the SCOPUS database (n = 260). As a result, 29 texts qualified for a final qualitative synthesis of the results. The analyses were most frequently conducted in small and medium-sized enterprises (SMEs) based on both quantitative and qualitative methods. In order to draw conclusions, analyses were made by classifying the research presented in the texts according to the type of intervention implemented, classifying the outcomes identified, and indicating the type of evaluation made by the researcher. The analysis showed that most of the outcomes presented refer to changes in the strategy and organizational culture, as well as the behavior of employees. In 18 studies, the indication of outcomes resulted directly from the evaluation outcomes. In other cases, the outcomes were identified by an evaluation of the process or structure of WHPI. The conducted analysis showed significant diversity in terms of the outcomes measured and the research methods used. The quasi-experimental methods, randomly controlled cluster trials, or cross-sectorial studies used in the study to confirm the effectiveness of WHPI were used only in every third study. In these studies, measurements were usually performed twice: at baseline and after intervention. The majority of studies confirmed that WHPIs led to a positive change in the healthy behavior of employees and effected an organizational change, and more rarely led to savings or a reduction in costs resulting from sickness absenteeism, presentism, turnover, etc., and return on investment (ROI). The article shows the need to conduct further research towards the development of guidelines for the evaluation of the effectiveness of implemented programs.
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Promoção da Saúde , Local de Trabalho , Absenteísmo , Pesquisa Empírica , Cultura OrganizacionalRESUMO
The main goal of this study was to explore the organizational strategies used by younger and older adults when encoding words, using eye-tracking. Participants had to learn a set of organizable words and then a set of non-organizable words, each presented on a single display. Participants were then asked to recall the words of each set in the order in which they came to their mind. Hence, the participants' encoding strategies revealed by eye-tracking could be directly related to their subsequent memory performance. The results confirmed the detrimental impact of aging on memory and the weaker use of organizational strategies by older adults during the recall phase. The eye-tracking data showed that when they encode the words, older adults do not look at them for as long as younger adults, probably because of slower eye movements. They also revealed that compared to younger adults, older adults were much less able to adapt their word scanning strategy according to whether the words to encode were organizable or not. Finally, the relationships that were found between the recall scores and the eye-tracking data suggest that the eye movement pattern at learning can predict how people will recall the words.
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Movimentos Oculares , Rememoração Mental , Idoso , Envelhecimento , Cognição , Humanos , AprendizagemAssuntos
Esgotamento Profissional/prevenção & controle , Internato e Residência , Cultura Organizacional , Melhoria de Qualidade/organização & administração , Criatividade , Avaliação do Impacto na Saúde/métodos , Promoção da Saúde , Humanos , Internato e Residência/métodos , Internato e Residência/organização & administraçãoRESUMO
Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.
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This study presents descriptive findings from in-depth interviews with 29 representatives of organizations in Africa, Asia, Europe, Oceania, and North and South America that engage men and boys in preventing gender-based violence. In particular, the findings suggest that strategies are responsive to the specific cultural, economic, and contextual concerns of the local community, with nuanced messages and appropriate messengers. In addition, respondents reported key principles informing their organizational strategies to deepen men and boys' engagement. Attention is also paid to respondents' caution about the risks of framing of engagement practices as separate from both women's organizations and women and girls themselves.