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1.
South Med J ; 116(2): 225-230, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36724540

RESUMO

The history of New Orleans radiology helps us understand how innovative medical ideas are transmitted and adopted and how the specialty evolved to incorporate these new ideas. As radiology became a required component of medical practice, additional expertise was needed. This resulted in the need for standardized specialized training and the necessity for some form of certification. New Orleans radiologists have always been involved in these American Board of Radiology efforts and also have held leadership positions in other national radiology organizations. The practice of radiology evolved from photographers being employees to physicians becoming members of a unique specialty with practice ownership interests. Radiologists united to form large practice groups and joined professional associations to share technological innovations as well as ensure a culture of professional collegiality. In New Orleans, organizations and events such as the New Orleans Radiology Society, the Spring Roentgen Conference, and the New Orleans Ultrasound Association were organized. Local radiologists who directed these efforts also participated on boards of many national radiologic organizations and helped advance the science of radiology. As the financial complexity and political stresses of radiology practice increased, groups merged, with a resultant decrease in individual autonomy and an increase in radiologist burnout. This has directly and indirectly resulted in many radiologists becoming employees as they were in the early days of New Orleans radiology.


Assuntos
Radiologia , Humanos , Estados Unidos , Nova Orleans , Radiologia/educação , Certificação , Sociedades Médicas , Liderança
2.
BMC Geriatr ; 23(1): 35, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36670357

RESUMO

BACKGROUND: The global leadership initiative on malnutrition (GLIM) proposed the first international standards (GLIM criteria) for malnutrition diagnosis. Early screening using nutritional tools is recommended to improve the prognosis of older patients. The association between Mini Nutritional Assessment-Short Form (MNAⓇ-SF) and Geriatric Nutritional Risk Index (GNRI) and prognosis has been reported, but there is insufficient evidence to develop the GLIM criteria for older inpatients. We aimed to evaluate the MNAⓇ-SF, GNRI, and GLIM criteria to determine their contribution to the prognosis prediction of hospitalized older patients at 1 year after discharge. METHODS: This study included 386 patients hospitalized between September 2014 and October 2015, and May and December 2019. After excluding 17 patients who died at the time of initial hospitalization, 23 who were lost to follow-up after 1 year, and 28 who had missing data on admission, only 318 were included in the final analysis. The primary outcome was death within 1 year after discharge, assessed using the MNA®-SF, GNRI, and GLIM criteria, and survival analysis was conducted. Multivariate Cox proportional hazards analysis was performed to identify the nutritional assessment tools that contributed to the prognosis prediction. RESULTS: A total of 43 patients died within 1 year. Of them, 58.1% had malnutrition and 37.2% were at risk of malnutrition, assessed using the MNAⓇ-SF; 27.9% had severely malnourished assessed using the GNRI; and 58.1% had severely malnourished assessed using the GLIM criteria. The proportions of malnourished and severely malnourished patients were significantly higher in the mortality group than in the survival group. Multivariate Cox proportional hazards analysis showed hazard ratios of 1.06 (95% confidence interval [CI]: 0.24-4.71) for at risk and 2.17 (95% CI: 0.48-9.84) for malnutrition (MNAⓇ-SF); 5.68 (95% CI: 2.74-11.80) for moderately malnourished and 7.69 (95% CI: 3.13-18.91) for severely malnourished (GNRI); and 1.47 (95% CI: 0.48-4.50) for moderately malnourished and 2.45 (95% CI: 1.22-4.93) for severely malnourished (GLIM criteria); GNRI had the most significant contribution to prognosis prediction. CONCLUSIONS: GNRI significantly contributed to the prognosis prediction 1 year after hospital discharge of older patients.


Assuntos
Desnutrição , Estado Nutricional , Humanos , Idoso , Avaliação Nutricional , Estudos de Coortes , Liderança , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/complicações , Prognóstico , Avaliação Geriátrica
3.
Semin Oncol Nurs ; 39(1): 151361, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36621414

RESUMO

OBJECTIVES: This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation. DATA SOURCES: Data sources include published and grey literature from around the world. CONCLUSION: Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing. IMPLICATIONS FOR NURSING PRACTICE: Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.


Assuntos
Neoplasias , Enfermagem Oncológica , Humanos , Recursos Humanos , Atenção à Saúde , Liderança
4.
J Occup Health ; 65(1): e12383, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36653825

RESUMO

OBJECTIVES: Against the background of e-government, it is discussed whether self-organization represents an independent component of digital leadership. Addressing this research question, the instrument "DigiFuehr" is being expanded to include the aspects of self-determination and coordination. The aim is to test the model quality of three adapted scales against the already established support-focusing version. METHODS: Based on an online survey of n = 422 employees at visual display unit workstations in German municipal administrations in April 2022, the original version of DigiFuehr as well as one reduced and two extended versions were validated considering their local and global model fit. RESULTS: All four scales show a good local fit with regard to internal consistency (Cronbach's α), discriminatory power, and dimensionality. Only the scale extended by two items also offers a sufficient global fit and is thus most suitable as a predictor for psychological stress, work satisfaction, and satisfaction with the professional exchange during homeworking. CONCLUSIONS: With "DigiFuehr 2.0", an improved version of the original scale is available. Self-organization is not a component independent of the support dimension, but a further important indicator of a latent digital leadership culture. Neither should come at the expense of the other.


Assuntos
Liderança , Estresse Psicológico , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
5.
Fam Med ; 55(1): 38-44, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36656886

RESUMO

BACKGROUND AND OBJECTIVES:  The onset of the COVID-19 pandemic severely threatened all aspects of academic family medicine, constituting a crisis. Multiple publications have identified recommendations and documented the creative responses of primary care and academic organizations to address these challenges, but there is little research on how decisions came about. Our objective was to gain insight into the context, process, and nature of family medicine leaders' discussions in pivoting to address a crisis. METHODS:  We used a qualitative descriptive design to explore new dimensions of existing concepts. The setting was the academic family medicine department at the University of Toronto. To identify leadership themes, we used the constant comparative method to analyze transcripts of monthly meetings of the departmental executive: three meetings immediately before and three following the declaration of a state emergency in Ontario. RESULTS:  Six themes were evident before and after the onset of the pandemic: building capacity in academic family medicine; developing leadership; advancing equity, diversity, and inclusion; learner safety and wellness; striving for excellence; and promoting a supportive and collegial environment. Five themes emerged as specific responses to the crisis: situational awareness; increased multidirectional communication; emotional awareness; innovation in education and patient care; and proactive planning for extended adaptation to the pandemic. CONCLUSION:  Existing cultural and organizational approaches formed the foundation for the crisis response, while crisis-specific themes reflected skills and attitudes that are essential in clinical family medicine, including adapting to community needs, communication, and emotional awareness.


Assuntos
COVID-19 , Médicos de Família , Humanos , Pandemias , Medicina de Família e Comunidade , Liderança
6.
BMC Med Educ ; 23(1): 10, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36604671

RESUMO

BACKGROUND: Leadership has been recognized as an important competency in medicine. Nevertheless, leadership curricula for Canadian medical students lacks standardization and may not be informed by medical students' perspectives of physician leadership. The purpose of this study was to elicit these perspectives on physician leadership. METHODS: The present study utilized semi-structured interviews to ascertain the views of medical student participants, including students in their first, second and third years of medical school, on physician leadership. Interview questions were based on 'the 3-C model' of physician leadership, which includes three aspects of leadership, namely character, competence and commitment. The interviews were audio-recorded, transcribed and then coded using thematic analysis. RESULTS: The medical students of this study provided rich examples of resident and staff physicians demonstrating effective and ineffective leadership. The participants identified the importance of character to effective physician leadership, but some participants also described a feeling of disconnect with the relevance of character at their stage of training. When discussing physician competence, medical students described the importance of both medical expertise and transferable skills. Lastly, the leadership aspect of commitment was identified as being relevant, but medical students cautioned against the potential for physician burnout. The medical student participants' suggestions for improved leadership development included increased experiences with examples of physician leadership, opportunities to engage in leadership and participation in reflection exercises. CONCLUSIONS: Overall, the study participants demonstrated an appreciation for three aspects of leadership; character, competence and commitment. Furthermore, they also provided recommendations for the future design of medical leadership curricula.


Assuntos
Educação de Graduação em Medicina , Médicos , Estudantes de Medicina , Humanos , Liderança , Canadá , Currículo
7.
Nurs Manage ; 54(1): 48-50, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36607188

RESUMO

The following manuscript is the winning 2022 Richard Hader Visionary Leader Award entry submitted to Nursing Management in recognition of Kisler "Angelle" Cooper, BSN, RN, CCRN, nurse director of the Neuro Critical Care Unit (NCCU) at Our Lady of the Lake Regional Medical Center in Baton Rouge, La.


Assuntos
Distinções e Prêmios , Enfermeiras Administradoras , Cuidados de Enfermagem , Humanos , Liderança , Hospitais
8.
Vet Rec ; 192(1): i-ii, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36607668

RESUMO

From her first job helping with the practice books, to chairing the Veterinary Management Group board, Ruth Mckay has focused her career around leadership and management skills.


Assuntos
Liderança , Médicos Veterinários , Feminino , Animais , Humanos , Logro , Mobilidade Ocupacional
11.
Cuad. psicol. deporte ; 23(1): 234-247, ene.-abr. 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-214822

RESUMO

El objetivo de esta investigación fue analizar el proceso de planificación y toma de decisiones de los entrenadores españoles de fútbol en función variables sociodemográficas, de formación y del contexto del equipo. A través de un diseño descriptivo, comparativo y transversal, se administraron los cuestionarios de estilos de decisión y planificación en el deporte a una muestra de 315 de entrenadores de fútbol en activo. Se analizó la validez y fiabilidad de las escalas empleadas y se realizó un análisis correlacional entre los factores de cada escala. Los resultados indican que los entrenadores puntúan más alto la toma de decisiones democráticas (M= 3,77 ±,74) y la planificación flexible (M= 4,04 ±,69). De igual modo, se encontraron correlaciones entre la toma de decisiones y planificación siendo los pares: democrática-flexible y autoritaria-rígida. También se encontraron diferencias significativas en relación a la edad, características del equipo, formación universitaria y deportiva. (AU)


The objective of this research is to analyse the planning and decision-making process of Spanish football coaches according to socio-demographic, educational and team context variables. Using a descriptive, comparative and cross-sectional design, the questionnaires on decision-making and planning styles in sport were administered to a sample of 315 active football coaches. The validity and reliability of the scales used were analysed and a correlational analysis was carried out between the factors of each scale. The results indicate that coaches scored democratic decision-making (M= 3.77 ±.74) and flexible planning (M= 4.04 ±.69) higher. Similarly, correlations were found between decision-making and planning with the pairs being democratic-flexible and authoritarian-rigid. Significant differences were also found in relation to age, team characteristics, university and sports training. (AU)


O objectivo desta investigação era analisar o processo de planeamento e tomada de decisões dos treinadores espanhóis de futebol de acordo com variáveis sociodemográficas, educacionais e de contexto de equipa. Através de um desenho descritivo, comparativo e transversal, os questionários de estilos de decisão e planeamento no desporto foram administrados a uma amostra de 315 treinadores de futebol activos. A validade e fiabilidade das escalas utilizadas foram analisadas e foi efectuada uma análise correlacional entre os factores de cada escala. Os resultados indicam que os treinadores pontuaram a tomada de decisão democrática (M= 3,77 ±,74) e o planeamento flexível (M= 4,04 ±,69) mais alto. Do mesmo modo, foram encontradas correlações entre a tomada de decisões e o planeamento, sendo os pares democrático-flexível e autoritário-rígido. Foram também encontradas diferenças significativas em relação à idade, características da equipa, formação universitária e desportiva. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Tomada de Decisões , Futebol , Liderança , Planejamento , Espanha , Estudos Transversais
13.
Rev. clín. esp. (Ed. impr.) ; 223(1): 1-9, ene. 2023.
Artigo em Espanhol | IBECS | ID: ibc-214303

RESUMO

Antecedentes y objetivo Los datos disponibles avalan las diferencias por género en el liderazgo de las investigaciones clínicas (IC). Este estudio analiza en qué medida las mujeres lideran estas investigaciones. Materiales y métodos Estudio observacional retrospectivo en un hospital universitario terciario asociado a uno de los institutos de investigación sanitaria más importantes de España. Analizamos los investigadores principales (IP) por género (2001-2020). Variable principal: proporción de IC lideradas por mujeres durante el período de estudio. Variables secundarias: diferencias de IP por género según el tipo de estudio: ensayos clínicos (EC) o estudios de no-intervención (ENI) y según la financiación. Fuentes de datos: registros del Comité de Ética en Investigación con medicamentos (CEIm) y del Departamento de Recursos Humanos. Resultados Durante el estudio, el CEIm aprobó 8.466 protocolos; el 52% (4.408/8.466) fueron EC y el resto, ENI. Las mujeres lideraron un 39,7% (3.360/8.466) del total. La brecha de género se observó principalmente en EC: las mujeres fueron IP de un 31,5% de ellos (1.391/4.408) y de un 48,5% (1.969/4.058) de los ENI. Ello a pesar de la tendencia creciente del número de facultativas. Los estudios de financiación privada fueron más comúnmente liderados por hombres. Conclusiones Nuestros resultados demuestran que existe una infrarrepresentación de las mujeres en puestos de liderazgo en la investigación, principalmente en aquellos con financiación privada. Este estudio refuerza la idea de que todavía queda un largo camino por recorrer en este campo. Se necesitan más estudios para la identificación de diferencias existentes que permitan implantar cambios a nivel institucional y cultural que promuevan la igualdad de género en el ámbito de la investigación clínica (AU)


Background and objective Available data support differences by gender in the leadership of clinical investigations (CI). This study analyzes to what extent women lead these investigations. Materials and method Observational-retrospective study in a tertiary university hospital associated with one of the most important health research institutes in Spain. We analyzed the principal investigators (PI) by gender from 2001 to 2020. Main outcome: proportion of CI led by female doctors (FD) during the study period. Secondary outcomes: differences in PI by gender according to the type of study: clinical trials (CT) or non-interventional-researches (NIR) and according to type of funding. Data sources: Research Ethics Committee (REC) and Human Resources Department registries. Result During the study, the REC approved 8,466 protocols, 52% (4,408/8,466) were EC, the rest were NIR. Women led 39.7% (3,360/8,466) of the total. The gender gap was observed mainly in EC: FD were IP of 31.5% of them (1,391/4,408) and 48.5% (1,969/4,058) of NIR. This despite the increasing trend in the number of FD staff. By type of funding, when the studies were supported by private sector there was a wider gap markedly unfavorable for women. Conclusions Our results show that there is underrepresentation of women in research leadership, mainly those with private financing. This study reinforces the idea that there is still a long way to go in this field. More studies are necessary to identify the existing differences that allow the implementation of actions at the institutional and cultural level that promote gender equality in the field of clinical research (AU)


Assuntos
Humanos , Feminino , Pesquisa Biomédica/estatística & dados numéricos , Mulheres , Liderança , Estudos Retrospectivos , Espanha
16.
J Nurs Adm ; 53(2): 74-80, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36692996

RESUMO

OBJECTIVE: This study aimed to develop and validate a tool to measure authentic nurse leadership (ANL) from the perspective of nurse leaders. BACKGROUND: The COVID-19 pandemic heightened the need for ANL to establish healthy work environments (HWE) that promote positive outcomes. METHODS: A nonexperimental design and exploratory psychometric analysis developed and validated the Authentic Nurse Leadership Questionnaire for Nurse Leaders (ANLQ-NL) instrument. Relationships were explored between ANLQ-NL and HWE, as measured by the Areas of Worklife Survey (AWS). The Marlowe-Crowne Social Desirability Scale (MC-SDS) was used to measure the nurse leaders' tendency to produce socially desirable responses. The sample consisted of 188 nurse leaders from several US hospitals. RESULTS: The ANLQ-NL instrument was found to be valid and highly reliable. Each of the constructs aligned with the ANL conceptual framework. CONCLUSION: The ANL conceptual framework and instruments (ANLQ and ANLQ-NL) can be used for educational programs aimed at developing ANL attributes among nurses.


Assuntos
COVID-19 , Enfermeiras Administradoras , Enfermeiras e Enfermeiros , Humanos , Pandemias , Liderança , Inquéritos e Questionários
17.
BMC Public Health ; 23(1): 163, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694140

RESUMO

BACKGROUND: Female genital mutilation (FGM) is one of the diehard cultures in the Mediterranean and sub-Saharan Africa. The act involves chopping off part of the female genitals in varying degrees depending on the society. The motive behind this practice includes reducing female sexual desire, a sign of maturation, and retaining the culture. The current study explored the roles of community members and leaders in the fight against FGM; and the reasons for continuing the practice in some societies. METHOD: We did an exploratory cross-sectional qualitative study between June - July 2020 in six purposively selected villages from Kilindi and Handeni districts in Tanga that were part of the five years implementation project. The project was named Alternative Right of Passage (APR) by Amref Health Africa Tanzania to eradicate FGM. The interventions were to sensitize the community on the effects of FGM on women's health, educate and create demand for girl children to attend and complete school. Ethnic leaders and village members aged 19 years and above were purposively selected. Due to the sensitive nature of the study, FGDs were conducted separately between men and women. In addition, we did the inductive thematic analysis. RESULTS: Four main themes emerged from the analysis; (1) the history of FGM and reasons behind persistent FGM practices, (2) Challenges to abandonment of FGM, (3) strategies to be used to eradicate FGM, and (4) Key change agents in ending FGM. It was reported that the FGM practice was inherited from elders years ago and is believed to reduce women's sexual desire when the husband travels away for a long time. Some societies still practice FGM secretly because marrying an uncircumcised girl is a curse, as the husband and children will die. Some older women still practice FGM as they still hold the ancient culture. Constant communication with community leaders, seniors, and the young generation on complications of FGM will fasten efforts toward eradicating FGM practice. CONCLUSION: There are sporadic cases done secretly associated with FGM practice since the ant-FGM campaign, so this should be the reason to continue with the campaign. Winning the tribal/ethnic leaders can facilitate better achievement in the fight against FGM. In addition, social diffusion with inter-tribe marriages was also singled out as one of the factors that will make FGM practice unfamiliar to the communities in the future.


Assuntos
Circuncisão Feminina , Masculino , Criança , Feminino , Humanos , Idoso , Tanzânia , Estudos Transversais , Liderança , Saúde da Mulher
19.
Subst Use Misuse ; 58(3): 320-330, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36629127

RESUMO

Background: This study examined fidelity of implementation strategies used in an organizational process improvement intervention (OPII) designed to improve evidence-based practices related to assessments for drug-involved clients exiting incarceration. Leadership was studied as a moderating factor between fidelity and outcomes. Methods: A mixed-method cluster randomized design was used to randomize 21 sites to early- or delayed-start within 9 research centers. Parent study protocol was reviewed to develop fidelity constructs (i.e., responsiveness, dose, quality, adherence). Outcomes were site-level success in achieving goals and objectives completed during the OPII (e.g., percent goals achieved). Correlations, analyses of covariance, regressions and moderation analyses were performed. Qualitative interviews assessed facilitators/barriers to implementation. Results: Fidelity constructs related to outcomes. No differences were found in fidelity by early or delayed condition. At low levels of leadership, high staff responsiveness (i.e., engagement in the OPII) related to poorer outcome. Conclusions: It is important to consider contextual factors (e.g., leadership) that may influence implementation strategy fidelity when deploying evidence-based practices. Findings are relevant to researchers, clinicians, administrators and policy makers, and suggest that goal completion during implementation of evidence-based practices requires monitoring of leadership competence, fidelity to implementation strategies (i.e., staff responsiveness to strategies) and attendance to goal importance.


Assuntos
Prática Clínica Baseada em Evidências , Humanos , Prisioneiros , Transtornos Relacionados ao Uso de Substâncias , Liderança
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