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Background By 2050, the global demand for orthotic and prosthetic services is expected to double. Unfortunately, the orthotic/prosthetic workforce is not well placed to meet this growing demand. Strengthening the regulation of orthotist/prosthetists will be key to meeting future workforce demands, however little is known about the extent of orthotist/prosthetist regulation nor the mechanisms through which regulation could best be strengthened. Fortunately, a number of allied health professions have international-level regulatory support that may serve as a model to strengthen regulation of the orthotic/prosthetic profession. The aims of this study were to describe the national-level regulation of orthotist/prosthetists globally, and the international-level regulatory support provided to allied health professions. Method Two environmental scans benchmarked the national-level regulation of the orthotist/prosthetist workforce, and the regulatory support provided by international allied health professional bodies using a set of nine core practitioner standards (core standards) including: Minimum Training/Education, Entry-level Competency Standards, Scope of Practice, Code of Conduct and/or Ethics, Course Accreditation, Continuing Professional Development, Language Standard, Recency of Practice, and Return-to-Practice. Each identified country was categorised by income status (i.e. High-, Upper-Middle-, Lower-Middle-, and Low-Income countries). Results Some degree of regulation of the orthotist/prosthetist workforce was identified in 30 (15%) of the world’s 197 countries. All core standards were present in 6 of these countries. Countries of higher economic status had more core standards in place than countries of lower economic status. International-level professional bodies were identified for 14 of 20 allied health professions. International bodies for the physical therapy (8 core standards) and occupational therapy (5 core standards) professions provided regulatory support to help national associations meet most of the core standards. Conclusion Given the small proportion of countries that have national practitioner regulatory standards in place, most orthotist/prosthetists are working under little-to-no regulation. This presents an opportunity to develop rigorous national-level regulation that can support workforce growth to meet future workforce demands. Given the financial and expertise barriers that hinder the development of a more regulated orthotist/prosthetist workforce, particularly for Low- and Lower-Middle-Income countries, we recommend the establishment of an international professional body with the express purpose to support national-level regulation of orthotist/prosthetists, and thereby build the regulatory capacity of national orthotic/prosthetic associations.

OBJECTIVES: Presenting the Belgian new framework for Advanced Practice Nursing (APN) - 'Verpleegkundig Specialist [VS]'/"Infirmier de pratique avancée [IPA]" outlined in the Law of 22 April 2019, followed by a discussion of the lack of clarity, the current challenges and future opportunities. METHODS: The framework was analyzed by an expert in healthcare legislation and discussed by academics in Nursing Science and members of the board of directors of the Belgian Society of APN. RESULTS: Relevant paragraphs within this new law are"Article 46 §1. No one is allowed to carry the title of 'VS/IPA' who does not possess a bachelor in nursing mentioned in article 45 and who does not meet the requirements specified in this article. At the minimum, a master's degree in Nursing Sciences is also required. §2. Additional to the scope of practice of nursing as mentioned in article 46, the 'VS/IPA' perform, in the context of complex nursing care, medical interventions in order to maintain, improve or restore the health of the patient. Care is provided in the context of a specific target group of patients and in close concertation with the physician and potential other healthcare professionals. CONCLUSION: Although the legal recognition of the title of VS/IPA is a major breakthrough that will innovate healthcare, clarification is needed: How do VS/IPA distinguish themselves from other nursing functions, what is complex nursing care, which medical interventions can be performed, what is meant by specific target group of patients, what does 'in close concertation with the physician' entail, and will advisory power be possible? ispartof: ACTA CLINICA BELGICA vol:77 issue:1 pages:65-70 ispartof: location:England status: published

Background Collaborative medication review (CMR) practices for older adults are evolving in many countries. Development has been under way in Finland for over a decade, but no inventory of evolved practices has been conducted. The aim of this study was to identify and describe CMR practices in Finland after 10 years of developement. Methods An inventory of CMR practices was conducted using a snowballing approach and an open call in the Finnish Medicines Agency’s website in 2015. Data were quantitatively analysed using descriptive statistics and qualitatively by inductive thematic content analysis. Clyne et al’s medication review typology was applied for evaluating comprehensiveness of the practices. Results In total, 43 practices were identified, of which 22 (51%) were designed for older adults in primary care. The majority (n = 30, 70%) of the practices were clinical CMRs, with 18 (42%) of them being in routine use. A checklist with criteria was used in 19 (44%) of the practices to identify patients with polypharmacy (n = 6), falls (n = 5), and renal dysfunction (n = 5) as the most common criteria for CMR. Patients were involved in 32 (74%) of the practices, mostly as a source of information via interview (n = 27, 63%). A medication care plan was discussed with the patient in 17 practices (40%), and it was established systematically as usual care to all or selected patient groups in 11 (26%) of the practices. All or selected patients’ medication lists were reconciled in 15 practices (35%). Nearly half of the practices (n = 19, 44%) lacked explicit methods for following up effects of medication changes. When reported, the effects were followed up as a routine control (n = 9, 21%) or in a follow-up appointment (n = 6, 14%). Conclusions Different MRs in varying settings were available and in routine use, the majority being comprehensive CMRs designed for primary outpatient care and for older adults. Even though practices might benefit from national standardization, flexibility in their customization according to context, medical and patient needs, and available resources is important.

Institutional entrepreneurship research has described and conceptualized dramatic cases of successful institutional change. We know less about whether it can help people trying to change institutions, for example, struggling to change the energy system. Do concepts from the institutional entrepreneurship literature offer sustainable energy practitioners insights on the political aspects of their work? And vice-versa: do practitioners have useful insights on the potential and limits of agency in institutional change? The present study contributes to these questions through collaborative inquiry together with government-affiliated organizations with a mission to promote sustainable energy. The results suggest that concepts from the institutional entrepreneurship literature do serve to make practitioners' implicit competencies explicit and hence a legitimate subject for organizational development and joint learning about the political aspects of energy systems change. We conclude that institutional entrepreneurship appears to require a form of organizing that combines environmental scanning, grand strategy and everyday tactical moves on the ground. peerReviewed

Purpose This paper aims to investigate the conceptualisation of corporate communication management (CCM) and its dimensionality from the practitioners’ perspectives. It proposes to validate an operational definition and dimensions of the CCM construct, which have not been identified in the literature. Design/methodology/approach The initial concepts are based on academic literature and followed by 12 face-to-face interviews with corporate communication practitioners and consultants from Malaysia to confirm the practicality of each dimension. QSR Nvivo Version 9.0 software is used to analyse the qualitative data. Then, the data are classified through deductive content analysis based on key words or themes. Findings The diverse perspectives are shown from the practitioners and consultants on the dimensionality of CCM. Most of the interviewees suggest that CCM dimensions include corporate advertising, corporate affairs, investor relations and employee communication within the corporate communication and other departments. They also found the public relations and media relations are clearly under corporate communications manager’s supervision. This research confirms the concept of CCM and its dimensionality to operationalise the CCM construct. The CCM dimensions also offer opportunities for further research to develop the measurement scales. Originality/value This research contributes to the clarification on the subject matter by developing clear concepts of the CCM and by offering insights about the role of the CCM dimensions, which help managers to more successfully incorporate the CCM dimension into the corporate management strategy. This paper also examines the concept of CCM and confirms its dimensionality, which helps in developing the CCM measurement for further quantitative research.

Background: Constant appraisal of healthcare workforce trends is vital; this measure determines the adequacy of the workforce in meeting its society’s healthcare demands. This includes determining the number of the incoming workforce (students, interns) and the active or practising workforce relevant registries. Objective: This study aimed to examine patterns of workforce growth in the medical technology profession (students, interns and practitioners) from 2008 to 2018 in South Africa. Methods: Student, intern and practitioner medical technology registries, from the 2012/2013, 2016/2017 and 2017/2018 Health Professions Council of South Africa (HPCSA) annual reports, were analysed. The number of National Health Laboratory Service and private laboratory posts were secured from the National Health Laboratory Service plan performance report. A comparison between the total number of South African medical technology (private and public) posts occupied versus the HPCSA practitioner 2016 register was completed, to determine the saturation status. Results: Annual student, intern, and practitioner registries indicated a mean growth of 6.8%, 28.9%, and 0.7% from 2008 to 2018. The transition of interns to practitioners is progressively dwindling (2015–2018). The practitioner register showed a 1.2% decline in registration from 2013 until 2018. In 2016, only 55.9% of the HPCSA registered medical technologists were employed (p 0.001). Conclusion: There are more medical technologists than available public and private sector posts. The progressively growing student register compared to the dwindling practitioner register indicates attrition in the profession. An investigation identifying the reasons why graduates neglect to register as practising medical technologists should be undertaken.

While social vulnerability in the face of disasters has received increasing academic attention, relatively little is known about the extent to which that knowledge is reflected in practice by institutions involved in disaster management. This study charts the practitioners' approaches to disaster vulnerability in eight European countries: Belgium; Estonia; Finland; Germany; Hungary; Italy; Norway; and Sweden. It draws on a comparative document analysis and 95 interviews with disaster managers and reveals significant differences across countries in terms of the ontology of vulnerability, its sources, reduction strategies, and the allocation of related duties. To advance the debate and provide conceptual clarity, we put forward a heuristic model to facilitate different understandings of vulnerability along the dimensions of human agency and technological structures as well as social support through private relations and state actors. This could guide risk analysis of and planning for major hazards and could be adapted further to particular types of disasters.وفي حين أنه قد حظي الضعف الاجتماعي في موجهة الكوارث باهتمام أكاديمي متزايد، لا يعرف سوى القليل نسبيًا عن مدى انعكاس تلك المعرفة في الممارسة العملية من جانب المؤسسات المشاركة في إدارة الكوارث. نرسم في هذه الدراسة نهج الممارسين للتعرض للكوارث في ثمانية بلدان أوروبية: المانيا، إيطاليا، بلجيكا، المجر، السويد، النرويج، فنلندا، واستونيا. وتستند الدراسة إلى تحليل مقارن للوثائق و 95 مقابلة مع مديري الكوارث وتكشف عن اختلافات كبيرة بين البلدان من حيث علم الضعف ومصادرة واسستراتيجيات الحد منه وتخصيص المهام ذات الصلة. ولتقدم النقاش وتوفير الوضوح المفاهيمي، طرحنا نموذجا للتوضيح لمختلف مفاهيم الضعف على طول ابعاد الوكالة البشرية والهياكل التكنولوجية فضلاً عن الدعم الاجتماعي من خلال العلاقات الخاصة والجهات الفاعلة. الكلمات الدليلية: التحليل المشترك بين الثقافات، إدارة الكوارث، الضعف، تقييم الضعف.虽然学术界越来越多人开始关注社会面对灾害时的脆弱性，但很少人了解灾害管理机构的实践中反映了多少相关知识。在这项研究中，我们列出了八个欧洲国家应对灾害脆弱性的方法：德国、意大利、比利时、匈牙利、瑞典、挪威、芬兰和爱沙尼亚。该研究通过文件比较分析，并借鉴95次灾害管理人员的访谈，揭示了各国在脆弱性、脆弱性的来源、应对战略和相关职责分配方面的显着差异。为了推进辩论并提供清晰概念，我们提出了一个模型，用于解释由人的想法不同、技术结构不同、以及个人和国家的社会支持不同等造成的对脆弱性的不同理解。 关键词：跨文化分析、灾害管理、脆弱性、脆弱性评估.

BMJ open 11(6), e046160 (2021). doi:10.1136/bmjopen-2020-046160, Published by BMJ Publishing Group, London

Background and purpose Few empirical studies have focused on what quality management practitioners actually do, with even fewer studies focusing on what it actually takes to do quality management work, i.e. the competencies of quality management. The purpose of this paper is to introduce a competence-based terminology for describing general competencies of quality management work in organisations and to create a competence framework in order to understand what is needed to be a quality management practitioner. Design/methodology/approach This paper is based on an embedded, qualitative multiple-case study design incorporating four Swedish large size organisations where designated quality management practitioners (n= 33) were selected and interviewed. Findings A quality management competence framework incorporating four main quality management competence dimensions is presented: the human, the methods & process, the conceptual and the contextual competence dimensions. Four generic quality management role responsibilities are also posited: centralised & strategic, centralised & operational, local & strategic and local & operational role responsibilities. The competencies and role responsibilities are discussed in relation to the notion of emergent quality management and the emerging need of more integrative and business excellence-oriented quality management.

Improving land tenure security (LTS) is a significant challenge for sustainable development. The Sustainable Development Goals and other recent global initiatives have renewed and increased the need to improve LTS to address climate change, biodiversity loss, food security, poverty reduction, and other challenges. At the same time, policymakers are increasingly interested in evidence‐based policies and decisions, creating urgency for practitioners and researchers to work together. Yet, incongruent characterizations of LTS (identifying the key components of LTS) by practitioners and researchers can limit collaboration and information flows necessary for research and effective policymaking. While there are systematic reviews of how LTS is characterized in the academic literature, no prior study has assessed how practitioners characterize LTS. We address this gap using data from 54 interviews of land tenure practitioners working in 10 countries of global importance for biodiversity and climate change mitigation. Practitioners characterize LTS as complex and multifaceted, and a majority of practitioners refer to de jure terms (e.g., titling) when characterizing it. Notably, in our data just one practitioner characterized LTS in terms of perceptions of the landholder, contrasting the recent emphasis in the academic literature on landholder perceptions in LTS characterizations. Researchers should be aware of incongruence in how LTS is characterized in the academic literature when engaging practitioners.

This study explores the tensions inherent in place branding consulting, by problematising the prescriptive and functionalistic view of consultants that characterises the place branding literature. If consultants’ pervasive impact on the contemporary place branding practice cannot be ignored, their fixed representation as powerful agents of top-down policies might limit more holistic accounts of consultancy practice. Indeed, consultants can find themselves mediating between bottom-up and top-down approaches to place branding. Thus, they can decide to promote more inclusive activities that give voice to local communities, while simultaneously addressing the needs of urban elites that are likely to pay the consultancy bill. Liminality is suggested as an appropriate idea to challenge role fixity and appreciate the ambiguity of place branding consultancy. The study reports self-reflective accounts from a case study on Rio de Janeiro, where the first author was involved in a three-year activity of working with stakeholders to stimulate a more inclusive public debate on city-brand management. Charting, snowballing, coopting consultants, informal advising, feeding and scientific arming are the six types of consulting practices of stakeholder engagement that the study identifies in order to offering a more nuanced representation of place brand consulting.

Simple Summary The increasing implementation of technological advances originally developed for video gaming (PlayStation, Xbox) is helping to progress livestock production so that it is both more efficient and more focused on the welfare of the animals. Such advances are necessary to ensure that innovations can emerge from applications using cameras, microphones and sensors to enhance the farmers’ eyes, ears and nose in everyday farming. This technology for remote monitoring of livestock, termed precision livestock farming, is the ability to automatically track individual livestock in real time. The goal of this review is to apprise swine veterinarians and their clientele on precision livestock farming with a general introduction to the technology available, a review of research and commercially available technology and the implications and opportunities for swine practitioners and farmers. Drawing from pig welfare criteria in the Common Swine Industry Audit, this review explains how these applications can be used to improve swine welfare within current pork production stakeholder expectations. Swine veterinarians and specialists, by virtue of their animal advocacy role, interpretation of benchmarking data, and stewardship in regulatory and commodity programs, can play a broader role in facilitating the transfer of precision livestock farming and technology to their clients. Abstract The burgeoning research and applications of technological advances are launching the development of precision livestock farming. Through sensors (cameras, microphones and accelerometers), images, sounds and movements are combined with algorithms to non-invasively monitor animals to detect their welfare and predict productivity. In turn, this remote monitoring of livestock can provide quantitative and early alerts to situations of poor welfare requiring the stockperson’s attention. While swine practitioners’ skills include translation of pig data entry into pig health and well-being indices, many do not yet have enough familiarity to advise their clients on the adoption of precision livestock farming practices. This review, intended for swine veterinarians and specialists, (1) includes an introduction to algorithms and machine learning, (2) summarizes current literature on relevant sensors and sensor network systems, and drawing from industry pig welfare audit criteria, (3) explains how these applications can be used to improve swine welfare and meet current pork production stakeholder expectations. Swine practitioners, by virtue of their animal and client advocacy roles, interpretation of benchmarking data, and stewardship in regulatory and traceability programs, can play a broader role as advisors in the transfer of precision livestock farming technology, and its implications to their clients.

Background To ascertain whether person centred coordinated care (P3C) is being delivered in healthcare services, components relating to the construct need to be measured. Patient reported measures (PRMs) can be used to provide a measurement of patients’ experiences of P3C. Traditionally, they have been used to assess whether interventions are delivering P3C. Recently there has been an increased interest in using them to directly enhance P3C in clinical practice by, for example, improving practitioner-patient communication. However, there is limited research available on how P3C can be implemented in practice. This study aimed to extend this literature base by exploring how professionals use PRMs to enhance P3C. Methods Cross sectional thematic analysis of 26 semi-structured interviews with a variety of professionals who have experience of how PRMs can be used to make improvements to P3C. Inductive themes were mapped onto components of P3C care that fell under five established domains of P3C (Information and Communication; My Goals/Outcomes; Decision making; Care Planning and Transitions) to explore whether and how individual components of P3C were being improved through PRMs. Barriers and facilitators that affected the delivery and the results of the PRMs were also identified. Results Three P3C domains (Information and Communication, My Goals/Outcomes and Care Planning) were mapped frequently onto themes generated by the participants’ interviews about PRM use. However, the domain ‘Decision Making’ was only mapped onto one theme and ‘Transitions’ was not mapped at all. Participant reports suggested that PRM use by practitioners enhanced patients’ ability to self-manage, communicate, engage and reflect during consultations. Barriers to PRM use were related to a lack of a whole service approach to implementation. Conclusions Practitioners use both PROMs and PREMs in various ways to improve different aspects of patient care. By sharing experiences professionals can benefit from each other’s learning and work together to extend the potential value that PRMs can offer to P3C delivery.

When managers are implementing change, practitioners are sometimes seen as the receivers of the change. However, practitioners often need to actively create the changes to daily practices because managers might not be familiar with the practices. Building information modelling (BIM), an important driver of organizational change, requires change not only by bringing new technology into use but also to the practices of collaboration between different professions. In their daily work, practitioners can create new practices through reflective learning. We have a limited understanding of how practitioners are actively involved in a change through reflective learning when implementing BIM. To address this limitation, we conducted a qualitative case study. Our primary data consist of interviews, which were analysed with insights from philosophy. We identified two methods of reflective learning from the data: deconstruction and reconstruction. Deconstruction occurs when the new requirements for the practices are ...

Biofield therapies (BTs) are increasingly employed in contemporary healthcare. In this white paper, we review specific challenges faced by biofield practitioners resulting from a lack of (1) a common scientific definition of BT; (2) common educational standards for BT training (including core competencies for clinical care); (3) collaborative team care education in complementary and alternative medicine (CAM) and in integrative health and medicine (IHM); (4) a focused agenda in BT research; and (5) standardized devices and scientifically validated mechanisms in biofield research. We present a description of BT and discuss its current status and challenges as an integrative healthcare discipline. To address the challenges cited and to enhance collaboration across disciplines, we propose (1) standardized biofield education that leads to professional licensure and (2) interprofessional education (IPE) competencies in BT training required for licensed healthcare practitioners and encouraged for other practitioners using these therapies. Lastly, we discuss opportunities for growth and a potential strategic agenda to achieve these goals. The Academy of Integrative Health and Medicine (AIHM) provides a unique forum to facilitate development of this emerging discipline, to facilitate IPE, and to further increase the availability of BT to patients.

Observational phantom study. This study aimed to evaluate the radiation exposure dose of practitioner's hands when performing C-arm guided procedures and to determine the usefulness of our newly designed radiation shielding device. C-arm guided procedures including lumbar transforaminal epidural steroid injections (TFESIs) are commonly used for pain control induced by lumbar radiculopathy. The practitioner's hands are vulnerable to radiation exposure because of the long exposure time and short distance from the radiation resource. No studies to date have reported the cumulative exposure of the physician's hands according to location and exposure time. Using a chest phantom irradiated with X-rays under lumbar TFESI conditions, cumulative scatter radiation dose was measured at 36 points using a dosimeter. The measurements were checked at 1, 3, 5, 10 minutes of radiation exposure. The experiment was repeated using our newly designed shielding device. Significant radiation accumulation was observed in the field where the practitioner's hands might be placed during C-arm guided procedures. The further the distance from the radiation resource and the shorter the exposure time, the smaller was the cumulative radiation expose dose. The new shielding device showed an excellent shielding rate (66.0%–99.9%) when the dosimeter was within the shielding range. However, at some points, increased accumulated radiation exposure dose was observed, although the dosimeter was within the range of the shielding device. To reduce radiation exposure of the practitioner's hands when performing C-arm-guided procedures, the radiation exposure time should be decreased and a greater distance from the radiation resource should be maintained. When using our shielding device, placing the hand close to the device surface and minimizing the time using fluoroscopy minimized the radiation exposure of the hand.

Business rescue proceedings attempt to rehabilitate businesses that are in financial distress. In spite of its importance, there is a seemingly low rate of success of the current business rescue regime (at just 15% as at June 2016). This article seeks to understand the issues that may be hindering the current rate of success of business rescue proceedings and provides practising accountants (in their capacity as business rescue practitioners) with a better understanding of the issues surrounding business rescue attempts. This will allow them to better perform their duties and give corporates in need of rescue a fighting chance. Through the use of qualitative interviews, the research findings show that there is a lack of clarity of the definition of success, which may be cause for concern. However, in the view of practitioners, the success rate is expected to improve with time. This study provides details on a few key insights into business rescue practices in South Africa, namely, the practitioners’ perceptions of success, their perceptions of the trust of stakeholders during the course of business rescue, their perceptions of the impact of the qualifications and experience of the business rescue practitioner, and their perceptions on the preparation of the business rescue plan.

Research and development have a strategic role in formulating and implementing the policy. Research and development is one important step in order to produce a new idea. This article has a purpose produce a picture the existence of the difference between the point of view of academics with the point of view of a practitioner in formulating and implementing the policy.This article produced based on data collection started from focus group discussion and seminar. The results of analysis from focus group discussion, strengthened by seminar-seminar both at the local, national and international.The topic of the study subjects of many times successfully identified obstacles the role of academics and analysis the role of academics and the benefit of involvement academics.A new idea produced by academics cannot always directly applied by a practitioner. Any different and gap between the results of the study with the application of policy is caused by several factors. The differences that appear among others the different the time, different conception, different audience, different motivation and different consequences. There are 3 (three) way academics in influencing policy, through policy, the policy of research and development, and education policy and training (Adam, 2014). There are 3 (three) the key to strengthen the role of academics in the formulation policy among others network, reputation, and expectations.

Purpose The purpose of this paper is to investigate the relationship between intellectual capital (IC) and sustainability using practitioners’ perspectives and by developing an analysis of comments and practices published in 1,651 blog posts in one of the leading sources of sustainability research: CSRwire.com. Design/methodology/approach A total of 1,651 posts, containing more than 1.5 million words, published by experts in the field of sustainability are analysed using Leximancer and content analysis. Findings The results reveal IC and sustainability to be complex topics under active discussion by practitioners, and several links to the IC literature are identified and compared. The findings focus on the managerial practices applied by leading companies, as discussed by practitioners, that show IC and sustainability influence each other in answering a plurality of demands or logics. Research limitations/implications First, the authors identify the need to study the managerial practices proposed by practitioners, rather than their company reports. Second, the authors propose developing a trading zone for IC researchers and practitioners. Third, the authors reflect on the role of new communication tools, such as integrated reporting, to connect IC and sustainability. Finally, the authors conclude that the relationship between IC and sustainability could benefit from a fifth stage of IC research that considers justifications of the worth of IC and sustainability practices. Originality/value The paper is novel because it addresses concerns about the relationship between IC and sustainability by examining messages posted by practitioners, rather than examining company disclosures. This leads to an understanding of the impact of practices rather than the desires motivating practice. The results support the view that it is time to remove the boundaries of IC research and work towards reconciling the worth of IC to different people in different contexts. The authors argue that practitioners require scholars to reduce the ambiguity between IC and its expected results. This would open the door to a potentially productive way of understanding IC and the complexity of economic, social, and environmental value. In short, researchers should change their research questions from, “What is IC worth to investors, customers, society, and the environment?” to “Is managing IC a worthwhile endeavour?”

This article describes few steps of the application of the modified Calgary-Cambridge Guides (CCG) to consultations in bovine medicine. A review of pertinent clinical communication skills literature in human medicine was integrated with the burgeoning research within veterinary medicine. In particular, there are more recent studies examining companion animal veterinarian’s communication skills and outcomes which can be extrapolated to practitioners. This was integrated into a teaching example of a reproductive case consultation. The first article deals with the 1) Preparation, 2) Initiating the Session and 3) Gathering Information sections. The aim of the modified CCG is to provide a set of skills to facilitate a relationship-centred approach to consultations in bovine medicine, both at the individual animal and population level. They were initially developed for human medicine and expanded recently for use in veterinary medicine. The CCG enable the practitioner to facilitate interacting with that particular client at the time of the consultation. It is likely that the majority of practitioners do use many of the skills recommended by the modified CCG. These skills are often gained through experience. However, they may not use the skills intentionally and with purpose for a specific communication goal or outcome. Practitioners can improve their communication skills using the set of skills as recommended by the modified CCG. They allow the practitioner to gain insight into the client’s understanding of the problem, including underlying aetiology, epidemiology and pathophysiology. The guides also provide opportunity to understand client’s expectations regarding the outcome, motivation and willingness to change and adherence.

A importância do indivíduo na construção, manutenção e mudança das instituições caracteriza as teorias das práticas sociais. O objetivo deste estudo é analisar o perfil e o envolvimento dos estrategistas nas práticas de responsabilidade social. Parte-se da identificação do papel, agência, experiência e características dos praticantes que atuam na certificação ambiental de empresas brasileiras. A discussão dos resultados tem como base os conceitos de responsabilidade social corporativa e da teoria da estratégia como prática. A pesquisa foi feita em duas etapas. Na primeira, de caráter qualitativo e exploratório, um estudo de caso foi realizado na empresa Suzano Papel e Celulose. Na etapa seguinte, desenvolveu-se um levantamento quantitativo em 23 empresas, que representam 41% da população de empresas certificadas. O trabalho contribui ao destacar as diferentes dimensões do perfil dos praticantes e sua relação com a coletividade de práticas e seu envolvimento com o processo de certificação. The importance of the individual in the construction, maintenance, and change of institutions characterizes Social Practice Theory. The purpose of this study is to analyze the profile and involvement of strategists in social responsibility. This begins with the identification of the role, agency, experience, and characteristics of the practitioners who operate in the environmental certification of Brazilian companies. The discussion of the results is based on the concepts of corporate social responsibility and the theory of Strategy as Practice. The study was conducted in two phases. In the first stage, consisting of a qualitative and exploratory nature, a case study was implemented at the Suzano Paper and Cellulose Company. In the second stage, a quantitative survey of 23 companies was conducted. These companies account for 41% of the population of certified companies. This study contributes to the field by highlighting the different dimensions of the profile of practitioners and their relationship with collective practices and their involvement in the certification process.

Purpose This paper examines the engagement of business practitioners with academic business research. The purpose of this paper is to assess whether there is a gap between academic research and business people, and, if so, how to bridge this gap. Design/methodology/approach Over 150 senior business practitioners were interviewed, in order to capture their views on the usefulness of academic research to them in their roles as practicing managers. Survey questions covered both their current access and reading of business-related publications and what the ideal academic business journal should be, in terms of access and contents. Findings Academic journals are not very well known among business professionals. If these professionals could choose, they would like academic journals to be written by experienced business people, to contain business cases and to be accessible on line. Existing academic business journal “repositories,” such as Google Scholar, are not mentioned in the survey results. Practical implications The findings indicate that potential solutions to bridge the gap between academic journals and business practitioners should not be complicated to implement, and would greatly help bring these two communities closer, with mutually enriching results. Originality/value This paper takes a very pragmatic view of the gap between academic journals and business practitioners, and seeks to assess this gap in terms of how it can be bridged on an everyday basis, rather than take a theoretical approach. It begs for the definition of actionable next steps.

Background Competence profiles are purposed to provide a blueprint in support to develop and/or benchmark the learning outcomes of undergraduate dental curricula. This study aims to investigate whether a competence profile as proposed by academic- and clinical experts is able to represent the real clinical reality. Methods A questionnaire was developed including questions about gender and age, perception about required competences, and educational organisation and was distributed among Flemish dentists via email and on paper during a symposium. The data was analysed using descriptive statistics, Chi-square and non-parametric Mann-Whitney U-tests. Results A total of 312 questionnaires were completed (=6.5% of dentist population, with similar gender and age characteristics). All competences in the European competence profile were rated between 7.2 and 9.4 on a 10-point scale. In dentists under 50 years, females rated the importance of identifying/managing anxiety and abnormal patient behaviour; and promoting/improving oral health as significantly higher than males. In dentists of 50 years and above, females rated 8 competences significantly higher than males, including obtaining/recording a complete history; identifying/managing anxiety and abnormal patient behaviour; obtaining/interpreting radiography; identifying temporomandibular and associated disorders; identifying orthodontic needs; awareness of own limitations/when to refer; managing dental urgencies; and basic-life-support/defibrillation. Clinical practice management was most frequently reported as additional competence to address in dental education. Furthermore, the respondents suggested an undergraduate dental curriculum based on 34% theoretical education, 26% preclinical skills training, and 40% clinical education and 86% agreed with a duration of 5 years. Finally, the respondents also illustrated the dynamic nature of dentistry including a reduction of amalgam fillings, a shift from individual practice to group practices, an increased administrative load, and more assertive patients. Conclusion Findings in the present study suggest the validation of the proposed competences for graduating European dentists within the clinical reality of dental professionals in daily practice. Nevertheless, the results have also demonstrated heterogeneity regarding gender and age within the dentist population and emphasised a continuously evolving dental profession and required competences. Hence, to maintain high quality of dental care, a strategy should be developed in which dental curricula are continuously benchmarked against an evolving clinical reality. Electronic supplementary material The online version of this article (doi:10.1186/s12903-017-0403-4) contains supplementary material, which is available to authorized users.

Background A growing body of evidence suggests that healthcare practitioners who enhance how they express empathy can improve patient health, and reduce medico-legal risk. However we do not know how consistently healthcare practitioners express adequate empathy. In this study, we addressed this gap by investigating patient rankings of practitioner empathy. Methods We conducted a systematic review and meta-analysis of studies that asked patients to rate their practitioners’ empathy using the Consultation and Relational Empathy (CARE) measure. CARE is emerging as the most common and best-validated patient rating of practitioner empathy. We searched: MEDLINE, Embase, PsycINFO, Cinahl, Science & Social Science Citation Indexes, the Cochrane Library and PubMed from database inception to March 2016. We excluded studies that did not use the CARE measure. Two reviewers independently screened titles and extracted data on average CARE scores, demographic data for patients and practitioners, and type of healthcare practitioners. Results Sixty-four independent studies within 51 publications had sufficient data to pool. The average CARE score was 40.48 (95% CI, 39.24 to 41.72). This rank s in the bottom 5th percentile in comparison with scores collected by CARE developers. Longer consultations (n = 13) scored 15% higher (42.60, 95% CI 40.66 to 44.54) than shorter (n = 9) consultations (34.93, 95% CI 32.63 to 37.24). Studies with mostly (>50%) female practitioners (n = 6) showed 16% higher empathy scores (42.77, 95% CI 38.98 to 46.56) than those with mostly (>50%) male (n = 6) practitioners (34.84, 95% CI 30.98 to 38.71). There were statistically significant (P = 0.032) differences between types of providers (allied health professionals, medical students, physicians, and traditional Chinese doctors). Allied Health Professionals (n = 6) scored the highest (45.29, 95% CI 41.38 to 49.20), and physicians (n = 39) scored the lowest (39.68, 95% CI 38.29 to 41.08). Patients in Australia, the USA, and the UK reported highest empathy ratings (>43 average CARE), with lowest scores (

Item does not contain fulltext AIMS: To examine the effects of individual video-feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care. BACKGROUND: Continuing professional education may be necessary to refresh and reflect on the communication and motivational interviewing skills of experienced primary care practice nurses. A video-feedback method was designed to improve these skills. DESIGN: Pre-test/posttest control group design. METHODS: Seventeen Dutch practice nurses and 325 patients participated between June 2010-June 2011. Nurse-patient consultations were videotaped at two moments (T0 and T1), with an interval of 3-6 months. The videotaped consultations were rated using two protocols: the Maastrichtse Anamnese en Advies Scorelijst met globale items (MAAS-global) and the Behaviour Change Counselling Index. Before the recordings, nurses were allocated to a control or video-feedback group. Nurses allocated to the video-feedback group received video-feedback between T0 and T1. Data were analysed using multilevel linear or logistic regression. RESULTS: Nurses who received video-feedback appeared to pay significantly more attention to patients' request for help, their physical examination and gave significantly more understandable information. With respect to motivational interviewing, nurses who received video-feedback appeared to pay more attention to 'agenda setting and permission seeking' during their consultations. CONCLUSION: Video-feedback is a potentially effective method to improve practice nurses' generic communication skills. Although a single video-feedback session does not seem sufficient to increase all motivational interviewing skills, significant improvement in some specific skills was found. Nurses' clinical competences were not altered after feedback due to already high standards.

A variety of terms are used to describe advanced practice nursing roles internationally. This has resulted in confusion in terminology around these roles. The aim of this concept analysis was to clarify what is meant by advanced practice nursing internationally, what attributes signify advanced practice nursing and what are its antecedents, consequences, references and related terms. Rodgers's evolutionary method of concept analysis was used. Data sources included Medline, CINAHL, Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Library, Science Direct, SCOPUS, Web of Science, Dissertation Abstracts and DARE as well as relevant nursing texts and professional organization websites. The analysis reveals that there are many different articulations of the advanced practice nursing role outlined in the literature. This variety in terminology hinders developments in advanced practice nursing roles. Consensus on advanced practice nursing definitions, terminology, educational requirements and regulatory approaches is integral to the implementation of the advanced practice nursing role internationally. peer-reviewed

Sleep is a restorative circadian process underpinned by numerous interrelated biological processes (Brown et al., 2012; Goel et al., 2013; Zeitzer, 2013; Vyazovskiy and Delogu, 2014). Specifically, biological rhythms in core temperature, blood pressure, immune function as well as melatonin, and other hormones demonstrate an intricate relationship with sleep (Zisapel, 2007). Therefore, whilst sufficient sleep [7–9 h is recommended by the National Sleep Foundation (NSF) for adults (Hirshkowitz et al., 2015)] facilitates an optimal internal temporal order, an increased risk of poor quality of life, morbidity, and mortality (Zisapel, 2007) are seen with insufficient sleep (

At present interest in building HVAC (Heating, Ventilating and Air Conditioning) systems based on a desiccant wheel is increasing, due to the possibility of realizing high-energy-efficiency systems and of integrating renewable energy sources. The design of air handling units based on this technology is quite complex because of the difficulties in predicting the performance of the desiccant wheel, which is the crucial component of the system. In fact, desiccant wheel performance strongly depends on inlet airflow conditions and on the revolution speed. As a consequence, in HVAC systems, practitioners and engineers mainly prefer to adopt conventional cooling and heating coils, which are well-known components. In this context, the purpose of this chapter is to review and analyse the main simplified models available in literature to calculate desiccant wheels performance. Such correlations can be easily used in worksheets or in energy simulation programs, being a useful tool to compare desiccant wheel-based HVAC systems with conventional configurations.

Schools have also traditionally relied on established filmmakers … passing on their skills, knowledge and insights to the up-and-coming generations as visiting tutors. … [T]his ensured continuity and tradition, within and beyond specific national cinemas. (Petrie and Stoneman 4). However, many institutions cannot completely demystify the workings of the industry, given the variety of courses on offer and their short duration. As a result, in some situations additional specialised or technical training by employers for those entering employment is required (House of Lords 1: 71). Students within a closed learning environment during their film education may struggle to gain a genuine sense of the realities of film production, such as a working hierarchy or the diverse technical and even managerial skillsets required professionally.

Patient delay is the interval between the day someone first becomes aware of an unexplained symptom and the day they seek medical consultation. This pre-diagnostic period is comprised of several stages which may involve delay on the part of the individual. This study investigated factors influencing the process of detecting cancer symptoms and consulting a general practitioner (GP). Twenty-three patients were interviewed about their experiences during this process. Among factors stimulating the process of detection and consultation were associating symptoms with cancer, and discussing symptoms with others. Being ashamed or embarrassed about the symptoms and attributing symptoms to common ailments were among the impeding factors. The findings of the present study suggest that future health education on early detection of cancer should focus on increasing knowledge and providing positive information about early detection of cancer. It is recommended that educational materials be disseminated to the general public via more channels, including non-medical channels.

After the involvement of the audit profession in several financial scandals, the international body of the profession, International Federation of Accountants – IFAC, has developed and published a conceptual framework and reviewed most of the reference standards in auditing to provide references regarding the responsibility of the professionals and the extent of their missions. Thus was established the use of a general term for professionals, the “practitioner”, in the context of specific missions using the “auditor”, “practitioner” or “accountant”. On the other hand, have been revised professional standards establish insurance missions and non-insurance operations, with their specific missions that do not provide insurance, including the recoding. The use of these references by audit professionals constitutes one of the “keys” to their success.

Background: chronicity amongst musculoskeletal patients remains a considerable burden and predicting outcomes in these patients has proven difficult. Although a large number of studies have investigated a range of predictors of outcome few have looked at the practitioners’ ability to discern those that improve from those most likely to fail to improve. This study aimed to investigate the ability of chiropractors to predict patient outcomes.Methods: prediction and outcome data were collected from 440 consecutive patients with back, neck or shoulder pain accepted for chiropractic care within 5 linked private practices.Predictions by chiropractors were compared to patient outcomes as measured by Bournemouth Questionnaire (BQ) scores, pain NRS scores and patient global impression of change (PGIC) collected at 4 and 12 weeks following the initial consultation.Results: overall, chiropractors appear unable to accurately predict poor outcomes in their patients particularly in the longer term. Although some conditions (neck) faired a little better in some cases with some trends in short term pain scores being associated with the clinicians prediction, this was marginal. Subgrouping by practitioners or duration did not improve the performance of these predictionsConclusions: chiropractors generally fail to reliably predict poor treatment outcome of patients at initial consultation.

Objectives: 1) To determine the WHO Prescribing Core Drug Use (PCDU) indicators in the management of acute fever (of less than 2 weeks duration) of the MBBS (allopathic) and BAMS (ayurvedic) General Practitioners (GPs) in Pune city. 2) To verify the appropriateness of the treatment. and 3) To compare the above parameters of the MBBS and the BAMS practitioners. Methods: Pune city was divided in five zones, north, south, east, west and central. A list of doctors was obtained from the Indian Medical Association and it was divided zone wise. 2 MBBS and 2 BAMS GPs. were selected per zone. An informed consent was obtained from the GPs. The sample size was 20 encounters per GP. The patients of all ages and both sexes, who suffered from fever of less than 2 weeks duration, were included in the study. The indicators which were studied were 1) the WHO Prescribing Core Drug Use indicators and 2) the complimentary drug use indicators for the appropriateness of the treatment. Results: 1) The age, sex and diagnosis wise distribution of the patients was comparable in both the groups. 2) Among the WHO PCDU indicators, a highly significant difference was observed in the average number of drugs which was prescribed, the antibiotic usage and in the injections which were prescribed among the MBBS and the BAMS GPs 3) The use of the drugs from EDL and that of the generic drugs were comparable in both the groups.4) A marked irrationality was found in the injectable antimicrobials by the BAMS GPs.5) The selection of the antimicrobials was inappropriate in 64.14% and 17.5% of the encounters which were made by the BAMS and the MBBS GPs respectively. Conclusion: Among the BAMS GPs: the WHO prescribing core drug use indicators were all significantly abnormal and the percentage of the inappropriate prescriptions was alarmingly high (92%). Among the MBBS GPs: There was more use of the antimicrobials but the proportion of the inappropriate prescriptions was less (42%).

peer-reviewed Twelve years ago a group of practitioners and researchers came together to try to solve problems relating specifically to Global Software Engineering (GSE) practice. This paper aims to assess whether the many hundreds of GSE research papers written over this period have had an impact on practice. We conducted semi-structured interviews with senior managers and project managers from ten companies, four of which are large multinationals (three in Fortune 100); four are medium sized enterprises, and two are small startups. GSE research is perceived as useful by industry with all participants stating that studying the subject would improve GSE performance; but all were unanimous in saying they did not read articles on GSE. Practitioners go to books, blogs, colleagues, forums, experience reports of 1-2 pages in length, or depend on their own experience to solve problems in GSE. Controversially, many didn’t see GSE as separate from general project management. Practitioners don’t want frameworks; they want patterns of context specific help. While dissemination techniques need to be improved, that is not sufficient. Experience-based advice is just as important.

Background NICE guidelines emphasise the need for a confident, early diagnosis of Chronic Fatigue Syndrome/ Myalgic Encephalitis (CFS/ME) in Primary Care with management tailored to the needs of the patient. Research suggests that GPs are reluctant to make the diagnosis and resources for management are currently inadequate. This study aimed to develop resources for practitioners and patients to support the diagnosis and management of CFS/ME in primary care. Methods Semi structured interviews were conducted with patients, carers, GPs, practice nurses and CFS/ME specialists in North West England. All interviews were audio recorded, transcribed and analysed qualitatively using open explorative thematic coding. Two patient involvement groups were consulted at each stage of the development of resources to ensure that the resources reflect everyday issues faced by people living with CFS/ME. Results Patients and carers stressed the importance of recognising CFS/ME as a legitimate condition, and the need to be believed by health care professionals. GPs and practice nurses stated that they do not always have the knowledge or skills to diagnose and manage the condition. They expressed a preference for an online training package. For patients, information on getting the most out of a consultation and the role of carers was thought to be important. Patients did not want to be overloaded with information at diagnosis, and suggested information should be given in steps. A DVD was suggested, to enable information sharing with carers and family, and also for those whose symptoms act as a barrier to reading. Conclusion Rather than use a top-down approach to the development of training for health care practitioners and information for patients and carers, we have used data from key stakeholders to develop a patient DVD, patient leaflets to guide symptom management and a modular e-learning resource which should equip GPs to diagnose and manage CFS/ME effectively, meet NICE guidelines and give patients acceptable, evidence-based information.

Objective The objectives of this study were to identify nutrition communication styles of Dutch GPs, their strategies regarding nutrition communication and nutrition information seeking behaviours. Another aim is to provide a hypothetical model for nutrition communication style, including psycho-social and socio-demographic variables. Methods Nine focus groups with 81 GPs were used to obtain GPs’ perceptions of nutrition communication. Data were analysed with the computer software program NUD*IST. Results Five nutrition communication styles were identified, namely informational, reference, motivational, confrontational and holistic style. Referring to a dietician, providing advice according to Dietary Guidelines, and offering written education materials were mentioned as strategies regarding nutrition communication. GPs sought nutrition information in scientific studies, specialist literature, and postgraduate training courses. Conclusion The informational style of nutrition communication was dominant among Dutch GPs. GPs hardly provided maintenance advice for nutrition behaviour. Many GPs referred patients to dieticians, who were viewed as colleagues. GPs tried to get basic information about nutrition by scanning the literature, but they were seldom actively involved in seeking specific nutrition information. Although GPs felt that patients expect expert nutrition information, they perceived their nutrition knowledge as restricted. Practice implications We advise to raise self-efficacy of GPs regarding nutrition communication and to build good collaboration with dieticians.

2004 In the past 20 years, the popularity of natural medicine has increased, with nurses and medical practitioners being amongst several groups of clinicians expressing a widespread interest in natural therapies. It is argued that the degree of natural therapy use and the attitudes of these practitioners toward natural medicine may not only influence patient exposure to these therapies, but also have some bearing on the future use of natural medicine. Hence, in a critical review of recent studies, the utilisation of natural therapies and the attitudes of nurses, medical practitioners and the public toward natural medicine are explored.

Communication behavior of programmers plays an essential role in success of software development. Computer-mediated communication (CMC) system, such as e-mail, or the World Wide Web (WWW), have substantial implications for coordinating work of programmers. Yet, no studies have dealt systematically with CMC behaviors of programmers. Drawing upon theories in organizational studies, information science, computer-mediated communication and software engineering, this research examines what programmers accomplish through CMC systems. Data were gathered from survey questionnaires mailed to 730 programmers, who are members of the Association of Computing Machinery (ACM) and are involved in a variety of programming work. Based on factor analysis, the study found that programmers use CMC systems (1) to achieve progress in work-related tasks (i.e., task-related purposes), (2) to satisfy their social and emotional needs (i.e., socio-emotional purposes), and (3) to explore for information (i.e., exploring purposes). The findings of this research extend an insight into important patterns for which programmers use CMC systems. This insight has advanced theories of computer-mediated communication in the context of computer programmers. Also, practitioners, especially in software development, may use the results as guidelines in fostering a firm’s feasible network policy that fits with what their programming staff accomplish through computer-mediated communication.

This paper explores the experiences of four nurse practitioners specialised in diabetes care, in the development and implementation of two Dutch nurse-led shared care projects to improve quality of care. The focus is on the impeding factors involved. The nurses' views are compared to those of the 38 participating physicians by using instruments of qualitative research. Both nurses and physicians consider the way shared care delivery has been structured as the most impeding factor, particularly downward substitution of care from doctor to nurse. In the end, lessons are drawn for nurses, doctors and managers, to solve the assessed impediments to shared care.

Whether a student, a retiree or in professional practice, today one confronts many situations where it would be helpful to have a particular way of sifting through issues to determine appropriate courses of action. Gordon Preece (2002) writing on a recent topical issue put it this way: 'The womb is like an ethical war-zone. Embryonic stem-cell research, deaf lesbians choosing deaf-babies, IVF embryos chosen and conceived to save existing children, single and lesbian women accessing IVF. Hardly a day goes by without a new ethical dilemma. The pace of technological change and precedent makes it almost impossible to keep up. ' This paper gives the background that gave rise to this technique, the process itself, and then makes use of exemplary scenarios to illustrate how the procedure can be useful to practitioners. One scenario illustrates the approach, while a second illustrates the value in designing appropriate scenarios. The paper ends with suggestions of how the technique, first used in a student context, can be extended to suit professionals from different disciplines as multi-disciplinary teams engage in activities such as building websites.

This paper reports on knowledge and behavior among Dutch adults ( n =1530) regarding early detection of cancer (passive detection, active detection and help-seeking behavior). Written questionnaires assessed knowledge of detection methods and cancer symptoms, symptom recognition, detection behaviors, and help-seeking behaviors. Respondents did not have much general knowledge of detection methods and cancer symptoms, but recognized most cancer symptoms. More women than men paid attention to cancer symptoms. For most symptoms, medical help would be sought within the appropriate time by the majority of the respondents. Principal component analyses revealed relations between symptoms pertaining to the ‘interior' body and those pertaining to the ‘exterior' body. Correlations between symptom recognition, detection behavior and help-seeking behavior were low. Differences in demographic groups and differences in knowledge and behavior require adaptation of future health education on early detection of cancer to different groups.