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Difficult Situation (difficult + situation)
Selected AbstractsAL01 SURGICAL AUDIT IN DIFFICULT SITUATIONSANZ JOURNAL OF SURGERY, Issue 2009A. J. Green Approved peer reviewed surgical audit activity is a necessary for annual and Triannual Professional Standards requirements. Surgeons working in large hospitals, usually as part of surgical teams have resources to facilitate this. There are situations where the surgeon or surgeons need to organise a process themselves and may need more assistance. Three problem areas that will be particularly discussed include: 1Audit for remote surgeons 2Audit for urban/suburban surgeons with no teaching hospital attachments (often in smaller private facilities with no audit programs) 3Regional surgeons particularly in the Specialities eg ENT, Urology, Plastics where there are small numbers (1,3) Practical ways to achieve successful audits will be addressed [source] Receiving power through confirmation: the meaning of close relatives for people who have been critically illJOURNAL OF ADVANCED NURSING, Issue 6 2007Åsa Engström Abstract Title.,Receiving power through confirmation: the meaning of close relatives for people who have been critically ill Aim., This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit. Background., Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation. Method., A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur. Findings., One major theme was identified, experiencing confirmation, with six sub-themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will-power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them. Conclusion., Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff. [source] Numerical simulation of the microscale impregnation in commingled thermoplastic composite yarnsADVANCES IN POLYMER TECHNOLOGY, Issue 2 2010R. Gennaro Abstract The impregnation of a glass woven fabric with an amorphous polyethylene terephthalate copolymer (PET- g) matrix was investigated using a finite element (FE) model for interbundle and intrabundle flow of the matrix. Micrographs of samples obtained by film stacking of PET- g to impregnate the glass fabric have confirmed the occurrence of interbundle and intrabundle flow, taking place as separate steps. On the basis of this evidence, two different mechanisms for the fiber impregnation were postulated. The first flow process is associated with a macroscale interbundle impregnation, whereas the second is associated with microscale intrabundle impregnation. Two different FE models were developed to simulate the microscopic and macroscopic flow of the matrix, considering a large number of different random fiber arrangements. Both models could account for the non-Newtonian rheological behavior of the thermoplastic matrix. The microscale impregnation of fibers was simulated by using randomly spaced and nonoverlapping unidirectional filaments. The effect of the number of filaments and the number of random distributions necessary to achieve an adequate accuracy of the method was assessed. The results obtained from the simulation showed that at low pressures, the polymer melt exhibits Newtonian behavior, which makes it possible to predict the tow permeability by the Darcy law. A more difficult situation arises at high pressures because of the non-Newtonian behavior of the melt. This requires the introduction of a value for the permeability that is also dependent on the rheological properties of the melt. The same non-Newtonian behavior of the matrix was observed for macroscale impregnation of bundles. © 2010 Wiley Periodicals, Inc. Adv Polym Techn 29:122,130, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20179 [source] JUST SAY NO TO WALL STREET: PUTTING A STOP TO THE EARNINGS GAMEJOURNAL OF APPLIED CORPORATE FINANCE, Issue 4 2002Joseph Fuller CEOs are in a bind with Wall Street. Managers up and down the hierarchy work hard at putting together plans and budgets for the next year only to discover that the bottom line falls far short of Wall Street's expectations. CEOs and CFOs are therefore left in a difficult situation; they can stretch to try to meet Wall Street's projections or prepare to suffer the consequences if they fail. All too often, top managers react by suggesting or even mandating that middle- and lower-level managers redo their forecasts and budgets to get them in line with external expectations. In some cases, managers simply acquiesce to increasingly unrealistic analyst forecasts and adopt them as the basis for setting organizational goals and developing internal budgets. But either approach sets up the firm and its managers for failure if external expectations are impossible to meet. Using the recent experiences of Enron and Nortel, the authors illustrate the dangers of conforming to market pressures for unrealistic growth targets. They emphasize that an overvalued stock, by encouraging overpriced acquisitions and other value-destroying forms of overinvestment, can be as damaging to the long-run health of a company as an undervalued stock. Ending the "expectations game" requires that CEOs reclaim the initiative in setting expectations and forecasts so that stocks can trade at close to their intrinsic value. Managers must make their organizations more transparent to investors; they must promise only those results they have a legitimate prospect of delivering and be willing to inform the market when they believe their stock to be overvalued. [source] Active labour market policy in East GermanyTHE ECONOMICS OF TRANSITION, Issue 4 2009Waiting for the economy to take off Matching estimation; causal effects; programme evaluation; panel data Abstract We investigate the effects of the most important East German active labour market programmes on the labour market outcomes of their participants. The analysis is based on a large and informative individual database derived from administrative data sources. Using matching methods, we find that over a horizon of 2.5 years after the start of the programmes, they fail to increase the employment chances of their participants in the regular labour market. However, the programmes may have other effects for their participants that may be considered important in the especially difficult situation experienced in the East German labour market. [source] What changes in ,parenting' approaches occur over the course of adolescent foster care placements?CHILD & FAMILY SOCIAL WORK, Issue 4 2004Jo Lipscombe ABSTRACT An overview of the parenting skills and strategies utilized by foster carers looking after adolescents was given in an earlier paper. This paper focuses specifically on the relationship between the behaviour of fostered adolescents and the quality of parenting provided by the carer. In particular, the paper considers the consequences of situations in which fostered young people have a detrimental impact on other children within the foster family, as this was an especially difficult situation for foster carers to manage. Similarly, foster carers appeared to find it difficult to maintain good parenting skills with young people who were at risk due to their own sexual behaviour although, conversely, caring for a young person whose sexual behaviour put others at risk was connected with improved parenting. The quality of parenting provided by the foster carers was also influenced by the level of stress they were experiencing, with increased levels of stress leading to poorer parenting of the fostered adolescent. [source] ,Right' way to ,do' illness?INTERNAL MEDICINE JOURNAL, Issue 10 2006Thinking critically about positive thinking Abstract Exhortations to ,be positive' accompany many situations in life, either as a general injunction or in difficult situations where people are facing pressure or adversity. It is particularly evident in health care, where positive thinking has become an aspect of the way people are expected to ,do' illness in developed society. Positive thinking is framed both as a moral injunction and as a central belief system. It is thought to help patients cope emotionally with illness and to provide a biological benefit. Yet, the meanings, expectations and outcomes of positive thinking are infrequently questioned and the risks of positive thinking are rarely examined. We outline some of the latter and suggest that health professionals should exercise caution in both ,prescribing' positive thinking and in responding to patients and carers whose belief systems and feelings of obligation rest on it. [source] Opening up: psychiatric nurses' experiences of participating in reflection groups focusing on the use of coercionJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2005B. OLOFSSON rn phd Psychiatric staff report that the use of coercion towards patients in psychiatric care engenders feelings of discomfort and conflicts. The aim of this study was to describe psychiatric nurses' experiences of participating in reflection groups focused on the use of coercion, in relation to their views regarding systematic clinical supervision and staff support. Twenty-one nurses who had participated in reflection groups were interviewed retrospectively. The structured interview focused on: (i) their views of clinical supervision and support in general; (ii) their views of clinical supervision and support specifically concerning the use of coercion; and (iii) their experiences of participating in groups reflecting the use of coercion. Nurses were largely positive about participating in reflection groups, as expressed in the subthemes: having time for reflection; being confirmed; gaining new perspectives; sharing fellowship with colleagues; and relating more effectively to patients. Complications concerning participation in the reflection groups and other forms of clinical supervision as reported by nurses were: providing time for participation; having a common aim; being vulnerable in difficult situations; and assuming that the need for supervision and support could indicate that they were not coping with their job. [source] Using appreciative inquiry to evaluate project activities of a nongovernmental organization supporting victims of trauma in Sri LankaNEW DIRECTIONS FOR EVALUATION, Issue 100 2003Mette Jacobsgaard Appreciative Inquiry was used to highlight the successes of a donor-supported project of working with victims of trauma in an environment of civil war and high security risk, and thereby also to honor the work of dedicated staff who often face extremely difficult situations. [source] | |||||||||||||