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Difficult Times (difficult + time)
Selected AbstractsPatients Report Doctors Do a Good Job at a Difficult TimeCA: A CANCER JOURNAL FOR CLINICIANS, Issue 2 2002Article first published online: 31 DEC 200 No abstract is available for this article. [source] Related factors in using a free breastfeeding hotline service in TaiwanJOURNAL OF CLINICAL NURSING, Issue 7 2008IBCLC, Shu-Fang Wang RN Aims., This study aimed to examine the use of a free hotline service for breastfeeding mothers in Taiwan. Specific attention was given to the accumulated consultation time and to investigate the trends and reasons that prompted people to contact the service. Background., Breastfeeding can be a difficult time for mothers, especially during the first two weeks after birth. It has been suggested that a telephone hotline service may be helpful for breastfeeding mothers. Design., In this quantitative study data, including the demographic data and the problems of consultations, were gathered from callers during August 2003 to August 2005. Results., Of the 2445 callers, 935 made subsequent calls (38·2%). Approximately 25·25 calls were answered each day by two specially-trained staff according to an answering book. The mean consultation time for single first-call was 21·82 minutes and for one subsequent-call was 15·87 minutes. Perceived insufficient milk supply (30%) and returning to work (21%) were the top two reasons for a first-call. If callers' problems were about babies' sickness, perceived insufficient milk supply, babies' body weight gain and supplement issues, the accumulated consultation time would last longer. More than half (53·3%; 1303/2445) of callers made the first-call during the first month after birth, followed by 23·2% (566/2445) during babies' age between one and three months old. Conclusion., The telephone hotline service for breastfeeding mothers in Taiwan was well used during the two year period of this study. Many mothers used the service repeatedly for a variety of reasons. Relevance to clinical practice., Recommendations for breastfeeding support strategies for the professionals include category of common breastfeeding problems by different stages after birth. This study supports the establishment of free hotline services may encourage greater empowerment in breastfeeding mothers. Future studies are required to examine client satisfaction of the telephone service. [source] Budget Deficits in the States: VirginiaPUBLIC BUDGETING AND FINANCE, Issue 1 2010JAMES K. CONANT We are all faced with truly, truly dreadful choices. (Delegate Kristen Amundsen, The Washington Post, December 17, 2008) The stimulus package is our salvation. (Delegate Kenneth R. Plum, Richmond Times Dispatch, March 1, 2009) For more than a decade, Virginia has won praise as one of the nation's best-managed states. Nevertheless, Virginia's elected officials have had a very difficult time dealing with the dramatic effects that the current recession, which began in December of 2007, has had on state general fund revenues and thus on the state's general fund budget. For the FY 2008,2010 biennium, revenues fell approximately $5 billion, or 14 percent, below the revenue estimates published in December of 2006. As estimated revenues for the biennium were falling, however, the state was faced with additional costs for the biennium, the largest of which was the $1 billion required to meet the state's K-12 standards of quality. Although Virginia's lawmakers were able to draw on the state's budget stabilization fund and other reserves to offset some of the lost revenue, they had to repeatedly cut state spending in order to retain structural balance. The full effects of those cuts were temporarily cushioned during the 2008,2010 biennium, however, by funds contained in the American Recovery and Reinvestment Act of 2009. [source] District Complexity as an Advantage in Congressional ElectionsAMERICAN JOURNAL OF POLITICAL SCIENCE, Issue 4 2009Michael J. Ensley Scholars of congressional elections have argued that an increase in constituent diversity increases the level of electoral competition. Following models of boundedly rational candidates, we argue that there is strong reason to believe that the opposite is true. As the complexity of the electoral landscape increases, challengers will have a more difficult time locating an optimal platform when facing an experienced incumbent. Using data from the 2000 National Annenberg Election Study, we construct a novel measure of district complexity for U.S. House districts and test whether the entry of quality challengers and the incumbent's share of the two-party vote are affected by the complexity of the electoral landscape. We find strong support for the hypothesis that complexity benefits incumbents for both indicators of electoral competition, which stands in contrast to most of the existing literature on diversity and incumbent performance. [source] The phenomenon of resilience in crisis care mental health cliniciansINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2005Karen-leigh Edward ABSTRACT:, The purpose of this study, undertaken in 2003, was to explore the phenomenon of resilience as experienced by Australian crisis care mental health clinicians working in a highly demanding, complex, specialized and stressful environment. For the purpose of this research, the term ,resilience' was defined as the ability of an individual to bounce back from adversity and persevere through difficult times. The six participants for this study were drawn from Melbourne metropolitan mental health organizations , the disciplines of nursing, allied health and medicine. A number of themes were explicated from the participants' interview transcripts , Participants identified the experience of resilience through five exhaustive descriptions, which included: ,The team is a protective veneer to the stress of the work'; Sense of self; Faith and hope; Having insight; and Looking after yourself. These exhaustive descriptions were integrated into a fundamental structure of resilience for clinicians in this role. The study's findings have the potential to inform organizations in mental health to promote resilience in clinicians, with the potential to reduce the risk of burnout and hence staff attrition, and promote staff retention and occupational mental health. [source] In difficult times: influences of attitudes and expectations on training and redeployment opportunities in a hospital contraction programmeINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 3 2002Jeff Hyman This article explores reasons behind the low take,up of training and redeployment opportunities in a three,year downsizing programme in a National Health Service (NHS) mental health hospital. It examines these from an interpretive paradigm, identifying social,psychological effects on barriers and motivation to training and redeployment. In reporting factors that inhibit the movement of staff from the hospital the findings indicate that the direction of even a well,planned and positively intentioned programme can be confounded by the responses of employees faced with an uncertain future. When drawing up restructuring programmes involving retraining and redeployment, managers need to take into account the anticipated profound reactions of those affected. [source] The JCMS Lecture: Managing Diversity and Change in the European Union,JCMS: JOURNAL OF COMMON MARKET STUDIES, Issue 1 2006LOUKAS TSOUKALIS European integration is going through difficult times. Poor economic performance and the growing feeling of insecurity among many Europeans play a major role. So does the weakening of the old political consensus. More clarity and realism about what Europe can deliver would help enormously: the Lisbon process and further enlargement are good examples. Economic liberalization also creates losers. This problem needs to be tackled at both national and European levels. [source] Martin Stutzmann: Editor, Teacher, Scientist and FriendPHYSICA STATUS SOLIDI (C) - CURRENT TOPICS IN SOLID STATE PHYSICS, Issue 2 2005Manuel Cardona On 2 January 1995 Martin Stutzmann became Editor-in-Chief of physica status solidi, replacing Professor E. Gutsche, who had led the journal through the stormy period involving the fall of the Iron Curtain, the unification of Germany and the change in its Eastern part, where physica status solidi was based, from "socialism as found in the real world" (a German concept) to real world capitalism. In 1995 it was thought that the process had been completed (we should have known better!) and after the retirement of Prof. Gutsche the new owners of physica status solidi (Wiley-VCH) decided that a change in scientific management was desirable to adapt to the new socio-political facts and to insure the scientific continuity of the journal. Martin had moved in 1993 from my department at the Max-Planck-Institute to Munich where he soon displayed a tremendous amount of science man- agement ability during the build-up of the Walter Schottky Institute. The search for a successor as Edi- tor-in-Chief was not easy: the job was not very glamorous after the upheavals which had taken place in the editorial world following the political changes. Somebody in the Editorial Boards must have suggested Martin Stutzmann. I am sure that there was opposition: one usually looks for a well-established person ready to leave his direct involvement in science and take up a new endeavor of a more administrative nature. Nevertheless, the powers that be soon realized that Martin was an excellent, if somewhat unconventional candidate who had enough energy to remain a topnotch scientist and to lead the journal in the difficult times ahead: he was offered the job. In the negotiations that followed, he insisted in getting the administrative structures that would allow him to improve the battered quality of the journal and to continue his scientific productivity. Today we are happy to see that he succeeded in both endeavors. The journal has since grown in size and considerably improved its quality. Martin Stutzmann's scientific output has continued and today he can be found listed among the 400 most cited physicists worldwide. According to the Institute of Scientific Information (ISI) he has published nearly 400 articles in source journals; they have been cited over 4600 times. His scientific visibility has been partly responsible for the success of the journal under his leadership. When he took over in 1995 the Impact Factors of physica status solidi (a) and (b) were about 0.5. Now they oscillate around 1.0. The journals occupy places 30 (a) and 29 (b) among the 57 condensed matter publications listed in the ISI. Six years ago these places were 34 (a) and 30 (b). The journal is even better placed with respect to the so-called cited half-life which is 8.2 years for pss (a) (place 16 among 57) and 6.7 years for pss (b) (place 20 among 57). Martin, of course, has contributed with his original publications to the success of the journal, having published 36 articles in pss(a) and 32 in pss(b). I would like to some of the editorial decisions implemented under Martin's leadership. They have been largely responsible for the quantitative improvements just described. Martin introduced international standards of peer review, usually involving two anonymous referees: The increase of the rejection rate from ca. 20% to 60% followed. He discontinued the Short Notes, which had become nearly irrelevant, and replaced them, in 1997 by Rapid Research Notes (today Rapid Research Letters) with especially strict reviewing rules and a rather attractive layout. Martin's participation in many international conferences and their organization gave him a handle to acquire the publication of conference proceedings. Organizing committees usually prefer publication in international journals rather than special books because of their guaranteed future availability in libraries and the partaking in the reviewing procedure. The journal became increasingly popular along these lines, a fact which moved Martin to launch in 2002 part (c) of the journal, devoted mainly, but not exclusively, to conference articles. Martin also introduced the publication of Feature Articles, topical issues, and the instrument of the Editor's Choice to highlight articles deemed to be especially interesting. He appointed Regional Editors (6 at this point) which represent the journal in important geographic regions. He also brought the journal online, a must these days. The upheavals that followed the collapse of most of the communist world, the rapid development of science in many emerging nations and the enhanced competitiveness, even in the developed countries, have not ebbed out. Some of them are particular damaging to the reputation of science in a world increasingly skeptical of its values. I am thinking of scientific misconduct and outright fraud, in the form of plagiarism and data fabrication. physica status solidi was also afflicted by this plague: after all, it happened in the best of families. Two of the most notorious offenders of the past decade, J. H. Schön and Y. Park, also visited physica status solidi. In two courageous editorials Martin Stutzmann and Stefan Hildebrandt (Managing Editor of the journal) rapidly exposed these cases of misconduct together with other cases in which there was also good reason to suspect misconduct. Some of the articles involved were rapidly retracted by the authors, others were not. It is reassuring to say that none of them had any impact worth mentioning (1,3 citations, mostly by the authors themselves or in the editorials just mentioned). Only few journal editors dared to convey to the readers a warning that some work of those authors may be faulty even if no air-tight proof was available. However, Martin and Stefan did. We wish that Martin will remain at the helm at least another decade, before he switches to research on the liquid state as practiced in Southern France. [source] A Theoretical Model of the Effects of Public Funding on Saving Decisions by Charitable Nonprofit Service ProvidersANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 2 2003by Femida Handy Why do charitable nonprofit, service-providing organizations save? What are the tradeoffs between using income to build up cash reserves and serving more clients? Saving may generate income, protect the organization against a drop in donations, and increase the organization's chances of survival. Saving, though, may affect the likelihood that nonprofits receive private and public funding. We model the relationship among private and public income, economic conditions, and nonprofit savings. We find that anticipation of government help during difficult times tends to reduce the amount of saving done by the nonprofit. This effect is strengthened if government officials view unspent donations as indicative of a lack of need. Both these effects provide a strong incentive for nonprofits to spend on current consumption rather than to save for the future, and thus to increase the burden on the public purse. [source] ,A Story to Tell': learning from the life-stories of older people with intellectual disabilities in IrelandBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 4 2009Carol Hamilton Accessible summary ,,Older people with intellectual disabilities have been telling their life-stories in Ireland. ,,People remember being taken away from their family and community. People talk about sad memories of times in institutions. ,,People talk about the kindness of friends and family. ,,These stories tell staff that older people want to talk about their past and need help to do this. Doing life-story work will help staff to find out what older people who are in services in Ireland need to make their lives meaningful and comfortable. Summary This article draws on life-stories told by older people with intellectual disabilities for a research study in the Republic of Ireland. Research participants recalled their experiences of confinement, coercion and exclusion that resulted from their being labelled as having intellectual disabilities. Participants also recalled the positive interactions with workers and family members that sustained them during these difficult times. Extracts from these narratives show how past medical and social processes interlinked to classify members of this group as ,deficient' or ,lacking' in some way. Life-stories collected in this project illustrate the value of a narrative approach to exploring how services might begin to enhance the quality of support currently provided to older people with intellectual disabilities. However, life-story work in a service setting is far from straightforward, and support is needed for staff involved in this process. [source] | ||||||||||||||||