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Holistic Approach (holistic + approach)
Selected AbstractsA Holistic Approach to New Product Development: New InsightsJOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 4 2004Michael Tracey SUMMARY The literature for some time has endorsed a participative approach to new product development. Nonetheless, practice still seldom follows theory. The production, purchasing and logistics areas, as well as suppliers and customers, continue to be underrepresented at many manufacturing firms. This research provides empirical support for including these parties early in new product development. It demonstrates the positive impact their participation can have on manufacturing efficiency and agility, delivery service and organizational performance. It also reveals that there is ample room to increase their participation at many firms. [source] Balneo-Phototherapy: A New Holistic Approach To Treating PsoriasisJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2003Colleen Mikula ANP-C Purpose To present and describe a new holistic therapy for the treatment of psoriasis and demonstrate its outcomes through a case study presentation. Data Sources Selected scientific literature and patient case study. Conclusion Balneo-phototherapy, though new to the United States, has effective, safe outcomes as a new holistic treatment for psoriasis. Implications for Practice Nurse practitioners (NPs) and patients have an additional choice in psoriasis treatment that provides efficacious outcomes with fewer side effects compared to current therapies. [source] Design for Lean Six Sigma: A Holistic Approach to Design and Innovation by Rajesh Jugulum and Philip SamuelTHE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 5 2010Carla Kuesten No abstract is available for this article. [source] How to Achieve Confidence in Drug Discovery and Development: Managing Risk (from a Reductionist to a Holistic Approach)CHEMMEDCHEM, Issue 6 2009Annette Bakker Dr. Abstract Confidence in mechanism: Creating a more holistic understanding of disease pathophysiology and an early confidence in the mechanism under investigation could help facilitate the selection of not only the most appropriate targets but also the best mechanisms for disease intervention and how to select and optimise the best compounds. Drug target and candidate selection are two of the key decision points within the drug discovery process for which all companies use certain selection criteria to make decisions on which targets to accept into their discovery pipelines and which compounds will pass into development. These steps not only help define the overall productivity of every company but they are also decisions taken without full predictive knowledge of the risks that lie ahead or how best to manage them. In particular, the process of selecting new targets does not normally involve full evaluation of the risk(s) in the mechanism under investigation (the modulation of the target), which may result in an inability to fully connect in,vitro and animal model results to the disease (clinical) setting. The resulting poor progression statistics of many compounds in the clinic is at least partially the result of a lack of understanding of disease pathophysiology. Notably, the lack of efficacy is still a major reason for failure in the clinic.1 Creating a more holistic understanding of disease pathophysiology and an early confidence in the mechanism under investigation could help facilitate the selection of not only the most appropriate targets but also the best mechanisms for disease intervention and how to select and optimise the best compounds. [source] Taking Stock of Corporate Governance Research While Looking to the FutureCORPORATE GOVERNANCE, Issue 3 2009Igor Filatotchev ABSTRACT Manuscript Type: Editorial Research Question/Issue: This essay identifies some key issues for the analysis of corporate governance based on the articles within this special review issue coupled with our own perspectives. Our aim in this issue is to distil some research streams in the field and identify opportunities for future research. Research Findings/Results: We summarize the eight papers included in this special issue and briefly highlight their main contributions to the literature which collectively deal with the role and impact of corporate boards, codes of corporate governance, and the globalization of corporate governance systems. In addition to the new insights offered by these reviews, we attempt to offer our own ideas on where future research needs to be targeted. Theoretical Implications: We highlight a number of research themes where future governance research may prove fruitful. This includes taking a more holistic approach to corporate governance issues and developing an inter-disciplinary perspective by building on agency theory while considering the rich new insights offered by complementary theories, such as behavioral theory, institutional theory and the resource-based views of the firm. In particular, future corporate governance research needs to be conducted in multiple countries, particularly in emerging economies, if we want to move closer to the journal's aim of producing a global theory of corporate governance. Practical Implications: Our analysis suggests that analytic and regulatory approaches to corporate governance issues should move from a "one-size-fits-all" template to taking into account organizational, institutional and national contexts. [source] New Corporate Governance: from good guidelines to great practiceCORPORATE GOVERNANCE, Issue 5 2005Martin Hilb This paper presents a new, holistic approach to corporate governance, adding simultaneous value to shareholders, customers, employees and society. This new approach to directing and controlling companies integrates components of corporate governance that have historically been treated in isolation of each other in research, teaching and practice. [source] ,Milking The Elephant': Financial Markets as Real Markets in KenyaDEVELOPMENT AND CHANGE, Issue 2 2004Susan Johnson Financial liberalization policies in the 1990s were intended to raise formal sector interest rates, enhance competition and expand access for users. This article investigates patterns of provision and use in a local financial market in Karatina, Kenya, at the end of the 1990s after a period of financial and economic liberalization. It takes a holistic approach, examining both formal and informal financial arrangements and microfinance interventions. This is because the role of the informal financial sector is particularly important for poor people and has received relatively little attention in the discussion of the consequences of reform. The author does this using a ,real' markets approach that sees markets as socially regulated and structured. Significant provision by the mutual sector (formal and informal), and poor lending performance by the banking sector is explained through an examination of the characteristics of the services on offer and their embeddedness in social relations, culture and politics. [source] Mental health improvements of substance-dependent clients after 4 months in a Therapeutic CommunityDRUG AND ALCOHOL REVIEW, Issue 5 2010ANNE-MAREE POLIMENI Abstract Introduction and Aims. Odyssey House Victoria's Therapeutic Community (TC) accepts substance-dependent clients, including those with co-occurring mental health issues. American data suggest that TCs are effective in rehabilitating such clients; however, Australian research is limited. The aim of the study was to examine Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profiles of Odyssey House TC residents early in their residency and again after 4 months, to chart changes in MMPI-2 profiles and compare them with norms for psychological health. Design and Methods. The sample comprised 351 clients who were part of the residential program between 1997 and 2007, and who remained in treatment at the TC for at least 4 months. They were administered the MMPI-2 after 5 weeks in treatment and again after 4 months. Results. At the first assessment, the validity scales of the MMPI-2 plus the clinical scales Depression, Psychopathic Deviate, Paranoia, Psychasthenia and Schizophrenia were in the clinical range. At the second assessment, mean scores on all clinical scales except Mania were significantly or near significantly lower and, except for Psychopathic Deviate, within the normal range. The validity scales also demonstrated improvement, although two of the three remained in the clinical range. Discussion and Conclusions. Results indicated that treatment within the TC over this time span was associated with improved mental health. The present study suggests that residential rehabilitation's holistic approach provides a suitable treatment model for clients with co-occurring mental health and substance use disorders.[Polimeni A-M, Moore SM, Gruenert S. Mental health improvements of substance-dependent clients after 4 months in a Therapeutic Community. Drug Alcohol Rev 2010] [source] A holistic approach to assessing C-level candidatesEMPLOYMENT RELATIONS TODAY, Issue 2 2009Doug Reiter First page of article [source] The transformation of post-communist societies in Central and Eastern Europe and the Former Soviet Union: an economic and ecological sustainability perspectiveENVIRONMENTAL POLICY AND GOVERNANCE, Issue 3 2008erban Scrieciu Abstract Since the collapse of Communism in Central and Eastern Europe and the Former Soviet Union, the reform process has been considerably influenced by the neoclassical economic approach to transition. This has heavily emphasized competitive markets and economic liberalization measures per se, often ignoring the establishment of adequate institutional frameworks and resulting in high transition costs and the side-lining of environmental concerns. Alternative models of market transformations in post-Communist societies have been forwarded in the literature, though these have been arguably less influential. We explore the role of these economic ideologies in shaping transition paths, with a focus on the Post-Keynesian economic approach as an alternative to the neoclassical paradigm. We further propose a holistic approach to transition to account for appropriate institutional developments in the area of environmental sustainability. We argue that transition economies need to reconsider their ,market transformation' process in order to capitalize on their potential and mark their own contribution to positive shifts in sustainable development paradigms. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [source] Psychodrama: helping families to adapt to childhood diabetesEUROPEAN DIABETES NURSING, Issue 3 2006B Bektas RN. Abstract Effective management of diabetes in children requires a holistic approach that takes into account the roles of diabetes education, treatment and disease management, and the integral role of family relationships. Psychodrama is a group-based psychological support technique that aims to improve the acceptance and understanding of diabetes within the families of diagnosed children. Through group improvisation, role plays and feedback sessions, the families of children with diabetes participate in a cathartic process that helps them to share their problems, benefit from others' insight and feedback and to discuss behavioural changes that will avoid similar problems in the future. The families that participated in this study reported an enhanced understanding of the contribution that relationships with their children have on the successful management of their diabetes. Through recognition of the reasons for their anxieties about their children's diabetes, they were able to address fixed behavioural patterns in a supportive, non-judgmental arena, and to work towards positive change. Their children benefited indirectly through changes in their parents' behaviour and improved communication within their families. A reduction in the children's HbA1c levels was observed through the course of the study, although this could not be considered a direct result of psychodrama. Copyright © 2006 FEND. [source] An Approach to Interdisciplinary Training in Postgraduate EducationEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2006P Brodin Aims, A primary goal for clinical graduate training is to provide the student with the expertise required for specialist treatment in the actual discipline. At the same time there is an increasing need for a broader perspective on specialist care and the students should be aware of the limitations inherent in own specialty. In order to plan treatment in the best interest of the patient, and to be prepared to take part in treatments involving other specialties, the students should be exposed to interdisciplinary cooperation throughout the training. An approach to joint academic and clinical training with the purpose of providing graduate students with a broader perspective on specialist care is described and discussed. Material and methods, During their first year graduate students in the 7 different disciplines complete a joint Core Curriculum consisting of 8 different courses to stimulate a scientific approach to their profession and understanding of basic biologic mechanisms. To create a learning environment focusing on the development of interdisciplinary competence, a joint clinic has been established. Teams of students from different disciplines have been organized in order to establish ,partnership' for the treatment of patients with complex problems. The students also take part in the sessions held by a faculty Team of experts for assessment and treatment planning of referred patients with complex problems. Furthermore, faculty members conduct courses and seminars for students from other disciplines and students also participate in selected parts of the regular program in other disciplines. Results, Formal evaluation has so far been conducted for the Core Curriculum. Most students respond that they are satisfied with the courses, and the curriculum has also been adjusted based on the comments. The students report that treatment of patients in need of interdisciplinary treatment has been facilitated by having ,partners' in other disciplines. Participation in the Team of expert's sessions has been appreciated, and the attendance at interdisciplinary courses and seminars has been good. Conclusions, Based on the experience over the last 5 years, the interdisciplinary aspects of graduate training should be expanded to stimulate a holistic approach also to specialist treatment. [source] Modeling the Porosity Formation in Austenitic SGI Castings by Using a Physics-Based Material Model,ADVANCED ENGINEERING MATERIALS, Issue 3 2010B. Pustal Abstract On solidification, microsegregations build up in solid phases due to changes in solid concentrations with temperature. Diffusion, which is a kinetic process, usually reduces the occurrence of microsegregations. This work is aimed at modeling such kinetic effects on the solidification of austenitic cast iron, using a holistic approach. For this purpose, a microsegregation model is developed and validated. Moreover, this model is directly coupled to a commercial process-simulation tool and thermodynamic software. A series of GJSA-XNiCr 20-2 clamp-rings is cast by varying the inoculation state and the number of feeders. The composition of this cast alloy is analyzed and the microstructure characterized to provide input data for the microsegregation model. In order to validate the software, cooling curves are recorded; differential thermal analysis, electron dispersive X-ray analysis and electron probe micro analysis are carried out. Furthermore, the porosity within the casting is analyzed by X-ray. By performing coupled simulations, the different cooling characteristics within the casting lead to pronounced differences in phase fractions and solidification temperatures which are due to dendrite arm coarsening. The hot spot effect below the feeders is assisted by a shift towards lower solidification temperatures over the solidification time. This shift is a result of the local cooling characteristics, which can only be predicted when process simulation is directly coupled with material simulation. The porosity predictions and the porosity analysis exhibit good agreement. A comparison between experimental and virtual cooling curves closes, implying that the novel coupling concept and its implementation are valid. [source] Experiences and support needs of siblings of children with cancerHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2000BA MA PhD CPsychol Patricia Sloper Abstract The diagnosis and treatment of childhood cancer places considerable demands on family life. Siblings have been shown to be at risk for development of emotional and behavioural problems. However, most studies have relied on parents' reports, and less is known about siblings' own views of their experiences. This paper presents findings from interviews with 94 siblings of children with cancer, at 6 and 18 months after diagnosis of the illness. Results show that, six months after diagnosis, siblings reported a number of problems: loss of attention and status; loss of their own and their families' usual activities and routines; loss of certainty and security; and loss of companionship of the ill child. For many, problems had resolved 18 months after diagnosis, but problems remained or had arisen for some. These were not confined to those whose brothers or sisters had relapsed or continued to have treatment. Supportive relationships were reported to be important resources, providing an opportunity for siblings to express their own feelings and needs, and information about the illness and treatment helped them to understand why family life was disrupted. Positive effects were also apparent: gains in maturity, understanding and compassion, and closer family relationships. The findings point to the need for support for siblings to provide information to help them make sense of the situation; opportunities to express their own feelings and reassurance to avoid fear and guilt; attention to feel valued and maintain self-esteem; and help to keep up their own interests and activities. Attention of parents and professionals in contact with the families was generally paid to the ill child. There is a need for health professionals, particularly those in the family's home community, to take a holistic approach to family support, to ensure that information and support is available to siblings. [source] The acceptance of systemic thinking in various fields of technology and consequences on the respective safety philosophiesHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 3 2003Willy Geysen Systemic thinking aims to develop a common language that makes it possible for scientists of different disciplines and technologies to communicate with one another. The specific methodology of systemic thinking is a means of tackling complex, interrelated problems by applying a holistic approach that focuses on the interrelation of individual aspects. In this article, an attempt is made to show the impact of systemic thinking in different areas of science and technology. In particular, the authors argue that a multidisciplinary, systemic approach can play an important role in developing a general theory of safety science. © 2003 Wiley Periodicals, Inc. Hum Factors Man 13: 231,242, 2003. [source] Enhancing technology development through integrated environmental analysis: Toward sustainable nonlethal military systemsINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 2 2010Oral S. Saulters Abstract New technologies are not only critical in supporting traditional industrial and military success but also play a pivotal role in advancing sustainability and sustainable development. With the current global economic challenges, resulting in tighter budgets and increased uncertainty, synergistic paradigms and tools that streamline the design and dissemination of key technologies are more important than ever. Accordingly, a proactive and holistic approach can facilitate efficient research, design, testing, evaluation, and fielding for novel and off-the-shelf products, thereby assisting developers, end users, and other diverse stakeholders in better understanding tradeoffs in the defense industry and beyond. By prioritizing mechanisms such as strategic life-cycle environmental assessments (LCEA); programmatic environment, safety, and occupational health evaluations (PESHE); health hazard assessments (HHA); and other innovative platforms and studies early within systems engineering, various nonlethal military technologies have been successfully developed and deployed. These efforts provide a framework for addressing complex environment, safety, and occupational health risks that affect personnel, infrastructure, property, socioeconomic, and natural/cultural resources. Moreover, integrated, comprehensive, multidisciplinary, and iterative analyses involving flexible groups of specialists/subject matter experts can be applied at various spatiotemporal scales in support of collaborations. This paper highlights the Urban Operations Laboratory process utilized for inclusive and transformative environmental analysis, which can translate into advantages and progress toward sustainable systems. Integr Environ Assess Manag 2010;6:281,286. © 2009 SETAC [source] Third-wave public health?INTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES, Issue 4 2004Compassion, community, end-of-life care Abstract Clinical approaches to end-of-life care often extend their practise into community care, but frequently that practise has been under-recognized and under-theorized. A seamless practise connection with community approaches to end-of-life care is crucial to a total healthcare response to death and loss. One-on-one practises find their greatest therapeutic and aftercare support in a complementary community approach to that care. What public health models might we adapt to assist the psychological professions to support a community response to death and loss? This article reviews recent World Health Organization (WHO) work in community development, in particular the "Healthy Cities" projects. From this review, a "Compassionate Cities" framework is suggested as one fruitful way forward to address issues of prevention, health promotion, and aftercare in a holistic approach to end-of-life care. Copyright © 2004 Whurr Publishers Ltd. [source] End-to-end response time with fixed priority scheduling: trajectory approach versus holistic approachINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 1 2005Steven Martin Abstract In this paper, we are interested in providing deterministic end-to-end guarantees to real-time flows in a distributed system. We focus on the end-to-end response time, quality of service (QoS) parameter of the utmost importance for such flows. We assume that each node uses a Fixed Priority scheduling. We determine a bound on the end-to-end response time of any real-time flow with a worst case analysis using the trajectory approach. We establish new results that we compare with those provided by the classical holistic approach for flows visiting the same sequence of nodes. These results show that the trajectory approach is less pessimistic than the holistic one. Moreover, the bound provided by our worst-case analysis is reached in various configurations, as shown in the examples presented. Copyright © 2004 John Wiley & Sons, Ltd. [source] Healthy eating in the school environment , a holistic approach,INTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 2 2002Linda Burke Abstract The curriculum that pupils are taught within the classroom environment can either be reinforced or weakened by what goes on in the rest of the school environment. The study focused on pupils aged 11,12 years, to establish if healthy eating theory was put into practice in the school environment. The research encompassed three areas within the school: the pupils who are the recipients of the theory; the teacher who teaches them the importance of food and cooking skills; and the providers of food within the school environment. Three different post-primary schools located within the Coleraine area of Northern Ireland were used. [source] Reconceptualizing the learning transfer conceptual framework: empirical validation of a new systemic modelINTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 3 2004Constantine Kontoghiorghes The main purpose of this study was to examine the validity of a new systemic model of learning transfer and thus determine if a more holistic approach to training transfer could better explain the phenomenon. In all, this study confirmed the validity of the new systemic model and suggested that a high performance work system could indeed serve as a catalyst to successful training transfer. [source] Characteristics of a world-class zoo or aquarium in the 21st centuryINTERNATIONAL ZOO YEARBOOK, Issue 1 2003M. HUTCHINS At the start of the 21st century modern zoos and aquariums are expected to contribute to the survival of the species they display, to educate the public, and to maintain the physical and psychological well-being of the animals in their care. For the future, however, zoos and aquariums will have to be extraordinary in both quality and accomplishments. In this article the characteristics of a world-class zoo or aquarium are described, ranging from organizational structure and philosophy, and staff recruitment and training, to animal care and husbandry, research, conservation, education and exhibit design. The importance of inter-institutional co-operation, technology, government affairs, marketing and development, and public relations are also discussed. In the future managers will have to take a more holistic approach to all these characteristics in order to achieve their core mission without losing sight of the primary objectives of the zoo or aquarium. [source] Irrigation and drainage systems research and development in the 21st century,IRRIGATION AND DRAINAGE, Issue 4 2002Bart Schultz irrigation; drainage; développement durable; système de réseau Abstract One critical problem confronting mankind today is how to manage the intensifying competition for water between expanding urban centres, traditional agricultural activities and in-stream water uses dictated by environmental concerns. In the agricultural sector, the dwindling number of economically attractive sites for large-scale irrigation and drainage projects limits the prospects of increasing the gross cultivated area. Therefore, the required increase in agricultural production will necessarily rely largely on a more accurate estimation of crop water requirements on the one hand, and on major improvements in the construction, operation, management and performance of existing irrigation and drainage systems, on the other. The failings of present systems and the inability to sustainably exploit surface and groundwater resources can be attributed essentially to poor planning, design, system management and development. This is partly due to the inability of engineers, planners and managers to adequately quantify the effects of irrigation and drainage projects on water resources and to use these effects as guidelines for improving technology, design and management. To take full advantage of investments in agriculture, a major effort is required to modernize irrigation and drainage systems and to further develop appropriate management strategies compatible with the financial and socio-economic trends, and the environment. This calls for a holistic approach to irrigation and drainage management and monitoring so as to increase food production, conserve water, prevent soil salinization and waterlogging, and to protect the environment. All this requires, among others, enhanced research and a variety of tools such as water control and regulation equipment, remote sensing, geographic information systems, decision support systems and models, as well as field survey and evaluation techniques. To tackle this challenge, we need to focus on the following issues: affordability with respect to the application of new technologies; procedures for integrated planning and management of irrigation and drainage systems; analysis to identify causes and effects constraining irrigation and drainage system performance; evapotranspiration and related calculation methods; estimation of crop water requirements; technologies for the design, construction and modernization of irrigation and drainage systems; strategies to improve irrigation and drainage system efficiency; environmental impacts of irrigation and drainage and measures for creating and maintaining sustainability; institutional strengthening, proper financial assessment, capacity building, training and education. Copyright © 2002 John Wiley & Sons, Ltd. Résumé Aujourd'hui le problème critique pour l'humanité est comment manier la compétition intensifiante pour de l'eau entre les centres urbains en expansion, pour des activités traditionnellement agricoles et pour l'usage de l'eau fluviale prescrit par des conditions écologistes. Dans le secteur agricole les perspectives d'agrandir les champs cultivés bruts sont limitées par le nombre diminuant des terrains économiquement attractifs pour des projets d'irrigation et du drainage de grande envergure. Par conséquent l'augmentation nécessaire de la production agricole comptera surtout sur une évaluation plus précise du besoin des plantes d'un côté, et de l'autre sur de grandes améliorations dans la construction, dans l'opération, dans le management et dans la performance des systèmes d'irrigation et du drainage. On peut attribuer les défauts des systèmes actuels et l'incompétence d'exploiter durablement les ressources hydriques de surface et souterraines au planification, au système de la gestion de l'eau et au système du développement. Cela est partiellement dû à l'incapacité des ingénieurs, des planificateurs et des gérants, de quantifier adéquatement les effets des projets d'irrigation et de drainage sur les ressources hydriques et d'utiliser ces résultats pour améliorer la technologie, la planification et la gestion de l'eau. Pour profiter le mieux possible des investissements dans l'agriculture, on exige un effort considérable pour moderniser les systèmes d'irrigation et de drainage et pour développer des stratégies de gestion de l'eau qui doivent être appropriées et compatibles avec les tendances financières et socio-économiques et avec l'environnement. Ceci a besoin d'une procédure holistique pour la gestion et le monitorage de l'eau, pour augmenter la production d'aliments, pour conserver l'eau, pour prévenir la salination du sol et pour protéger l'environnement. Tout cela demande, entre autres choses, une recherche d'avant-garde et une variété d'instruments comme les contrôles du régime hydrique et les appareils de régulation, la télédétection, les systèmes de l'information géographique, les systèmes et les modèles de support de décision et de même les levés sur le terrain et les techniques d'évaluation. Pour entreprendre ce défi nous devons nous concentrer sur les questions suivantes: capacité de mettre enoeuvre des technologies nouvelles; le développement des procédures pour intégrer la planification et la gestion des systèmes d'irrigation et de drainage; l'analyse pour identifier les causes et les effets de forcer à la performance des systèmes d'irrigation et de drainage; l'évapotranspiration et les méthodes de calcul en question; l'évaluation des exigences hydriques des cultures; les technologies pour le dessein, la construction et la modernisation des projets d'irrigation et de drainage; les stratégies pour améliorer l'efficacité des systèmes d'irrigation et de drainage; les impacts des projets d'irrigation et de drainage et des mesures appropriées pour créer et entretenir la durabilité; l'amélioration du contexte institutionnel, l'évaluation financière, la formation et l'amélioration des compétences techniques. Copyright © 2002 John Wiley & Sons, Ltd. [source] Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006MSc(A), Susan Slaughter RN OBJECTIVES: To evaluate measures of dementia care environments by comparing a special care facility (SCF) with traditional institutional facilities (TIFs). DESIGN: A cross-sectional comparative study of nursing home environments conducted as part of a longitudinal study on quality of life for residents with dementia. SETTING: Twenty-four traditional nursing homes and one special care facility. PARTICIPANTS: One SCF with six distinct environments, 24 TIFs with 45 distinct environments, and 88 family members. MEASUREMENTS: Therapeutic Environment Screening Scale,2+ (TESS-2+); Special Care Unit Environmental Quality Scale (SCUEQS), a subset of the TESS-2+ items; Composite Above Average Quality Score (CAAQS), a composite score of all items on the TESS-2+; and Models of Care Instrument (MOCI). RESULTS: The SCUEQS did not detect a significant difference between the SCF and the TIFs (30.0 vs 27.2, P=.28). The CAAQS detected a significant difference between the SCF and the TIFs, whereby the SCF environments were rated as having above-average quality in 71.4% of the domains, compared with 57.3% for the TIF environments (95% confidence interval (CI) for difference=2.6,25.6%, P=.02). Using the MOCI, SCF families were 1.8 times as likely to rate the SCF as a home or resort versus a hospital as TIF families rating TIFs (95% CI for odds ratio=1.5,2.1, P<.001). CONCLUSION: The TESS-2+ CAAQS differentiated between physical environments better than the more established SCUQES. The MOCI distinguished between environments using a more holistic approach to measurement. The availability of environmental measures that are able to discriminate between specialized and traditional long-term care settings will facilitate future outcome-based research. [source] Process integration technology review: background and applications in the chemical process industryJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 9 2003Russell F Dunn Abstract Process integration is a holistic approach to process design and operation which emphasizes the unity of the process. Process integration design tools have been developed over the past two decades to achieve process improvement, productivity enhancement, conservation in mass and energy resources, and reductions in the operating and capital costs of chemical processes. The primary applications of these integrated tools have focused on resource conservation, pollution prevention and energy management. Specifically, the past two decades have seen the development and/or application of process integration design tools for heat exchange networks (HENs), wastewater reduction and water conservation networks, mass exchange networks (MENs), heat- and energy-induced separation networks (HISENs and EISENs), waste interception networks (WINs) and heat- and energy-induced waste minimization networks (HIWAMINs and EIWAMINs), to name a few. This paper provides an overview of some of these developments and outlines major driving forces and hurdles. The fundamental aspects of this approach along with their incorporation in an overall design methodology will be discussed. The paper also highlights several recent applications of process integration to industrial processes. Copyright © 2003 Society of Chemical Industry [source] Interprofessional education: the interface of nursing and social workJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Engle Angela Chan Aims., To examine the influence of interdisciplinary seminars on undergraduate nursing and social work students' perceptions of their learning. Background., Collaboration is considered to be important for health professionals in working towards good patient care, and interdisciplinary education is seen as one way of addressing this need for greater collaboration and team work. Today's health professionals are dealing with an increasing number of older and chronically ill patients. The biopsychosocial dimensions inherent in such chronic illnesses bring about a closer working relationship between the nursing and social work professions to foster good patient care. No local research in Hong Kong, however, has looked specifically at how these two professions can develop their collaborative skills and qualities through interdisciplinary education. Design., Mixed methods design. Method., Data from questionnaires, videotape recordings of the sessions and follow-up phone interviews were used for quantitative and qualitative analyses. Results., The findings revealed three themes: an increased awareness of each other's professional values and personal judgement, a recognition of each other's disciplinary knowledge emphases and more, and an appreciation for, and learning about each other's roles for future collaboration. Conclusions., Whilst, it is usual to identify health professionals as non-judgemental, it is also important to recognise the existence of their personal and professional values and beliefs that shape their decision-making. Equally beneficial for students is their reported understanding of the other discipline's emphasis on the physical or social aspects of care, and the interrelationships and complementary values that lead to students' appreciation of each other's roles and the possibility for their future collaboration in the holistic care of patients. Relevance to clinical practice., The sharing of each other's knowledge and their appreciation of the corresponding roles enhanced students' decision-making capacity and the extension of the holistic approach beyond one profession, which is essential for good patient care. [source] A review of the psychosocial issues for nurses in male genitalia-related careJOURNAL OF CLINICAL NURSING, Issue 8 2008MMed (Cardiovascular Surgery), Yu-Li Zang BMed (Nursing) Aim., This literature review aimed to highlight psychosocial issues for nurses in the practice of male genitalia-related care so as to guide the improvement of the teaching and practice of male genitalia-related care. Background., Male genitalia-related care is common in hospitals and in the community. In several conditions, e.g. incontinence, postradiotherapy or following operation for cancer of genitalia, bladder, colon or rectum, patients will require male genitalia-related care. Patients who require male genitalia-related care may encounter psychosocial and/or sexual dysfunction. In the holistic approach to men's health, nurses are expected to meet patients' psychosocial and sexual needs, while the literature suggests that nurses' perceptions and attitudes in providing certain male genitalia-related care, e.g. genital hygiene, sexual counselling, are negative. Method., Systematic literature review. Conclusion., Issues surrounding male genitalia-related care for nurses are complicated and may be related to privacy, intimacy, sexuality, dirty work and emotional discomfort. Age, gender, race and social class could compound these issues. Relevance to clinical practice., Nurses' negative perceptions, responses and attitudes towards male genitalia-related care may exacerbate patients' conditions under which male genitalia-related care is required. Appropriate strategies should be developed to overcome these problems. [source] A health protection model for Hispanic adults with Type 2 diabetesJOURNAL OF CLINICAL NURSING, Issue 7b 2007Christine L Latham RN Aims., The Hispanic Health Protection Model (HHPM) was designed to assist practitioners' systematic assessment of Hispanic people to establish baselines and evaluate the success of early diabetes treatment. This article provides the research basis of the HHPM and related assessment tools. Background., The treatment of diabetes incorporates lifestyle change, and this adjustment is particularly important to follow with vulnerable groups. One such group is the Hispanic population, since the impact of diabetes is greatest on economically disadvantaged segments of this population, who suffer disproportionately higher Type 2 diabetes prevalence and higher levels of morbidity and mortality as compared with other populations. Traditional Hispanic health beliefs are often in conflict with Western medicine, so the adjustments to the lifestyle demands of this disease need to be evaluated. Methods., To understand this discrepancy fully in patient outcomes, a culturally sensitive assessment framework was developed based on health protection theories and research with Hispanic people with diabetes and, based on this framework, assessment tools were translated for use during interviews with low literacy, Spanish-speaking patients. Conclusions., The HHPM translated measures of premorbid lifestyle, health beliefs, support, self-efficacy, quality of life, knowledge of diabetes, and physiological parameters can be used during consecutive clinic visits during the first six months of therapy to map the success of patients' understanding of and psychological adjustment to diabetes. Relevance to clinical practice., The HHPM is a culturally-relevant, systematic, and holistic approach to assessing adjustment of Hispanic people to a new diagnosis of diabetes, including their psychological, cognitive, and physiological outcomes. Using this type of systematic approach will allow practitioners to target barriers to therapy, such as a lack of self-efficacy or incomplete knowledge of the disease and its treatment in a strategic manner to improve patient success in managing the complex lifestyle changes of diabetes mellitus. [source] Spirituality at the beginning of lifeJOURNAL OF CLINICAL NURSING, Issue 7 2006Jennifer Hall MSc, PGDip(HE) Aim., The aim of this paper was to explore the issues surrounding the spirit of the unborn child. Background., Pregnancy and birth have been recognised to have a spiritual nature by women and health professionals caring for them. Midwives and nurses are expected to have a holistic approach to care. I suggest that for care to be truly holistic exploration is required of the spiritual nature of the unborn fetus. Methods., Historical, philosophical and religious views of the spirit of the fetus, are explored as well as those of women. Investigation was made of views of the timing of ,ensoulment'. Results., The review demonstrates the value women place on the sacredness of pregnancy and birth, and that the spiritual nature of the unborn should be recognised. Conclusion., This paper shows that the views and values women have of pregnancy and birth and the powerful, spiritual relationship they have with the unborn, indicates that further discussion and research needs to be carried out in this area. Relevance to clinical practice., It is recommended that all who work with women who are pregnant should recognise the spiritual nature of the unborn when carrying out care. [source] Patients' experience of learning and gaining personal knowledge during a stay at a mental hospitalJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2008L. BORGE ba rpn rnt The focus is on voluntarily hospitalized patients' subjective experiences of learning and gaining personal knowledge during a stay at a mental hospital. The aim was to explore and describe patients' learning as personal knowledge acquisition related to the therapeutic process during hospitalization. The study was exploratory and descriptive, with a hermeneutic , phenomenological approach in data collection and analysis. Qualitative interviews were carried out with 15 patients during and after their stay. A re-analysis was conducted. The results underline the importance of the environmental effects on patients' motivation for learning and self-esteem in an acknowledging milieu. Moving towards relearning presupposes that the patient's motivation is aroused. Patients must participate in the treatment and the validity of the knowledge must be tested in the individual patient's life. The patients confirmed and helped each other to increase insight through recognizing each other's problems and reactions. Time in itself seemed to increase self-reflection. Receiving impulses and getting concrete tools through therapy stimulated meaning and hope for future living. The professionals must use a holistic approach including a learning climate in pleasant surroundings and a conjoint contribution from fellow patients and staff. Further research should focus on how to combine therapy with learning , preferably by means of a co-operative inquiry design. [source] Evidence-based care and the case for intuition and tacit knowledge in clinical assessment and decision making in mental health nursing practice: an empirical contribution to the debateJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2001I. Welsh BEd (Hons) RGN ONC RNTDipN (London) This paper provides empirical evidence that challenges the view that methods of clinical assessment and decision making should not rely solely on logical positivist approaches. Whilst the National Health Service (NHS) Executive currently takes a hard positivist line on what constitutes evidence-based practice, data reveal that it is not always appropriate to disregard the tacit knowledge and intuition of experienced practitioners when making assessment decisions in mental health nursing practice. Data support the case for a holistic approach which may draw on intuition and tacit knowledge, as well as traditional approaches, to meet the requirements of clients with complex mental health problems. A model based on Schon's notion of reflection in and reflection on practice is proposed which demonstrates the value of intuition and tacit knowledge. This model allows the generation of insights which may ultimately be demonstrated to be acceptable and empirically testable. It is accepted that an element of risk taking is inevitable, but the inclusion of a formal analytical process into the model reduces the likelihood of inappropriate care interventions. The cognitive processes which experienced nurses use to make clinical decisions and their implications for practice will be explored. [source] | ||||||||||||||||||||||||||||||||||||||||||||||