Suchergebnisse

Extensive economic research demonstrates correlations between unions with wages, income inequality, health insurance, discrimination, and other factors. Corresponding epidemiologic literature demonstrates correlations between income, income inequality, insurance, discrimination, and other factors with health. The first purpose of this narrative review is to link these literatures and identify 28 possible pathways whereby labor unions might affect the health of workers. This review is restricted to effects within workplaces; we do not consider unions' political activities. This review covers studies from the US, Europe, and Canada from 1980 through April 1, 2021. Pathways are grouped within five domains informed by the CDC 5-domain model of social determinants of health and the traditional 3-domain model of occupational medicine. Linked pathways include wages, inequality, excessive overtime, job satisfaction, employer-provided health insurance (EPHI), and discrimination. Second, we identify studies analyzing correlations between unions directly with health outcomes that do not require links. Outcomes include occupational injuries, sickness absence, and drug overdose deaths. Third, we offer judgments on the strength of pathways and outcomes --- labeled "consensus," "likely," "disputed" or "unknown" --- based on literature summaries. In our view, whereas there are four "consensus" pathways and outcomes and 16 "likely" pathways and outcomes for unions improving health, there are no "consensus" or "likely" pathways for harming health. The strongest "consensus" pathways and outcomes with salubrious associations include EPHI, OSHA inspections, dangerous working conditions, and injury deaths. Fourth, we identify research gaps and suggest methods for future studies. Unions are an underappreciated social determinant of health.

BACKGROUND: Collaboration is the way to deliver the desired health outcome for the patients or service users in the healthcare. Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between physicians and pharmacists within the public hospitals of Jigjiga town, Somali National Regional State, Ethiopia, 2020. METHODS: A cross-sectional study qualitative was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians. RESULTS: This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals' collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established. CONCLUSIONS: The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration. RECOMMENDATION: Physicians and pharmacists need to exert more efforts to enhance this collaboration. Further qualitative study might be needed to search for factors affecting, barriers and how to develop collaborative practice. ...

Abstract This study assessed the influence of menopausal-related health symptoms on quality of life of women in Irepodun Local Government Area in Osun State. Descriptive research design of the survey type was adopted in this study. The populations for this study were the women within the age range 45-60 years in six selected wards in Irepodun Local Government. A total of 339 respondents were purposively selected. The research instrument used was a questionnaire tagged Menopausal – Specific Quality of Life Questionnaire which was adapted for the collection of data. The research instrument was validated and reliability index of 0.81 for symptoms of menopause, and 0.89 for Menopause specific quality of life were gotten. Descriptive statistics were used to answer the research questions. Inferential statistics of chi-square was used to test the hypotheses at 0.05 level of significance. The study revealed that menopausal-related health symptoms that women are experiencing are, vasomotor (58.47%), sexual (55.4%), physical (54.87%) and psychosocial (49.23%) domains. A statistically significant relationship was found between vasomotor (X2 = 8.881 at P .007), psychological (X2 = 18.765 at P = .000), physical (X2 = 31.117 at P = .000) and sexual domains (X2 = 14.987 at P = .000) domains of menopausal-related health symptoms and quality of life. It was recommended among others that that health care providers need to play a more visible and instrumental role in continuously assessing menopausal women's needs as well as implement appropriate health education programs for women about the menopausal period and how to pass through it safely. Keywords: Menopausal-Related, Health Symptoms, Quality of Life, Women, ; This article has been published at www.ijarbas.com , Issue: 3, Vol.#2, March, 2020.

Les pratiques de l'agriculture itinérante incontrôlée, en Côte d'Ivoire en général et dans le Département d'Akoupé en particulier, ont eu des effets néfastes sur le couvert forestier. La présente étude, a pour objectif de décrire les stratégies que développent les acteurs du domaine forestier dans la préservation des forêts villageoises. La méthode adoptée a consisté à combiner recherches documentaires, observations directes et enquêtes de terrain. Les enquêtes ont été conduites sur la base d'un guide d'entretien. Pour rendre les résultats objectifs, la théorie de l'interactionnisme symbolique et celle de la représentation sociale ont été adoptées. Les résultats ont montré que l'Etat de Côte d'Ivoire et les populations locales développent des stratégies tant modernes que traditionnelles, à travers les structures chargées du domaine forestier, pour préserver les forêts villageoises. The uncontrolled agricultural nomadic practices conducted in Ivory Coast, especially in the Department of Akoupe, have resulted to some negative impacts on the forest covert. This investigation conducted in that department targetsthe description of the strategies implemented by the actors of the forest domain, who are willing to protect the natural forests in villages. The methodology they adopted consisted of a combination of documentary researches, direct observations, and ground investigations. The investigations occurred on the basis of an interview guide targeting the performers of the forest area. To be much more objective, the theory of the symbolic interactionism and that of the social representation were adopted. The results of the study show that the Ivorian government as well as the local populations, using the structures in charge of the forest area, created both modern and traditional strategies to preserve the village forests.

AbstractAlthough family quality of life (FQOL) and the family‐centered approach (FCA) are often conceptually linked, empirical research on their relation is scarce. This study investigated the relation between the FCA and FQOL in families with a child (0–18 years) with an intellectual disability receiving home‐based support (HBS) in Flanders. The impact of the parental work situation and the child's support needs on FQOL (domains) were studied too. Through the Helpgiving Practices Scale (HPS) and the Enabling Practices Scale (EPS), parents of participating families (n = 58) reported about the FCA in their families' HBS. Using the Beach Center FQOL Scale, mainly mothers reported about their families' quality of life. The relation between the realization of the FCA, parental employment, and the child's support needs on the one hand, and FQOL on the other hand was studied via multiple regression analyses. Additionally, the best predicting model was determined for FQOL (domains). Globally, a positive relation between FQOL and the FCA was found. Dependent on the FQOL domain, a different relation was identified with the family‐centered components. Components of the EPS (i.e., comfort and parental autonomy) were better predictors than those of the HPS. The parental work situation was a significant predictor for satisfaction regarding total FQOL (with and without disability‐related support), family interactions, and parenting. The child's support needs were a significant predictor for emotional well‐being. As the first of its kind, this study investigated the relation between FQOL and the FCA in detail. More, in depth, and especially long‐term research is, however needed to fully understand the relation between FQOL and its contributors.

Purpose
The organisational and service delivery landscape of the emergency services in the UK has been rapidly changing and is facing further change in the foreseeable future. The purpose of this paper is to examine recent and ongoing organisational changes in the policy development, service delivery and regulatory landscape of the emergency services, in order to capture the overall picture and potential opportunities for improvement or further investigation.


Design/methodology/approach
This general review utilises the characteristics of the three domains of a national framework, namely, policy development, service delivery and public assurance, and uses these characteristics as lenses to examine the three main blue light emergency services of police, fire and ambulances.


Findings
What emerges in the organisational landscape and conceptual maps for the police and even more so for the Fire and Rescue Service, is the immaturity of many of the organisations in the policy and the public assurance domains while the service delivery organisations have remained relatively stable. In the relatively neglected ambulance services, we find the NHS's recent Ambulance Response Programme has considerable potential to improve parts of all three domains.


Research limitations/implications
The review is limited to the UK and primarily focussed on England.


Practical implications
The review identifies opportunities for improvement, potential improvement and further research.


Originality/value
Although the National Audit Office has attempted in the past to provide organisational landscape reviews of individual emergency services, this contemporary comparative review of all three services using a common model is unique. It provides considerable new insights for policy makers, service delivers and regulators.

Software is everywhere and the productivity of Software Engineers has increased radically with the advent of new specifications, design and programming paradigms and languages. The main objective of the DECODER project is to introduce radical solutions to increase productivity by increasing the abstraction level, at specification stage, using requirements engineering techniques to integrate more complete specifications into the development process, and formal methods to reduce the time and efforts for integration testing. DECODER project will develop a methodology and tools to improve the productivity of the software development process for medium-criticality applications in the domains of IoT, Cloud Computing, and Operating Systems by combining Natural Language Processing techniques, modelling techniques and Formal Methods. A radical improvement is expected from the management and transformation of informal data into material (herein called knowledge ) that can be assimilated by any party involved in a development process. The project expects an average benefit of 20% in terms of efforts on several use cases belonging to the beforehand mentioned domains and will provide recommendations on how to generalize the approach to other medium-critical domains. ; This work has been developed with the financial support of the European Union's Horizon 2020 research and innovation programme under grant agreement No. 824231 and the Spanish State Research Agency under the project TIN2017-84094-R and co-financed with ERDF. ; Torres Bosch, MV.; Gil Pascual, M.; Pelechano Ferragud, V. (2019). DECODER - DEveloper COmpanion for Documented and annotatEd code Reference. Springer. 596-601. https://doi.org/10.1007/978-3-030-35333-9_44 ; S ; 596 ; 601

Modern information communication technology eradicates barriers of geographic distances, making the world globally interdependent, but this spatial globalization has not eliminated cultural fragmentation. The Two Cultures of C.P. Snow (that of science–technology and that of humanities) are drifting apart even faster than before, and they themselves crumble into increasingly specialized domains. Disintegrated knowledge has become subservient to the competition in technological and economic race leading in the direction chosen not by the reason, intellect, and shared value-based judgement, but rather by the whims of autocratic leaders or fashion controlled by marketers for the purposes of political or economic dominance. If we want to restore the authority of our best available knowledge and democratic values in guiding humanity, first we have to reintegrate scattered domains of human knowledge and values and offer an evolving and diverse vision of common reality unified by sound methodology. This collection of articles responds to the call from the journal Philosophies to build a new, networked world of knowledge with domain specialists from different disciplines interacting and connecting with other knowledge-and-values-producing and knowledge-and-values-consuming communities in an inclusive, extended, contemporary natural–philosophic manner. In this process of synthesis, scientific and philosophical investigations enrich each other—with sciences informing philosophies about the best current knowledge of the world, both natural and human-made—while philosophies scrutinize the ontological, epistemological, and methodological foundations of sciences, providing scientists with questions and conceptual analyses. This is all directed at extending and deepening our existing comprehension of the world, including ourselves, both as humans and as societies, and humankind.

15 pags., 6 figs., 3 tabs. -- Open Access funded by Creative Commons Atribution Licence 4.0 ; p53 is frequently mutated in human cancers. Its levels are tightly regulated by the E3 ubiquitin ligase MDM2. The complex between MDM2 and p53 is largely formed by the interaction between the N-terminal domain of MDM2 and the N-terminal transactivation (TA) domain of p53 (residues 15–29). We investigated the kinetic and thermodynamic basis of the MDM2/p53 interaction by using wild-type and mutant variants of the TA domain. We focus on the effects of phosphorylation at positions Thr18 and Ser20 including their substitution with phosphomimetics. Conformational propensities of the isolated peptides were investigated using in silico methods and experimentally by circular dichroism and H-NMR in aqueous solution. Both experimental and computational analyses indicate that the p53 peptides are mainly disordered in aqueous solution, with evidence of nascent helix around the Ser20-Leu25 region. Both phosphorylation and the phosphomimetics at Thr18 result in a decrease in the binding affinity by ten- to twenty-fold when compared to the wild-type. Phosphorylation and phosphomimetics at Ser20 result in a smaller decrease in the affinity. Mutation of Lys24 and Leu25 also disrupts the interaction. Our results may be useful for further development of peptide-based drugs targeting the MDM2/p53 interaction. ; This work was supported by Spanish Ministry of Economy and Competitiveness [CTQ 2015–64445-R (to JLN)]. JLN acknowledges the regional government Generalitat Valenciana for a BEST short-stay fellowship in the Department of Pharmacology, Cambridge, UK. LSI acknowledges support of a Senior Fellowship from the Medical Research Foundation (UK).

BACKGROUND: Ambitious overseas recruitment targets have been set by the UK government to help alleviate the current GP shortage. European Economic Area (EEA) doctors can join the UK's GP register under European law. Non-EEA doctors must obtain a Certificate of Eligibility for General Practice Registration (CEGPR), demonstrating equivalence to UK-trained doctors. CEGPR applications can be time-consuming and burdensome. To meet overseas recruitment targets, it is important to facilitate the most efficient route into UK general practice while maintaining registration standards and patient safety. AIM: To develop a methodology to map postgraduate GP training and healthcare contextual data from an overseas country to the UK. DESIGN & SETTING: Desk-based research and stakeholder interviews. METHOD: Four stages were undertaken: 1) developing a data collection template; 2) conducting a case study (using Australia as a test case); 3) refining the data collection template; and 4) creating a mapping framework. The case study used the 2016 curricula for the UK and Australia. RESULTS: Five 'domains' were identified: healthcare context, training pathway, curriculum, assessment, and continuing professional development (CPD) and revalidation. The final data collection template comprised 49 mapping items across the domains. The methodology incorporated the application of a red, amber, or green (RAG) rating to indicate similarity of data across the five domains. Australia was rated 'green' for training pathway, curriculum, and assessment, and 'amber' for healthcare context and CPD and revalidation. The overall rating was 'green'. CONCLUSION: Implementing this systematic methodology for mapping GP training between countries may support the UK's ambitions to recruit more GPs, and alleviate current GP workforce pressures.

OBJECTIVE: To examine experiences of racial/ethnic discrimination among Latinos in the United States, which broadly contribute to their poor health outcomes. DATA SOURCE AND STUDY DESIGN: Data come from a nationally representative, probability‐based telephone survey including 803 Latinos and a comparison group of 902 non‐Hispanic white US adults, conducted January—April 2017. METHODS: We calculated the percent of Latinos reporting discrimination in several domains, including health care. We used logistic regression to compare the Latino‐white difference in odds of discrimination, and among Latinos only to examine variation by socioeconomic status and country of birth. PRINCIPAL FINDINGS: One in five Latinos (20 percent) reported experiencing discrimination in clinical encounters, while 17 percent avoided seeking health care for themselves or family members due to anticipated discrimination. A notable share of Latinos also reported experiencing discrimination with employment (33 percent applying for jobs; 32 percent obtaining equal pay/promotions), housing (31 percent), and police interactions (27 percent). In adjusted models, Latinos had significantly higher odds than whites for reporting discrimination in health care visits (OR: 3.18, 95% CI: 1.61, 6.26) and across several other domains. Latinos with college degrees had significantly higher odds of reporting discrimination in multiple domains than those without college degrees, with few differences between foreign‐born and US‐born Latinos. CONCLUSIONS: Latinos in the United States report experiencing widespread discrimination in health care and other areas of their lives, at significantly higher levels than whites. Being born in the United States and earning a college degree are not protective against discrimination, suggesting that further health and social policy efforts to eliminate discrimination are needed.

BACKGROUND: Previously published work established the need for a specialty-specific definition of professionalism in pediatric anesthesiology. That work established a composite definition consisting of 11 domains and their component "defining themes" for professionalism in pediatric anesthesiology. As a next step towards assessing generalizability of our single-center findings, we sought to gain input from a national sample of pediatric anesthesiologists. AIM: To establish the construct validity of our previously published multidimensional definition of professionalism in pediatric anesthesiology using a nationally representative sample of pediatric anesthesiologists. METHODS: A survey was distributed via snowball sampling to the leaders of every pediatric anesthesiology fellowship program and pediatric anesthesia department or clinical division in the United States. Survey items were designed to validate individual component themes in the working definition. For affirmed items, the respondent was asked to rate the importance of the item. Respondents were also invited to suggest novel themes to be included in the definition. RESULTS: 216 pediatric anesthesiologists representing a variety of experience levels and practice settings responded to the survey. All 40 themes were strongly supported by the respondents, with the least supported theme receiving 71.6% approval. 92.8% of respondents indicated that the 11 domains previously identified formed a comprehensive list of domains for professionalism in pediatric anesthesiology. Four additional novel themes were suggested by respondents, including wellness/self-care/burnout prevention, political advocacy, justice within a practice organization, and respect for leadership/experienced partners. These are topics for future study. The survey responses also indicated a near-universal agreement that didactic lectures would be ineffective for teaching professionalism. CONCLUSION: This national survey of pediatric anesthesiologists serves to confirm the construct validity ...

As a result of widespread mistreatment and overt discrimination in all dimensions of their lives, women lack significant autonomy. The central preoccupation of this book is to explore key sources of female empowerment and discuss the current challenges and opportunities for the future. Schematically, three main domains are distinguished. The first is marriage and women's relative bargaining position within the household. Since in developing countries marriage is essentially universal and generally arranged by the parents, women have little say in the choice of their partner and largely depend on their husband for their livelihoods and well-being. How marriage, divorce, and remarriage practices have evolved and with what effects for women, is therefore of crucial concern. The second domain is the set of options available to women outside of marriage and in the context of their community. Given the importance of household dynamics in determining female well-being, a crucial step towards women's empowerment consists of improving such options, economic and collective action opportunities in particular. The third domain belongs to the realm of over-arching discriminatory laws and cultural norms. Can the government acting as lawmaker contribute to modifying norms and practices that disadvantage women? Or, to be effective, do legal moves need to be complemented by other initiatives such as the expansion of economic opportunities for women? Do discriminatory social norms necessarily dissolve with improved legal status for women? These questions, and other related issues, are tackled from different perspectives, by top scholars with well-established experience in gender-focused economic and social research.

2016 saw the referendum on Britain's continued membership of the EU, in which almost half of the voters went with one option, while just over a half cast their ballot for the other. In this paper, we will investigate what metaphors and scenarios were used in news reports and opinion pieces on the country's most popular national news websites the day after the vote. Using the Metaphor Identification Procedure (Pragglejaz, 2007), we identified metaphors for the UK electorate and political establishment and analysed them qualitatively. Results show widespread use of spatial and ontological metaphors (e.g. 'the towns and estates left behind', 'deeply divided opinion'). While the spatial metaphor is used to represent the relationship between the electorate and the establishment, the ontological metaphor serves to construe divides within these groups. What is more, the spatial metaphor is perspectivised by image schemas (e.g. FRONT-BACK) whereas the ontological metaphor is specified by particular source domains (e.g. War/Violence:1 'voters were bombarded with hysterical threats'). Such specific source domains also motivate more dynamic metaphor scenarios (Musolff, 2006, Semino et al., 2016), i.e. mini-narratives featuring actors, actions and evaluations. Our analysis provides a data-driven model of the relations between metaphors, image schemas, source domains and scenarios. As such, it adds conceptual complexity to Musolff's (2006) notion of metaphor scenarios while simultaneously testing Kövecses' (2017) taxonomy of metaphor against discourse data. We thereby demonstrate how the analysis of discourse can benefit from cognitive semantics and how, vice versa, conceptual metaphor theory can be advanced through empirical studies.

Blockchain can potentially be appropriated as a social computing technology, which enables transactions across people and artefacts via a large socio-technical information infrastructure constituted by the actions of multiple people and computers. However, Blockchain is not a social computing technology
a priori
; instead to emerge as one, much effort and work is required to radically transform existing domains, including wrestling with traditions, standards, and legacy. In this article, we expand on previous work on Blockchain as an information infrastructure, and on the notion of
infrastructural grind.
Infrastructural grind allows us to analytically explore how the emerging Blockchain technology is appropriated into established business domains, in our case the shipping industry. We present ethnographic data unpacking three different accounts of infrastructural grind taking place at the intersection of the shipping and the Blockchain information infrastructures. The results demonstrate that infrastructural grind occurs as a result of various infrastructuring activities taking place at different intersections between the two infrastructures and is constituted of the sum of these activities. We propose a framework in which infrastructural grind is constituted of three entangled dimensions:
permeability, interoperability
, and
velocity
. These socio-technical dimensions relate to infrastructural properties such as legacy, embeddedness, and standards, as well as to technical properties of specific solutions deployed at specific points of infrastructural grind. Our analysis shows that these dimensions are enacted differently along the shipping supply chain, and depending on the dynamic interplay between them at various points of infrastructural grind. At different points in time, the infrastructural grind between Blockchain and the shipping domain will thus manifest itself differently and at differential velocity.