ABSTRACT
Ineffective physician-nurse collaboration has been recognised to adversely impact patient and organisational outcomes, and some studies suggest an underlying factor may be that nurses and physicians have different perceptions of interprofessional collaboration (IPC). The objectives of this study were to evaluate for a difference in the perception of IPC between physicians and nurses and to explore potential contributing factors at the individual and organisational levels to any observed difference. Data including measures of perceptions of IPC were collected from a convenience sample of resident physicians (n = 47), attending physicians (n = 18), and nurses (n = 54) providing care for internal medicine patients in a large tertiary care academic medical centre. Regression analysis revealed significantly lower perceptions of IPC scores for nurses in comparison to the scores of both the resident and attending physician groups (p = .0001 for both). Although demographic and workload factors also differed by profession, only profession and workload remained significant in regression analysis. Given the known relationships between effective physician-nurse collaboration and superior patient and organisational outcomes, better defining the individual and organisational predictors of IPC scores may support development of more effective interventions targeting improvements in IPC.
Subject(s)
Academic Medical Centers , Attitude of Health Personnel , Cooperative Behavior , Organizational Culture , Physician-Nurse Relations , Adult , Female , Humans , Linear Models , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
BACKGROUND: Developmental instability of shelled gastropods is measured as deviations from a perfect equiangular (logarithmic) spiral. We studied six species of gastropods at 'Evolution Canyons I and II' in Carmel and the Galilee Mountains, Israel, respectively. The xeric, south-facing, 'African' slopes and the mesic, north-facing, 'European' slopes have dramatically different microclimates and plant communities. Moreover, 'Evolution Canyon II' receives more rainfall than 'Evolution Canyon I.' METHODOLOGY/PRINCIPAL FINDINGS: We examined fluctuating asymmetry, rate of whorl expansion, shell height, and number of rotations of the body suture in six species of terrestrial snails from the two 'Evolution Canyons.' The xeric 'African' slope should be more stressful to land snails than the 'European' slope, and 'Evolution Canyon I' should be more stressful than 'Evolution Canyon II.' Only Eopolita protensa jebusitica showed marginally significant differences in fluctuating helical asymmetry between the two slopes. Contrary to expectations, asymmetry was marginally greater on the 'European' slope. Shells of Levantina spiriplana caesareana at 'Evolution Canyon I,' were smaller and more asymmetric than those at 'Evolution Canyon II.' Moreover, shell height and number of rotations of the suture were greater on the north-facing slopes of both canyons. CONCLUSIONS/SIGNIFICANCE: Our data is consistent with a trade-off between drought resistance and thermoregulation in snails; Levantina was significantly smaller on the 'African' slope, for increasing surface area and thermoregulation, while Eopolita was larger on the 'African' slope, for reducing water evaporation. In addition, 'Evolution Canyon I' was more stressful than Evolution Canyon II' for Levantina.
Subject(s)
Climate , Ecosystem , Evolution, Molecular , Snails/anatomy & histology , Animals , Israel , Rain , RotationABSTRACT
The American College of Foot and Ankle Surgeons developed the Universal Evaluation Scoring System to evaluate parameters related to foot and ankle surgery. The project was developed in four sections or modules. The second of these modules, Forefoot, is presented here.
Subject(s)
Foot Deformities/physiopathology , Forefoot, Human , Severity of Illness Index , Foot Deformities/diagnostic imaging , Humans , RadiographyABSTRACT
The American College of Foot and Ankle Surgeons presents the Universal Evaluation Scoring System to evaluate parameters related to foot and ankle surgery. This instrument was developed primarily to allow investigators a means of consistency in clinical assessments. The project was developed in four sections or modules. The first of these modules, First Metatarsophalangeal Joint and First Ray, is presented. This project is unique in that it is the first clinical scoring system of the foot and ankle to become validated by statistical analysis.
