In a research series carried out between 1984 and 1988 in the county of Västerbotten in northern Sweden, various aspects of the professional role and work of physiotherapists were studied. A variety of research methods were used: questionnaires (n = 163), a time budget study (n = 149), and a qualitative interview (n = 24). Physiotherapy was considered varied and creative, but not well defined or very specific in its objectives. Physiotherapy is still a predominantly female profession, though the proportion of male physiotherapists was increasing. The proportion entering full-time employment in physiotherapy increased due both to the greater number of male graduates and the increasing number of women working full-time. A partial internal division of work between the sexes has arisen. More women than men are employed in in-patient care, while proportionately more men worked outside institutions. Most respondents were firmly in control of their treatment methods, but were somewhat restricted in their freedom to decide whom to treat, and when to terminate treatment. Few had carried out any research concerning treatment and results. The time budget study showed that the treatment of patients took up on average 33% of the physiotherapists’ gross working hours and was the largest single task. Continuing education accounted for 5%, development work for 1% and the remaining occupational tasks for 38%. Occupational area was the most important factor in explaining the distribution of working hours, when other factors were kept constant. Neither sex nor gender markedly affects the carrying out of tasks other than treatment. Nor does professional post particularly affect time utilization other than for administrative tasks. This profession has a double objective: care and service more generally and to provide physiotherapy in particular—both equally important. In order to improve the quality of physiotherapy, and at the same time to extend their own specific, theoretical body of knowledge, a number of physiotherapists have reappraised and extended their concept of the profession to include management and research in their everyday work. Conclusion: The fact that occupational area exercises such a profound influence on the work of physiotherapists, taken together with the slight influence that professional post has, reveals that the individual physiotherapist must be prepared to play a broadly defined professional role. There seems to be a wealth of skill and expertise available within the profession, which could, however, be more efficiently used if the management and organization of physiotherapy service were better adapted to serve its objectives, and if these were better delineated and communicated. / digitalisering@umu.se

INTRODUÇÃO: Conhecer o perfil dos fisioterapeutas é o primeiro passo para dar início ao desenvolvimento de ações em busca do crescimento, reconhecimento e valorização da profissão. No Estado de São Paulo estão registrados mais de 34% dos fisioterapeutas brasileiros, é o Estado em que foi criado o primeiro curso de fisioterapia e que possui o maior número de universidades com o curso de fisioterapia em atividade. O curso de fisioterapia da Faculdade de Medicina da Universidade de São Paulo (FMUSP) é o pioneiro no país. Já foi estudado o perfil do fisioterapeuta em outros estados, especialidades, universidades ou locais de trabalho específicos, porém não temos conhecimento do atual perfil do fisioterapeuta do Estado de São Paulo. OBJETIVO: Descrever o perfil do fisioterapeuta do Estado de São Paulo e do egresso do curso de fisioterapia da FMUSP segundo os aspectos demográfico, formativo e de atuação profissional. Como objetivo secundário, avaliar se há associação entre o tipo de instituição cursada, o local de trabalho e o ano de graduação com a renda salarial mensal. MÉTODO: Todos os fisioterapeutas inscritos no Conselho Regional de Fisioterapia e Terapia Ocupacional da 3ª Região com pelo menos um ano de graduado foram convidados a participar do estudo que consistia em responder um questionário online (Survey Monkey®). Para assegurar a confidencialidade da identificação do profissional, o envio foi realizado pelo Crefito-3 e os questionários não exigiam identificação. Todos os dados foram analisados e foram apresentados em frequências absoluta e relativa. As associações foram analisadas pelo Teste de Qui Quadrado. RESULTADOS: No total 2323 fisioterapeutas participaram da pesquisa, provenientes de todo o Estado de São Paulo, sendo 110 graduados na FMUSP. A amostra geral consistiu em 80% de mulheres, 62% graduou-se entre os anos de 2001 e 2010, 83% graduou-se em uma universidade privada, cerca de 85% dos profissionais realizaram alguma pós graduação, sendo 66,7% pós-graduação lato sensu e 18,3% stricto sensu. As áreas de especialização lato sensu mais procuradas foram a ortopedia (12,7%), cardiorrespiratória (12,0%), acupuntura (10,5%) e neurologia (8,5%), porém 19,0% realizaram uma pós-graduação em uma área ainda não reconhecida pelo Conselho Federal de Fisioterapia e Terapia Ocupacional, como a hidroterapia, geriatria, fisiologia do exercício e gestão hospitalar. Em relação ao stricto sensu, 10,8% possuem título de mestre e 7,5% de doutores. Dos entrevistados, 83,2% atua como fisioterapeuta e em 67,3% a fisioterapia é a sua única fonte de renda. O local de trabalho predominante é o atendimento domiciliar (35,4%) e a renda bruta mensal foi de acima de R$3.000,00 em 35,9% dos casos, sendo que os profissionais com mais tempo de formado ganham mais do que os graduados há menos tempo, e os que atuam em universidades são melhores remunerados. Trinta e sete por cento dos participantes estão parcialmente satisfeitos com a profissão, 98% atualizam-se participando de congressos, cursos e leitura de artigos científicos, apresentam baixa adesão aos sindicatos e associações de classe (15,8%) e somente 13% tinha conhecimento sobre o valor do piso salarial atual. O egresso da FMUSP apresentou como diferencial comparado ao perfil do fisioterapeuta do Estado de São Paulo, a maior dedicação à docência e pesquisa, maior atuação nas universidades, melhores remunerações e encontraram menores dificuldades na inserção no mercado de trabalho. Na análise secundária, não foram encontradas associadas entre a renda salarial mensal e o tipo de instituição, a atuação em clínicas próprias está associada a melhores remunerações e os graduados há mais tempo possuem melhores salários. CONCLUSÃO: A classe de fisioterapeutas do Estado de São Paulo é formada predominantemente por mulheres jovens, graduadas após 2001 em uma universidade privada, com pós-graduação lato sensu, autônoma, realizando atendimentos domiciliares, com renda mensal entre R$1.500,00 a R$6.000,00, estão parcialmente satisfeitos com a profissão, possuem a fisioterapia como única fonte de renda e mantém-se atualizados através da participação em congressos, cursos e leitura de artigos científicos / INTRODUCTION: To know of professional profile is the first step to start actions development to pursuit growth, recognition and appreciation of the profession. In Sao Paulo are registered more than 34% of brazilian physical therapists, is the state which first physical therapy course and has the largest number of universities with physical therapy course. The profile of physical therapist in other states or specific area has been studied, but do not know about the current profile of the physical therapist in the State of Sao Paulo. OBJECTIVE: To present the profile of the physical therapist in the Sao Paulo State according to socio-demographics, academic background, scientific and technical knowledge, labor Market and knowledge of current legislation. METHOD: All registered physical therapist in Crefito-3 with at least one year of graduate were invited to participate in the study that consist in to answer an online survey (Survey Monkey®). We did not acess to professional identification and only Crefito-3 sent e-mail to all physical therapist. All data were analyzed and organized in tables with absolute and relative frequences. Results: In total 2363 physical therapists participated in the survey from all over the state. The sample consisted of 80% women, 62% graduated between 2001 and 2010, 83% graduated from a private university, 85% of professional performed some post graduate, 66,7% lato sensu and 18,3% stricto sensu. The main areas of post graduate are orthopedics (12,7%), cardiothoracics (12%), acupuncture (10,5%) and neurology (8,5%), but 19% performed a post graduate not recognized by COFFITO such as hydrotherapy, geriatrics, exercise physiology and hospital management. Regardind the stricto sensu, 10,8% have a master\'s degree and 7,5% of doctors. Of the participants, 83,2% works with physical therapy and 67,3% had the physical therapy such their liny source of money. The predominant place of work is the home care (35,4%) and earn R$1500,00 to R$3000,00 by month in 34,4% of cases and professional with some years of graduation earn more than graduates less time and those who work in universities are better salaries. 37% of participants are partially satisfy with the profession, 98% updated through congress, courses an reading scientifics articles, low subscription in sindicates and class associations and only 13,8% known about current minimum income. CONCLUSION: The physical therapist profile of Sao Paulo State is formed predominantly by Young women, graduated after 2001 in a private university, post-graduation course, autonomous, works in home care and monthly income between R$1500,00 to R$3000,00, are partially satisfied with the profession, the physical therapy as only source of income and remains updated through participation in conferences, courses and reading scientific articles

The social work has change from a voluntary dedication to an established profession. Social work is a profession in constant change and development. This study is about how social work has changed over time and how these changes have affected social workers professional practice. Our study highlights the changes in Sweden in the last 30 years. Our study is a qualitative study with an individual perspective and was conducted through semi-structured interviews with social workers over 55 years old. The results were consequently analyzed by using organizational theory, new institutonalism, professionalism and specialization. The result showed mainly three changes. These changes were digitization, streamlining and specialization. The result showed that these changes have contributed to both positive and negative consequences. Some of the consequences are; less client contact, high workload and more administrative work. The social work is changing as society develops. The result also shows that the professional identity is complex and associated to many other things. The disadvantage of the social worker's professional profession is the complexity, because social workers are a professional group with broad knowledge who can work in many different fields, which means that a professional identity can be  difficult to create.

abstract: Empathy is a critical component of high-quality healthcare. When present in the clinical encounter, empathy is important to physicians (empathy is correlated with reductions in physician anxiety and burnout) and to patients (empathy is correlated with better medical decision making, enhanced trust, and improved treatment adherence). Unfortunately, there is an empathy gap in healthcare–physicians often miss opportunities to demonstrate empathy to their patients. This leaves patients feeling unheard, less likely to bring up details important to their care, and less likely to follow treatment guidelines from physicians, thus disrupting the physician-patient relationship. Luckily, communicating with empathy is a skill that can be taught and learned. With the right tools, learners can strengthen their empathic muscle and become better prepared for responding in difficult situations. The present thesis aims to validate a new tool for teaching empathy to medical trainees. This tool, an empathic communication guide, is drawn from social work as well as medical expertise. It is catered specifically to how medical trainees are accustomed to learning and provides the actual words to say in order to respond with empathy in difficult situations. A group of 8 palliative care fellows at MD Anderson Cancer Center in Houston, Texas received a copy of this guide and participated in an accompanying communication workshop. To gauge empathic responding ability, fellows completed pre- and post- surveys and patient simulations. These data were analyzed using a combination of novel and established methods for quantifying empathic behaviors. Fellows’ empathic communication skill significantly improved after exposure to the guide opening avenues for future study and application. / Dissertation/Thesis / Masters Thesis Social Work 2020

Seit 2005 untersuchen Fachbehörden in Dauerfeldversuchen unterschiedliche Bodenbearbeitungssysteme und Verfahren zum Schutz vor Wassererosion und Schadverdichtung. Sechs Fachbeiträge stellen die Wirkung auf Ertrag, Erosionsgefährdung, Infiltrationsverhalten sowie Humus- und Nährstoffgehalte dar. Dauerhaft konservierende Bodenbearbeitung ist die wirksamste Erosionsschutzmaßnahme und vermindert den Bodenabtrag durch Wassererosion um bis zu 90 Prozent. Sie führt auf sandigeren Böden und auf Lössböden in den oberen Bodenschichten zur Anreicherung von Humus, Kalium und Magnesium, in Sachsens Lössboden auch zur P-Anreicherung. Zwischen pfluglos und mit Pflug bestellten Fruchtarten gab es keine Ertragsunterschiede. Konservierende Bodenbearbeitung/Direktsaat führen gegenüber dem Pflug zum Anstieg der Bodendichte im unbearbeiteten Krumenboden und zur Abnahme der Luftkapazität. Auf Lössböden wird dies durch Wurmgänge und Wurzelröhren ausgeglichen. Lössböden können daher langfristig flach bearbeitet werden. Strukturschwache Sandböden müssen dagegen bodenzustandsabhängig intensiver und im Einzeljahr krumentief gelockert werden. Bandlaufwerke schützen Ackerflächen im Unterboden auch bei hoher Auflast von 14 t vorsorgend gegen Schadverdichtung. Schonend für das Bodengefüge wirkt eine Reifeninnendruckabsenkung in Kombination mit Vermeidung von Radlasten über 10 t.:Einleitung Einschätzung der Schadverdichtungsgefährdung und Verfahren zum Schutz des Bodens vor Schadverdichtung auf der Grundlage des mechanischen Bodenverhaltens Untersuchungen zum Infiltrationsvermögen von Böden nach langjährigem Pflugverzicht und Direktsaat Nachhaltige Bodenbearbeitungsverfahren unter den Bedingungen Mecklenburg-Vorpommerns – Wirkung langfristig praktizierter unterschiedlicher Bodenbearbeitungssysteme auf den Nährstoffgehalt des Bodens und den Ertrag landwirtschaftlicher Kulturen Gute fachliche Praxis der landwirtschaftlichen Bodennutzung diluvialer Ackerböden Brandenburgs - Aktuelle Schlussfolgerungen aus den Dauerfeldversuchen Groß Kreutz (P60, M4) und der ökologischen Fruchtfolge Güterfelde Bodengefügeschutz mit optimierter Fahrwerkstechnik Untersuchungen zu acker- und pflanzenbaulichen Auswirkungen einer dauerhaft konservierenden Bodenbearbeitung

Mechanically ventilated critically ill patients treated in the intensive care unit (ICU) require enteral feedings to maintain adequate nutrition during critical illness. Delivery of adequate enteral nutrition is also critical to the recovery of critically ill patients. Enteral nutrition has been shown to decrease length of time on the ventilator, decrease length of stay and ICU and decrease mortality. Despite all the evidence regarding the benefits of enteral nutrition, critically ill patients continue to receive less than their prescribed calories and protein. Nurses are in a unique position to influence the delivery of enteral nutrition. Nursing practices that contribute to underfeeding must be identified and corrected to ensure adequate delivery of nutrients is achieved. The purpose of the study was to describe the professional practice of critical care nurses regarding enteral feeding in mechanically ventilated critically ill patients. Several barriers were identified by the participants in the study that contributed to underfeeding including inconsistent practice regarding gastric residual volume, holding feeds when changing patient position and lack of a standardized protocol for enteral feeding. Also identified in the study was the idea that nurses do not see enteral feeding as a life-saving intervention. It is not the “sexy part” of what ICU nurses do. Enteral feeding guidelines need to be developed to include those interventions that are important to nursing practice in order to increase enteral feeding times and improve patient outcomes.

The purpose of the study was to determine administrators’ self-assessed perceived knowledge, importance, and perceptions of the International Society for Technology in Education Standards for Administrators (ISTE Standards-A) and the Virginia Technology Standards for Instructional Personnel (VTSIP). A survey instrument based on the ISTE Standards-A and the VTSIP was used in the study. 43 administrators in Virginia participated in the study. The participants were members of the Virginia Association of Elementary or Secondary School Principals. The study found that administrators perceived their knowledge of the ISTE Standards-A as good and their knowledge of the VTSIP as excellent. Administrators strongly agreed that both the ISTE Standards-A and the VTSIP were important in their practice. Additionally, their perceptions of both the ISTE Standards-A and the VTSIP were excellent. There were no statistically significant differences found between the perception of the standards and most of the demographic variables. However, there was a statistically significant difference found between male and female perceptions of the VTSIP. Also, there was a statistically significant difference found between administrators’ perceptions of the ISTE Standards-A and perceptions of the VTSIP. The study provided quantitative data on administrators’ perceived knowledge, importance and perceptions of practicing the ISTE Standards-A and the VTSIP. The findings of this study provide valuable information for administrators as they investigate their technology leadership and note areas of improvement, and for the Virginia Department of Education, local education agencies and universities. It is recommended that future research look qualitatively at administrator perceptions of the standards and why males and females differ in their perception of the standards. Further research is also recommended using a larger sample in the state or nationwide, and conducting more research to look into administrative leadership preparation programs, administrators’ perceptions of practice, program alignment or administrator implementation of the ISTE Standards-A and the VTSIP.

The purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of coping behaviors in response to workplace stressors. It was undertaken with the intention of identifying intervention strategies which will promote a healthy workforce and the retention of nurses in the workplace. An exploratory cross-sectional survey of 1235 staff nurses employed on the intensive, progressive and general medical-surgical nursing units of seven hospitals associated with a major Central Florida healthcare network tested a client-centered model in an effort to identify nurses vulnerable to the health consequences of job strain using structural equation modeling. Human subject protection was assured. An 82 item questionnaire was used to collect demographic data and measure responses to items associated with the constructs of health status, autonomy, collaboration, decentralization, coping, satisfaction, absenteeism and intent to leave. A variety instruments that were previously demonstrated as valid and reliable were used in the construction of the instrument. Subjects were also given the option of including additional written comments. A total of 325 surveys were returned, of which 308 met inclusion criteria, for a response rate of 25%. Data analysis determined that the measurement of job strain as a function of self-assessed generic health status was predictive of propensity to leave (ã = -.21). The experience of job strain shared a strong association with indicators of mental health status. Job strain was significantly influenced by coping behavior (ã = .56) which targeted activities associated with sustaining and balancing. Anecdotal remarks suggested that the need for balance influenced perceptions regarding stressors in the workplace. The professional practice environment was associated negatively with the propensity to leave (ã = -.58). Those staff nurses who experienced higher levels of autonomy expressed a greater degree of satisfaction and lower intent to leave. The variables of collaboration and decentralization contributed minimally to the construct of professional practice. Anecdotal remarks suggested that the low contribution of collaboration and decentralization contributed to a sense of powerlessness and frustration with work related circumstances. The influence of job strain, coping and the professional practice environment upon staff nurses suggests that health promotion strategies, efforts to enhance coping behavior and promotion of a professional practice environment will increase employee satisfaction and reduce intent to leave. Adoption of policies and procedures which support the health and well-being of individual staff members will benefit employees, strengthen the organizations in which they practice and promote the overall retention of nurses in the face of looming nurse shortages.

Introduction: Ethical decision-making is an important component of occupational therapy practice in Canada. Research is needed to understand ethical decision-making and how to build occupational therapists’ competency to make ethical decisions. Purpose: The aim of this thesis was to study ethical decision-making in occupational therapy practice in order to contribute to epistemological development regarding ethics in occupational therapy and to support continuing competency in ethical decision-making. Method: Three studies comprise this thesis. A constructivist grounded theory study was conducted involving in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings to explore the process of ethical decision-making. An interpretive description study using secondary analysis of grounded theory data was conducted to explore gaps related to continuing competency in ethical decision-making from the participants’ perspective and to generate recommendations for future directions to support continuing competency. Finally, a non-randomized, single-group, pre- and post-test study (n=33) was conducted to evaluate an on-line education module developed to support competency for clinician-educators. Findings: The grounded theory study led to development of an ethical decision-making prism capturing three processes: Considering the Fundamental Checklist, Consulting Others, and Doing What’s Right. The interpretive description study highlighted two gaps related to continuing competency in ethical decision-making: lack of knowledge and lack of supports. Education, tool development, and ethics mentorship were identified directions for development. The third evaluation study found that an on-line education module led to improvements in ethics knowledge and intent to change practice but not to actual practice change. Implications: This thesis advances a theoretical understanding of ethical decision-making in occupational therapy practice and an applied understanding of occupational therapists’ needs related to competent ethical decision-making. Findings also provide preliminary data regarding on-line ethics education to advance knowledge and skills of clinician-educators who are involved in cultivating ethical decision-making among student occupational therapists. / Thesis / Doctor of Philosophy (PhD) / “Doing what’s right”, or ethical decision-making, is an important part of being an occupational therapist in Canada. To help occupational therapists build knowledge and skills it is important to understand how they make ethical decisions in day-to-day practice. This PhD describes three studies that look at three different aspects of ethical decision-making. The first study presents a theoretical explanation of how occupational therapists decide what’s right to do. The second study uses the same data to look at supports that occupational therapists feel they need to build knowledge and skills about ethical decision-making. The third study measures the value of an on-line education course in helping occupational therapy educators teach students about ethical decision-making. Results of these studies can be used to support occupational therapists in doing what’s right. Results also highlight areas for additional study to further support ethical occupational therapy practice in Canada.

Aim: According to the existing evidence-base, the experience of the death of a therapy client (from a cause other than suicide) for Clinical Psychologists is substantially under researched. Moreover, previous studies into the experience of patient or client death for healthcare professionals indicate this may be an important focus for research. The present study aimed to explore the often unheard, lived experiences of client death for Clinical Psychologists at the beginning of their career. It was hoped that these research findings may assist training courses, clinical supervisors and other Psychologists of all grades to make sense of this experience in greater depth. Method: A qualitative approach was adopted for this study. Semi-structured interviews were conducted with nine female junior Clinical Psychologists (Trainee, Newly Qualified) who had experienced the death of a client. The accounts were analysed using IPA, which attempts to illuminate the lived experience of a phenomenon for small samples of individuals. Results: The analytic procedure highlighted three main themes as emerging from participants’ accounts in the context of their client’s death: Connected and affected: Being unprepared for initial reactions to the client's death; "we do it so why can't you?" facing institutional denial and avoidance; "It's not something I've forgotten about", The lasting impact of client death: Learning reluctant lessons and experiencing continuing bonds. Implications: This study highlights the importance of recognising the impact of client death on Clinical Psychologists in particular, and healthcare professionals in general. Client death, by all causes, appears much overlooked within the current research base, which may have led to a self-perpetuating cycle of hidden and unspoken stories. The findings indicate death needs to be on the research and teaching agenda within the institution of Clinical Psychology. As a result we may be able to begin to break the current cycle of silence which has served to potentially disservice us as professionals, our teams and most importantly our clients.