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PubMed2005

Hospital development plans: a new tool to break ground for strategic thinking in Tanzanian hospitals.

Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking.

Budgets↗

PubMed2005

Thought for application and application with thought: issues in theoretical thinking and practical wisdom.

Both theoretical thinking and practical wisdom are used by health professionals in their clinical practice. Lately, discussion has centered on the abstract phrase "theory-practice gap." The health profession is not the only discipline that seeks unity in theory and practice issues. Education is also building bridges in this arena. One reoccurring myth is the notion that theory and practice are separate; as a result, this gives a mistaken impression that theory serves no purpose in practice. Discussion of the issues in this paper includes definitions of theoretical thinking and practical wisdom, theoretical and practical knowledge development, and relevance to health professional's education, practice and science. These issues must be communicated to practitioners, educators and theorists. A collective definition to begin communication is proposed and suggestions are offered for addressing key issues.

Health Knowledge, Attitudes, Practice↗

PubMed1981

Strategies for improving productive thinking in the language impaired adult.

The purpose of this article is to discuss a cognitive approach to therapy with a language impaired adult. Two types of productive thinking are explored in this research: concept awareness and problem solving. These are dynamic and creative processes underlying the development and use of cognition and language. This single subject study follows an ABAB design and describes techniques used in therapy and methods for measuring productive thinking in a 66-yr-old moderately language impaired adult. Results indicate a sharp increase in the subject's thought productivity in a variety of contexts. A critical appraisal of reasons for therapy effectiveness are given.

Aged↗

PubMed1991

Developing strategic thinking in senior management.

Chief Executive Officers have recently stated that their greatest staffing challenge for the 1990s is the development of strategic leadership in their senior management. In order to do this, it is necessary to identify the substance of strategic thinking, and the capabilities that must be mastered. Writers on strategy have identified six major elements of strategic thinking and these have been organized to reveal the tasks, questions, decisions, and skills that senior executives must acquire in order to lead their organizations strategically. Finally, the article identifies training programme elements which are used by Directors of Manpower Development to develop strategic leadership ability.

Administrative Personnel↗

PubMed2006

Do Chinese and English speakers think about time differently? Failure of replicating Boroditsky (2001).

English uses the horizontal spatial metaphors to express time (e.g., the good days ahead of us). Chinese also uses the vertical metaphors (e.g., 'the month above' to mean last month). Do Chinese speakers, then, think about time in a different way than English speakers? Boroditsky [Boroditsky, L. (2001). Does language shape thought? Mandarin and English speakers' conceptions of time. Cognitive Psychology, 43(1), 1-22] claimed that they do, and went on to conclude that 'language is a powerful tool in shaping habitual thought about abstract domains' (such as time). By estimating the frequency of usage, we found that Chinese speakers actually use the horizontal spatial metaphors more often than the vertical metaphors. This offered no logical ground for Boroditsky's claim. We were also unable to replicate her experiments in four different attempts. We conclude that Chinese speakers do not think about time in a different way than English speakers just because Chinese also uses the vertical spatial metaphors to express time.

Asian People↗

PubMed2004

The think aloud method: a guide to user interface design.

OBJECTIVES: Clinical use of computer systems has been hampered by their poorly designed user interfaces. The objective of this study was to design a user interface for a pediatric oncologists' computerized patient record with great consideration of their working behavior and of human computer interfacing principles so as to contribute to oncologists' efficiency and satisfaction in interaction with the system. METHODS: The think aloud method was used in combination with video recording to get a deep understanding of the way in which four pediatric oncologists searched through the paper-based patient record in preparing a patient visit. Protocol and video analyses was used to develop a cognitive task model reflecting pediatric oncologists' task behavior. This model was input for a prototype user interface, which was subsequently evaluated by eight other pediatric oncologists. RESULTS: The resulting computerized medical record system proved to meet pediatric oncologists' information needs and task behavior patterns. The design of the user interface minimized pediatric oncologists' work load and was highly efficient in supporting the pediatric oncologists in preparing their patient visits. The pediatric oncologists were very much satisfied with the computer system. CONCLUSIONS: It is argued that early involvement of cognitive engineering methods in the system design process may be of great help in designing systems that fully support health care professionals' work practices. The think aloud method, if applied under prescribed conditions, is a valuable information source of human task-behavior and as such a useful technique for requirements analysis in designing clinical computer systems.

Ambulatory Care Facilities↗

PubMed2005

Network thinking in ecology and evolution.

Although pairwise interactions have always had a key role in ecology and evolutionary biology, the recent increase in the amount and availability of biological data has placed a new focus on the complex networks embedded in biological systems. The increased availability of computational tools to store and retrieve biological data has facilitated wide access to these data, not just by biologists but also by specialists from the social sciences, computer science, physics and mathematics. This fusion of interests has led to a burst of research on the properties and consequences of network structure in biological systems. Although traditional measures of network structure and function have started us off on the right foot, an important next step is to create biologically realistic models of network formation, evolution, and function. Here, we review recent applications of network thinking to the evolution of networks at the gene and protein level and to the dynamics and stability of communities. These studies have provided new insights into the organization and function of biological systems by applying existing techniques of network analysis. The current challenge is to recognize the commonalities in evolutionary and ecological applications of network thinking to create a predictive science of biological networks.

Journal Article↗

PubMed2004

Perioperative education--perspective from the think tank.

The AORN Foundation and the National League for Nursing (NLN) cosponsored a think tank to address concerns about the shortage of perioperative nurses and the lack of perioperative experiences in many nursing programs. Think tank participants identified traditional and existing paradigms in nursing education and envisioned a new self-directed learning model for nursing school curricula, in which students would be held accountable for their own learning and faculty members would serve as learning facilitators. AORN and NLN members agreed to collaborate to spread the message that the perioperative arena is an excellent place for nursing students to develop the knowledge, skills, and values they will need to practice effectively in today's complex health care institutions.

Curriculum↗

PubMed1992

Keeping strategic thinking in strategic planning: macro-environmental analysis in a state department of public health.

This paper examined the tendency of strategic decision makers in public health to allow their strategic planning process to degenerate into short-term, operational management. The temptation is great in light of pressing current problems. However, the danger of not thinking strategically about the future and of failing to attempt to position the organization in such a way as to take advantage of its strengths and minimize the adverse consequences of its weaknesses can be catastrophic. An attempt is made to illustrate how one state department of public health attempted to ensure that strategic thinking remained a part of its strategic planning process. The process was built around the energizing of the expertise present in the department and the mobilization of resources under the direction of the State Health Officer. The process is ongoing and is constantly fine tuned. However, the procedure utilized can be adapted easily to the unique circumstances facing most public health organizations.

Decision Making↗

PubMedDate not supplied

Use of the think aloud method to examine fruit and vegetable purchasing behaviors among low-income African American women.

The purpose of this report is to describe the development and implementation of the think aloud method in relation to fruit and vegetable purchasing behaviors of low-income African American mothers. Women (n = 70) were audiotaped as they thought aloud while selecting fruits and vegetables during a routine shopping trip. Audiotapes were transcribed, text was coded, and coded text was sorted using a database software program. Data were analyzed using content analysis procedures. The method was found to be useful in its ability to provide verbalization data for the majority of the women in the sample that reflected a typical shopping experience, were not excessively affected by the presence of the investigator, and captured information processing in relation to salient factors that influenced food purchasing decisions. Because a few women indicated that the method itself may have influenced behavior, future research is needed to test the reactivity of the think aloud method and its relationship to final choice of products.

Adult↗

PubMedDate not supplied

Critical thinking: incorporation into the paramedic curriculum.

The purpose of this paper is to present approaches to foster critical thinking skills within the context of the current paramedic curriculum. It reviews some of the definitions and concepts of critical thinking from selected adult education and nursing literature in an attempt to formulate a workable definition as it applies to paramedics. From that definition, elements are identified and incorporated to form a teaching model for use in presenting the curriculum content. Some sample teaching strategies based on revised objectives of the airway/ventilation section also are included.

Adult↗

PubMed2002

Thinking outside the box: mechanisms of environmental selective pressures on the outcome of the materno-fetal relationship.

PROBLEM: Study of mechanisms causing spontaneous abortion of the vascularized placenta have focused primarily on the feto-maternal immunological relationship within the pregnant mother. The Th1 cytokines such as tumor necrosis factor (TNF)-alpha + interferon (IFN)-gamma derived in part from natural killer (NK) and NKgammadeltaT cells have been implicated in causing abortion via up-regulation of the novel prothrombinase fgl2 at the feto-maternal interface; Th2/3 cytokines such as interleukin (IL)-10, progesterone-induced blocking factor (PIBF), and TGF-beta2 derived from gammadeltaT cells stimulated by embryo antigens in the context of the OX-2 (CD200) tolerance signal have been viewed as counteracting the Th1 effect. These mechanisms are distinct from those causing and preventing occult pregnancy loss during the periimplantation phase of pregnancy prior to development of a vascularized placenta. Spontaneous abortions in the CBA/J x DBA/2 can be boosted by injecting TNF-alpha + IFN-gamma, but the boosted abortion rates can range from < or = 30 to > 80%, depending on the loss rate in uninjected mice, and this is not explainable by the endogenous level of these cytokines. Furthermore, there is a poor correlation between Th1/Th2.3 cytokine ratios and abortion rates. Could there be a third factor involved, and if so, what might this mean? METHODS: Known precipitants of recurrent abortion in mice were reviewed with particular attention to stress and endotoxin absorption. The effect of antagonizing the response to bacterial lipopolysaccharide (LPS) (endotoxin) was tested. Data on environmental selective pressures were considered (i.e. thinking outside the 'box', which typifies the conventional approach to thinking about materno-fetal interactions). RESULTS: Th1 cytokine-triggered abortions appear to depend on availability/presence of LPS. CONCLUSIONS: Environmental selective pressures are implicated in eliminating 'genetically weaker' embryos in early pregnancy.

Abortion, Habitual↗

PubMed2001

Differences in preschool children's conceptual strategies when thinking about animate entities and artifacts.

Two-, 3-, and 4-year-old children viewed 10 stimulus sets. Each set contained a sample picture (e.g., a dog), a basic-level taxonomic match (e.g., another dog), a thematic match (e.g., a bone), and an irrelevant match (e.g., a pen). The children were asked to choose a match that "goes with" each sample. Sample pictures were either animate entities or artifacts. The children's choice behavior indicated that a shift occurs between 3 and 4 years of age from a taxonomic bias to a thematic bias and that, at both ages, animate sample stimuli enhance the children's tendency to adopt thematic conceptual strategies. These data are consistent with recent suggestions that thematic thinking presupposes basic-level taxonomic thinking during early conceptual development and that this developmental progression occurs more rapidly in some domains of knowledge than in others.

Age Factors↗

PubMed1994

"If only I weren't" versus "if only I hadn't": distinguishing shame and guilt in counterfactual thinking.

The role of counterfactual thinking in 2 emotions--shame and guilt--was examined. In 1 series of studies, Ss read about situations evocative of shame and guilt or described personal experiences of guilt or shame. They then generated counterfactual alternatives to "undo" the distressing outcomes. Consistent with predictions derived from Tangney (1991), Ss tended to undo shame situations by altering qualities of the self and to undo guilt situations by altering actions. In a 2nd series of studies, Ss imagined themselves in a situation that could evoke either guilt or shame. Ss were then led to mutate the self or behavior to undo the situation. Mutation manipulations amplified shame and guilt such that the former Ss anticipated feeling greater shame, whereas the latter anticipated feeling greater guilt. The role of counterfactual thinking in specific emotions and in differentiating shame- and guilt-prone personalities is discussed.

Adaptation, Psychological↗

PubMed2001

The semantic--procedural interface model of the self: the role of self-knowledge for context-dependent versus context-independent modes of thinking.

How do independent and interdependent self-construals affect cognition? The authors proposed the semantic-procedural interface model, which distinguishes 2 such mechanisms. In addition to semantic differences, different procedural modes of thinking are associated with independent and interdependent self-construals. Independent self-definitions coincide with the tendency to process stimuli unaffected by the context in which they appear. Interdependent self-construals facilitate context-bounded thinking (i.e., processing stimuli by paying attention to their relation to the given context). With semantic-free dependent variables, 4 experiments showed independence-primed participants to exhibit higher degrees of context independence than did interdependence-primed participants. The results are discussed with reference to their potential explanations for cross-cultural differences.

Adult↗

PubMed1997

Thinking the unthinkable--what next?

In December 1996, the BDA's NHS Policy Group ran a one day workshop called 'Thinking the unthinkable' in front of an invited audience from all sectors of the profession. The idea of the day was to do some preliminary forward thinking on professional issues and perhaps create a new awareness within the Association of what is happening in the rest of healthcare and to learn some lessons from them.

Dental Service, Hospital↗

PubMed1996

Maternal thinking in dementia care.

Carers of demented people living in a group dwelling were interviewed and observed individually and together. The aim of the study was to illuminate the thinking of pre-identified good dementia carers and to make explicit their means of understanding demented people. The tape-recorded and transcribed interviews were interpreted using a phenomenological hermeneutic method. The findings showed that these carers explicitly referred to the concept of mother, used when explaining their ability to understand demented people. They created a home-like atmosphere together with the inhabitants. The findings were interpreted metaphorically as maternal love, thinking and practice in creating an understanding relationship with the demented people they cared for. This metaphorical aptitude considered the fulfilment of life for these demented people and included partly unconscious tools that the carers used to compensate for the loss of abilities suffered by the demented people. The carers' attitudes towards the inhabitants of the ward and each other were based on respect as in a functioning family. Their ambition was interpreted as an attempt to create an atmosphere that functioned not only as an institution, but as an incubator for human lives, which had become dependent on others for their survival and the preservation of their human dignity throughout their physical existence.

Anxiety↗

PubMed1999

Factors associated with success or failure in radiological interpretation: diagnostic thinking approaches.

RATIONALE AND OBJECTIVES: To identify those radiological diagnostic thinking approaches associated with success or failure in film interpretation. METHODS: A questionnaire was designed, piloted and tested for validity and reliability prior to use. This questionnaire was adapted and modified from the 'diagnostic thinking inventory' by Bordage et al. 21 One hundred and eighty students anonymously answered the questionnaire prior to their 15-case comprehensive film interpretation examination. Oral film-reading sessions were performed on a stratified random sample (n = 48) of students with complete transcripts of each session recorded. Spearman's correlation coefficient and multiple regression analysis statistics were applied to the questionnaire data. The unpaired t-test, ANOVA and correlation statistics were used to analyse the oral film-reading sessions. RESULTS: The most successful students were those who could easily see the integration of radiology with other subjects (P = 0.0042), students who could easily link the clinical information to the radiographic signs (P = 0.0354), and students who could easily identify the 'key' abnormal radiographic findings (P = 0.047). Students who used a flexible but complete search pattern performed significantly better (P = 0.0235) than students using any other search pattern approach. CONCLUSIONS: Radiology is a classic example of clinical problem solving and thus should be taught in that format. Those same factors which differentiate expert from novice diagnosticians are also evident in more successful vs. less successful students in radiology.

Chiropractic↗