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Clinical nutrition management position: responsibilities and skill development strategies.

OBJECTIVE: To determine the duties of clinical nutrition managers, the factors associated with the performance of the duties, the job specifications for the position, and the skill development strategies used by clinical nutrition managers. DESIGN: Clinical nutrition managers from 700 randomly selected, acute-care hospitals in the United States (with 300 or more beds) received a survey questionnaire. Respondents were asked to indicate performance or nonperformance, perceived importance, and methods used to develop skills for 54 duties related to clinical nutrition management. We requested additional information about position requirements, position characteristics, and demographic information. STATISTICAL ANALYSES PERFORMED: An 82% response rate with 67% usable responses (n = 472) was achieved. Frequencies for performance and nonperformance, mean importance, and frequencies for methods of skill development were determined for each duty. chi 2 Analysis with P < .10 was used to determine if an association existed between performance of a duty and time allotted to the position, number of personnel supervised, and type of personnel supervised. RESULTS: This study validated 46 of the duties as responsibilities of practicing clinical nutrition manager. Three duties not validated were related to financial management. The duty performed least often was conducting research/investigative studies. The number and type of personnel supervised was found to influence performance of duties, but time allotted to position was not an influence. The major strategies used for skill development were continuing education, networking, work experience in clinical dietetics, work experience in management dietetics, and their present job. APPLICATIONS: These results can be used by clinical nutrition managers to assess the characteristics of their current position and develop a plan for enhancing their scope of responsibility. The identification of duties actually performed by clinical nutrition managers can also be used to develop standards of practice with performance indicators and recommended thresholds. Information regarding the skill development strategies of clinical nutrition managers can be used by practitioners to enhance their current skills and knowledge and by others to prepare for career opportunities in clinical nutrition management.

Administrative Personnel↗

The utility of MMPI subtle, obvious scales for detecting fake good and fake bad response sets.

The MMPI was administered twice to 40 graduate students to determine the utility of the Weiner subtle and obvious scales (D, HY, PD, PA, MA) for estimating how fake good and fake bad response sets might influence full scale scores. The first time, the MMPI was administered under standard conditions. Subjects then were divided randomly into two groups: fake good (complete MMPI for job application) and fake bad (qualify for psychotherapy). There were significant multivariate test effects (standard vs. response set) for the raw scores of all five obvious, subtle, and full scales. However, when raw scores were converted to T scores to ascertain practical significance, the obvious scales appeared to provide the most useful information to enhance the interpretation of full scale scores in normal populations.

Adult↗

Corporate culture and the employment of persons with disabilities.

This article addresses key questions arising from the economic and social disparities that individuals with disabilities experience in the United States. For instance, "What role does corporate culture play in the employment of people with disabilities?" "How does it facilitate or hinder their employment and promotional opportunities, and how can corporations develop supportive cultures that benefit people with disabilities, non-disabled employees, and the organization as a whole?" Corporate culture can create attitudinal, behavioral, and physical barriers for workers and job applicants with disabilities. This research concludes that if the employment prospects of people with disabilities are to be improved significantly, attention must be paid to the ways in which corporate culture creates or reinforces obstacles to employees with disabilities, and how these obstacles can be removed or overcome. Ultimately, we will make the case that corporate culture and societal attitudes must change if people with disabilities are to be accepted and incorporated fully into the workplace.

Architectural Accessibility↗

The job-finding module: training skills for seeking competitive community employment.

The opportunity to return to work is often the culmination of extensive and collaborative efforts by clients, psychiatrists, and allied mental health and rehabilitation practitioners. Successful vocational placement and tenure is a victory not only for each individual client but also for the comprehensive set of services and supports established to foster this self-determination. Much as a chain is only as strong as its links, successful job placement must be viewed as but one link in a comprehensive rehabilitation program. Our research in competitive community employment placement over the past decade has resulted in the development of the Job Finding Module, as our contribution to one link of this evolving chain of necessary treatment and rehabilitation services for the seriously mentally ill.

Aspirations, Psychological↗

When Equal Chances = Good Chances: Verbal Probabilities and the Equiprobability Effect.

When six equally qualified candidates compete for the same position, p = 1/6 for each. People seem to accept this principle more readily for numerical than for verbal probabilities. Equal chances with three to six alternatives are often verbally described in a positive vein as "entirely possible" or "a good chance" and rarely negatively as "doubtful" or "improbable." This equiprobability effect of verbal probabilities is demonstrated in five studies describing job applicants, lottery players, competing athletes, and examination candidates. The equiprobability effect is consistent with a causal (propensity) view of probabilities, where chances are believed to reflect the relative strength of facilitating and preventive causes. If important conditions in support of the target outcome are present (the candidate is qualified for the position), and there is little to prevent it from occurring (no stronger candidates), chances appear to be good. In the presence of obstacles (one stronger candidate), or in the absence of facilitating conditions (the candidate is poorly qualified), chances appear to be poor, even when numerical p values remain constant. The findings indicate that verbal and numerical probability estimates can reflect different intuitions. Copyright 2001 Academic Press.

Journal Article↗

Public attitudes towards people with mental illness in six German cities: results of a public survey under special consideration of schizophrenia.

OBJECTIVES: Attitudes of the urban population in Germany towards people with mental illness were investigated in this study. The results are compared with those of attitude surveys conducted by other research centres participating in the World Psychiatric Association's (WPA) global anti-stigma-programme "Fighting Stigma and Discrimination because of Schizophrenia - Open the Doors" (WPA 1998). METHODS: A total of 7246 German-speaking persons aged 16 and over were interviewed in private households in six German cities by telephone using a standardised questionnaire. The respondents were asked about their knowledge in regard to schizophrenia, their social distance towards people with schizophrenia and estimations of the social stigmatisation of mental patients in general. RESULTS: 33.1 % of the interviewees were able to name causes of schizophrenia. 76.5 % of the interviewees believe that people with schizophrenia often or very often need prescription drugs to control their symptoms. 81.1 % believe that most people would pass over the job application of a former mental patient in favour of another applicant. CONCLUSIONS: Improvements in the education of the public about mental illnesses and provision of the opportunity for personal contact with mentally ill people are considered to be important measures for promoting the acceptance of the mentally ill by the public.

Adolescent↗

Genetic predictive testing and private insurances.

Genetic information is a potential tool for selection of job applicants and of candidates for insurance. Social implications of genetic information may represent a threshold for the access to health care facilities. Some of the issues related to the use of predictive genetic information by private life and health insurance companies are discussed. They include the potential threat for the privacy of the individual and his relatives, the pressure to undergo genetic testing and the social consequences of the use of genetic information by private insurance companies. The justified financial interests of insurance companies and the interests of the individual to have his privacy protected and to be able to partake in social attainments have to be brought into balance. A ban on genetic testing in connection with access to insurances and a limitation to the use of existing genetic information have been suggested by the Dutch Health Council. This approach to the problem should be adopted throughout the European Communities, so that medical progress does not turn out to be against the interests of the consumer.

AIDS Serodiagnosis↗

Judgements by health professionals of personal characteristics of people with a visible physical disability.

Discussion within rehabilitation literature suggests that visible disability is a cue which influences impressions that others form of a person. These impressions extend to include personality and social characteristics that have no necessary relationship with the disability. Evidence of such "spread" of judgement has emerged in studies with health professionals and raises concern for the quality and appropriateness of their interactions with clients with disabilities. This article incorporates the feature of disability within the wider context of implicit personality theory by exploring its effects on impression formation in conjunction with the effects of gender and manner of behaviour. A sample of 636 trainee and practising health professionals made Semantic Differential ratings of a job applicant observed in a videotaped interview. Twelve parallel videos were produced in which disability (use of a wheelchair), gender, and manner of behaviour (shy-neutral-brash) of the applicant were varied. Analyses of variance revealed significant main effects for each independent variable. Interaction effects were limited. Further study of Semantic Differential ratings indicated that respondents devalued the disabled applicants, with presence of wheelchair influencing judgments about social and psychological adjustment and about general competence and capability. Reasons posited for these findings include the nature of health professional-client relationship and occupation-related experiences. A disability awareness package is described which is aimed at health professionals and service providers and which is designed to address negative attitudes by providing accurate information and personal contact with people with disabilities.

Adaptation, Psychological↗

Brief Minnesota Multiphasic Personality Inventory scales to screen for substance abuse.

Research has focused on development of accurate screening instruments to detect alcoholism. The Minnesota Multiphasic Personality Inventory (MMPI) has long been employed, but the utility of previous scales in differentiating substance abusers from normals remains unclear. Conley and Kammeier (J. Consult. Clin. Psychol., 48 (1980) 665) identified seven MMPI items which appeared to be specific to alcoholism. In a replication attempt, this study compared MMPI's for 1403 male and 323 female job applicants and 228 male and 76 female chemical dependency inpatients. MMPI items were chosen through empirical identification of those with greatest endorsement differences. A 13-item scale emerged with an endorsement differential exceeding 45%. Four of the seven Conley-Kammeier items replicated in the 13-item scale. These shorter MMPI scales appear superior to the older 50-item-plus MacAndrew and Holmes scales for screening normal populations, providing cutting scores which yield specificity exceeding 80% with sensitivity greater than 90%. However, results must be interpreted with caution, and limitations regarding the state of the art are set forth.

Alcoholism↗

Choosing or becoming an interim administrator.

Filling an administrative position on an interim basis requires careful deliberation even when the decision has to be made quickly. A poor fit, even for a short-term position, can lead to problems for the interim administrator, the subsequent permanent administrator, faculty, staff, students, and the nursing program. This article poses questions for decision makers who are contemplating filling a position with an interim appointee. These decision makers must determine the need for an interim administrator, his or her role, the anticipated length of an interim appointment, and whether the interim appointee can apply for the permanent position. In addition, relevant questions are presented for those persons who are considering accepting an interim position, including questions about the position itself and their preparation and personal goals and considerations for leaving the temporary position.

Choice Behavior↗

Employer-employee relations.

As an employer, a veterinarian must be vigilant to protect the rights of both job applicants and employees. Federal and state statutes guarantee that applicants and employees will not be subjected to discrimination in any aspect of employment, including recruitment, hiring, promotion, compensation, and termination of employment. An employer may not discriminate on the basis of sex, race, color, national origin, religion, age, or physical disability. In addition, common law tort actions give employees powerful causes of action be against those employers who injure employees. More than ever, employers must be diligent in obeying the law. Employers must also take measures to protect themselves from employee claims by instituting risk management plans and purchasing adequate insurance coverage.

Civil Rights↗

Percentage of emergency medicine residency graduates who got their first choice of jobs did not change between 1995 and 1997.

The objective of this study was to compare the number of emergency medicine (EM) graduates unable to find a job in the city/area of their first choice in 1995 and 1997. Self-administered questionnaires were distributed to EM residents who graduated in both 1995 and 1997. The survey ascertained resident's practice city and state, whether their job was in the city/area of first choice and how satisfied they were with their practice selection. Eighty (83%) programs and 507 (70%) of eligible residents participated. Thirty-eight percent of graduates chose to practice in the city or metropolitan area where they trained and 75% of respondents were very satisfied with their practice selection. Nineteen percent stated they would not be practicing in the city/area of their first choice; one-third indicated there were no jobs available and two-thirds stated that jobs were available but not desirable. These numbers were similar to the 1995 data (P = .79). Job selection was more important than liking (P < .001) or having lived in (P < .001) a desired city/area of practice location. In conclusion, 1997 EM residency graduates were as successful as 1995 graduates in obtaining their first choice of jobs.

Adult↗