bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing Project Stakeholder Management Plan at Coffee Plant Construction Project for Successful Initiating Phase in Ciwidey
Authors: Pratami Devi , Puspitasari Nurfitri Ayu , Haryono Imam
Published: September 2017

CV Trianom Agrotektur is a company engaged in coffee industry. Due to high demand and expanded business process the company owner is going to build a new plant in Ciwidey. The current plant cannot cover the whole business process of in processing coffee beans. The extensification towards the plant requires some guidance to lead the successful contruction project. However, building plants in rural area is not a simple thing. There should be some investigation towards stakeholders’ needs/interests or requirements. The project should also face an issue pertaining to management, i.e. how to manage stakeholders who still keep their local tradition. This study is aimed at designing project stakeholder management plan based on PMBOK 5 edition. The study shows that there are 21 stakeholders classified in 4 quadrants. Those stakeholders will be managed based on their power and interest level.
USULAN PERANCANGAN METODE PEMINDAHAN MATERIAL PADA PROSES LOADING SAYURAN BUNCIS DENGAN MENGGUNAKAN PENDEKATAN BIOMEKANIKA (STUDI KASUS DI PT ABO FARM)
Authors: Dewi Ni Made Yunita Sari , Anugraha Rino Andias , Nugroho Yusuf , Setiawan M. Fadli , Sofan Ayren Tantri
Published: September 2017

Manual material handling memiliki cedera berisiko tinggi seperti low back pain. PT ABO FARM adalah perusahaan yang bergerak di bidang agrikultur, khususnya dalam ekspor biji sayuran. Salah satu proses ekspornya ialah proses pengangkutan biji dari gudang ke stasiun kerja kolektor di PT ABO FARM. Hasil observasi menunjukkan bahwa menghilangkan material dalam proses loading seperti mengambil, membawa, dan menempatkan karung biji ke dalam truk pick-up pada koleksi stasiun kerja dilakukan secara manual dan kurang ergonomis. Material dipindahkan dalam karung biji dengan berat rata-rata 55 kg. Penelitian ini bermaksud untuk merancang metode manual material handling dalam proses loading agar lebih ergonomis. Pendekatan yang digunakan dalam penelitian ini adalah pendekatan biomekanika dan lifting equation yang direkomendasikan oleh NIOSH dalam perancangan fasilitas. Metodeperancangan manual material handling dilakukan dengan membuat perbaikan untuk posisi pegangan pada wadah yang diusulkan dan melakukan pengujian beberapa alternatif metode manual material handling dengan parameter yang dihasilkan oleh gaya tekan L5/S1. Hasil dari pengujian beberapa alternatif metode dari hasil manual material handling lebih ergonomis. Hal tersebut ditunjukkan oleh penurunan gaya tekan L5/S1 terhadap setiap kegiatan dalam proses loading dan mengakibatkan penurunan sebesar 97.7% dari 276,2 N menjadi 12168 N. Dalam proses membawa, gaya tekan berkurang sebesar 85.7% dari 9213 N menjadi 1320.8 N. Dan untuk proses menempatkan, gaya tekan berkurang sebesar 78.7% dari 7109 N menjadi 1541.6 N.
PENERAPAN V.S.N HARDWARE KEY SCHEME DENGAN RSA CRYPTOSYSTEM UNTUK PENGAMANAN PERANGKAT LUNAK
Authors: Victor Andy , Putra Taufan Maulana
Published: September 2017

Jumlah pencurian data perusahaan meningkat dari tahun ke tahun. Hal ini dikarenakan kurangnya kesadaran pihak perusahaan akan pentingnya suatu sistem keamanan yang efisien dan unik. Pihak perusahaan mengira bahwa hanya dengan password, data tersebut sudah sangat aman. Pada penelitian ini, dibuat suatu skema keamanan data, yakni V.S.N Hardware Key dengan algoritma kriptografi RSA. Volume Serial Number yang terdapat di dalam suatu hardware yang berbentuk bilangan hexadecimal diambil dengan fungsi API GetVolumeInformation dan diubah menjadi bilangan decimal yang kemudian digunakan sebagai otentifikasi dalam pengaksesan sebuah aplikasi. RSA merupakan salah satu algoritma kriptografi asimetris yang menggunakan sepasang kunci, yaitu kunci publik dan kunci privat. Panjang kunci dapat diatur, dimana semakin panjang bit pembentukan kunci maka semakin sukar untuk dipecahkan karena sulitnya memfaktorkan dua bilangan yang sangat besar. Aplikasi yang dirancang dalam mendukung V.S.N Hardware Key dengan algoritma kriptografi RSA telah diuji dengan melibatkan data-data confidential perusahaan, dan terbukti ampuh dalam membuat para intruder gagal melakukan pencurian data penting perusahaan termasuk penggandaan ilegal. Secara umum V.S.N Hardware Key dengan algoritma kriptografi RSA digunakan sebagai skema penyempurna pengamanan data perusahaan yang secara umum berbentuk aplikasi sistem informasi.
PERANCANGAN MATERIAL HANDLING EQUIPMENT PADA PROSES PENGGILINGAN KE OKSIDASI ENZIMATIS BUBUK TEH MENGGUNAKAN METODE PERANCANGAN PRODUK RASIONAL PADA PT PERKEBUNAN NUSANTARA VIII RANCABALI
Authors: Lestari Imelia Rizki , Anugraha Rino Andias , Iqbal Muhammad
Published: September 2017

PT Perkebunan Nusantara VIII Rancabali merupakan salah satu perusahaan pengolahan teh hitam ortodoks di Indonesia yang menghasilkan dua belas jenis teh hitam untuk dijual di dalam negeri maupun diekspor ke beberapa negara. Kualitas teh yang dihasilkan oleh perusahaan ini tentunya akan mempengaruhi harga teh yang akan dijual. Dalam proses pengolahan teh hitam ortodoks, proses oksidasi enzimatis merupakan proses yang paling menentukan kualitas bubuk teh yang akan dihasilkan nantinya, sehingga dibutuhkan pengawasan ketat terhadap ketentuan teknis proses tersebut. Proses oksidasi enzimatis pada PT Perkebunan Nusantara VIII Rancabali mulai terjadi saat bubuk teh digiling pada proses penggilingan dan akan berhenti saat bubuk teh dikeringkan pada proses pengeringan. Pada proses penggilingan ke oksidasi enzimatis ditemukan pelaksanaan ketentuan teknis proses oksidasi enzimatis bubuk teh yang tidak sesuai. Dengan menggunakan metode perancangan produk rasional oleh Nigel Cross diharapkan dapat memperbaiki sistem material handling existing menjadi continue dan sesuai dengan ketentuan teknis proses tersebut, sehingga dapat memaksimalkan kualitas bubuk teh yang akan dihasilkan. Perumusan rekomendasi disusun berdasarkan pengolahan data, analisis data, dan diskusi dengan pihak perusahaan yang bertujuan untuk memaksimalkan proses oksidasi enzimatis. Rekomendasi yang diberikan adalah desain perancangan material handling equipment dengan jenis industrial truck khususnya four-wheel hand truck yang disesuaikan dengan ketentuan dalam proses oksidasi enzimatis.
ANALISIS POSITIONING PROGRAM STUDI CREATIVE MULTIMEDIA PROFESSIONAL BERDASARKAN PERCEPTUAL MAP DENGAN METODE MULTI DIMENSIONAL SCALLING
Authors: Fatharany Meilana , Amani Husni , Wulandari Sari
Published: September 2017

Rendahnya pengetahuan masyarakat mengenai perbedaan yang dimiliki oleh Telkom Professional Certified Competency (TPCC) melalui program studinya Creative Multimedia Professional (CMP) dibandingkan dengan pesaingnya di bidang multimedia mengindikasikan bahwa TPCC belum memiliki positioning yang kuat di benak masyarakat. Tagline merupakan salah satu cara yang dapat digunakan untuk mengkomunikasikan perbedaan tersebut juga belum dimiliki oleh TPCC. Penelitian ini bertujuan untuk mengetahui positioning dari TPCC melalui program studi CMP diantara lembaga pelatihan dan sertifikasi lainnya khususnya di bidang multimedia yang berada di wilayah Bandung dan Jabodetabek. Metode yang digunakan dalam penelitian ini adalah Multi Dimensional Scalling (MDS) yang menghasilkan output berupa perceptual map. Perceptual map yang dihasilkan menggambarkan persepsi masyarakat mengenai TPCC melalui program studi CMP dengan pesaingnya bedasarkan tiga belas atribut yang ada. Hasil rekomendasi dari penelitian ini adalah keunggulan program TPCC dikomunikasikan melalui tagline, menyediakan program khusus konsultasi, melengkapi fasilitas akademik, membuat beberapa program yang dapat mengasah softskill, bekerjasama dengan perusahaan di bidang multimedia, menambah variasi kegiatan pembelajaran.
PERANCANGAN SOP MANAGEMENT REVIEW BERDASARKAN INTEGRASI ISO 9001:2015 (KLAUSUL 9.3) DAN ISO 14001:2015 (KLAUSUL 9.3) DENGAN MEMPERTIMBANGKAN RISIKO MENGGUNAKAN METODE BENCHMARK DI CV XYZ
Authors: Farhana Naila , Widaningrum Sri , Lalu Heriyono
Published: September 2017

CV XYZ merupakan perusahaan manufaktur yang telah menerapkan Sistem Manajemen Mutu (SMM) sesuai dengan ISO 9001:2008. CV XYZ memiliki beberapa SOP hasil penelitian sebelumnya, salah satunya adalah SOP management review yang telah sesuai dengan integrasi ISO 9001:2008 dan ISO 14001:2004. Perubahan standar pada ISO 9001:2015 dan ISO 14001:2015 menuntut perbaikan SOP sehingga dapat memenuhi requirement baru dan sesuai dengan kebutuhan maupun kondisi perusahaan. Berdasarkan hal tersebut dilakukan perbaikan terhadap SOP hasil penelitian sebelumnya sehingga didapatkan SOP yang memenuhi requirement standar baru. Perancangan SOP dilakukan dengan mengintegrasikan requirement ISO 9001:2015 dan ISO 14001:2015 serta menyusun proses bisnis dengan melakukan benchmark. Proses bisnis yang didapat dibandingkan dengan hasil requirement integrasi sehingga didapatkan proses bisnis sesuai dengan requirement. Berdasarkan ISO 9001:2015 dan ISO 14001:2015 mengenai penerapan risk based thinking, disusun risk register dengan menggunakan risk assessment sebagai bentuk pertimbangan risiko dalam memenuhi requirement tersebut. Penanganan risiko pada risk register menjadi masukan dalam penyusunan SOP management review. Hasil dari penelitian ini adalah SOP management review sesuai dengan requirement integrasi ISO 9001:2015 dan ISO 14001:2015 yang sudah mempertimbangkan risiko. Manfaat dari SOP hasil penelitian ini yaitu CV XYZ dapat menjamin pelaksanaan proses management review karena penyusunan prosesnya berdasarkan hasil benchmark dengan perusahaan yang telah menerapkan proses tersebut secara berkelanjutan. Berdasarkan penerapan risiko dari hasil risk register, SOP tersebut memiliki ketentuan maupun aktivitas yang dapat mengantisipasi munculnya risiko sehingga tujuan proses management review dapat tercapai.
PERANCANGAN ALOKASI PENYIMPANAN DI GUDANG BAHAN BAKU PADA DIVISI ALAT PERKERETAAPIAN PT PINDAD (PERSERO) UNTUK MENGURANGI WAKTU DELAY MENGGUNAKAN PENDEKATAN ANALISIS FSN DAN CLASS BASED STORAGE POLICY
Authors: Amalia Yurinda , Ridwan Ari Yanuar , Santosa Budi
Published: September 2017

PT Pindad merupakan perusahaan manufaktur di bawah Badan Usaha Milik Negara (BUMN) yang memproduksi produk militer dan produk komersial. PT Pindad memiliki beberapa gudang, salah satunya adalah gudang Divisi Alat Perkeretaapian yang menyimpan berbagai bahan baku untuk memproduksi produk air brake system. Delay terjadi aktivitas storing dan picking, hal ini disebabkan karena adanya proses searching. Penempatan produk secara random oleh operator, menyebabkan alokasi penyimpanan SKU pada tempat penyimpanan tidak tertata rapi dan teratur. Langkah awal yang dilakukan adalah memetakan seluruh proses bisnis dan aktivitas yang terdapat pada gudang Divisi Alat Perkeretaapian PT Pindad dengan menggunakan value stream mapping (VSM) dan process activity mapping (PAM) sehingga didapatkan waktu proses dan value dari masing-masing aktivitas. Untuk itu dilakukan alokasi penyimpanan produk agar mengurangi waktu non value added dengan pengklasifikasian menggunakan analisis FSN, kemudian dilakukan slotting dan zonafikasi untuk menentukan area penempatan barang untuk-untuk masing-masing SKU berdasarkan klasifikasi. Setelah dilakukan pengklasifikasian, slotting dan zonafikasi, maka langkah selanjutnya adalah merancang future state map perancangan usulan, sehingga didapatkan disimpulkan waktu delay menurun 22% dari total waktu keseluruhan waktu proses yaitu 846,26 detik atau 14,10 menit, dan penurunan persentase non value added sebesar 17%.
PERANCANGAN ARSITEKTUR BISNIS PENGEMBANGAN PEMBELAJARAN PERGURUAN TINGGI DI INDONESIA BERBASIS ORGANIZATIONAL LEARNING DENGAN PENDEKATAN TOGAF ADM
Authors: Lalu Heriyono
Published: September 2017

Keberhasilan dalam pengembangan dan penerapan organizational learning serta pengelolaan pengetahuan merupakan faktor kunci bagi kesuksesan dan produktivitas organisasi. Perguruan Tinggi merupakan sebuah organisasi yang seharusnya adalah sebuah learning organization, termasuk perguruan tinggi di Indonesia. Di Indonesia, tata kelola perguruan tinggi telah diatur secara ketat dalam banyak peraturan perundangan dan standar-standar akreditasi. Aturan dan standar tersebut juga termasuk di dalamnya tentang pengembangan pembelajaran. Penelitian ini ingin menawarkan sebuah model arsitektur bisnis pengembangan pembelajaran yang sejalan dengan aturan dan akreditasi perguruan tinggi di Indonesia, dan juga dirancang sebagai model organizational learning di perguruan tinggi Indonesia. Arsitektur bisnis pengembangan pembelajaran berbasis organizational leraning dimaksud dirancang dengan mengikuti kelengkapan komponen arsitektur dan fase pengembangan arsitektur dalam TOGAF ADM yaitu business motivation pengembagan pembelajaran, organizational units pegembangan pembelajaran, business functions and services pengembangan pembelajran, business processes pengembangan pembelajaran, dan business roles and actors pengembangan pembelajaran.
Model Penjadwalan Pada Batch Processor Tunggal Dengan Waktu Proses Yang Tidak Konstan Untuk Meminimasi Total Waktu Tinggal Aktual
Authors: Astuti Murni Dwi , Halim Abdul Hakim
Published: September 2017

Penjadwalan batch sudah didiskusikan di beberapa penelitian. Terdapat dua jenis penjadwalan batch yaitu job processor dan batch processor. Pada job processor, part diproses secara bergantian sampai semua part dalam satu batch selesai diproses, sedangkan pada batch processor part diproses bersama dalam satu waktu sehingga waktu untuk memproses batch besarnya sama dengan waktu untuk memproses satu part. Berbeda dengan penelitian sebelumnya, pada penelitian ini waktu untuk memproses batch bukan hanya waktu untuk memproses satu part namun gabungan dari waktu yang diperlukan untuk memproses satu part dan waktu untuk memasang tools pada setiap part dalam satu batch. Penelitian ini merupakan tahap ke dua, setelah sebelumnya dikembangkan model yang sama namun untuk masalah single item dengan due date yang sama maka pada penelitian ini due date dari item berbeda – beda. Model penjadwalan untuk masalah multi due date diselesaikan dengan menganggap satu interval waktu yang merupakan selisih antar dua due date yang berurutan sebagai masalah common due date. Jumlah minimum batch yang terbentuk untuk setiap interval waktu ini adalah satu dan waktu minimal untuk memproses batch besarnya sama dengan waktu untuk memproses satu part ditambah dengan waktu yang diperlukan untuk memasang tools untuk seluruh part pada satu batch. Jika waktu pada interval waktu tidak cukup untuk memproses part yang diminta pada interval waktu tersebut maka part diproses pada interval waktu setelahnya. Model diuji dengan beberapa set data hipotetik. Variabel keputusan adalah jumlah batch dan ukuran batch untuk setiap interval waktu, dan urutan pengerjaan batch sehingga akan meminimasi total waktu tinggal aktual.
Perancangan Sistem Otomasi Untuk Kartu Tekstil Jacquard Pada Mesin Punching Untuk Di PT Buana Intan Gemilang
Authors: Hakim Luqman Abdul , Anugraha Rino Andias
Published: September 2017

Indonesia’s textile industry has been successfully being the fifth ranked textile product exporter country by contributed Gross Domestic Bruto (GDP) which is 9% in non-oil industry. As the rapid development of technology, its encouraging textile industry to be able to implement it into the production process, its automation system regarding can improve the productivity. PT. Buana Intan Gemilang is one of textile industry which manufactures greige, sajadah, and curtains fabric within various pattern. Increasing demand regarding pattern therefore company should intensify productivity of machine, operator, and system in order to produce pattern card called jacquard card in thousand amounts. The Problem statement which showed is the manufacturing process is still manual rely on recur the operator’s activities, inconsistent cycle time that occurs on incapacity production target. Automation system design on punching machine using a Programmable Logic Controller (PLC) as the primary controller with using User Requirement Spesification (URS) for providing the solution in designing automated system implemented to solve the problem. According to conducted research it can be conclude that, automation system design for jacquard on punching machine at PT.Buana Intan Gemilang has been accomplished and decrease the cycle time around 10 seconds/card. By using automation system on jacquard card production is expected to increase the production capacity and eliminate the workload of operator therefore offer benefit and productivity of company.
In Operando Deconvolution of Photovoltaic and Electrocatalytic Performance in Water Splitting Photocathodes
Authors: Tilley David , Cui Wei , Niu Wenzhe , Wick René , Moehl Thomas
Published: September 2017

Many present-day investigations of water splitting photoelectrodes are based on buried p–n junctions, which usually offer an improved photovoltage and therefore a higher solar-to-hydrogen efficiency in tandem photoelectrochemical cells. In this work, we demonstrate that the dual working electrode (DWE) technique enables the measurement of the surface potential of water splitting buried-junction photocathodes under operation, enabling the deconvolution of the photovoltaic and electrocatalytic performance in operando. Consequently, we can access properties of the buried p–n junction independent of the surface kinetics, and gain information related to the charge transfer through the electrode/electrolyte interface independent of the photovoltaic properties. Moreover, the DWE technique provides a clearer understanding of the photocathode degradation mechanism during stability tests. Two p–n junction-based photocathodes are investigated in this work: a pn+-Si/TiO2 photocathode as model system, and the application of the developed method to the emerging material system Cu2O/Ga2O3/TiO2.
Person-Centered Care In Mental Health Education and Practice Through Arts-Informed Narrative Inquiry
Authors: Schwind Jasna , Lindsay Gail , Coffey Sue , Morrison Debbie , Mildon Barb
Published: September 2017

Objectives: We conceptualize person-centred care (PCC) as whole person care that is enacted through the relationship between caregivers and care-receivers. This understanding bridges education and practice, nursing students and nurses, and methodological approaches. The objective of our Associated Medical Services Phoenix Call to Caring funded research is to explore how students and nurses in mental health construct and enact person-centred care.Methods: Our participants include students and nurses in mental health education and practice. We meet with them in integrated groups of nurses and students. Our research process engages participants in four arts-informed narrative inquiry sessions: stories of giving and receiving PCC, use of metaphors to access tacit knowing, collages and mandalas to explore embodied experience of PCC. Our research is multi-method through the addition of pre and post caring scales to document changes in participant attitudes and behaviours. A follow-up telephone call three months after the fourth session provides an evaluation of the significance of this exploration to PCC in their practice.Results: Dimensions of enacting PCC are revealed including personal, regulatory, professional and institutional forces that shape students’ and nurses’ choice to be person-centred in their practice. Nurses and students increase self-awareness and critical thinking about the value and enactment of PCC in their practice, also shaping the healthcare environment. The significance of arts-informed narrative methods to illuminate knowledge construction is revealed.Conclusions: PCC includes the practitioner and student as knowledge maker, in partnership with a patient and family. PCC involves choosing how to be in relationship as a whole person as well as conceptualizing patients as whole persons. PCC involves practitioner self-awareness and courage to advocate for personal integrity of patients and self-as-caregiver. Arts-informed narrative inquiry provides nurses (established and emergent) processes for continuing reflection and professional development.
Creative Team Building with Staff Through Mandala Making
Authors: Goldman Sondra
Published: September 2017

Objectives: Participants will learn how art therapists can achieve individual or group goals through the use of art materials and processes. They will also learn how organizational goals can be incorporated into relevant art making experiences. The presentation begins with a brief overview of art therapy and the history of mandala making in community building. We will then review the mandala-making staff workshops. The discussion will close with an exploration of how this process may be applied to other work environments.Methods: These workshops were originally offered to our long-term care staff on eight different occasions during, "Planetree Month" in May of 2011, a month dedicated to staff self-care. The “Planetree Month” planning committee asked the art therapist to develop a team-building exercise that would be fun, creative and completed within 45 minutes. The committee also hoped that the workshop participants, who had little or no artistic experience or skill, would make a collective art work (within the time constraints,) that would be a source of pride for the participants and be good enough to be installed on the walls of the centre as a testament to the teamwork achieved.Results: The goals of the workshop were accomplished through the careful design of this workshop. More than 200 staff members participated, embraced the process and completed eight mandalas which are now permanently displayed on the walls of Donald Berman Maimonides Geriatric Centre. Creativity can bring out the best in people, creating synergy and positive community growth.
Who Am I? Exploring Our Professional Identities: A Workshop for Health Care Professionals
Authors: Sanderson Christine , Marr Lisa
Published: September 2017

Objectives:1. Explore the history and meaning of each participant’s own professional identity2. Reflect on how professional identity affects the ability to be present with the patient3. Create a space to playfully explore benefits and burdens of the professional persona for caregivers and patients4. Consider possible new ways of being present as professional caregivers which may be safe, authentic, and often joyful.Background: Health care is highly professionalised. Health professionals are perceived as powerful and prestigious, with great responsibility for patients’ well-being. Social expectations of health professionals are extremely pervasive. Professionalisation involves learning and negotiating one’s role, and becoming comfortable in the professional persona. To offer whole person care requires the professional caregiver to be simply and authentically present with the patient. Yet the professional persona can be a barrier to presence, often using behaviours that are distancing, disease-focused, and impersonal. Over time, working as a professional can deeply affect our experience of ourselves.Workshop process: This workshop offers an opportunity to explore the effects of professional identities on us as caregivers and as persons.Some topics that will be considered: How do we experience our professional identities?  Benefits and burdens of the roles we have adopted? Do they sustain us or not?  How do they help, and hinder, our ability to be present for patients?  How do we want to proceed in future? Through interactive, creative exercises in a supportive environment, participants will investigate the professional identities they have crafted over time.  Using meditation and writing exercises, participants will reflect on the self that offers whole person care to patients, and what is needed for this self to flourish.  Participants will share insights and challenges to being present, as a professional, with patients.
Music Therapy in Whole Person Care at the End of Life
Authors: Salmon Deborah
Published: September 2017

Whole Person Care aims to be deeply present to the person in the patient; acknowledging the integration of physical, psychosocial and spiritual facets of human experience, and creating a space in which healing, or a greater sense of wholeness, may occur. Music offers a potent tool in this endeavor. With its inherent capacity to engage body, mind and spirit, music can stimulate or calm, transport us to other times and places, reach our innermost emotions, and connect us to ourselves, our loved ones and our spirituality. In palliative care, music therapy joins with whole person care to meet patients and their loved ones as fully as possible.Concepts central to whole person care will be presented and illustrated through the lens of clinical music therapy. For example, exploring how the skilful use of music addresses many dimensions of personhood will highlight Cassell’s concept of personhood. Demonstrating the ability of a significant melody to access and externalize personal meaning will integrate ideas from Frankl on meaning.  Observing how relationship and creativity function as healing connections will draw from Mount, as will the idea of helping one move on a continuum from suffering to healing (Mount, Hutchinson, Kearney). The role of the health care professional as a ‘vulnerable-enough’ caregiver (Papadatou) or ‘wounded healer’ (Kearney) will also be touched upon. Throughout the presentation, poignant images, stories and video clips of patients engaging in music therapy at the end of life will serve to both enliven the didactic material and demonstrate how music therapy can create a space in which experiences of greater integrity may occur.
Narrative Reflective Process: A Means to Whole Person Research Cluster Formation
Authors: Schwind Jasna , McCay Elizabeth , Lapum Jennifer , Fredericks Suzanne , Beanlands Heather , Romaniuk Daria , Edwards Susanna , LeGrow Karen
Published: September 2017

Objectives:  As nursing faculty members of Health and Illness research cluster our focus is on promoting humanistic practices, such as person-centered care, for individuals and their families living with illness and its consequences. In keeping with this holistic focus we wanted to explore a non-traditional approach to building a productive professional collaboration.Methods:  In the early stages of our research cluster formation, we chose to engage in Schwind’s Narrative Reflective Process (NRP), a creative self-expression activity that is informed by the Connelly and Clandinin’s Narrative Inquiry research approach. Creative activities included storytelling, metaphors and drawing. We began the process by working in pairs, telling stories of our research experiences, both positive and negative. We then drew images that metaphorically represented each of these. Following, we described our images to the cluster group, while considering common narrative threads. The process ended by the group envisioning our interpretation of our collaborative cluster work. Throughout the year, our cluster met on a regular basis working on our common interest of person-centred care. One year later, we recreated our images to see how the view of our collaborative cluster work had evolved. This time we chose to create one large image together.Results:  We found that our creative experiential activities opened possibilities for trust and created a safe space for research cluster members to share their developing ideas. We felt that by sharing our personal experiences through drawings and metaphors allowed us to connect with one another as whole persons. It allowed us to recognize that we are more than just our professional roles.Conclusions:  Through the creative self-expression of NRP we engaged the research cluster members as whole persons. As a result, the cohesion, trust and collaboration resulted in increased research creativity and productivity, which would not have been possible to create alone.
Whole Person Teaching Makes an Effective Baccalaureate Nursing Teacher: Student Voices Enlighten Us
Authors: Matthew-Maich Nancy , Martin Lynn , Mines Carrie , Ackerman-Rainville Rosemary , Hammond Cynthia , Palma Amy , Roche Carmen , Sheremet Darlene , Stone Rose
Published: September 2017

Objectives: The goals of this study were to understand: 1) what makes an effective teacher in each level of the baccalaureate nursing program, 2) what are the skills, attributes and strategies of an effective teacher in both theory and clinical courses, and 3) how does this impact student learning and the student experience in each level of the curriculum?Methods: A qualitative description approach was used. All BScN students at two sites (1000 students) were emailed an invitation to participate in an online survey to identify what makes an effective teacher in the baccalaureate nursing program. Students were also invited to participate in focus groups to discuss what makes an effective teacher and the impact on their learning. It is anticipated that six focus groups of 10 to 12 students will be conducted. Survey and focus group data are analyzed using qualitative content analysis.Findings: A preliminary finding emergent from the data is that students perceive whole person teaching, that is understanding the learner as a whole person, makes an effective teacher. This study has the potential for important impact on students and faculty in baccalaureate nursing programs. The results will be used to plan faculty development initiatives throughout all levels within relevant programs. Findings, conclusions and recommendations will be shared at the conference.Conclusions: Will be available at the time of the conference. Faculty members are learning how to optimally facilitate learning in a new context that embraces a person-centered, problem based, self-directed and small group learning approach. Students are in the best position to articulate what makes an effective teacher in each year of the four year program. Students were eager and empowered to share their perceptions and faculty eager to learn from student voices to optimize student experiences and learning.
Fostering Resilience over Multiple Losses for Nursing Staff in the Palliative Care Unit: Whole Person Approach – Part 2
Authors: Kurihara Yukie , Munesada Minako , Takahashi Satoe , Tanaka Keiko
Published: September 2017

Objectives: “Bereavement overload” due to multiple losses is one of the stressors for the nursing staff working at Palliative Care Unit (PCU), which may be especially tough to those with less exposure to it. A support program was developed for the nursing staff of newly-opened PCU (April 2011) in order to foster resilience and wellness despite multiple losses. We conducted a study to evaluate the effectiveness of the support program with “whole person approach” – consisting of 3 modules: 1) lecture on grief and bereavement (mind), 2) experiential workshop on body awareness and relaxation (body/spirit), and 3) group discussion (mind/spirit), for the increased sense of self-efficacy, awareness of their inner healing power, and fostering mutual understanding and support.Methods: 20 nurses were randomly assigned to two groups for the action research project. Data included participant observation, individual and focus group interviews with one of the investigators. The support program package was offered from October to December 2012 (A) and from January to March 2013 (B) respectively, using wait-list control method. Self-efficacy scale was used at the base line, at the completion of package A, and at the completion of package B. Participants also answered brief survey after each module, followed by semi-structured interview.Results: The participants’ overall responses were positive, with comments like “becoming more aware of my own grief process” (module 1), “was amazed by the power of awareness and simple touch” (module 2), “inspired by learning others’ perspectives on death and dying” (module 3). Shared learning and reflection as well as “learning something tangible” seem to be important components of the program.Conclusions: The support program was positively received and contributed to the nursing staff’s increased sense of self-efficacy and resilience over “bereavement overload.” Continued program development is in progress based on the feedback.
Using Popular Nursing Literature Critique to Help Nursing Students Explore Their Perceptions of Disability
Authors: Anyinam Charles , Coffey Sue
Published: September 2017

Objectives: Disabled people have a history of disadvantage, discrimination, and disempowerment that continues to present day. Despite strong critique and activism by disabled people, popular understandings of disability as necessarily tragic, medically based, and individualistic requiring ‘fixing’ persist among health professionals.  Recent research demonstrates that health professional students often harbour negative attitudes that may directly affect their relationships with and care provided to disabled clients (Sabin & Akyol, 2010; Scullion, 1999). Further, personal accounts and research evidence suggests that the relationship between healthcare providers and disabled people is often unsatisfactory (Sabin & Akyol, 2010; Seccombe, 2007; Scullion, 1999).Methods: Nursing education has a responsibility to ensure that nursing practice with disabled people is enabling rather than disabling (Scullion, 1999a, 1999b, 2000; Sabin & Akyol, 2010). A key strategy is to imbed within curricula opportunities for students to engage in the processes of critical thinking towards and analysis of disability and the experiences of disabled people. This poster describes an approach to teaching-learning in which critique of ‘popular culture’ nursing literature is used to support student exploration of messaging about disability.Results and Conclusions: The purpose and description of the assignment, authors’ experiences, and outcomes for both teachers and learners will be presented. Application beyond nursing to other health professions will be described.ReferencesSabin, H. & Akyol, A. D. (2010). Evaluation of nursing and medical students' attitudes towards people with disabilities. Journal of Clinical Nursing, 19, 2271­2279.Scullion, P. A. (1999). Conceptualizing disability in nursing: Some evidence from students and their teachers. Journal of Advanced Nursing, 29, 648­657.Scullion, P. A. (2000). Enabling disabled people: Responsibilities of nursing education. British Journal of Nursing, 9(15), 1010-1015.Seccombe, J. A. (2007). Attitudes towards disability in an undergraduate nursing curriculum: A literature review. Nurse Education Today, 27, 459­465.
Impact d'une formation à la gestion du stress sur le vécu de la maladie dans l'insuffisance rénale chronique dans un hôpital universitaire français
Authors: Isnard Bagnis Corinne , Khaldi Celine
Published: September 2017

Introduction : Les patients vivant avec une maladie rénale chronique expriment une franche altération de leur qualité de vie. Parmi les éléments impactant ces résultats, le stress chronique lié à la maladie et ses traitements et la douleur sont des plaintes très prévalentes et insuffisamment prises en charge. Cette étude évalue l'impact de la participation de patients insuffisants rénaux chroniques à un programme de gestion du stress par la méditation de pleine conscience (développé aux USA il y a plus de 25 ans par J. Kabat Zinn).Patients et Méthodes : L’enquête s’est concrétisée par la réalisation d’un dispositif « d’observation participante » par une sociologue au sein d’un programme MBSR (meditation-based-stress-reduction program) mis en place dans un service de néphrologie et la réalisation d’une enquête longitudinale : suivi des patients après la formation réalisés dans le cadre de « récits de vie ». Les résultats sont qualitatifs et portent sur la gestion du stress, la capacité à prendre soin de soi et à se mettre en posture de résilience.Résultats : Les premiers résultats permettent de rendre compte d’une amélioration des compétences des patients dans la gestion du stress, dans leur capacité à prendre soin d’eux, à anticiper les difficultés liées à leurs pathologies et à développer des mécanismes de compensation. L’enquête permet aussi de rendre compte d’une amélioration dans le vécu des malades du système de soin et une vision plus positive de l’hôpital et du rapport avec les soignants.Discussion et Conclusion : Les programmes d'education thérapeutique peuvent s'enrichir d'interventions pédagogiques orientées vers l'acquisition de compétences necessaires au maintien de soi en vie avec la maladie. L'amélioration de la gestion du stress par la méditation de pleine conscience pourrait être un moyen d'améliorer la qualité de vie des patients et en tous cas de diminuer le stress perçu.
Exploring the Relationship Between Subjective Ratings of Mindfulness Practices and Outcomes in Patients Participating in an MBSR Program
Authors: Bernardi Nicolò F. , Zhao Qinyi , Dobkin Patricia L
Published: September 2017

Objectives: The present study explored relationships between outcomes of the Mindfulness-Based Stress Reduction (MBSR) program and the importance attributed by patients to the mindfulness practices taught.Methods: Patients with chronic illnesses (46.8% breast cancer; N=126) completed questionnaires pertaining to medical symptoms, stress, and mindfulness, pre- and post-MBSR.  At program completion, each patient rated the importance of the mindfulness practices employed.  Stepwise linear regression analyses were run to investigate associations between changes in outcome variables and subjective ratings of practice importance.Results: Increases in mindfulness were associated with high ratings of importance for sitting meditation (p LT 0.02) and homework manual (p LT 0.02; Adjusted R2 = 0.10). Decreases in medical symptoms were associated with high ratings for the body scan (p LT 0.01) and small group exercises (p LT 0.01; Adjusted R2 = 0.13). High ratings for the body scan were moderately, albeit significantly, correlated with decreases in perceived stress (p LT 0.01, Adjusted R2 = 0.05). A cluster analysis performed on all 10 of the ratings of practice importance showed that greater importance was associated with better outcomes for all three dependent variables (p LT 0.01).  A qualitative examination of patients’ answers to open-ended questions revealed that incorporating mindfulness practices in daily life was a central component of the lifestyle changes experienced during the course of the program.Conclusions: Understanding the mechanisms underlying MBSR’s effectiveness is important as this program becomes recognized as an empirically-supported intervention. These results suggest that specific types of practice (concentration vs. the body scan) are related to distinct outcomes (dispositional mindfulness vs. medical symptoms, respectively). Overall, awareness of the importance of practicing is connected to actual program outcomes.
Primary Care and the Ethics of Integrating Genomic Medicine
Authors: Rahimzadeh Vasiliki
Published: September 2017

Objectives: To explore the practical barriers to, and implications of, incorporating genomic technologies in the primary care setting. In evaluating the primary care mission and anticipated role of genomic medicine in conversation with one another, I discuss the ways in which the primary care philosophy problematizes innovations afforded to clinical medicine through whole genome sequencing. I discuss these themes in relation to the evaluation frameworks that must precede full integration, specifically the Analytic validity, Clinical validity, Clinical Utility and Ethical, legal social considerations (ACCE) model. Finally, my analysis will consider the added ethical nuances for integrating genomic medicine in the wake of new standards for healthcare delivery in the U.S.Methods: I review the literature concerning 1) models for evaluating the applicability of emerging genomic technologies in the primary care setting, namely the ACCE model proposed by the Center for Disease Control, and 2) anticipated changes to primary care delivery through proposed healthcare legislation.Results: Three main facets of primary care delivery problematize full integration of genomic medicine in clinical practice. They include: primary care providers' propensity to maintain therapeutic relationships with patients over the lifecourse, acuity to community health patterns, and gaps in genetic/genomic-specific knowledge among practicing clinicians. Implementation of genomic medicine requires that technologies be adaptable to the heterogeneity of the primary care clinic, in both the diverse populations it serves and broad spectrum of resource availability.Conclusions: The rapid pace at which genomic technology has fundamentally altered the direction of medical research scene is extraordinary to say the least. The potential benefits for incorporating these innovations depict a clinical landscape that predicts and prevents disease before it manifests, and cares for patients using treatments that are tailored to their own genetic person. The primary care arena presents unique challenges to the evaluation, diffusion and translation of genomic technologies. Yet the same aspects that present limitations also reinforce the reasons why the primary care setting is a critical forum in which to operationalize genomic medicine in practice. With so much dialogue generated around ushering in a new era of medicine, it is unclear whether this is celebrating the novelty of the genomic revolution, or the reinvigoration of a longstanding clinical tradition in patient-centered primary care.
Staying Present to Youth with an Unknown Future
Authors: Poitras Susan
Published: September 2017

The intention of this workshop is to provide an opportunity to explore the various dimensions of clinical practice known to support and enhance coping in adolescents living with a life-threatening illness. The objectives are to: 1) Present recent research findings related to the future thinking activities of adolescents in pediatric palliative care; 2) Acknowledge that these findings stretch us as clinicians to “sit with” and \"create time for\" the youth’s exploration of future in the context of an anticipated shortened life; 3) Discuss several cases and provide experiential activities that can prepare the clinician in ‘being with’ and ‘staying present’ to youth who are exploring their future that remains unknown by virtue of the trajectory of illness.The workshop will be broken down into three parts. In the first 30 minutes the findings from a doctoral study aimed at examining the future thinking of adolescents living with a progressive life-threatening neurodegenerative illness will be presented and discussed. Secondly, consideration will be given to how clinicians can mindfully prepare themselves for supporting adolescents and to consider aspects of the clinical self in our work with this population and finally, through both storytelling and the facilitation of active experiential activities, the presenters will share stories and ideas that have been integrated into existing practices.
The Role of a Psychiatrist (Rehabilitation Physician) in the Palliative Care Team
Authors: Miyata Chieko , Tetsuya Tsuji , Hashiguchi Saori , Liu Meigen
Published: September 2017

Objective: Although palliative care consultation teams (PCTs) have become an integral part of all regional cancer care hospitals, cancer rehabilitation is still in the developing stage in Japan. At our hospital, a physiatrist, or a rehabilitation physician, joined the PCT as a member, and we have been achieving good results. The purpose of this study is to clarify the role of a physiatrist as a member of the PCT by investigating the current status of the PCT at our hospital.Method: We retrospectively analyzed the records of 144 patients receiving rehabilitation out of 345 patients who had started receiving PCT services from April 2012 to March 2013 at Keio University Hospital.Results: Among the 144 patients, 67 patients (46.5%) had already received rehabilitation before starting PCT services, and the remaining 77 patients (53.5%) started receiving rehabilitation based on the recommendation by the physiatrist. In the later group, Dietz Cancer Stage Classifications were: preventative, 6.5%; restorative, 40.0%; supportive, 45.5%; and palliative, 9.1%. ECOG-PS were: PS0, 0.0%; PS1, 23.4%; PS2, 29.9%; PS3, 28.6%; and PS4, 18.2%. The main purposes of rehabilitation were: 1) fracture prevention and pain relief of limbs with bone lesions, 2) social support (e.g. measures for the reduction of nursing requirement, assistance in finding social aids, counseling for family members), 3) psychological support, 4) treatment of lymphedema, 5) management of breathlessness, 6) and approaches to swallowing deficits.Conclusions: Half of the cancer patients started rehabilitation after the intervention by the PCT. Many patients receiving PCT services also needed rehabilitation services and the physiatrist had an important role of evaluating the rehabilitation needs. Physiatrists can act as important members of PCTs to maximize QOL while addressing the physical, psychological, social and spiritual needs of both patients and their families.
Person-Centred Dentistry: When Do We Start?
Authors: Apelian Nareg , Vergnes Jean-Noel , Bedos Christophe
Published: September 2017

Objectives: Although most health professions have adopted person-centred approaches in the last decades, dental professionals still rely on traditional paternalistic models. The objective of this research was to develop a model of person-centred care in dental practice.Methods: Adopting an action-research approach, we started our process by adapting Stewart and colleagues' model of person-centred care to the field of dentistry. We then implemented and tested the new clinical approach in a private dental office of Montreal, Canada. During several months, an academic researcher observed the clinical activities of a dental practitioner, who was also the first researcher. At the end of each appointment, the observer and the practitioner shared their observations about the encounter and evaluated the clinical approach. Both suggested improvements to the model and implemented solutions to the next patients. After 39 rounds of observation-evaluation-improvement, a form of saturation was reached in the development of the clinical approach.Results: The clinical encounter goes through four different stages. The first stage is how the relationship is built through an open dialogue on illness, fears and expectations. The second stage consists in gathering clinical information through examination, tests and questioning. The third stage is a disease-centered presentation of the results of the examination. The final stage is the development of a treatment plan after establishing a common ground through frank discussions and shared decision making. From this approach, a model emerged consisting in a stage of understanding, followed by planning, intervention, then back to understanding. This cycle takes place within the context of a patient-dentist relationship with mutual trust. This relationship, central to the encounter, acknowledges the whole-person dimension and psychosocial context of each party.Conclusions:  We hope this model will inspire other professionals and teaching institutions to develop their own approaches by using it as a theoretical framework.