Sample records for experience du service

  1. La Greffe de Peau dans le Traitement des Sequelles de la Main Brulee. A Propos de 152 Cas - Experience du Service de Chirurgie Plastique du Centre Hospitalier Universitaire Ibn-Sina, Rabat, Maroc

    PubMed Central

    El Mazouz, S.; Fejjal, N.; Hafidi, J.; Cherkab, L.; Mejjati, H.; Belfqih, R.; Gharib, N.; Abbassi, A.

    2010-01-01

    Summary La main est fréquemment exposée aux brûlures, entraînant des séquelles esthétiques et fonctionnelles. Le traitement de ces séquelles est surtout chirurgical et consiste en la greffe de peau, dont le type dépend de la localisation de la brûlure et du type des séquelles. Dans ce travail rétrospectif, nous rapportons une série de 152 cas de brûlures des mains colligés au service de chirurgie plastique du Centre Hospitalier Universitaire Ibn-Sina de Rabat sur une période de dix ans, allant de 1998 à 2007. Les indications thérapeutiques dépendent du type de séquelles et de la localisation de la brûlure. En tout, 97 patients ont bénéficié d'une greffe cutanée, dont 76% par greffe de peau totale, 21% par greffe de peau demi-épaisse et 3% par peau fine. Les séquelles des brûlures des mains posent un problème thérapeutique majeur, malgré la diversité des procédés chirurgicaux, d'où l'intérêt de la prévention. PMID:21991196

  2. [Care pathway of children managed by the Bouches-du-Rhone Child Welfare Services].

    PubMed

    Martin, Anaïs; Jego-Sablier, Maeva; Prudhomme, Johanne; Champsaur, Laurence

    2017-12-05

    To describe the care pathway of children managed by the Bouches-du-Rhône Child Welfare Services and to propose ways to improve this care pathway. ESSPER-ASE 13 survey is a descriptive and cross-sectional survey carried out between April 2013 and April 2014, which included 1,092 children under the age of 18 years placed in a Bouches-du-Rhône Child Welfare Services children's home or foster care. This survey studied the physical and mental health and the medical follow-up characteristics of these children. This article focuses on care pathway data. 82% of children were followed by general practitioners, while 15% of children, essentially children under the age of 6 years in child care, were followed by Maternal and Infant Protection (Protection Maternelle et Infantile). The care pathway of these children involved multiple actors and was dominated by psychological follow-up. On average, the children were followed by 2 professionals (specialist or paramedical professional) in addition to the medical examiner. In terms of prevention, children's immunization coverage rates were better than national rates. Coordination of the numerous actors is essential, including the creation of a referring physician.

  3. Gestion de l’anémie des patients hémodialysés chroniques: cas du Service de Néphrologie et d’hémodialyse du CHU du Point G au Mali

    PubMed Central

    Tounkara, Alhadji Ahmadou; Coulibaly, Abdoul Mahama Sériba; Coulibaly, Nouhoun; Traoré, Békaye; Maïga, Mahamane Kalil

    2017-01-01

    Introduction L'anémie est une complication fréquente de l'IRC couramment retrouvée chez les patients hémodialysés chroniques. Chez ces derniers, la prise en charge est principalement basée sur l'administration d'érythropoïétine et la supplémentation en fer. Le but de ce travail était d'évaluer la prise en charge de l'anémie des hémodialysés chroniques dans le service de Néphrologie du CHU du Point G. Méthodes Il s'agissait d'une étude transversale réalisée dans ledit service du 1er au 31 Août 2016. Résultats Au total, 63 patients sur 174 participants avaient été retenus, 34 hommes et 29 femmes avec un sex-ratio à 1,17 en faveur des hommes. L'âge moyen des patients était de 48,79 ans ± 11,59, la durée moyenne en hémodialyse était de 3,77ans ± 2,6. La fréquence hospitalière de l'anémie chez nos dialysés était de 84,12%. La transfusion sanguine était retrouvée chez 92,1%, avec une moyenne annuelle de 5,81poches ± 5,91. La supplémentation martiale était notée dans 87,3% des cas. Les moyennes respectives de ferritine et de CST étaient de 1245 ng/ml ± 629,52 et 46,16%±19,12. L'administration occasionnelle d'EPO à des doses n'excédant pas les 4000UI était rapportée par 79,4% des patients. La principale difficulté pour l'utilisation de l' EPO était le coût (74,6%). L'infection au VHC touchait 60,1% des patients ayant réalisé le dit bilan. Conclusion La gestion de l'anémie des dialysés chroniques doit être intégrée dans un cadre politique nationale de la santé. PMID:28674560

  4. Suivi après le traitement du cancer du sein

    PubMed Central

    Sisler, Jeffrey; Chaput, Geneviève; Sussman, Jonathan; Ozokwelu, Emmanuel

    2016-01-01

    Résumé Objectif Offrir aux médecins de famille un résumé des recommandations fondées sur les données probantes pour guider les soins aux survivantes traitées pour le cancer du sein. Qualité des données Une recherche documentaire a été effectuée dans MEDLINE entre 2000 et 2016 à l’aide des mots-clés anglais suivants : breast cancer, survivorship, follow-up care, aftercare, guidelines et survivorship care plans, en se concentrant sur la revue des lignes directrices publiées récemment par les organismes nationaux de cancérologie. Les données étaient de niveaux I à III. Message principal Les soins aux survivantes comportent 4 facettes : surveillance et dépistage, prise en charge des effets à long terme, promotion de la santé et coordination des soins. La surveillance des récidives ne se traduit que par une mammographie annuelle, et le dépistage d’autres cancers doit suivre les lignes directrices basées sur la population. La prise en charge des effets à long terme du cancer et de son traitement aborde des problèmes courants tels la douleur, la fatigue, le lymphœdème, la détresse et les effets indésirables des médicaments, de même que les préoccupations à long terme comme la santé du cœur et des os. La promotion de la santé met en relief les bienfaits de l’activité chez les survivantes du cancer, avec l’accent mis sur l’activité physique. Les soins aux survivantes sont de meilleure qualité lorsque divers services et professionnels de la santé participent aux soins, et le médecin de famille joue un rôle important dans la coordination des soins. Conclusion Les médecins de famille sont de plus en plus souvent les principaux fournisseurs de soins de suivi après le traitement du cancer du sein. Le cancer du sein doit être considéré comme une affection médicale chronique, même chez les femmes en rémission, et les patientes profitent de la même approche que celle utilisée pour les autres affections chroniques en

  5. Le role du phytoplancton de petite taille (<20 mum) dans les variations des proprietes optiques des eaux du Saint-Laurent

    NASA Astrophysics Data System (ADS)

    Mas, Sebastien

    Les mesures satellitaires de couleur des oceans sont largement determinees par les proprietes optiques inherentes (IOPs) des eaux de surface. D'autre part, le phytoplancton de petite taille (<20 mum) est le plus souvent dominant dans les oceans, et peut donc etre une source importante de variation des IOPs dans les oceans. Dans ce contexte, le but principal de ce doctorat etait de definir l'impact du phytoplancton (<20 mum) sur les variations des proprietes optiques de l'Estuaire et du Golfe du Saint-Laurent (Canada). Afin d'atteindre cet objectif, il etait necessaire de determiner en milieu controle les facteurs de variabilite des proprietes optiques cellulaires et des IOPs du phytoplancton (<20 mum) des eaux du Saint-Laurent, et d'evaluer la contribution du phytoplancton (<20 mum) aux proprietes optiques totales des eaux du Saint-Laurent. Des experiences en laboratoire ont montre que les variations des proprietes optiques des cellules phytoplanctoniques soumises a un cycle jour-nuit, ainsi qu'a des changements concomitants d'intensite lumineuse, peuvent contribuer significativement a la variabilite des proprietes optiques observee en milieu naturel. D'autres experiences ont, quant a elles, mis en evidence que les variations des proprietes optiques des cellules phytoplanctoniques dues aux phases de croissance peuvent alterer les IOPs des oceans, particulierement pendant les periodes de floraison. De plus, la presence de bacteries et de particules detritiques peut egalement affecter la variabilite des IOPs totales, notamment la diffusion. Au printemps, dans l'Estuaire et le Golfe du Saint-Laurent, la contribution du phytoplancton <20 mum aux IOPs presentait des differences regionales evidentes pour les proprietes d'absorption et de diffusion. En plus de la variabilite spatiale, les proprietes optiques cellulaires presentaient des variations journalieres, et ce particulierement pour le picophytoplancton. Enfin, la plupart des differences observees dans les

  6. Acceptabilité du test VIH proposé aux nourrissons dans les services pédiatriques, en Côte d'Ivoire, Significations pour la couverture du diagnostic pédiatrique

    PubMed Central

    Oga, Maxime; Brou, Hermann; Dago-Akribi, Hortense; Coffie, Patrick; Amani-Bossé, Clarisse; Ékouévi, Didier; Yapo, Vincent; Menan, Hervé; Ndondoki, Camille; Timité-Konan, M.; Leroy, Valériane

    2014-01-01

    Résumé Problème: Le dépistage VIH chez les enfants a rarement été au centre des préoccupations des chercheurs. Quand le dépistage pédiatrique a retenu l'attention, cela a été pour éclairer seulement sur les performances diagnostiques en ignorant même que le test pédiatrique comme bien d'autres peut s'accepter ou se refuser. Cet article met au cœur de son analyse les raisons qui peuvent expliquer qu'on accepte ou qu'on refuse de faire dépister son enfant. Objectif: Etudier chez les parents, les mères, les facteurs explicatifs de l'acceptabilité du test VIH des nourrissons de moins de six mois. Méthodes: Entretien semi-directif à passages répétés avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pesée/vaccination et les consultations pédiatriques avec proposition systématique d'un test VIH pour leur nourrisson. Résultats: Nous retenons que la réalisation effective du test pédiatrique du VIH chez le nourrisson repose sur trois éléments. Primo, le personnel de santé par son discours (qui dénote de ses connaissances et perceptions même sur l'infection) orienté vers les mères influence leur acceptation ou non du test. Secundo, la mère qui par ses connaissances et perceptions même sur le VIH, dont le statut particulier, l'impression de bien-être chez elle et son enfant influence toute réalisation du test pédiatrique VIH. Tertio, l'environnement conjugal de la mère, particulièrement caractérisé par les rapports au sein du couple, sur la facilité de parler du test VIH et sa réalisation chez les deux parents ou chez la mère seulement sont autant de facteurs qui influencent la réalisation effective du dépistage du VIH chez l'enfant. Le principe préventif du VIH, et le désir de faire tester l'enfant ne suffisent pas à eux seuls pour aboutir à sa réalisation effective, selon certaines mères confrontées au refus du conjoint. A l'opposé, les autres mères refusant la r

  7. Queue observing at the Observatoire du Mont-Mégantic 1.6-m telescope

    NASA Astrophysics Data System (ADS)

    Artigau, Étienne; Lamontagne, Robert; Doyon, René; Malo, Lison

    2010-07-01

    Queue planning of observation and service observing are generally seen as specific to large, world-class, astronomical observatories that draw proposal from a large community. One of the common grievance, justified or not, against queue planning and service observing is the fear of training a generation of astronomers without hands-on observing experience. At the Observatoire du Mont-Mégantic (OMM) 1.6-m telescope, we are developing a student-run service observing program. Queue planning and service observing are used as training tools to expose students to a variety of scientific project and instruments beyond what they would normally use for their own research project. The queue mode at the OMM specifically targets relatively shallow observations that can be completed in less than a few hours and are too short to justify a multi-night classical observing run.

  8. Élimination du bore du silicium par plasma inductif sous champ électrique

    NASA Astrophysics Data System (ADS)

    Combes, R.; Morvan, D.; Picard, G.; Amouroux, J.

    1993-05-01

    We analyzed purification mechanisms of silicon by inductive plasma with a fluoride slag. The aim is to study boron elimination from doped electronic grade silicon in function of the nature of the slag to obtain a photovoltaic grade silicon. The steady began with the calculation and the comparison of the stability diagram of boron compounds in presence of CaF2, BaF2 and MgF2. This study led us to conclude that BaF2 is the better slag for silicon purification. This has been confirmed by experience. In a second time, we made purifications under electric bias to enhance slag efficiency. We noticed that BaF2 is more sensitive to electric bias than other slags. Nous avons analysé le mécanisme de purification du silicium sous plasma inductif en présence d'un laitier fluoré. L'objectif principal est d'étudier l'élimination du bore du silicium électronique dopé en fonction de la nature du fluorure pour obtenir un silicium de qualité photovoltaïque. L'étude a commencé par l'établissement et la comparaison de diagrammes des composés du bore en présence de CaF2, de MgF2 et de BaF2. Nous avons déduit de cette première étude que BaF2 est le meilleur laitier pour la purification du silicium. Ceci a été corroboré par l'expérience. Nous avons ensuite opéré en présence d'un champ électrique dans le but d'améliorer encore l'efficacité des laitiers. Nous avons constaté que BaF2 est plus sensible au champ électrique que les deux autres laitiers utilisés.

  9. Preceptors' Experience of Nursing Service-Learning Projects.

    PubMed

    Voss, Heather C

    2016-03-01

    Service-learning is a teaching-learning strategy in higher education that provides hands-on experiences in authentic clinical environments. Mutual decision making, shared goals, reciprocity, and tangible benefits to organizations and the people they serve are hallmarks of service-learning. However, the literature is sparse pertaining to preceptor experiences with service-learning projects, the extent of reciprocity, or the projects' impact on those who received the service. A small phenomenological study was conducted to better understand the experiences of four community-based health professionals who worked with nursing students on service-learning projects. Four themes emerged from face-to-face interviews and written reflections: (a) reciprocity among preceptor, clinical faculty, and student, (b) intentional planning and project clarity, (c) meaningful and authentic experience, and (d) valued and beneficial contributions that addressed a need. Insight gained from the experiences of the four preceptors in this study suggest that through careful planning and reciprocity, service-learning can have a positive impact on community-based organizations and the people they serve. Copyright 2016, SLACK Incorporated.

  10. Approche de prise en charge du trouble du spectre de l’autisme

    PubMed Central

    Lee, Patrick F.; Thomas, Roger E.; Lee, Patricia A.

    2015-01-01

    Résumé Objectif Se pencher sur les critères diagnostiques du trouble du spectre de l’autisme (TSA) comme les définit le Manuel diagnostique et statistique des troubles mentaux, cinquième édition (DSM-V), et concevoir une approche de prise en charge du TSA à l’aide du cadre CanMEDS–Médecine familiale (CanMEDS-MF). Sources d’information Le DSM-V, publié par l’American Psychiatric Association en mai 2013, énonce de nouveaux critères diagnostiques du TSA. Le cadre CanMEDS-MF du Collège des médecins de famille du Canada fournit un plan d’orientation pour la prise en charge complexe du TSA. Nous avons utilisé des données recueillies par le Centers for Disease Control and Prevention afin de déterminer la prévalence du TSA, ainsi que la revue systématique et méta-analyse détaillée effectuée par le National Institute for Health and Care Excellence du R.-U. pour ses lignes directrices sur le TSA dans le but d’évaluer les données probantes issues de plus de 100 interventions. Message principal Selon les données du Centers for Disease Control and Prevention, la prévalence du TSA se chiffrait à 1 sur 88 en 2008 aux États-Unis. La classification du TSA dans la quatrième édition du DSM incluait l’autisme, le syndrome d’Asperger, le trouble envahissant du développement et le trouble désintégratif de l’enfance. La dernière révision du DSM-V réunit tous ces troubles sous la mention TSA, avec différents niveaux de sévérité. La prise en charge du TSA est complexe; elle exige les efforts d’une équipe multidisciplinaire ainsi que des soins continus. Les rôles CanMEDS-MF fournissent un cadre de prise en charge. Conclusion Les médecins de famille sont au cœur de l’équipe de soins multidisciplinaire pour le TSA, et le cadre CanMEDS-MF tient lieu de plan détaillé pour guider la prise en charge d’un enfant atteint de TSA et aider la famille de cet enfant.

  11. Evaluation du niveau de connaissance des patients sur la gestion du traitement par les antis vitamines K dans le service de cardiologie de Ouagadougou

    PubMed Central

    Samadoulougou, André; Temoua Naibe, Dangwé; Mandi, Germain; Yameogo, Relwendé Aristide; Kabore, Elisé; Millogo, Georges; Yameogo, Nobila Valentin; Kologo, Jonas Koudougou; Thiam/Tall, Anna; Toguyeni, Boubacar Jean Yves; Zabsonre, Patrice

    2014-01-01

    Introduction Les antivitamines K (AVK), traitement anticoagulant oral le plus largement prescrit, posent un réel problème de santé publique du fait de leur risque iatrogène. L'objectif de cette étude était de préciser le niveau de connaissance des patients sur la gestion de leur traitement par les AVK. Méthodes Il s'est agi d'une enquête transversale descriptive réalisée au CHU-Yalgado Ouédraogo, sur une période de 03 mois : du 1er mars au 31 mai 2012. Un questionnaire a été administré aux patients bénéficiant d'un traitement AVK depuis au moins un mois. Résultats Soixante-dix patients ont été inclus dans l'étude dont 30 hommes. L'âge moyen était de 49 ans ± 16 ans. Les cardiopathies et la maladie thromboembolique veineuse justifiant l'institution du traitement AVK étaient retrouvées respectivement dans 58,6% et 41,4% des cas. Le nom de l'AVK et la raison exacte du traitement étaient connus respectivement dans 91,4% et 67,1% des cas. Plus de la moitié des patients (68,6%) savaient que les AVK rendaient le sang plus fluide. Quarante-six patients (65,7%) citaient l'INR comme examen biologique de surveillance du traitement et seulement 28 patients (40%) connaissaient les valeurs cibles. La majorité des patients ne connaissait pas les risques encourus en cas de surdosage (72,8%) et de sous-dosage (71,4%). Une automédication par anti-inflammatoire non stéroïdien était signalée par 18 patients (25,7%). Les choux (74,3%) et la laitue (62,9%), aliments à consommer avec modération, étaient les plus cités. Conclusion Les connaissances des patients sur la gestion des AVK étaient fragmentaires et insuffisantes pour assurer la sécurité et l'efficacité du traitement. La création d'un programme d'éducation thérapeutique sur les AVK s'avère alors nécessaire. PMID:25870741

  12. Experiences with information locator services

    USGS Publications Warehouse

    Christian, E.

    1999-01-01

    Over the last few years, governments and other organizations have been using new technologies to create networked Information Locator Services that help people find information resources. These services not only enhance access to information, but also are designed to support fundamental information policy principles. This article relates experiences in developing and promoting services interoperable with the Global Information Locator Service standard that has now been adopted and promoted in many forums worldwide. The article describes sample implementations and touches on the strategic choices made in public policy, standards, and technology. Ten recommendations are offered for successful implementation of an Information Locator Service. Published by Elsevier Science Ltd. All rights reserved.

  13. Etude de l'affaiblissement du comportement mecanique du pergelisol du au rechauffement climatique

    NASA Astrophysics Data System (ADS)

    Buteau, Sylvie

    Le rechauffement climatique predit pour les prochaines decennies, aura des impacts majeurs sur le pergelisol qui sont tres peu documentes pour l'instant. La presente etude a pour but d'evaluer ces impacts sur les proprietes mecaniques du pergelisol et sa stabilite a long terme. Une nouvelle technique d'essai de penetration au cone a taux de deformation controle, a ete developpee pour caracteriser en place le pergelisol. Ces essais geotechniques et la mesure de differentes proprietes physiques ont ete effectues sur une butte de pergelisol au cours du printemps 2000. Le developpement et l'utilisation d'un modele geothermique 1D tenant compte de la thermodependance du comportement mecanique ont permis d'evaluer que les etendues de pergelisol chaud deviendraient instables a la suite d'un rechauffement de l'ordre de 5°C sur cent ans. En effet, la resistance mecanique du pergelisol diminuera alors rapidement jusqu'a 11,6 MPa, ce qui correspond a une perte relative de 98% de la resistance par rapport a un scenario sans rechauffement.

  14. Education as Service: The Understanding of University Experience through the Service Logic

    ERIC Educational Resources Information Center

    Ng, Irene C. L.; Forbes, Jeannie

    2009-01-01

    With the marketization of UK higher education, this paper develops a framework from services marketing that can assist universities in understanding what market orientation means and how students would value their offerings. Our study shows that the core service in a university experience is a learning experience that is cocreated and that the…

  15. Aspects épidémiologiques des traumatismes du rachis: à propos de 139 cas

    PubMed Central

    Bemora, Joseph Synèse; Rakotondraibe, Willy Francis; Ramarokoto, Mijoro; Ratovondrainy, Willy; Andriamamonjy, Clément

    2017-01-01

    Les traumatismes du rachis représentent une des lésions les plus fréquemment observées, chez les victimes d’accidents de circulation, d’accident de sportifs, domestique et du travail. Il s’agissait d’une étude rétrospective de 3 ans portant sur 139 cas de traumatismes du rachis hospitalisés et pris en charge dans le service de neurochirurgie du CHUJRA Madagascar. A travers cette étude, 25,17% des traumatisés étaient entre 21 et 30 ans avec une nette prédominance masculine de 69,78% (sexe ratio 2,3). L’étiologie était dominéepar la chute dans 33,09% des cas avec des facteurs de risque dont prise d’alcool (8,63%). Le traumatisme entrait dans le cadre d’un polytraumatisme dont un traumatisme crânien dans 34,63%. Les patients étaient admis dans le service 1 à 5h après le traumatisme dans 31,65% en utilisant comme moyen de transport une voiture personnelle dans 36,69%. Pendant l’hospitalisation 20 patients ont signé une décharge et 6,34% des patients sont décédés. Les traumatismes du rachis posent un problème de santé publique avec une prise en charge lourde surtout pour les patients déficitaires à vie. Devant tout traumatisme du rachis, il faut rechercher systématiquement une lésion crânienne. PMID:28450995

  16. Lambeaux autofermants pour le traitement des brulures electriques du scalp par haut voltage

    PubMed Central

    Hafidi, J.; El Mazouz, S.; El Mejatti, H.; Fejjal, N.; Gharib, N.E.; Abbassi, A.; Belmahi, A.M.

    2011-01-01

    Summary Les brûlures électriques par haut voltage sont responsables de gros dégâts tissulaires en immédiat et dans les jours suivant l’accident du fait de la chaleur importante dégagée par effet joule et de la thrombose microvasculaire évolutive. Les pertes de substances du scalp secondaires à ces brûlures nécessitent une couverture par lambeaux vu la destruction du périoste et du calvarium en regard. De juin 1997 à juin 2008, 15 patients ont été traités pour des pertes de substance du scalp secondaires à des brûlures électriques par haut voltage de diamètre allant de 8 à 11 cm et siégeant dans la région tonsurale. Ces patients ont été opérés dans la première semaine suivant l’accident. Les pertes de substance du scalp de taille moyenne secondaires à ces brûlures peuvent être couvertes per primam de façon fiable par des lambeaux locaux axialisés et multiples. Nous relatons l’expérience du Service de Chirurgie Plastique du Centre Hospitalier Universitaire Ibn-Sina, Rabat, Maroc, dans la gestion et la prise en charge de ces brûlures. PMID:22262963

  17. Syndrome métabolique chez les patients hypertendus dans le service cardiologie du CHU Yalgado Ouedraogo de Ouagadougou, Burkina Faso

    PubMed Central

    Millogo, Georges Rosario Christian; Samandoulougou, André; Yaméogo, Nobila Valentin; Yaméogo, Aristide Relwendé; Kologo, Koudougou Jonas; Toguyeni, Jean Yves; Zabsonré, Patrice

    2014-01-01

    Introduction Le syndrome métabolique constitue de nos jours un véritable problème de santé publique. Le syndrome métabolique est le moteur d'une double épidémie mondiale de diabète type II et de maladies cardiovasculaires. L'objectif de notre étude est de décrire les aspects épidémiologiques, cliniques, para cliniques et évolutifs chez les hypertendus dans le service de Cardiologie du CHU Yalgado Ouédraogo. Méthodes Il s'agissait d'une étude rétrospective sur une période de deux ans dans le service de cardiologie chez les patients hypertendus ayant un syndrome métabolique. Résultats La fréquence du syndrome métabolique était de 17,5% des patients hypertendus. Le sex ratio était de 1,2. L’âge moyen des patients étaient de 56,1 ±10,7 ans. Les patients connus hypertendus étaient de 92,1% avec une durée moyenne d’évolution de l'HTA qui était de 8,7 ± 5,9 ans. Le suivi était irrégulier dans 60% cas et une rupture du traitement dans 37,1% des cas. La dyslipidémie était notée dans 84,2% des cas et le diabète dans 60,5% des cas. La PAS moyenne était de 184,3 ± 47,3 mmHg et la PAD moyenne était de 110,7 ± 27,7 mmHg. L'HTA était sévère dans 63,2% des cas. La glycémie moyenne était de 8,3 ± 4,3 mmol/L, le LDL cholestérol moyen était de 3,5 ± 1,0 mmol/L et le taux des triglycérides moyen était de 1,6 ± 1,1 mmol/L. L'HVG électrique était notée chez 76,3% des patients et échographique dans 58,8% des cas. Les atteintes viscérales étaient neurologique dans 44,5%, rénale dans 55,3% et cardiaque dans 31,2% des cas. Le nombre moyen d'antihypertenseurs était de 3,0 ± 1,0 et 76,3% ont reçu au moins une trithérapie antihypertensive. Le taux de mortalité était de 5,3%. Conclusion Le syndrome métabolique est une pathologie qui pose la problématique de la définition qui n'est pas consensuelle d'une part et d'autre part du contrôle de ses éléments constitutifs surtout l'HTA. PMID:25883718

  18. Accessible Fixed Route Bus Service Experience

    DOT National Transportation Integrated Search

    1981-05-01

    The research report discusses the operator and user experience with lifting devices on regular bus transit services that facilitate the entry and exit of wheelchair users and semi-ambulatory passengers. The study draws data mainly from experiences at...

  19. Road to Success: Service Learning Enhances Tech Ed Experience

    ERIC Educational Resources Information Center

    Howell, Robert T.

    2008-01-01

    Service learning, a form of experiential learning, is not a new idea. Students learn through participation in thoughtfully organized service experiences that meet real community needs are are coordinated in collaboration with schools/faculty and community organizations. the service experiences are integrated into the students' academic curriculum,…

  20. Discrete choice experiments of pharmacy services: a systematic review.

    PubMed

    Vass, Caroline; Gray, Ewan; Payne, Katherine

    2016-06-01

    Background Two previous systematic reviews have summarised the application of discrete choice experiments to value preferences for pharmacy services. These reviews identified a total of twelve studies and described how discrete choice experiments have been used to value pharmacy services but did not describe or discuss the application of methods used in the design or analysis. Aims (1) To update the most recent systematic review and critically appraise current discrete choice experiments of pharmacy services in line with published reporting criteria and; (2) To provide an overview of key methodological developments in the design and analysis of discrete choice experiments. Methods The review used a comprehensive strategy to identify eligible studies (published between 1990 and 2015) by searching electronic databases for key terms related to discrete choice and best-worst scaling (BWS) experiments. All healthcare choice experiments were then hand-searched for key terms relating to pharmacy. Data were extracted using a published checklist. Results A total of 17 discrete choice experiments eliciting preferences for pharmacy services were identified for inclusion in the review. No BWS studies were identified. The studies elicited preferences from a variety of populations (pharmacists, patients, students) for a range of pharmacy services. Most studies were from a United Kingdom setting, although examples from Europe, Australia and North America were also identified. Discrete choice experiments for pharmacy services tended to include more attributes than non-pharmacy choice experiments. Few studies reported the use of qualitative research methods in the design and interpretation of the experiments (n = 9) or use of new methods of analysis to identify and quantify preference and scale heterogeneity (n = 4). No studies reported the use of Bayesian methods in their experimental design. Conclusion Incorporating more sophisticated methods in the design of pharmacy

  1. Customer service and overall satisfaction with angling experiences

    Treesearch

    Thomas D. Wickham; Alan R. Graefe; Robert C. Burns

    2003-01-01

    This study explores the relationship between individual customer service items and satisfaction with facilities, services, information, recreation experience and overall quality of fishing for a diverse group of anglers at lakes in the New England region. Recent attention to customers and their experiences and attitudes has increased the interest of, both managers and...

  2. Domestic and International Service Learning Experiences: A Comparative Study of Pre-Service Teacher Outcomes

    ERIC Educational Resources Information Center

    Miller, Kari Knutson; Gonzalez, Amber M.

    2010-01-01

    This paper examines pre-service teacher outcomes associated with service learning in domestic and international settings. Participants included upper-division, undergraduate-level pre-service teachers who participated in service learning experiences in either local, domestic settings (Orange County, CA) or international settings (Shanghai and…

  3. Valeria Fike: College of DuPage Library, Glen Ellyn, IL

    ERIC Educational Resources Information Center

    Berry, John N., III

    2006-01-01

    In this article, the author profiles Valeria Fike, supervisor of reference support and College and Career Information Center services at the College of DuPage Library (CODL), Glen Ellyn, Illinois. Valeria Fike, who supervises some 21 paraprofessionals at CODL, modestly attributes her successful career there to her being "simply in the right…

  4. Service users' experiences of participation in decision making in mental health services.

    PubMed

    Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

    2015-11-01

    Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core

  5. Le traumatisme du colon: l'expérience du CHU Hassan II de Fès

    PubMed Central

    Benjelloun, El Bachir; Hafid, Hasnai; Karim, Ibnmajdoub; Ousadden, Abdelmalek; Mazaz, Khalid; Taleb, Kahlid Ait

    2012-01-01

    Introduction Les traumatismes du colon sont associés à un risque majeur de complications septiques et de mortalité. Le but de notre étude est d’évaluer les circonstances, la prise en charge, le suivi et les facteurs pronostic de morbidité postopératoire des malades victimes d'un traumatisme colique. Méthodes Il s'agit d'une étude rétrospective sur une série de 49 patients opérés pour des plaies coliques aux services de chirurgie viscérale du CHU HASSAN II de Fès sur une période de 8 ans de juillet 2003 à juillet 2011. Résultats L’âge moyen de nos patients était de 25ans (16-70) avec une nette prédominance masculine (93.8%). Les plaies coliques secondaires à un traumatisme par arme blanche représentent 85% des cas (42 patients), suivi par les plaies iatrogènes au cours d'une coloscopie chez 6 patients (13%), puis les contusions abdominales chez 1 patient (2%). Les parties du cadre colique les plus touchées étaient le colon transverse chez 19 patients (38%) et le colon descendant chez 12 patients (24, 5%). Le colon sigmoïde était le segment le plus touché au cours d'une coloscopie4/6. Quarante-deux patients (85%) ont eu une suture primaire des plaies coliques, six patients (13%) une diversion fécale et un patient (2%) une résection-anastomose. Deux patients (4%) sont décédés suite à un choc septique. La morbidité globale était de 38,7% dominé essentiellement par l'infection de la paroi chez 14 patients et une péritonite post opératoire chez 3 patients. L'analyse univarié a montré une différence significatif en terme d'infection de la paroi entre le groupe colostomie versus suture simple (50% vs 20,9% p<0,05). L'atteinte du colon gauche et la réalisation d'une colostomie sont associés à un risque plus élevés de complications postopératoires. Conclusion La suture primaire peut être effectuée avec un faible taux de complications postopératoire chez la majorité des patients suite à un traumatisme du colon. PMID

  6. Niveaux d'étude du cerveau, et sagesse physique

    NASA Astrophysics Data System (ADS)

    Toulouse, Gérard

    1993-02-01

    The brain is a complex spatio-temporal affair. Several brain theories propose the definition of three superposed levels of study. But physics, though the experience of condensed matter physics, suggests that it is unwise to enforce onto brain theories a unified hierarchical scheme, the inspiration for which seems to come from the realm of sub-molecular physics. Le cerveau est une affaire spatio-temporelle complexe. Plusieurs théories du cerveau proposent de définir trois niveaux d'études superposés. Mais la physique, à travers l'expérience de la physique de la matière condensée, suggère qu'il n'est pas sage d'imposer sur les théories du cerveau un schéma hiérarchique unifié, dont l'inspiration semble provenir du domaine de la physique sub-moléculaire.

  7. Effect of Service Environment on Composite Materials

    DTIC Science & Technology

    1980-08-01

    AGARC -CP-288 . z AGARD Conference Procee•dings No.288 Effect of Service Environment on Composite Materials M1TflIBInj4 STATE 9s~k 7- II LLU...ORGANISATION DU TRAITE DE L’ATLANTI )UE NOR3) AGARD Conference Proceedings 1, o.288 EFFECT OF SERVICE ENVIRONM ENT ONj I COMPOSITE MATERIALS --- I... composites soumis aux divers types d’agressions que l’on recouvre aujourd’hui du vocable d’...environnement". On doit admettre que cette revue 6tait part

  8. Analyzing a Service-Learning Experience Using a Social Justice Lens

    ERIC Educational Resources Information Center

    Tinkler, Barri; Hannah, C. Lynne; Tinkler, Alan; Miller, Elizabeth

    2014-01-01

    This mixed methods study explores a service-learning experience embedded in a social foundations course in a teacher education program. The authors differentiate learning outcomes for social justice and charity service-learning, and utilize this framework to examine whether the service-learning experience fosters a social justice perspective. The…

  9. The du Bois sign.

    PubMed

    Voelpel, James H; Muehlberger, Thomas

    2011-03-01

    According to the current literature, the term "du Bois sign" characterizes the condition of a shortened fifth finger as a symptom of congenital syphilis, Down syndrome, dyscrania, and encephalic malformation. Modern medical dictionaries and text books attribute the eponym to the French gynecologist Paul Dubois (1795-1871). Yet, a literature analysis revealed incorrect references to the person and unclear definitions of the term. Our findings showed that the origin of the term is based on observations made by the Swiss dermatologist Charles du Bois (1874-1947) in connection with congenital syphilis. In addition, a further eponymical fifth finger sign is closely associated with the du Bois sign. In conclusion, the du Bois sign has only limited diagnostic value and is frequently occurring in the normal healthy population.

  10. Cancer du sein bilatéral synchrone au Maroc: caractéristiques épidémiologiques et cliniques

    PubMed Central

    Boufettal, Houssine; Samouh, Naïma

    2015-01-01

    Préciser la fréquence, les facteurs de risque et le pronostic du cancer du sein bilatéral, à partir d'une étude rétrospective de 22 cas de cancer du sein bilatéral synchrone dans un pays du Maghreb. De 2002 à 2010, 625 patientes étaient prises en charge pour cancer du sein au service de Gynécologie-Obstétrique «C» du centre hospitalier universitaire de Casablanca. 22 cas de cancer bilatéral synchrone étaient diagnostiqués. Nos résultats sont comparés avec ceux de la littérature. La fréquence de la bilatéralité du cancer du sein synchrone était de 3,52% (22/625). L'intervalle de temps moyen entre les deux cancers est de 4 mois (0 à 6 mois). Les patientes âgées de moins de 40 ans lors du premier cancer avaient six fois plus de risque de développer un cancer au niveau du sein controlatéral que les femmes âgées de plus de 40 ans. Les patientes atteintes d'une tumeur T3 ou T4 avaient un risque neuf fois plus élevé que les autres. 90,9% (2/22) des cas des premiers cancers sont des adénocarcinomes infiltrants. Les types histologiques du premier et du douzième cancer étaient identiques dans 86,4% (19/22) des cas. Quant au pronostic, il dépend à la fois du stade du premier et du deuxième cancer et le traitement de ce dernier doit obéir aux mêmes règles du traitement du premier cancer. L'incidence du cancer bilatéral synchrone du sein est de 3,52% dans notre série. Le cancer du sein unilatéral constitue un facteur de risque de développement d'un cancer du sein controlatéral. Une surveillance à vie est nécessaire au cours d'un cancer du sein pour détecter un cancer controlatéral. PMID:26090066

  11. Experience-based co-design in an adult psychological therapies service.

    PubMed

    Cooper, Kate; Gillmore, Chris; Hogg, Lorna

    2016-01-01

    Experience-based co-design (EBCD) is a methodology for service improvement and development, which puts service-user voices at the heart of improving health services. The aim of this paper was to implement the EBCD methodology in a mental health setting, and to investigate the challenges which arise during this process. In order to achieve this, a modified version of the EBCD methodology was undertaken, which involved listening to the experiences of the people who work in and use the mental health setting and sharing these experiences with the people who could effect change within the service, through collaborative work between service-users, staff and managers. EBCD was implemented within the mental health setting and was well received by service-users, staff and stakeholders. A number of modifications were necessary in this setting, for example high levels of support available to participants. It was concluded that EBCD is a suitable methodology for service improvement in mental health settings.

  12. 14 CFR 21.277 - Data review and service experience.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Data review and service experience. 21.277....277 Data review and service experience. (a) If the Administrator finds that a product for which a type... unsafe feature or characteristic caused by a defect in design or manufacture exists, the manufacturer...

  13. 14 CFR 21.277 - Data review and service experience.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Data review and service experience. 21.277....277 Data review and service experience. (a) If the Administrator finds that a product for which a type... unsafe feature or characteristic caused by a defect in design or manufacture exists, the manufacturer...

  14. A Co-Mentoring Project: An Intergenerational Service-Learning Experience

    ERIC Educational Resources Information Center

    Zucchero, Renee A.

    2011-01-01

    Intergenerational service-learning between college students and older adults is a commonly used in educational gerontology. Service-learning is believed to enhance student learning through an equivalent focus on service and learning, reflection, and linking course content with the service experience. This article describes a comentoring project…

  15. Subclinical psychotic experiences and subsequent contact with mental health services.

    PubMed

    Bhavsar, Vishal; Maccabe, James H; Hatch, Stephani L; Hotopf, Matthew; Boydell, Jane; McGuire, Philip

    2017-03-01

    Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. We linked a representative survey of south-east London (SELCoH-1, n =1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03-2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

  16. 14 CFR 21.477 - Data review and service experience.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Data review and service experience. 21.477... Procedures § 21.477 Data review and service experience. (a) If the Administrator finds that a product for... that an unsafe feature or characteristic caused by a defect in design or manufacture exists, the DAS...

  17. An experiment to enable commercial mobile satellite service

    NASA Technical Reports Server (NTRS)

    Lovell, R. R.; Knouse, G. H.; Weber, W. J.

    1982-01-01

    A Mobile Satellite Experiment (MSAT-X) is described, based on a planned cooperative U.S./Canadian program. The experiment would establish network architecture, develop system and ground-segment technology, and define the technical characteristics needed to help structure the regulatory/institutional framework needed to enable a first-generation commercial satellite service. A satellite of this type would augment terrestrial systems, both cellular and noncellular, in the thin-route/rural areas of the country where service is either unavailable or inadequate. Applications range from wide-area radio/dispatch (e.g., oil exploration and interstate trucking) to extension of the public mobile telephone service. Market estimates are provided and experiment objectives and requirements are delineated. The requirements are being developed in close coordination with the Department of Communications (DOC) of Canada and with industry and potential-user organizations. The paper closes with a development plan and milestone chart.

  18. "Cirque du Freak."

    ERIC Educational Resources Information Center

    Rivett, Miriam

    2002-01-01

    Considers the marketing strategies that underpin the success of the "Cirque du Freak" series. Describes how "Cirque du Freak" is an account of events in the life of schoolboy Darren Shan. Notes that it is another reworking of the vampire narrative, a sub-genre of horror writing that has proved highly popular with both adult and…

  19. Experiences of volunteering: a partnership between service users and a mental health service in the UK.

    PubMed

    Fegan, Colette; Cook, Sarah

    2012-01-01

    The aim of the study was to investigate how people with serious mental illness perceived the experience of volunteering for the health care organisation in which they had received a service. The study took a qualitative approach and in phase one, eleven service user volunteers were purposefully sampled and interviewed. In depth interviews were analysed using grounded theory. This paper describes the findings from phase one, and highlights the following themes to represent the volunteering experience: 1) rehearsing for a new direction; 2) treading carefully at first; 3) discovering my new self; and, 4) using my experience and extending relationships. These themes further support a tentative theoretical framework that considers supported volunteering to enhance recovery because it fosters positive risk taking and gives individuals a valued identity that integrates their mental health experience. In phase two, this framework will be tested with service users in more diverse volunteer positions. The findings of my study suggest that mental health services are in a unique position to build partnerships with service users to support their recovery and journeys toward employment by providing opportunities for volunteering.

  20. Subclinical psychotic experiences and subsequent contact with mental health services

    PubMed Central

    Maccabe, James H.; Hatch, Stephani L.; Hotopf, Matthew; Boydell, Jane; McGuire, Philip

    2017-01-01

    Background Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. Aims To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. Method We linked a representative survey of south-east London (SELCoH-1, n=1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. Results After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03–2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. Conclusions Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license. PMID:28357132

  1. Child and adolescent service experience (ChASE): measuring service quality and therapeutic process.

    PubMed

    Day, Crispin; Michelson, Daniel; Hassan, Imren

    2011-11-01

    OBJECTIVES. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience DESIGN. The study comprises a non-experimental, cross-sectional design. METHODS. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) (Stallard, 1996) and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. RESULTS. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. CONCLUSIONS. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance. ©2011 The British Psychological Society.

  2. Prévalence du portage asymptomatique du plasmodium chez les donneurs bénévoles de sang à Kisangani, République Démocratique du Congo

    PubMed Central

    Bassandja, Jacques Ossinga; Agasa, Salomon Batina; Likwela, Joris Losimba

    2014-01-01

    Introduction Le paludisme transfusionnel est une réalité en Afrique Sub-saharienne, en raison des transfusions sanguines répétées, peu ou non contrôlées et où les donneurs sont en majorité potentiellement porteurs d'hématozoaires. L'objectif de cette étude était de déterminer la prévalence du portage asymptomatique du plasmodium chez les donneurs bénévoles de sang à Kisangani. Méthodes Une étude transversale a été menée au Centre Provincial de Transfusion Sanguine à Kisangani du 1er Décembre 2012 au 31 Mars 2013 et a concerné 480 donneurs bénévoles de sang. Résultats La prévalence du portage asymptomatique du plasmodium chez les donneurs bénévoles de sang était de 28,3%. Plasmodium falciparum était l'espèce la plus répandue (96,3%). Près de la moitié des donneurs avait une parasitémie supérieure à 2000 parasites/µl. Les facteurs qui étaient significativement associés à la parasitémie étaient le jeune âge, le 1er don, et la non utilisation de la moustiquaire imprégnée d'insecticide à longue durée (MILD). Conclusion Les résultats de cette étude montrent que la prévalence du portage asymptomatique du plasmodium chez les donneurs bénévoles de sang était élevée, constituant ainsi un risque important de transmission du parasite aux receveurs souvent en mauvais état général. Cependant, l'utilisation de la MILD et la fidélisation des donneurs bénévoles semblent constituer des moyens utiles de réduction du risque de portage asymptomatique du Plasmodium. Une sensibilisation et éventuellement des distributions ciblées de MILD aux donneurs, en particuliers les plus jeunes, pourraient réduire considérablement le portage du Plasmodium parmi les donneurs de sang et ainsi réduire le risque de paludisme transfusionnel. PMID:25328616

  3. The Impact of a Service-Learning Experience in Mentoring At-Risk Youth

    ERIC Educational Resources Information Center

    Wasburn-Moses, Leah; Fry, Jay; Sanders, Kari

    2014-01-01

    Service-learning experiences for college students are increasing in popularity. Although youth mentoring is thought to be a significant service-learning experience for students, data in this area are lacking. This study evaluates a unique school-based service-learning mentoring experience at a midsized Midwestern university. Data were collected…

  4. Changing students' perceptions of the homeless: A community service learning experience.

    PubMed

    Gardner, Janet; Emory, Jan

    2018-03-01

    The homeless are an underserved, local vulnerable population that can benefit from a service learning clinical practicum experience for baccalaureate prepared nursing students. Negative attitudes and disrespect among healthcare workers has been identified by the homeless as a barrier to healthcare. A service learning experience with a vulnerable population has been shown to change nursing students' attitudes and beliefs. A large university in a southern city partnered with a community based organization that provided services to the homeless to educate senior nursing students in a service learning experience. The goal of this project was to examine attitudes and perceptions of nursing students toward the homeless population before and after participation in a service learning clinical practicum experience. This case study utilized a pre and post experience questionnaire to collect qualitative data for the purposes of the project. The findings revealed students demonstrated a decrease in fear, an increase in empathy, and a deeper understanding of the advocacy role of nurses for people experiencing homelessness. Nurse educators are challenged to engage students with vulnerable populations to change the attitudes and perceptions for improvement in the overall health of communities served worldwide. Partnerships and service learning experiences can benefit all. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Pre-Service Teachers' Cultural and Teaching Experiences Abroad

    ERIC Educational Resources Information Center

    Ateskan, Armagan

    2016-01-01

    This study investigates Turkish pre-service teachers' experiences related to a two-month international teaching and cultural experience in the United States of America. In total, 289 graduate students from Turkey participated in a collaborative project from 2001 to 2010. The experience included an orientation week, six weeks of student teaching in…

  6. Canadian Paramedic Services Standards Report: A Strategic Planning Report

    DTIC Science & Technology

    2014-06-01

    Gestion des programmes 7. Nouvelle technologie 8. Gestion des situations d’urgence La section 4 du rapport sur la stratégie de ...normalisation (CSA) et du Programme canadien pour la sûreté et la sécurité (PCSS). Ce projet a réuni des experts clés de la communauté canadienne du ...existantes pour les services paramédicaux actuels au Canada aux besoins présents et futurs de la communauté

  7. Command and Control (C2) Agility (Agilite du commandement et du controle (C2))

    DTIC Science & Technology

    2014-10-01

    de la rigueur et de l’emploi des méthodes de mesure et d’amélioration de l’agilité du C2. Le spectre des missions... Control and Intelligence (C2I) Section DRDC Valcartier 2459 de la Bravoure Road Québec (Québec) G3J 1X5 CANADA Email: Micheline.Belanger@drdc...Agilité du commandement et du contrôle (C2) (STO-TR-SAS-085) Synthèse L’agilité est la capacité à effectuer avec succès, s’occuper de

  8. Using family and staff experiences of a botulinum toxin-A service to improve service quality.

    PubMed

    Burton, K L O; Bau, K; Lewis, J; Aroyan, K R; Botha, B; Botman, A G M; Stewart, K; Waugh, M-C A; Paget, S P

    2017-11-01

    The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics. © 2017 John Wiley & Sons Ltd.

  9. ISES Experience in Delivering Space Weather Services

    NASA Astrophysics Data System (ADS)

    Boteler, David

    The International Space Environment Service has over eighty years experience in providing space weather services to meet a wide variety of user needs. This started with broadcast on December 1, 2008 from the Eiffel Tower about radio conditions. The delivery of information about ionospheric effects on high frequency (HF) radio propagation continue to be a major concern in many parts of the world. The movement into space brought requirements for a new set of space weather services, ranging from radiation dangers to man in space, damage to satellites and effects on satellite communication and navigation systems. On the ground magnetic survey, power system and pipeline operators require information about magnetic disturbances that can affect their operations. In the past these services have been delivered by individual Regional Warning Centres. However, the needs of new trans-national users are stimulating the development of new collaborative international space weather services.

  10. Can nurse innovation improve customer perception of service quality and experience?

    PubMed

    Weng, Rhay-Hung; Chen, Wan-Ping; Huang, Ching-Yuan; Hung, Chiu-Hsia; Hsu, Ching-Tai

    2016-07-01

    This study aimed to clarify how nurse innovation is related to customer perception of medical service quality and experience. Recently, many hospitals have put much emphasis upon the development of nurse innovation. A cross-sectional study was employed. This study adopted questionnaire survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilised to test the possible impact of nurse innovation on medical service quality and experience. In terms of the dimensions of nurse innovation, 'innovation behaviour' ranked the highest (3·24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4·35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4·44). All dimensions of nurse innovation have no significant effects on medical service quality and experience. Of these three dimensions of nurse innovation, the level of innovation behaviour was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on customer perception of service quality and experience. Hospitals shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on 'patient-centred' shall be enhanced among hospital nurses. Healthcare managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses. © 2016 John Wiley & Sons Ltd.

  11. Student perception of travel service learning experience in Morocco.

    PubMed

    Puri, Aditi; Kaddoura, Mahmoud; Dominick, Christine

    2013-08-01

    This study explores the perceptions of health profession students participating in academic service learning in Morocco with respect to adapting health care practices to cultural diversity. Authors utilized semi-structured, open-ended interviews to explore the perceptions of health profession students. Nine dental hygiene and nursing students who traveled to Morocco to provide oral and general health services were interviewed. After interviews were recorded, they were transcribed verbatim to ascertain descriptive validity and to generate inductive and deductive codes that constitute the major themes of the data analysis. Thereafter, NVIVO 8 was used to rapidly determine the frequency of applied codes. The authors compared the codes and themes to establish interpretive validity. Codes and themes were initially determined independently by co-authors and applied to the data subsequently. The authors compared the applied codes to establish intra-rater reliability. International service learning experiences led to perceptions of growth as a health care provider among students. The application of knowledge and skills learned in academic programs and service learning settings were found to help in bridging the theory-practice gap. The specific experience enabled students to gain an understanding of diverse health care and cultural practices in Morocco. Students perceived that the experience gained in international service learning can heighten awareness of diverse cultural and health care practices to foster professional growth of health professionals.

  12. Consequences experimentales des effets des fluctuations du vide sur la fluorescence parametrique et la generation du second harmonique en milieu confine

    NASA Astrophysics Data System (ADS)

    Robichaud, Luc

    Les fluctuations du vide, qui consistent en l'apparition momentanee de particules, ce qui est permit par le principe d'incertitude de Heisenberg, joue un role primordial dans les processus photoniques, en particulier les processus non-lineaires. Par la manipulation de ces fluctuations du vide a l'aide de confinement optique, on retrouve deux phenomenes particuliers : l'intensification de la fluorescence parametrique (Walker, 2008) et l'inhibition de la generation du second harmonique (Collette, 2013). Dans ce travail, on presente les resultats dans le cas classique ; c'est-a-dire sans fluctuations du vide et confinement. Par la suite, on presente les effets des fluctuations du vide et du confinement, ce qui mene aux deux effets mentionnes. Dans le cas de la fluorescence parametrique, le bruit quantique sur le champ interne et externe est calcule, le role du desaccord de phase dans le modele est expose et une generalisation tridimensionnelle est etudiee afin de generaliser la conception du modele d'un cas unidimensionnel a un cas tridimensionnel planaire. Dans le cas de la generation du second harmonique, les difficultes d'un modele purement tridimensionnel sont exposees et ensuite le cas limite planaire est etudie.

  13. Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website

    PubMed Central

    Fossey, Ellie; Farhall, John; Foley, Fiona; Thomas, Neil

    2018-01-01

    Background Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Objective Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. Methods In total, 36 service users with experience of using the website participated in individual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. Results According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included “being inspired,” “knowing I’m not alone,” and “believing recovery is possible.” Experiences of watching the videos were influenced by the participants’ intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Conclusions Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers

  14. Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website.

    PubMed

    Williams, Anne; Fossey, Ellie; Farhall, John; Foley, Fiona; Thomas, Neil

    2018-05-08

    Digital interventions offer an innovative way to make the experiences of people living with mental illness available to others. As part of the Self-Management And Recovery Technology (SMART) research program on the use of digital resources in mental health services, an interactive website was developed including videos of people with lived experience of mental illness discussing their recovery. These peer videos were designed to be watched on a tablet device with a mental health worker, or independently. Our aim was to explore how service users experienced viewing the lived experience videos on this interactive website, as well as its influence on their recovery journey. In total, 36 service users with experience of using the website participated in individual semistructured qualitative interviews. All participants had experience of psychosis. Data analysis occurred alongside data collection, following principles of constructivist grounded theory methodology. According to participants, engaging with lived experience videos was a pivotal experience of using the website. Participants engaged with peers through choosing and watching the videos and reflecting on their own experience in discussions that opened up with a mental health worker. Benefits of seeing others talking about their experience included "being inspired," "knowing I'm not alone," and "believing recovery is possible." Experiences of watching the videos were influenced by the participants' intrapersonal context, particularly their ways of coping with life and use of technology. The interpersonal context of watching the videos with a worker, who guided website use and facilitated reflection, enriched the experience. Engaging with lived experience videos was powerful for participants, contributing to their feeling connected and hopeful. Making websites with lived experience video content available to service users and mental health workers demonstrates strong potential to support service users' recovery

  15. Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis.

    PubMed

    Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice

    2017-11-28

    Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement

  16. Psychiatric service users' experiences of emergency departments: a CERQual review of qualitative studies.

    PubMed

    Carstensen, Kathrine; Lou, Stina; Groth Jensen, Lotte; Konstantin Nissen, Nina; Ortenblad, Lisbeth; Pfau, Margarete; Vedel Ankersen, Pia

    2017-05-01

    There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries. Screening by title/abstract identified 57 studies and, after full text assessment, nine studies were included. The included studies were critically appraised using CASP. Thematic synthesis was applied for data extraction and identification of findings. The CERQual approach was utilized to assess the confidence of the findings. The results of the review showed moderate confidence in the findings that service users experience meeting caring and judgmental ED staff, and that waiting times and a stressful environment are integral to their ED experiences. In contrast, low-to-very low confidence was seen in the findings that service users experience having their symptoms ignored and that EDs are used due to a lack of alternatives. A companion may improve service users experience and outcome of ED visits. Service users experience stress and discomfort in the ED. Service users highly appreciate knowing staff who can ease the discomfort. Overall, the results of this review speak in favour of integrated EDs where service users' needs are more likely to be recognized and accommodated.

  17. Shifting from Production to Service to Experience-Based Operations

    NASA Astrophysics Data System (ADS)

    Angelis, Jannis; de Lima, Edson Pinheiro

    This chapter covers the shift in focus of value added business operations from ­production to services, and in turn, to experience-based operations where customer involvement itself becomes part of the offering. The shift has significant implications for how businesses are managed. The greater service focus affects the firm's unique value proposition, which necessitates considerations on strategy, supplier relations, post-sale offerings and so on. Meanwhile, the inclusion of customer ­experiences affect the way operations are designed and employed so that these are structurally systematically captured and capitalised.

  18. R&D comes to services. Bank of America's pathbreaking experiments.

    PubMed

    Thomke, Stefan

    2003-04-01

    At the heart of business today lies a dilemma: Our economy is increasingly dependent on services, yet our innovation processes remain oriented toward products. Indeed, we have well-tested, scientific methods for developing and refining manufactured goods, but many of them don't seem applicable to the world of services. In this article, Harvard Business School professor Stefan Thomke points out the challenges of applying the discipline of formal R&D processes to services: Because a service often exists only in the moment of its delivery to a customer, it is difficult to isolate in a traditional laboratory. And since many services are tailored to individual buyers at the point of purchase, they can't be tested through large samples. As a result, experiments with new services are most useful when they are conducted live--with real customers engaged in real transactions. But live tests magnify the cost of failure; an experiment that doesn't work may harm customer relationships and even the brand. Given such challenges, it's no surprise that most service companies have not established rigorous, ongoing R&D processes, Thomke says. Here the author provides an in-depth look at a five-step process that Bank of America has used to create new service concepts for retail banking. The company has turned a set of its branches into, in effect, a laboratory where a corporate research team conducts service experiments with actual customers during regular business hours, compares results with those of control branches, and pinpoints attractive innovations for broader rollout. The author describes the program's workings, its successes, and the obstacles the bank faced. The effort reveals what a true R&D operation might look like inside a service business, he concludes.

  19. Communication, Community, and Disconnection: Pre-Service Teachers in Virtual School Field Experiences

    ERIC Educational Resources Information Center

    Wilkens, Christian; Eckdahl, Kelli; Morone, Mike; Cook, Vicki; Giblin, Thomas; Coon, Joshua

    2014-01-01

    This study examined the experiences of 11 graduate-level pre-service teachers completing Virtual School Field Experiences (VSFEs) with cooperating teachers in fully online, asynchronous high school courses in New York State. The VSFEs included a 7-week online teacher training course, and a 7-week online field experience. Pre-service teachers…

  20. Trans people's experiences with assisted reproduction services: a qualitative study.

    PubMed

    James-Abra, S; Tarasoff, L A; Green, D; Epstein, R; Anderson, S; Marvel, S; Steele, L S; Ross, L E

    2015-06-01

    What are the experiences of trans persons (i.e. those whose gender identity does not match the gender assigned to them at birth) who sought or accessed assisted reproduction (AR) services in Ontario, Canada, between 2007 and 2010? The majority of trans persons report negative experiences with AR service providers. Apart from research examining desire to have children among trans people, most of the literature on this topic has debated the ethics of assisting trans persons to become parents. To-date, all of the published research concerning trans persons' experiences with AR services is solely from the perspective of service providers; no studies have examined the experiences of trans people themselves. Secondary qualitative research study of data from nine trans-identified people and their partners (total n = 11) collected as part of a community-based study of access to AR services for sexual and gender minority people between 2010 and 2012. Trans-identified volunteers (and their partners, when applicable) who had used or attempted to access AR services since 2007 from across Ontario, Canada, participated in a 60-90 minute, semi-structured qualitative interview. Qualitative analysis was performed using a descriptive phenomenological approach. Emerging themes were continually checked against the data as part of an iterative process. The data highlight barriers to accessing AR services for trans people. Participant recommendations for improving AR service provision to better meet the needs of this population are presented. These recommendations address the following areas: (i) AR service provider education and training; (ii) service provider and clinic practices and (iii) clinic environment. The majority of study participants were trans people who identified as men and who resided in major urban areas; those living in smaller communities may have different experiences that were not adequately captured in this analysis. While existing literature debates the ethics of

  1. Colleges' Experiences: Integrating Support Services for Military Veterans

    ERIC Educational Resources Information Center

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  2. Pre-Service and In-Service Teachers' Experiences of Learning to Program in an Object-Oriented Language

    ERIC Educational Resources Information Center

    Govender, I.; Grayson, D. J.

    2008-01-01

    This paper presents the results of an investigation into the various ways in which pre-service and in-service teachers experience learning to program in an object-oriented language. Both groups of teachers were enrolled in university courses. In most cases, the pre-service teachers were learning to program for the first time, while the in-service…

  3. Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.

    PubMed

    Hudson Smith, Mel; Smith, David

    2018-06-03

    To examine the influence of dimensions of service quality on patient experience of primary care. Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients' perspectives on health care, which has policy implications for patient education. © Health Research and Educational Trust.

  4. Rupture simultanée du ligament croisé antérieur et du ligament patellaire: à propos d'un cas

    PubMed Central

    Achkoun, Abdessalam; Houjairi, Khalid; Quahtan, Omar; Hassoun, Jalal; Arssi, Mohamed; Rahmi, Mohamed; Garch, Abdelhak

    2016-01-01

    La rupture simultanée du tendon rotulien et du ligament croisé antérieur est une lésion relativement rare. Son diagnostic peut facilement manquer lors de l'examen initial. Les options de traitement incluent la réparation immédiate du tendon rotulien avec soit la reconstruction simultanée ou différée de ligament croisé antérieur. Nous rapportons le cas d'une rupture combinée du tendon rotulien et du ligament croisé antérieur chez un jeune footballeur de 22 ans. Une approche de traitement en deux temps a été effectuée avec un excellent résultat fonctionnel. PMID:27366288

  5. La reconstruction du sourcil par greffon composite du cuir chevelu: une astuce pour faciliter la technique

    PubMed Central

    El Omari, Mounia; El Mazouz, Samir; Gharib, Noureddine; EL Abbassi, Abdallah

    2015-01-01

    Les sourcils jouent un rôle important dans l’équilibre esthétique du visage. Leur reconstruction ou ophriopoïése, après séquelle de brûlure fait partie intégrante du programme de réhabilitation de la face brûlée. Plusieurs techniques ont été décrites. Nous insistons ici sur l'intérêt d'une technique simple, à la portée de tous les chirurgiens, et dont la méthode et les résultats peuvent être améliorés par un dessin bien planifié des zones donneuse et receveuse: la greffe composite prélevée au niveau du cuir chevelu dessinée à l'aide d'un calque du sourcil controlatéral. PMID:26401195

  6. The role of NGOs' service delivery experience in developing relevant research agendas: experience and challenges among NGOs in Malawi.

    PubMed

    Gooding, Kate

    2017-05-04

    There has been growing interest in the contribution of non-governmental organisations (NGOs) to international health research. One strength that NGOs may bring to research involves the potential value of service delivery experience for indicating relevant research questions, namely through their involvement in service delivery, NGO staff may be aware of frontline knowledge gaps, allowing these staff to identify questions that lead to research with immediate relevance. However, there is little empirical evidence on research agendas within NGOs to assess whether their service delivery experience does lead to relevant research or conditions that affect this. This article examines the identification and selection of research questions within NGOs to explore the role of their service delivery experience in generating relevant research agendas. The article reports comparative case study research on four NGOs in Malawi, including two international and two Malawian organisations. Each NGO conducts research and undertakes service delivery and advocacy. Data collection included interviews, focus groups, observation and document review. Analysis involved thematic coding and use of diagrams. The case NGOs' experiences suggest that using service delivery to identify research questions does not always match NGOs' aims or capacities, and does not guarantee relevance. First, NGOs do not want to rely only on service delivery when developing research agendas; they consider other criteria and additional sources of ideas when selecting questions they see as relevant. Second, service delivery staff are not always well-placed to identify research topics; indeed, involvement in hectic, target-driven service delivery can hinder input to research agendas. Third, NGOs' ability to pursue questions inspired by service delivery depends on control over their research agendas; relationships with external actors and financial autonomy affect NGOs' capacity to undertake the research they see as

  7. A Pharmacogenetics Service Experience for Pharmacy Students, Residents, and Fellows

    PubMed Central

    Drozda, Katarzyna; Labinov, Yana; Jiang, Ruixuan; Thomas, Margaret R.; Wong, Shan S.; Patel, Shitalben; Nutescu, Edith A.

    2013-01-01

    Objective. To utilize a comprehensive, pharmacist-led warfarin pharmacogenetics service to provide pharmacy students, residents, and fellows with clinical and research experiences involving genotype-guided therapy. Design. First-year (P1) through fourth-year (P4) pharmacy students, pharmacy residents, and pharmacy fellows participated in a newly implemented warfarin pharmacogenetics service in a hospital setting. Students, residents, and fellows provided genotype-guided dosing recommendations as part of clinical care, or analyzed samples and data collected from patients on the service for research purposes. Assessment. Students’, residents’, and fellows’ achievement of learning objectives was assessed using a checklist based on established core competencies in pharmacogenetics. The mean competency score of the students, residents, and fellows who completed a clinical and/or research experience with the service was 97% ±3%. Conclusion. A comprehensive warfarin pharmacogenetics service provided unique experiential and research opportunities for pharmacy students, residents, and fellows and sufficiently addressed a number of core competencies in pharmacogenetics. PMID:24159216

  8. A pharmacogenetics service experience for pharmacy students, residents, and fellows.

    PubMed

    Drozda, Katarzyna; Labinov, Yana; Jiang, Ruixuan; Thomas, Margaret R; Wong, Shan S; Patel, Shitalben; Nutescu, Edith A; Cavallari, Larisa H

    2013-10-14

    To utilize a comprehensive, pharmacist-led warfarin pharmacogenetics service to provide pharmacy students, residents, and fellows with clinical and research experiences involving genotype-guided therapy. First-year (P1) through fourth-year (P4) pharmacy students, pharmacy residents, and pharmacy fellows participated in a newly implemented warfarin pharmacogenetics service in a hospital setting. Students, residents, and fellows provided genotype-guided dosing recommendations as part of clinical care, or analyzed samples and data collected from patients on the service for research purposes. Students', residents', and fellows' achievement of learning objectives was assessed using a checklist based on established core competencies in pharmacogenetics. The mean competency score of the students, residents, and fellows who completed a clinical and/or research experience with the service was 97% ±3%. A comprehensive warfarin pharmacogenetics service provided unique experiential and research opportunities for pharmacy students, residents, and fellows and sufficiently addressed a number of core competencies in pharmacogenetics.

  9. Creating an Excellent Patient Experience Through Service Education

    PubMed Central

    2017-01-01

    Service quality and patient satisfaction affect an organization’s value-based payments. This new value paradigm calls for a new approach to service education and training for front-line staff. Thoughtfully conceived, department-specific content, infused with patient feedback, value creation, and science of service quality principles, was developed to give front-line staff a deeper understanding of the impact of their performance on patient experience, value creation, and value-based revenue. Feedback from nearly 1500 trainees in 60 educational sessions delivered over 7 years indicates good understanding of the content and appreciation of the targeted approach. On a 5-point scale ranging from 1 (least effective) to 5 (most effective), trainees’ ratings of their understanding of service quality concepts and impact on value ranged from 4.7 to 4.9. Verbatim comments showed a positive impact on staff. Employee feedback suggests that value-based service education may be useful in motivating front-line staff, improving service quality, and creating value. PMID:29276761

  10. Mise à jour sur le nouveau vaccin 9-valent pour la prévention du virus du papillome humain

    PubMed Central

    Yang, David Yi; Bracken, Keyna

    2016-01-01

    Résumé Objectif Informer les médecins de famille quant à l’efficacité, à l’innocuité, aux effets sur la santé publique et à la rentabilité du vaccin 9-valent contre le virus du papillome humain (VPH). Qualité des données Des articles pertinents publiés dans PubMed jusqu’en mai 2015 ont été examinés et analysés. La plupart des données citées sont de niveau I (essais randomisés et contrôlés et méta-analyses) ou de niveau II (études transversales, cas-témoins et épidémiologiques). Des rapports et recommandations du gouvernement sont aussi cités en référence. Message principal Le vaccin 9-valent contre le VPH, qui offre une protection contre les types 6, 11, 16, 18, 31, 33, 45, 52 et 58 du VPH, est sûr et efficace et réduira encore plus l’incidence des infections à VPH, de même que les cas de cancer lié au VPH. Il peut également protéger indirectement les personnes non immunisées par l’entremise du phénomène d’immunité collective. Un programme d’immunisation efficace peut prévenir la plupart des cancers du col de l’utérus. Les analyses montrent que la rentabilité du vaccin 9-valent chez les femmes est comparable à celle du vaccin quadrivalent original contre le VPH (qui protège contre les types 6, 11, 16 et 18 du VPH) en usage à l’heure actuelle. Toutefois, il faut investiguer plus en profondeur l’utilité d’immuniser les garçons avec le vaccin 9-valent contre le VPH. Conclusion en plus d’être sûr, le vaccin 9-valent protège mieux contre le VPH que le vaccin quadrivalent. Une analyse coûtefficacité en favorise l’emploi, du moins chez les adolescentes. Ainsi, les médecins devraient recommander le vaccin 9-valent à leurs patients plutôt que le vaccin quadrivalent contre le VPH.

  11. Connaissances des médecins généralistes de Mohammedia (Maroc) concernant le dépistage du cancer du sein

    PubMed Central

    Zine, Karima; Nani, Samira; Lahmadi, Imad Ait; Maaroufi, Abderrahmane

    2016-01-01

    Introduction Le cancer du sein représente un problème de santé publique majeur au Maroc. C'est le premier cancer chez la femme. L'objectif de ce travail était d'évaluer les connaissances des médecins généralistes (MG) en matière de dépistage du cancer du sein dans la préfecture de Mohammedia Maroc. Méthodes Nous avons mené une étude transversale, descriptive, exhaustive incluant les 97 MG exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Mohammedia. Résultats Le taux de participation était de 87%. L'âge moyen des MG était de 49,6 ± 8,1. Quatre-vingt pour cent (n=55) des MG ont donné une incidence incorrecte, 77,6% (n=85) ont reconnu l'existence d'un plan national de prévention et de contrôle du cancer (PNPCC) au Maroc, et 67,1 des MG ont rapporté l'existence d'un registre du cancer au Maroc. Le secteur d'activité était associé significativement avec les connaissances des MG sur le PNPCC et sur l'existence d'un guide de détection précoce du cancer du sein avec respectivement (p=0,003 et p=0,001). Une association significative entre l'ancienneté et l'existence d'un guide de détection précoce du cancer du sein et d'un registre du cancer du sein a été retrouvée avec (respectivement p=0,005 et p=0.002). Conclusion À la lumière de ces résultats il faudra renforcer les connaissances et les pratiques des MG par la promotion de la formation initiale et continue sur le dépistage. PMID:27800098

  12. Older individuals' experiences during the assistive technology device service delivery process.

    PubMed

    Gramstad, Astrid; Storli, Sissel Lisa; Hamran, Torunn

    2014-07-01

    Providing assistive technology devices to older individuals living in their ordinary homes is an important intervention to increase and sustain independence and to enable ageing at home. However, little is known about older individuals' experiences and needs in the assistive technology device (ATD) service delivery process. The purpose of this study was to investigate older individuals' experiences during the service delivery process of ATDs. Nine older individuals were interviewed three times each throughout the ATD service delivery process. The interviews were analysed within a hermeneutical phenomenological perspective. The results show that the service delivery process could be interpreted as an enigmatic journey and described using four themes: "hope and optimistic expectations", "managing after delivery or needing additional help", "having available help versus being abandoned", and "taking charge or putting up". The results emphasize the need for occupational therapists to maintain an individualized approach towards older clients throughout the service delivery process. The experiences of older individuals were diverse and related to expectations that were not necessarily articulated to the occupational therapist. The situation when the ATD is delivered to the client was highlighted by the clients as an important event with the potential to facilitate a successful service delivery process.

  13. Exploring Students' Perceptions of Service-Learning Experiences in an Undergraduate Web Design Course

    ERIC Educational Resources Information Center

    Lee, Sang Joon; Wilder, Charlie; Yu, Chien

    2018-01-01

    Service-learning is an experiential learning experience where students learn and develop through active participation in community service to meet the needs of a community. This study explored student learning experiences in a service-learning group project and their perceptions of service-learning in an undergraduate web design course. The data…

  14. Trust, negotiation, and communication: young adults’ experiences of primary care services

    PubMed Central

    2013-01-01

    Background Young adulthood is an important transitional period during which there is a higher risk of individuals engaging in behaviours which could have a lasting impact on their health. Research has shown that young adults are the lowest responders to surveys about healthcare experiences and are also the least satisfied with the care they receive. However, the factors contributing to this reduced satisfaction are not clear. The focus of our research was to explore the needs and experiences of young adults around healthcare services with an aim of finding out possible reasons for lower satisfaction. Methods Twenty young adults were interviewed at GP surgeries and at a local young adult advice agency, exploring their experiences and use of primary care services. Interviews were analysed using thematic analysis. Results The use of primary care services varied amongst the young adult interviewees. Many interviewees reported positive experiences; those who did not linked their negative experiences to difficulties in negotiating their care with the health care system, and reported issues with trust, and communication difficulties. Most of the interviewees were unaware of the use of patient surveys to inform healthcare planning and delivery and were not inclined to take part, mainly because of the length of surveys and lack of interest in the topic area. Conclusions In order to effectively address the health needs of young adults, young adults need to be educated about their rights as patients, and how to most efficiently use primary care services. GPs should be alert to effective means of approaching and handling the healthcare needs of young adults. A flexible, varied approach is needed to gathering high quality data from this group in order to provide services with information on the changes necessary for making primary care services more accessible for young adults. PMID:24373254

  15. Service Users' Experiences of a Brief Intervention Service for Children and Adolescents: A Service Evaluation

    ERIC Educational Resources Information Center

    Gallagher, Jen; Schlösser, Annette

    2015-01-01

    Ten per cent of young people experience mental health difficulties at any one time. Prevention and early intervention leads to better prognosis for young people's mental well-being in the short and long term. Child and Adolescent Mental Health Services (CAMHS) must be able to provide swift and effective interventions for a range of difficulties to…

  16. The Impact of Philosophy and Theology Service-Learning Experiences upon the Public Service Motivation of Participating College Students

    ERIC Educational Resources Information Center

    Seider, Scott C.; Rabinowicz, Samantha A.; Gillmor, Susan C.

    2011-01-01

    This mixed-methods study demonstrates that the SERVE Program at Ignatius University strengthened the public service motivation of participating undergraduates by combining weekly community service with readings in philosophy and theology. These findings offer insights about the role that philosophy and theology service-learning experiences can…

  17. Cirque du Monde en tant qu’intervention en santé

    PubMed Central

    Fournier, Cynthia; Drouin, Mélodie-Anne; Marcoux, Jérémie; Garel, Patricia; Bochud, Emmanuel; Théberge, Julie; Aubertin, Patrice; Favreau, Gil; Fleet, Richard

    2014-01-01

    Résumé Objectif Présenter le programme Cirque du Monde du Cirque du Soleil et son potentiel en tant qu’intervention en soins de santé de première ligne pour les médecins de famille. Sources des données Une revue de la littérature menée dans les bases de données PubMed, Cochrane Library, PsycINFO, La Presse, Eureka, Google Scholar et Érudit à l’aide des mots-clés circus, social circus, Cirque du Monde et Cirque du Soleil. Une initiative à Montréal nommée Espace Transition qui s’inspire directement de Cirque du Monde. Communication personnelle avec le conseiller principal en formation en cirque social du Cirque du Soleil. Sélection d’études Les 50 premiers articles ou sites Internet répertoriés pour chaque mot-clé dans chacune des bases de données ciblées ont été révisés sur la base des titres et des résumés, s’il s’agissait d’un article, ou sur la base du titre et du contenu de la page, s’il s’agissait d’une page Internet. Ensuite, les articles et les sites Internet qui étudiaient un aspect du cirque social ou qui présentaient une intervention impliquant le cirque étaient retenus pour une révision. Aucune contrainte d’année de publication n’a été appliquée étant donné qu’on cherchait une littérature générale sur le cirque social. Synthèse Aucun article n’a été trouvé sur le cirque social en tant qu’intervention en santé. Nous avons trouvé une étude sur l’utilisation du cirque en tant qu’intervention en milieu scolaire. Cette étude a démontré une augmentation de l’estime personnelle des enfants grâce à l’intervention. Nous avons trouvé une étude sur l’utilisation du cirque en tant qu’intervention sur une réserve amérindienne. Cette étude présente des résultats qualitatifs non spécifiques au programme du cirque social. Les autres articles répertoriés n’étaient que des descriptions du cirque social. Un site web concernant l’utilisation du cirque social pour

  18. Processing of next generation weather radar-multisensor precipitation estimates and quantitative precipitation forecast data for the DuPage County streamflow simulation system

    USGS Publications Warehouse

    Bera, Maitreyee; Ortel, Terry W.

    2018-01-12

    The U.S. Geological Survey, in cooperation with DuPage County Stormwater Management Department, is testing a near real-time streamflow simulation system that assists in the management and operation of reservoirs and other flood-control structures in the Salt Creek and West Branch DuPage River drainage basins in DuPage County, Illinois. As part of this effort, the U.S. Geological Survey maintains a database of hourly meteorological and hydrologic data for use in this near real-time streamflow simulation system. Among these data are next generation weather radar-multisensor precipitation estimates and quantitative precipitation forecast data, which are retrieved from the North Central River Forecasting Center of the National Weather Service. The DuPage County streamflow simulation system uses these quantitative precipitation forecast data to create streamflow predictions for the two simulated drainage basins. This report discusses in detail how these data are processed for inclusion in the Watershed Data Management files used in the streamflow simulation system for the Salt Creek and West Branch DuPage River drainage basins.

  19. Analysis of pre-service physics teacher skills designing simple physics experiments based technology

    NASA Astrophysics Data System (ADS)

    Susilawati; Huda, C.; Kurniawan, W.; Masturi; Khoiri, N.

    2018-03-01

    Pre-service physics teacher skill in designing simple experiment set is very important in adding understanding of student concept and practicing scientific skill in laboratory. This study describes the skills of physics students in designing simple experiments based technologicall. The experimental design stages include simple tool design and sensor modification. The research method used is descriptive method with the number of research samples 25 students and 5 variations of simple physics experimental design. Based on the results of interviews and observations obtained the results of pre-service physics teacher skill analysis in designing simple experimental physics charged technology is good. Based on observation result, pre-service physics teacher skill in designing simple experiment is good while modification and sensor application are still not good. This suggests that pre-service physics teacher still need a lot of practice and do experiments in designing physics experiments using sensor modifications. Based on the interview result, it is found that students have high enough motivation to perform laboratory activities actively and students have high curiosity to be skilled at making simple practicum tool for physics experiment.

  20. A Professional Experience Learning Community for Pre-Service Secondary Mathematics Teachers

    ERIC Educational Resources Information Center

    Cavanagh, Michael S.; Garvey, Thomas

    2012-01-01

    This paper reports the development and implementation of a collaborative professional experience learning community for a group of nine pre-service secondary mathematics teachers. The pre-service teachers and their methods lecturer made 12 school visits over one academic year to a local secondary school. The pre-service teachers observed and…

  1. Etude descriptive et analytique du cancer de l’œsophage au Togo

    PubMed Central

    Oumboma, Bouglouga; Mawuli, Lawson-Ananissoh Laté; Aklesso, Bagny; Laconi, Kaaga; Datouda, Redah

    2014-01-01

    Introduction Décrire les aspects épidémiologiques, cliniques, endoscopiques et histologiques du cancer de l’œsophage (CO) au Togo. Méthodes Il s'agit d'une étude rétrospective descriptive et analytique menée sur 8 ans (Janvier 2005-Décembre 2012) dans le service d'hépato-gastroentérologie (HGE) du CHU Campus de Lomé. Etaient inclus les dossiers des patients hospitalisés pour CO confirmé histologiquement. Résultats Sur 8 ans, 24 patients remplissant nos critères d'inclusion ont été retenus soit 3cas de CO par an et 0,55% des hospitalisations. L’âge moyen des patients était de 57,08 ans (extrêmes: 32 et 82 ans). La dysphagie et l’épigastralgie étaient les motifs d'hospitalisation les plus rencontrés. L'alcool (n=15), le tabac (n=13) étaient les facteurs de risque les plus présents. A la fibroscopie, les lésions étaient ulcéro-bourgeonnantes et hémorragiques (n=12), ulcéro-bourgeonnantes (n=5); ces lésions siégeaient au niveau du 1/3 inférieur (n= 11), à l'union 1/3 supérieur 1/3moyen de l’œsophage (n= 13) et aucun au niveau du 1/3 supérieur. Seize lésions étaient des carcinomes épidermoïdes et 3 des adénocarcinomes. L’évolution dans le service a été fatale dans 2cas; 16 patients avaient été transférés en chirurgie pour des soins palliatifs et 5 patients (20,8%) étaient perdus de vue. Conclusion Le CO semble en augmentation au Togo. L'alcool et le tabac sont les facteurs de risque et le pronostic sévère dans notre série est lié au retard diagnostic. Son dépistage précoce passe par une consultation rapide devant toute dysphagie chez un sujet de 50 ans et plus. PMID:25883742

  2. Profil épidémio-clinique des dermatoses chez les enfants vus en consultation dermatologique dans le service de dermatologie du centre national d’appui à la lutte contre la maladie à Bamako (Mali)

    PubMed Central

    Fofana, Youssouf; Traore, Bekaye; Dicko, Adama; Faye, Ousmane; Berthe, Siritio; Cisse, Lamissa; Keita, Alimata; Tall, Koureissi; Kone, Mamadou Bakary; Keita, Somita

    2016-01-01

    Introduction Les maladies de peau constituent un problème majeur de santé publique dans les pays en voie développement. En pratique courante les enfants représentent la couche sociale la plus touchée. Le but de notre travail était de décrire les aspects épidémio- cliniques des dermatoses chez les enfants de 0-15 ans dans le service de dermatologie du centre national d’appui à la lutte contre la maladie à Bamako, Mali. Méthodes Il s’agissait d’une étude transversale effectuée au cours de la période allant du premier janvier 2009 au 31 Décembre 2009 dans le service de Dermato-vénérologie du centre national d’appui à la lutte contre la maladie. Sur un total de 16339 patients ayant fait une consultation dermatologique 5149 enfants ont été inclus. Résultats La fréquence hospitalière des dermatoses infantiles était de 31,51%. Les malades se répartissaient en 2838 garçons (55,10%) et 2311 filles (44,90%) soit un sex-ratio de 1,22. L’âge des malades variait de 03 jours à 15 ans avec une moyenne d’âge de 8±5,7 ans. Parmi les affections retrouvées les dermatoses infectieuses représentaient 55,10% de l’ensemble des dermatoses, les dermatoses immuno-allergiques (32,5%), les dermatoses inflammatoires (11,85%). Conclusion Notre étude a révélé l’importance des pathologies infectieuses et immuno-allergiques et la nécessité de mener des actions de prévention simple comme l’hygiène, l’achat d’une tondeuse pour chaque enfant. PMID:28293354

  3. Epidémiologie et prise en charge des infections du per-partum à la maternité du centre hospitalier départemental de l'Ouémé-Plateau au Bénin

    PubMed Central

    Saizonou, Jacques; Ouédraogo, Laurent; Paraiso, Moussiliou Noël; Ayélo, Paul; Kpozèhouen, Alphonse; Daraté, René; Traoré, Esther

    2014-01-01

    Introduction La présente étude avait pour objectif de mesurer l'ampleur des infections du per-partum à la maternité du Centre Hospitalier Départemental de l'Ouémé-Plateau d'analyser les conditions de survenue et de prise en charge dans la perspective de l'amélioration des soins et services maternels et néonataux. Méthodes Une étude descriptive et analytique a été conduite de Août 2009 à Février 2010 et a impliqué 110 mères victimes d'infections du per-partum; elles ont été soumises à un questionnaire durant tout leur séjour hospitalier; des observations des pratiques de prise en charge des prestataires de soins ont été menées et des registres et autres supports de données sanitaires ont été exploités. L'analyse des données a été effectuée à l'aide du logiciel Epi Info 6.4 dans sa version française. Résultats L'incidence des infections du per-partum était de 5,9 pour 100 accouchements (110/ 1875); les types d'infections les plus incriminés étaient les endométrites (27,3%), les chorioamniotites (18,2%), les infections du site opératoire (12,7%) et les infections urinaires (2,7%). Les examens cliniques ont été relativement acceptables. En revanche, les examens biologiques ont été très insuffisants expliquant l'imprécision importante au niveau des diagnostics. L'antibiothérapie a été instaurée systématiquement. Le taux de mortinaissance était de 25,6% et les enfants de petit poids représentaient 23,2%. Conclusion L'incidence des infections du per-partum dans la présente étude était assez élevée. Des efforts de préventions et de dépistage de ces infections sont nécessaire afin d'améliorer la qualité des soins PMID:25120854

  4. Sharing Experience Learned Firsthand (SELF): Self-disclosure of lived experience in mental health services and supports.

    PubMed

    Marino, Casadi Khaki; Child, Beckie; Campbell Krasinski, Vanessa

    2016-06-01

    Self-disclosure of lived experiences with mental health challenges is a central method for challenging stigma and promoting empowerment. Individuals are encouraged to share their stories yet little is known about the process of self-disclosure in this context. This article presents the results of an investigation of the role of lived experience in professional training and work. A mixed methods design was used in a sequential exploratory manner. A purposive sample of 35 individuals participated in interviews and focus groups. Based on their reports and a literature review, an anonymous online survey (N = 117) was developed and distributed through consumer networks and the SAMHSA funded Consumer Technical Assistance Centers. The qualitative data was subjected to thematic analysis. The survey data were statistically analyzed for differences in levels of disclosure and factors regarding risks, benefits, and guidance regarding self-disclosure. Participants valued their lived experience as a resource through which they could assist others and service delivery. Lived experience was foundational to building relationships with individuals in recovery. Disclosure was dependent on social context and perceptions of safety. Individuals expressed concerns regarding exclusion and discrimination. Project participants maintained that their lived experience was their greatest strengths in helping others. At the same time, decisions about disclosure were made in complex social contexts featuring power differentials. Sharing lived experience is essential to peer-delivered services and further exploration is needed to support service development. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. Assessment of orofacial characteristics and oral pathology associated with cri-du-chat syndrome.

    PubMed

    Rodríguez-Caballero, A; Torres-Lagares, D; Yáñez-Vico, R-M; Gutiérrez-Pérez, J-L; Machuca-Portillo, G

    2012-03-01

    To obtain a deeper insight into the difficulties individuals with cri-du-chat syndrome experience by means of the analysis of the most common features and oral pathology observed in the subjects enrolled in the study. Intra-oral and extra-oral features of a total of 33 patients with cri-du-chat syndrome (the larger sample so far analyzed) through their clinical and photographic examination. Models, orthopantomographies, and teleradiographies have been collected to establish a pattern as accurate as possible of the oral pathology associated with these patients. The present descriptive study shows that patients with cri-du-chat syndrome present with a series of orofacial features such as mandibular retrognathism, high palate, and variable malocclusion, more commonly anterior open-bite. Most patients also present with perioral muscle relaxation with labial incompetence and short philtrum. As regards oral pathology, these patients suffer dental erosions provoked by gastroesophageal reflux and attritions because of intense day-and-night bruxism. The odontologists' familiarity with the orofacial pathology associated with cri-du-chat syndrome and with the specific needs such disorder conveys should improve the quality of the buccodental treatment these professionals may offer to these patients. © 2011 John Wiley & Sons A/S.

  6. Participation des médecins généralistes de la province de Benimellal (Maroc) dans le dépistage du cancer du col

    PubMed Central

    Nani, Samira; Benallal, Mohamed; Hassoune, Samira; Kissi, Dounia; Maaroufi, Abderrahmane

    2013-01-01

    Introduction Au Maroc, chaque année il y aurait environ 2000 nouveaux cas de cancer du col et les 2/3 des cas sont pris en charge à un stade très avancé. Nous avons mené une étude transversale, exhaustive incluant les 71 médecins généralistes exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Benimellal. Le but était d’évaluer leurs connaissances et leur participation au dépistage du cancer du col. Méthodes Nous avons mené une étude transversale, exhaustive incluant les 71 médecins généralistes exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Benimellal. Le but était d’évaluer leurs connaissances et leur participation au dépistage du cancer du col. Résultats Le niveau de connaissance était relativement modeste, 22 médecins généraliste avaient répondu à la question sur l'incidence du cancer du col au Maroc, Parmi eux (81,8%) avaient donné une réponse incorrecte. L'Herpes Papilloma virus comme facteur de risque du cancer du col a été identifié par seulement 21% des médecins généralistes. La participation au dépistage était également défaillante, 92,8% n'avaient jamais pratiqué le FCV chez leurs patientes à cause principalement du manque de formation (95,5%). Conclusion Les résultats montrent la nécessité d'améliorer les connaissances théoriques et pratique des médecins généralistes concernant le dépistage du cancer du col. PMID:23785557

  7. Séroprévalence et facteurs associés à l’acceptation du Conseil et Dépistage Volontaire du VIH chez l’enfant à Lubumbashi, République Démocratique du Congo

    PubMed Central

    Ngwej, Dieudonné Tshikwej; Mukuku, Olivier; Malonga, Françoise Kaj; Luboya, Oscar Numbi; Kakoma, Jean-Baptiste Sakatolo; Wembonyama, Stanis Okitotsho

    2017-01-01

    Résumé Introduction Malgré le dépistage du VIH proposé lors de la naissance ou au cours des consultations préscolaires, la proportion des enfants qui croissent ou décèdent sous statut sérologique au VIH inconnu est importante en République Démocratique du Congo (RDC). L’objectif de cette étude était de déterminer la séroprévalence au cours d’un dépistage volontaire et d’identifier les facteurs associés à l’acceptation du conseil et dépistage du VIH (CDV) en dehors de la maladie ou de toute exposition au VIH dans une population pédiatrique à Lubumbashi, RDC. Méthodes Il s’agissait d’une étude prospective transversale à visée analytique menée du 1er août 2006 au 31 septembre 2007. Elle avait été réalisée dans 4 centres communautaires de CDV répartis dans 4 zones de santé de la ville de Lubumbashi en RDC (Lubumbashi, Ruashi, Kampemba et de Kenya). L’étude avait consisté à faire le dépistage volontaire du VIH chez les enfants de moins de 15 ans. Les caractéristiques sociodémographiques et les paramètres relatifs au conseil et dépistage volontaire ont été étudiés. Les analyses statistiques descriptives usuelles et une régression logistique ont été réalisées. Résultats Sur 463 enfants dépistés du VIH, 41 (8,9%; IC 95%: 6,5%-11,9%) ont été testés positifs. L’acceptation du conseil et dépistage volontaire du VIH en dehors de la maladie ou de l’exposition au VIH était significativement plus élevée lorsque l’enfant était âgé de plus de 2 ans (Odds ratio ajusté (ORa) = 3,6 [IC 95%: 1,1-12,2]), lorsque le statut sérologique du VIH des parents était négatif ou inconnu (ORa = 27,4 [IC 95%: 9,4-80,0]), lorsque l’un ou l’autre ou les deux parents biologiques étaient en vie (ORa = 24,9 [IC 95%: 2,4-250,8]) et lorsque la connaissance du lieu de dépistage était fait par des moyens autres que le professionnel de santé (ORa = 2,9 [IC 95%: 1,0-7,9]). Conclusion Notre étude montre une forte

  8. Probing Pre- and In-service Physics Teachers' Knowledge Using the Double-Slit Thought Experiment

    NASA Astrophysics Data System (ADS)

    Asikainen, Mervi A.; Hirvonen, Pekka E.

    2014-09-01

    This study describes the use of the double-slit thought experiment as a diagnostic tool for probing physics teachers' understanding. A total of 9 pre-service teachers and 18 in-service teachers with a variety of different experience in modern physics teaching at the upper secondary level responded in a paper-and-pencil test and three of these teachers were interviewed. The results showed that the physics teachers' thought experiments with classical particles, light, and electrons were often partial. Many teachers also suffered a lack of the basic ideas and principles of physics, which probably hindered thought experimenting. In particular, understanding the ontological nature of classical particles, light and electrons seemed to be essential in performing the double-slit experiment in an appropriate way. However, the in-service physics teachers who had teaching experience in modern physics were more prepared for the double-slit thought experiment than the pre-service teachers. The results suggest that both thought experiments and the double-slit experiment should be given more weight in physics teacher education, even if experience in modern physics teaching at upper secondary school seems to some extent to develop teachers' abilities.

  9. Pre-Service Mathematics Teachers' Experiences with Proficiency-Based Learning

    ERIC Educational Resources Information Center

    Smith, Carmen Petrick; Tinkler, Alan; DeMink-Carthew, Jessica; Tinker, Barri

    2017-01-01

    Proficiency-based learning systems are becoming more common across the United States, yet few pre-service mathematics teachers have experienced this type of system in the classroom themselves. Teacher education courses are one opportunity for pre-service teachers to experience proficiency-based learning; however, we know little about the impact…

  10. The Reading Experiences and Beliefs of Secondary Pre-Service Teachers

    ERIC Educational Resources Information Center

    Daisey, Peggy

    2009-01-01

    The purpose of this study was to describe secondary pre-service teachers' past reading experiences, present attitudes and beliefs about reading, their attitudes and beliefs about a required content area literacy course, and their predicted use of reading in future instruction. Secondary pre-service teachers (N = 124) of diverse subject areas…

  11. L'Aventure du LHC

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2010-06-11

    Cette présentation s’adressera principalement aux personnes qui ont construit le LHC. La construction du LHC fut longue et difficile. De nombreux problèmes sont apparus en cours de route. Tous ont été résolus grâce au dévouement et à l’engagement du personnel et des collaborateurs. Je reviendrai sur les coups durs et les réussites qui ont marqués ces 15 dernières années et je vous montrerai combien cette machine, le fruit de vos efforts, est extraordinaire.

  12. Non-destructive analysis of DU content in the NIF hohlraums

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gharibyan, Narek; Moody, Ken J.; Shaughnessy, Dawn A.

    2015-12-16

    The advantage of using depleted uranium (DU) hohlraums in high-yield deuterium-tritium (DT) shots at the National Ignition Facility (NIF) is addressed by Döppner, et al., in great detail [1]. This DU based hohlraum incorporates a thin layer of DU, ~7 μm thick, on the inner surface along with a thin layer of a gold coating, ~0.7 μm thick, while the outer layer is ~22 μm thick gold. A thickness measurement of the DU layer can be performed using an optical microscope where the total DU weight can be computed provided a uniform DU layer. However, the uniformity of the thicknessmore » is not constant throughout the hohlraum since CAD drawing calculations of the DU weight do not agree with the computed values from optical measurements [2]. Therefore, a non-destructive method for quantifying the DU content in hohlraums has been established by utilizing gamma-ray spectroscopy. The details of this method, along with results from several hohlraums, are presented in this report.« less

  13. Particularités de la cardiomyopathie du péripartum en Afrique: le cas du Togo sur une étude prospective de 41 cas au Centre Hospitalier et Universitaire Sylvanus Olympio de Lomé

    PubMed Central

    Pio, Machihude; Afassinou, Yaovi; Baragou, Soodougoua; Akue, Edem Goeh; Péssinaba, Souleymane; Atta, Borgatia; Ehlan, Koffi; Alate, Amouzou; Damorou, Findibe

    2014-01-01

    Introduction La cardiomyopathie du péripartum (CMPP) est une défaillance cardiaque dont l’étiologie demeure encore méconnue. Méthodes Il s'agit d'une étude prospective descriptive réalisée dans le service de cardiologie du CHU Sylvanus olympio de Lomé du 1er janvier 2010 au 30 avril 2012. Elle a concerné 41 patientes ayant présenté une insuffisance cardiaque entre le 8eme mois de la grossesse et les 5 premiers mois du post-partum. Résultats L’âge moyen des patientes était de 31,47 ans (extrêmes 21 et 44ans). L'incidence de la CMPP était de 1/362 grossesses. La parité moyenne était de 3,07 (extrêmes 1 et 6). Les symptômes étaient apparus dans le post-partum dans 90,24% des cas. Un retard important de diagnostic était observé. L'insuffisance cardiaque globale était le mode de décompensation dans 65,85%. Les signes électrocardiographiques étaient essentiellement la tachycardie sinusale (97,56%) et l'hypertrophie ventriculaire gauche (97,56%). L’échographie cardiaque a montré dans tous les cas une cardiomyopathie dilatée. Quatre cas de thrombus intraventriculaire gauche étaient notés. La FEVG était sévèrement altérée. L'HTAP était importante dans 56,09%. Conclusion La cardiomyopathie du péripartum est une complication cardiaque grave de la grossesse de cause inconnue, fréquente dans la population africaine. PMID:25309645

  14. Portage vaginal du streptocoque du groupe B chez la femme enceinte au niveau de la région de Marrakech

    PubMed Central

    Bassir, Ahlam; Dhibou, Hanane; Farah, Majdi; Mohamed, Lharmis; Amal, Addebous; Nabila, Souraa; Abderahim, Aboulfalah; Asmouki, Hamid; Soummani, Abderraouf

    2016-01-01

    Introduction Le streptocoque du groupe B est le principal agent impliqué dans les infections materno-fœtales, les septicémies et les méningites du nouveau-né à terme. L'objectif est de déterminer le taux de portage maternel du streptocoque du groupe B (SGB) à terme. Méthodes Un prélèvement vaginal a été réalisé de manière prospective chez 275 parturientes lors de l'entrée en salle d'accouchement sur une période de 06 mois. Résultats Le taux de portage était de 20,2%. Le portage était variable en fonction de l’âge gestationnel, il constitue 57.5% entre 37 et 38 semaines d'aménorrhée. Aucun des facteurs de risque n'a était statistiquement prédictif du portage maternel du SGB. Conclusion Le dépistage doit être réalisé à partir de 37 semaines d'aménorrhée, et comme le portage est intermittent, un prélèvement négatif ne garantirait pas que le portage soit négatif à l'accouchement. PMID:27222693

  15. Receipt of Preventive Services After Oregon's Randomized Medicaid Experiment.

    PubMed

    Marino, Miguel; Bailey, Steffani R; Gold, Rachel; Hoopes, Megan J; O'Malley, Jean P; Huguet, Nathalie; Heintzman, John; Gallia, Charles; McConnell, K John; DeVoe, Jennifer E

    2016-02-01

    It is predicted that gaining health insurance via the Affordable Care Act will result in increased rates of preventive health services receipt in the U.S., primarily based on self-reported findings from previous health insurance expansion studies. This study examined the long-term (36-month) impact of Oregon's 2008 randomized Medicaid expansion ("Oregon Experiment") on receipt of 12 preventive care services in community health centers using electronic health record data. Demographic data from adult (aged 19-64 years) Oregon Experiment participants were probabilistically matched to electronic health record data from 49 Oregon community health centers within the OCHIN community health information network (N=10,643). Intent-to-treat analyses compared receipt of preventive services over a 36-month (2008-2011) period among those randomly assigned to apply for Medicaid versus not assigned, and instrumental variable analyses estimated the effect of actually gaining Medicaid coverage on preventive services receipt (data collected in 2012-2014; analysis performed in 2014-2015). Intent-to-treat analyses revealed statistically significant differences between patients randomly assigned to apply for Medicaid (versus not assigned) for 8 of 12 assessed preventive services. In intent-to-treat analyses, Medicaid coverage significantly increased the odds of receipt of most preventive services (ORs ranging from 1.04 [95% CI=1.02, 1.06] for smoking assessment to 1.27 [95% CI=1.02, 1.57] for mammography). Rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. Continued effort is needed to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. 22 CFR 96.37 - Education and experience requirements for social service personnel.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... social service personnel. 96.37 Section 96.37 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED... § 96.37 Education and experience requirements for social service personnel. (a) The agency or person... Convention adoption, adoption-related social service functions that require the application of clinical...

  17. 22 CFR 96.37 - Education and experience requirements for social service personnel.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... social service personnel. 96.37 Section 96.37 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED... § 96.37 Education and experience requirements for social service personnel. (a) The agency or person... Convention adoption, adoption-related social service functions that require the application of clinical...

  18. 22 CFR 96.37 - Education and experience requirements for social service personnel.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... social service personnel. 96.37 Section 96.37 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED... § 96.37 Education and experience requirements for social service personnel. (a) The agency or person... Convention adoption, adoption-related social service functions that require the application of clinical...

  19. 22 CFR 96.37 - Education and experience requirements for social service personnel.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... social service personnel. 96.37 Section 96.37 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED... § 96.37 Education and experience requirements for social service personnel. (a) The agency or person... Convention adoption, adoption-related social service functions that require the application of clinical...

  20. 22 CFR 96.37 - Education and experience requirements for social service personnel.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... social service personnel. 96.37 Section 96.37 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED... § 96.37 Education and experience requirements for social service personnel. (a) The agency or person... Convention adoption, adoption-related social service functions that require the application of clinical...

  1. Consultant-based otolaryngology emergency service: a five-year experience.

    PubMed

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  2. Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services.

    PubMed

    Kohler, Racquel E; Lee, Clara N; Gopal, Satish; Reeve, Bryce B; Weiner, Bryan J; Wheeler, Stephanie B

    2015-01-01

    In Malawi, routine breast cancer screening is not available and little is known about women's preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment. To identify important factors that are relevant to Malawian women's preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare. We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs. Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants' responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes, comprehension of choice tasks, and women's abilities to make trade-offs. Applying a discrete choice experiment for breast cancer early detection was feasible with appropriate tailoring for a low-income, low-literacy African setting.

  3. Remembering Reflection in Pre-Service Teachers' Professional Experience

    ERIC Educational Resources Information Center

    Ditchburn, Geraldine M.

    2015-01-01

    In an Australian education policy environment where professional standards are determining the parameters of effective teaching and learning, it is important that we revisit ways to ensure reflection and collegial engagement are embedded in pre-service teachers' professional experience. This article reports on a university program initiative that…

  4. The Eastern Québec Telepathology Network: a three-year experience of clinical diagnostic services

    PubMed Central

    2014-01-01

    Background The Eastern Quebec Telepathology Network (called Réseau de Télépathologie de l'Est du Québec in French) was created to provide uniform diagnostic telepathology services in a huge territory with low population density. We report our first 3-year experience. Methods The network was funded equally by the Québec ministry of Health and Canada Health Infoway, a federal telehealth funding agency. The coverage includes intraoperative consultations (IOC), expert opinions, urgent analyses and supervision of macroscopic description. The deployment of the equipment and software started in 2010 and clinical activities began in January 2011. This network comprises 24 hospitals providing oncologic surgery, of which 7 have no pathology laboratory and 4 have a pathology laboratory but no pathologist. The real-time gross evaluation during IOC was performed using a macroscopy station and the sample selection was performed distantly by a technician, a pathology assistant or the surgeon under on-site pathologist supervision. Slides were scanned into whole-slide images (WSI). Results As per March 2014, 7,440 slides had been scanned for primary/urgent diagnosis; 1,329 for IOC cases and 2,308 for expert opinions. A 98% concordance rate was found for IOC compared to paraffin material and the average turnaround time was 20 minutes. Expert opinion reports were signed out within 24 hours in 68% of cases and within 72 hours in 85%. A recent multi-method evaluation study of the Network demonstrated that, thanks to telepathology: 1. interruption of IOC service was prevented in hospitals with no pathologist on site; 2. two-stage surgeries and patients transfers were prevented according to surgeons and pathologists; 3. retention and recruitment of surgeons in remote hospitals were facilitated; and 4. professional isolation among pathologists working alone was reduced. This study also demonstrated that wider adoption of telepathology would require technological improvement and that

  5. Bullying Experiences of Child and Adolescent Mental Health Service-Users: A Pilot Survey

    ERIC Educational Resources Information Center

    Dyer, Kevin; Teggart, Tom

    2007-01-01

    Victims and perpetrators of bullying experience a variety of psychological problems. The aim of the current pilot study was to explore the bullying experiences of Child and Adolescent Mental Health (CAMHS) service-users. The investigation was conducted as a cross-sectional survey at a community-based specialist CAMH service. A modified version of…

  6. Creating Dissonance in Pre-Service Teachers' Field Experiences

    ERIC Educational Resources Information Center

    Eisenhardt, Sara; Besnoy, Kevin; Steele, Emily

    2012-01-01

    The study is practical in nature and addresses the call for investigating effective aspects of field experiences in teacher preparation. The authors designed a framework of assignments requiring the pre-service teachers to collect data about two diverse elementary students in their assigned elementary classroom during the twelve weeks of their…

  7. Experience of Control and Student Satisfaction with Higher Education Services

    ERIC Educational Resources Information Center

    Lee, Jungki; Anantharaman, Sekhar

    2013-01-01

    Although the delivery of satisfactory services is an important strategic goal in many colleges, students are known to face challenges and experience a significant amount of stress during their school life. This study proposes and tests students' experience of control over their college life as a promising factor that would enhance their…

  8. The DuPont Conference: Implications for the Chemical Technology Curriculum

    NASA Astrophysics Data System (ADS)

    Kenkel, John; Rutledge, Sue; Kelter, Paul B.

    1998-05-01

    Southeast Community College (SCC) hosted the first DuPont Conference for Chemical Technology Education at its Lincoln, Nebraska campus October 4-6, 1997. The conference brought together fourteen practicing chemists and chemistry technicians and five college and university faculty members for the express purpose of suggesting new laboratory activities that would help relate the real world of work to the education of chemical laboratory technicians in community colleges. Participants included seven men and seven women from DuPont, Procter & Gamble, Eastman Chemical, Eastman Kodak, Dow Chemical, Air Products and Chemicals, Monsanto, Union Carbide, the Nebraska Agriculture Laboratory, and the University of Nebraska Biological Process Development Facility, Department of Food Science. The conference, sponsored by the E. I. DuPont DeNemours & Company through a grant awarded to SCC in June 1997, was intended to help further the goals of the two major projects underway at SCC, funded by the National Science Foundation's Advanced Technological Education Program. These projects, dubbed "Assignment: Chemical Technology I and II", or ACT-I and ACT-II, are curriculum and materials development projects. The invited scientists had between 2 and 32 years of experience that ranged from bench work to management levels. Many are or have been active on the national scene as members and officers of the American Chemical Society's Division of Chemical Technicians and the ACS Committee on Technician Activities.

  9. Cirque du Monde as a health intervention

    PubMed Central

    Fournier, Cynthia; Drouin, Mélodie-Anne; Marcoux, Jérémie; Garel, Patricia; Bochud, Emmanuel; Théberge, Julie; Aubertin, Patrice; Favreau, Gil; Fleet, Richard

    2014-01-01

    Abstract Objective To present Cirque du Soleil’s social circus program, Cirque du Monde, to explore its potential as a primary health care tool for family physicians. Data sources A review of the literature in PubMed, the Cochrane Library, PsycINFO, LaPresse, Eureka, Google Scholar, and Érudit using the key words circus, social circus, Cirque du Monde, and Cirque du Soleil; a Montreal-based initiative, Espace Transition, modeled on Cirque du Monde; and personal communication with Cirque du Soleil’s Social Circus Training Advisor. Study selection The first 50 articles or websites identified for each key word in each of the databases were examined on the basis of their titles and abstracts in the case of articles, and on the basis of their titles and page content in the case of websites. Articles and websites that explored an aspect of social circuses or that described an intervention that involved circuses were then retained for analysis. Because all literature on social circuses was searched, no criterion for year of publication was used. Synthesis No articles on the social circus as a health intervention were found. One study on the use of the circus as an intervention in schools was identified. It demonstrated an increase in self-esteem in the children who took part. One study on the use of the circus in a First Nations community was found; it contained nonspecific, qualitative findings. The other articles identified were merely descriptions of social circuses. One website was identified on the use of the social circus to help youth who had been treated in a hospital setting for major psychiatric disorders to re-enter the community. The team in the pediatric psychiatry department at Centre Hospitalier Universitaire Sainte-Justine, the children’s hospital in Montreal, Que, was contacted; they were leading this project, called Espace Transition. The unpublished preliminary findings of its pilot project demonstrate substantial improvements in overall patient

  10. Character Formation and Service: A Millennial Student's Experience

    ERIC Educational Resources Information Center

    Okumu, Jacob O.

    2012-01-01

    The author, a millennial college student, describes how his international service experiences positively influenced his social and moral development. He suggests ways educators may inspire students to develop core character values. He also argues that promoting these core values has been a primary purpose of the academy in the United States since…

  11. Les campagnes de dépistage du VIH, une stratégie efficace pour l’accès universel à la prévention et au traitement ? L’expérience du Burkina Faso

    PubMed Central

    Somé, J.F.; Desclaux, A.; Ky-Zerbo, O.; Lougué, M.; Kéré, S.; Obermeyer, C.; Simaga, F.

    2014-01-01

    Objectifs l’augmentation du taux de personnes qui connaissent leur statut VIH est un impératif, notamment en Afrique subsaharienne, ce qui impose d’évaluer les stratégies utilisées pour accroître la fréquentation des services de dépistage. Cet article vise à faire le bilan de la pertinence, de la faisabilité et de l’efficacité des campagnes nationales de dépistagemenées entre 2006 et 2010 au Burkina Faso. Méthodologie une analyse de toutes les données de fréquentation du conseil dépistage sur cette période a été faite, couplée à des entretiens avec les principaux acteurs intervenant dans le dépistage. Résultats les résultats montrent que les huit campagnes de dépistage organisées sur la période ont permis à 487 727 personnes de faire leur test VIH. Ce nombre représente 50 % du nombre total de personnes ayant fait leur test et contribue à hauteur de 24,6 % au dépistage des personnes séropositives identifiées au cours de cette période. Les campagnes ont touché des populations difficiles à atteindre (en particulier les jeunes), à un coût moindre. Conclusions cette stratégie est donc pertinente pour identifier les personnes VIH+. Son intérêt pour la prévention, important selon les soignants et au vu des populations jeunes qui y participent, devrait être mesuré par des études complémentaires. Les campagnes sont efficaces et coût-efficaces même dans un pays de niveau de prévalence faible. Ces résultats soulignent l’intérêt de la synergie entre les associations et les services de santé dans l’offre de services de conseil et dépistage. PMID:24681563

  12. Fixing the system? The experience of service users of the quasi-market in disability services in Australia.

    PubMed

    Spall, Pam; McDonald, Catherine; Zetlin, Di

    2005-01-01

    A qualitative study involving semi-structured interviews with 31 people with disabilities and 32 carers in the state of Queensland, Australia, found that their experience of supportive service delivery had not improved despite reforms of the service delivery system driven by a version of the quasi-market model. Instead of delivering increased consumer choice and improved efficiency in service delivery, service users experienced inadequate service supply, service cutbacks, and an increased emphasis on cost subsidisation and assessment processes. Additionally, few consumers felt that individualised funding arrangements had personally delivered the benefits which the quasi-market model and associated policy paradigm had indicated that they should receive. For many consumers, the notion of consumer 'choice' around service provision was fictitious and they felt that any efficiency gains were at the agency level, largely at the consumers' cost. It is concluded that there appears to be no particular benefit to service users of quasi-market reforms, particularly in policy contexts where service delivery systems are historically under-funded.

  13. Market variations in intensity of Medicare service use and beneficiary experiences with care.

    PubMed

    Mittler, Jessica N; Landon, Bruce E; Fisher, Elliot S; Cleary, Paul D; Zaslavsky, Alan M

    2010-06-01

    Examine associations between patient experiences with care and service use across markets. Medicare fee-for-service (FFS) and managed care (Medicare Advantage [MA]) beneficiaries in 306 markets from the 2003 Consumer Assessments of Healthcare Providers and Systems (CAHPS) surveys. Resource use intensity is measured by the 2003 end-of-life expenditure index. We estimated correlations and linear regressions of eight measures of case-mix-adjusted beneficiary experiences with intensity of service use across markets. We merged CAHPS data with service use data, excluding beneficiaries under 65 years of age or receiving Medicaid. Overall, higher intensity use was associated (p<.05) with worse (seven measures) or no better care experiences (two measures). In higher-intensity markets, Medicare FFS and MA beneficiaries reported more problems getting care quickly and less helpful office staff. However, Medicare FFS beneficiaries in higher-intensity markets reported higher overall ratings of their personal physician and main specialist. Medicare MA beneficiaries in higher-intensity markets also reported worse quality of communication with physicians, ability to get needed care, and overall ratings of care. Medicare beneficiaries in markets characterized by high service use did not report better experiences with care. This trend was strongest for those in managed care.

  14. Disconfirming User Expectations of the Online Service Experience: Inferred versus Direct Disconfirmation Modeling.

    ERIC Educational Resources Information Center

    O'Neill, Martin; Palmer, Adrian; Wright, Christine

    2003-01-01

    Disconfirmation models of online service measurement seek to define service quality as the difference between user expectations of the service to be received and perceptions of the service actually received. Two such models-inferred and direct disconfirmation-for measuring quality of the online experience are compared (WebQUAL, SERVQUAL). Findings…

  15. Immigrant women's experience of maternity services in Canada: a meta-ethnography.

    PubMed

    Higginbottom, Gina M A; Hadziabdic, Emina; Yohani, Sophie; Paton, Patricia

    2014-05-01

    to synthesise data on immigrant women's experiences of maternity services in Canada. a qualitative systematic literature review using a meta-ethnographic approach a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings. the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings. in order to implement woman-centered care, to enhance access to maternity services, and to promote immigrant women

  16. Practical Tools for Content Development: Pre-Service Teachers' Experiences and Perceptions

    ERIC Educational Resources Information Center

    Yurtseven Avci, Zeynep; Eren, Esra; Seckin Kapucu, Munise

    2016-01-01

    This study adopts phenomenology approach as the research design method to investigate pre-service teachers' experiences and perceptions on using practical tools for content development. The participants are twenty-four pre-service teachers who were taking Computer II course during 2013-2014 spring semester at a public university in Turkey. During…

  17. Is patient satisfaction and perceived service quality with musculoskeletal rehabilitation determined by patient experiences?

    PubMed

    Medina-Mirapeix, Francesc; Jimeno-Serrano, Francisco J; Escolar-Reina, Pilar; Del Baño-Aledo, M Elena

    2013-06-01

    To assess the relationships between patient experiences and two overall evaluations - satisfaction and service quality - in outpatient rehabilitation settings. A cross-sectional, self-reported survey carried out in the year 2009. Three outpatient rehabilitation units belonging to Spanish hospitals located in Barcelona, Madrid and Seville. Four hundred and sixty-five outpatients (response rate 90%) mean age 39.4 (SD = 11.9) years. Self-reported experiences on aspects of care, participants' perception of service quality, satisfaction with care, socio-demographic and health characteristics. Satisfaction and service quality were highly correlated (rho = 0.72, P< 0.001). Two multivariate logistic regression models using satisfaction and service quality (with adjusted R(2) 31.5% and 37.1%, respectively) indicated that patients' experiences and global rating of health improvement have more effect on those evaluations than socio-demographic characteristics. Mean satisfaction was 8.9 (SD = 1.2), and 88% of respondents described high service quality. However, nearly 25% of the respondents who reported high-quality evaluations also indicated a problem score of more than 50% in almost all aspects of care studied. Satisfaction and service quality provide a poor indicator of patients' experiences. Both are two proxies but distinct constructs in rehabilitation care. Besides, not all problems encountered by patients are equally important to them.

  18. Determining Appropriate Coupling between User Experiences and Earth Science Data Services

    NASA Astrophysics Data System (ADS)

    Moghaddam-Taaheri, E.; Pilone, D.; Newman, D. J.; Mitchell, A. E.; Goff, T. D.; Baynes, K.

    2012-12-01

    NASA's Earth Observing System ClearingHOuse (ECHO) is a format agnostic metadata repository supporting over 3000 collections and 100M granules. ECHO exposes FTP and RESTful Data Ingest APIs in addition to both SOAP and RESTful search and order capabilities. Built on top of ECHO is a human facing search and order web application named Reverb. Reverb exposes ECHO's capabilities through an interactive, Web 2.0 application designed around searching for Earth Science data and downloading or ordering data of interest. ECHO and Reverb have supported the concept of Earth Science data services for several years but only for discovery. Invocation of these services was not a primary capability of the user experience. As more and more Earth Science data moves online and away from the concept of data ordering, progress has been made in making on demand services available for directly accessed data. These concepts have existed through access mechanisms such as OPeNDAP but are proliferating to accommodate a wider variety of services and service providers. Recently, the EOSDIS Service Interface (ESI) was defined and integrated into the ECS system. The ESI allows data providers to expose a wide variety of service capabilities including reprojection, reformatting, spatial and band subsetting, and resampling. ECHO and Reverb were tasked with making these services available to end-users in a meaningful and usable way that integrated into its existing search and ordering workflow. This presentation discusses the challenges associated with exposing disparate service capabilities while presenting a meaningful and cohesive user experience. Specifically, we'll discuss: - Benefits and challenges of tightly coupling the user interface with underlying services - Approaches to generic service descriptions - Approaches to dynamic user interfaces that better describe service capabilities while minimizing application coupling - Challenges associated with traditional WSDL / UDDI style service

  19. Client Experiences with Shelter and Community Care Services in the Netherlands: Quality of Services for Homeless People, Homeless Youth, and Abused Women

    ERIC Educational Resources Information Center

    Asmoredjo, Jolanda; Beijersbergen, Mariëlle D.; Wolf, Judith R. L. M.

    2017-01-01

    Purpose: To gain insight into client experiences with shelter or community care services for homeless people, homeless youth, and abused women and identify priority improvement areas. Methods: Seven hundred and forty-four clients rated their experiences and 116 clients rated the services' importance. Results: Clients had most positive experiences…

  20. Mesure de haute resolution de la fonction de distribution radiale du silicium amorphe pur

    NASA Astrophysics Data System (ADS)

    Laaziri, Khalid

    1999-11-01

    Cette these porte sur l'etude de la structure du silicium amorphe prepare par irradiation ionique. Elle presente des mesures de diffraction de rayons X sur de la poudre de silicium cristallin, du silicium amorphe relaxe et non relaxe, ainsi que tous les developpements mathematiques et physiques necessaires pour extraire la fonction de distribution radiale correspondant a chaque echantillon. Au Chapitre I, nous presentons une methode de fabrication de membranes minces de silicium amorphe pur. Il y a deux etapes majeures lors du processus de fabrication: l'implantation ionique, afin de creer une couche amorphe de plusieurs microns et l'attaque chimique, pour enlever le reste du materiau cristallin. Nous avons caracterise premierement les membranes de silicium amorphe par spectroscopie Raman pour verifier qu'il ne reste plus de trace de materiau cristallin dans les films amorphes. Une deuxieme caracterisation par detection de recul elastique (ERD-TOF) sur ces memes membranes a montre qu'il y a moins de 0.1% atomique de contaminants tels que l'oxygene, le carbone, et l'hydrogene. Au Chapitre II, nous proposons une nouvelle methode de correction de la contribution inelastique "Compton" des spectres de diffusion totale afin d'extraire les pics de diffusion elastique, responsable de la diffraction de Bragg. L'article presente tout d'abord une description simplifiee d'une theorie sur la diffusion inelastique dite "Impulse Approximation" (IA) qui permet de calculer des profils de Compton en fonction de l'energie et de l'angle de diffusion 2theta. Ces profils sont utilises comme fonction de lissage de la diffusion Compton experimentale. Pour lisser les pics de diffusion elastique, nous avons utilise une fonction pic de nature asymetrique. Aux Chapitre III, nous exposons de maniere detaillee les resultats des experiences de diffraction de rayons X sur les membranes de silicium amorphe et la poudre de silicium cristallin que nous avons preparees. Nous abordons aussi les

  1. L'Aventure du LHC

    ScienceCinema

    None

    2018-05-16

    Cette présentation s’adressera principalement aux personnes qui ont construit le LHC. La construction du LHC fut longue et difficile. De nombreux problèmes sont apparus en cours de route. Tous ont été résolus grâce au dévouement et à l’engagement du personnel et des collaborateurs. Je reviendrai sur les coups durs et les réussites qui ont marqués ces 15 dernières années et je vous montrerai combien cette machine, le fruit de vos efforts, est extraordinaire.

  2. Pre-Service Teachers' Personal Practical Theories and Autonomy: Development during Professional Internship Experiences

    ERIC Educational Resources Information Center

    Shin, Doohyun L.

    2013-01-01

    Professional internship experiences play a critical role in the development of pre-service teachers. This research investigates pre-service teachers' personal practical theories (PPTs) and autonomy and how they are developed during professional internship experiences. This study also explores relationships that exist for PPTs and autonomy and…

  3. The Effect Structured Participation Experiences Have on Pre-Service Teachers' Preparedness to Teach Reading

    ERIC Educational Resources Information Center

    Brannon, Diana; Fiene, Judy

    2013-01-01

    Many pre-service teachers express a lack of confidence and preparedness to face the challenges of teaching reading in today's classrooms. The current study looks at whether Structured Participation Experiences (SPE) in reading increase pre-service teachers' preparedness to teach reading compared to more traditional unstructured field experiences.…

  4. A focus group study of chiropractic students following international service learning experiences

    PubMed Central

    Boysen, James C.; Salsbury, Stacie A.; Derby, Dustin; Lawrence, Dana J.

    2016-01-01

    Objective: One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students. Methods: Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes. Results: The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor–patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning. Conclusion: Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices. PMID:27258817

  5. Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.

    PubMed

    Heslehurst, Nicola; Dinsdale, Sarah; Brandon, Helene; Johnston, Camilla; Summerbell, Carolyn; Rankin, Judith

    2017-06-01

    to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity. a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes. one NHS Trust maternity and dietetic services, North East England, UK. fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m 2 . four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring. women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base. it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of

  6. Dedicated Caravan Sites for French Gens du Voyage

    PubMed Central

    2017-01-01

    Abstract In France, gens du voyage (“people who travel” or “travellers”) is a term used by the government to categorize various itinerant populations, the majority of which are diverse Romani groups. People categorized as gens du voyage are legally required to reside in particular locations called “dedicated caravan sites.” Parliamentary debates about these dedicated caravan sites have clarified that one of the objectives of such sites is to help fulfill the gens du voyage’s right to health. However, there is a significant gap between the officially stated goals of such sites and the reality of life within them. This paper draws on research finding that the conditions in most dedicated caravan sites do not conform with the rights of gens du voyage to acceptable sanitary conditions and other underlying determinants of health. PMID:29302165

  7. A Service-Learning Project Using Crowdfunding Strategy: Students' Experience and Reflection

    ERIC Educational Resources Information Center

    Mat-jizat, Jessnor Elmy; Khalid, Khalizul

    2016-01-01

    The aim of this study was to explore students' experience and reflection in doing a Service Learning project as part of their course work. The Service Learning project allows the students to practice their knowledge of raising capital through crowdfunding, and at the same time situates them in an environment where they could learn from the…

  8. Preferences of older patient regarding hip fracture rehabilitation service configuration: A feasibility discrete choice experiment.

    PubMed

    Charles, Joanna M; Roberts, Jessica L; Din, Nafees Ud; Williams, Nefyn H; Yeo, Seow Tien; Edwards, Rhiannon T

    2018-05-14

    As part of a wider feasibility study, the feasibility of gaining older patients' views for hip fracture rehabilitation services was tested using a discrete choice experiment in a UK context. Discrete choice experiment is a method used for eliciting individuals' preferences about goods and services. The discrete choice experiment was administered to 41 participants who had experienced hip fracture (mean age 79.3 years; standard deviation (SD) 7.5 years), recruited from a larger feasibility study exploring a new multidisciplinary rehabilitation for hip fracture. Attributes and levels for this discrete choice experiment were identified from a systematic review and focus groups. The questionnaire was administered at the 3-month follow-up. Participants indicated a significant preference for a fully-qualified physiotherapist or occupational therapist to deliver the rehabilitation sessions (β = 0·605, 95% confidence interval (95% CI) 0.462-0.879), and for their rehabilitation session to last less than 90 min (β = -0.192, 95% CI -0.381 to -0.051). The design of the discrete choice experiment using attributes associated with service configuration could have the potential to inform service implementation, and assist rehabilitation service design that incorporates the preferences of patients.

  9. Une étude rétrospective sur l'incidence de l'insuffisance rénale chronique dans le service de Médecine Interne et Néphrologie du Centre Hospitalier Universitaire d'Antananarivo

    PubMed Central

    Ramilitiana, Benja; Ranivoharisoa, Eliane Mikkelsen; Dodo, Mihary; Razafimandimby, Evanirina; Randriamarotia, Willy Franck

    2016-01-01

    L'insuffisance rénale chronique est un problème de santé publique au niveau mondial. Dans les pays développés, cette affection survient essentiellement chez les sujets âgés, mais en Afrique, elle s'installe plutôt chez les sujets jeunes actifs. C'est une affection de lourde prise en charge dans un pays à faible revenu à cause de ses coûts. Notre but est de décrire les aspects épidémiologiques des nouveaux cas d'insuffisance rénale chronique à Madagascar. Il s'agit d'une étude rétrospective descriptive de 3 ans partant du 1er janvier 2007 au 31 décembre 2009 dans le service de Médecine Interne et Néphrologie du Centre Hospitalier Universitaire d'Antananarivo portant sur 239 patients diagnostiqués comme une insuffisance rénale chronique. L'incidence était de 8,51% parmi les patients hospitalisés dans le service. L’âge moyen des patients était de 45,4 ans avec des extrêmes de 16 et 82 ans et un sex-ratio de 1,46. Le principal antécédent était l'hypertension artérielle (59,8%). L'insuffisance rénale chronique était terminale dans 75,31% des cas (n=180). Les causes de l'insuffisance rénale chronique étaient dominées par la glomérulonéphrite chronique (40,1%), la néphroangiosclérose (35,5%). L'hémodialyse était réalisée chez 3 patients (1,26%), aucun patient n’était pas programmé pour une greffe rénale. Le taux de mortalité dans le service était de 28,87%. L'insuffisance rénale chronique est une maladie de pronostic redoutable et handicapante qui affecte les sujets jeunes à Madagascar. Son traitement reste inaccessible dans la majorité des patients. L'accent doit donc être mis principalement sur la prévention notamment une bonne prise en charge précoce des infections, de l'hypertension artérielle et du diabète pour réduire ses impacts négatifs sur la santé communautaire et publique. Le projet de la transplantation rénale - donneur vivant, traitement efficace et moins coûteux par rapport à l

  10. The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia

    PubMed Central

    2013-01-01

    Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155

  11. The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia.

    PubMed

    Xiao, Lily Dongxia; De Bellis, Anita; Habel, Lesley; Kyriazopoulos, Helena

    2013-10-22

    Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia.

  12. Creating International Community Service Learning Experiences in a Capstone Marketing-Projects Course

    ERIC Educational Resources Information Center

    Metcalf, Lynn E.

    2010-01-01

    This article outlines the development of a project-based capstone marketing course, specifically designed to provide marketing students with an international community service learning experience. It differs significantly from previous studies, which focus on integrating service learning into existing marketing courses and on helping local…

  13. Planning and Implementing Health Promotion in the Workplace: A Case Study of the Du Pont Company Experience.

    ERIC Educational Resources Information Center

    Bertera, Robert L.

    1990-01-01

    The PRECEDE framework was used to focus planning and evaluation of key areas of health knowledge, attitudes, and behavior in designing a workplace health promotion program for Du Pont. One pilot location experienced a 47.5 percent decline in absenteeism over six years as a result of the comprehensive needs assessment and health intervention. (SK)

  14. The service telemetry and control device for space experiment “GRIS”

    NASA Astrophysics Data System (ADS)

    Glyanenko, A. S.

    2016-02-01

    Problems of scientific devices control (for example, fine control of measuring paths), collecting auxiliary (service information about working capacity, conditions of experiment carrying out, etc.) and preliminary data processing are actual for any space device. Modern devices for space research it is impossible to imagine without devices that didn't use digital data processing methods and specialized or standard interfaces and computing facilities. For realization of these functions in “GRIS” experiment onboard ISS for purposes minimization of dimensions, power consumption, the concept “system-on-chip” was chosen and realized. In the programmable logical integrated scheme by Microsemi from ProASIC3 family with maximum capacity up to 3M system gates, the computing kernel and all necessary peripherals are created. In this paper we discuss structure, possibilities and resources the service telemetry and control device for “GRIS” space experiment.

  15. Polymorphisme de l'apolipoprotéine E dans la population du nord du Maroc: fréquence et influence sur les paramètres lipidiques

    PubMed Central

    Benyahya, Fatiha; Barakat, Amina; Ghailani, Naima; Bennani, Mohcine

    2013-01-01

    Introduction L'objectif de ce travail est de déterminer les fréquences alléliques et génotypiques des sites polymorphes situés dans le gène de l'apolipoprotéine E (apo E) ainsi que leur impact sur les paramètres cliniques et lipidiques dans un échantillon de la population du nord du Maroc cliniquement diagnostiqué ADH. Méthodes Le génotype de l'apo E a été analysé par séquençage direct chez 46 patients cliniquement diagnostiqués ADH selon les critères standards. Résultats Les fréquences des allèles epsilon 3, epsilon 2 et epsilon 4 ont été respectivement 78.3%, 2.2% et 19.6%. La fréquence de l'allèle epsilon 4 est très élevée chez la population du nord du Maroc en comparaison avec les populations des autres régions marocaines. Elle est similaire à celle rapportée dans les pays de l'Europe du nord. Les taux du cholestérol total, du cholestérol LDL ainsi que la présence des xanthomes et les maladies cardiovasculaires ne différent pas entre les génotypes de l'apoE. En revanche, les résultats ont montré une influence de l'allèle epsilon4 sur le taux des triglycérides chez les sujets obèses. Conclusion Le génotype de l'apoE ne peut expliquer le phénotype clinique et biochimique présenté par des patients du Nord du Maroc cliniquement diagnostiqués ADH. PMID:24396563

  16. Étude des déterminants individuels de l’adoption du dossier de santé électronique du Québec

    PubMed Central

    Mezni, H; M-P, Gagnon; Duplantie, J

    2016-01-01

    Résumé Objectif Selon des études précédentes, les dossiers de santé électroniques peuvent améliorer l’efficacité, la sécurité et la qualité de la prise en charge médicale. Cependant, les prestataires de soins restent réticents quant à son utilisation, ce qui limite son impact sur le système de santé. La présente étude avait pour objectif d’évaluer les perceptions des médecins face au dossier de santé du Québec. Méthodes À partir d’une revue de la littérature sur les facteurs influençant l’adoption des nouvelles technologies de l’information et des communications (NTIC) en général et de la cybersanté en particulier, nous avons élaboré un questionnaire semi-structuré. Au total, 12 médecins utilisateurs potentiels du dossier de santé du Québec (DSQ) ont complété et retourné le questionnaire. Par la suite, nous avons opéré une analyse thématique de contenu, suivie par une théorisation des concepts obtenus. Résultats L’intention d’adopter le DSQ est influencée positivement par l’utilité perçue, la facilité d’utilisation perçue, la démonstrabilité des résultats, la compatibilité du système avec la pratique et l’autoefficacité informatique perçue par les médecins. Inversement, la résistance au changement influence négativement l’adoption du DSQ par les médecins. Conclusion L’identification des déterminants de l’adoption du dossier de santé du Québec est cruciale pour les responsables du secteur de la santé au Québec. Il sera ainsi possible de saisir les attentes des utilisateurs potentiels et d’ajuster les stratégies d’implantation en vue de favoriser une meilleure intégration de cette technologie dans les pratiques médicales. PMID:27867453

  17. A Decomposition of Hospital Profitability: An Application of DuPont Analysis to the US Market.

    PubMed

    Turner, Jason; Broom, Kevin; Elliott, Michael; Lee, Jen-Fu

    2015-01-01

    This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services' Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO hospitals, significant financial differences remain

  18. A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

    PubMed

    Guest, Ella; Griffiths, Catrin; Harcourt, Diana

    2018-01-01

    A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

  19. Le kyste hydatique du cordon spermatique: une localisation exceptionnelle

    PubMed Central

    Hamdane, Mohamed Moncef; Bougrine, Fethi; Msakni, Issam; Dhaoui-Ghozzi, Amen; Bouziani, Ammar

    2011-01-01

    L’ hydatidose est une anthropo-zoonose due au développement chez l'homme de la forme larvaire du taenia Echinococcus granulosis. La plupart des kystes hydatiques se localisent dans le foie et les poumons. Le kyste hydatique du cordon spermatique est extrêmement rare avec seulement 4 cas rapportés dans la littérature. Les auteurs rapportent dans cet article un nouveau cas d'hydatidose du cordon spermatique. Il s'agissait d'un homme de 40 ans qui consultait pour des douleurs scrotales évoluant depuis huit mois. L'examen clinique a mis en évidence une tuméfaction mobile, inguino-scrotale, droite. L’échographie testiculaire a objectivé une hernie inguinale droite associée à deux kystes épididymaires bilatéraux. Le patient a été opéré pour cure de son hernie avec découverte en per-opératoire d'un kyste du cordon spermatique qui a été réséqué. L'examen anatomopathologique a conclu à une hydatidose du cordon spermatique. PMID:22384304

  20. Adults with Learning Disabilities Experiences of Using Community Dental Services: Service User and Carer Perspectives

    ERIC Educational Resources Information Center

    Lees, Carolyn; Poole, Helen; Brennan, Michelle; Irvine, Fiona

    2017-01-01

    Background: The government alongside other health and social care organisation have identified the need to improve the care provided for people with learning disabilities. Materials and Methods: This service evaluation aimed to explore the experiences of people with learning disabilities and their carers who accessed community dental services…

  1. Black African Parents' Experiences of an Educational Psychology Service

    ERIC Educational Resources Information Center

    Lawrence, Zena

    2014-01-01

    The evidence base that explores Black African parents' experiences of an Educational Psychology Service (EPS) is limited. This article describes an exploratory mixed methods research study undertaken during 2009-2011, that explored Black African parents' engagement with a UK EPS. Quantitative data were gathered from the EPS preschool database and…

  2. How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience.

    PubMed

    Thomson, Louise; Barker, Marcus; Kaylor-Hughes, Catherine; Garland, Anne; Ramana, Rajini; Morriss, Richard; Hammond, Emily; Hopkins, Gail; Simpson, Sandra

    2018-06-15

    A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health

  3. Pre-Service Teachers' Experiences and Views on Project-Based Learning Processes

    ERIC Educational Resources Information Center

    Dag, Funda; Durdu, Levent

    2017-01-01

    Project-based learning (PjBL) has been promoted as an effective and frequently used student-centered learning approach for various learning environments. To have various learning experiences with PjBL is an important requirement for pre-service teachers (PSTs). The purpose of the study was to investigate the experiences PSTs had with group work…

  4. Production experience with the ATLAS Event Service

    NASA Astrophysics Data System (ADS)

    Benjamin, D.; Calafiura, P.; Childers, T.; De, K.; Guan, W.; Maeno, T.; Nilsson, P.; Tsulaia, V.; Van Gemmeren, P.; Wenaus, T.; ATLAS Collaboration

    2017-10-01

    The ATLAS Event Service (AES) has been designed and implemented for efficient running of ATLAS production workflows on a variety of computing platforms, ranging from conventional Grid sites to opportunistic, often short-lived resources, such as spot market commercial clouds, supercomputers and volunteer computing. The Event Service architecture allows real time delivery of fine grained workloads to running payload applications which process dispatched events or event ranges and immediately stream the outputs to highly scalable Object Stores. Thanks to its agile and flexible architecture the AES is currently being used by grid sites for assigning low priority workloads to otherwise idle computing resources; similarly harvesting HPC resources in an efficient back-fill mode; and massively scaling out to the 50-100k concurrent core level on the Amazon spot market to efficiently utilize those transient resources for peak production needs. Platform ports in development include ATLAS@Home (BOINC) and the Google Compute Engine, and a growing number of HPC platforms. After briefly reviewing the concept and the architecture of the Event Service, we will report the status and experience gained in AES commissioning and production operations on supercomputers, and our plans for extending ES application beyond Geant4 simulation to other workflows, such as reconstruction and data analysis.

  5. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    PubMed

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  6. Déclenchement du travail à terme par le misoprostol: expérience d'une maternité tunisienne

    PubMed Central

    Ouerdiane, Nadia; Tlili, Nihel; Othmani, Kaouther; Daaloul, Walid; Masmoudi, Abdelwaheb; Hamouda, Sonia Ben; Bouguerra, Badreddine

    2016-01-01

    Evaluer l'efficacité et l'innocuité de l'utilisation du misoprostol par voie vaginale pour le déclenchement du travail à terme. Etude prospective réalisée au service de gynécologie obstétrique B de l'hôpital Charles Nicolle de Tunis sur une durée de 4 mois. La population sélectionnée concernait les patientes à terme devant bénéficier d'une maturation cervicale. Le misoprostol à la dose de 50 µg par voie vaginale toutes les 12 h était utilisé. Les paramètres étudiés étaient les anomalies contractiles, les anomalies du RCF, le mode d'accouchement, le délai d'accouchement et l’état néonatal. 44 patientes ont bénéficié d'une maturation cervicale par misoprostol. Le terme moyen était de 40 SA. Le taux de nullipare était de 23/44 (52%). Le taux d'accouchement par voie basse était de 31/44 (70.4%). 84% des patientes ont reçu une seule dose de misoprostol. Les anomalies du RCF ont été notées dans 14/44 (32%). Le taux de liquides méconiaux était de 12/44 (27%). Un score d'Apgar à 5 mn inférieur à 7 était noté chez 7/44 (16%). Un cas de rupture utérine était survenue chez une primipare et ce après une seule prise de misoprostol. Nos résultats sont décevants en raison de la survenue d'une rupture utérine et d'une morbidité néonatale importante. D'autres études prospectives multicentriques restent utiles pour mieux s'assurer de l'efficacité mais surtout de l'innocuité du misoprostol à dose faible pour le déclenchement du travail à terme. PMID:27583092

  7. Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience

    PubMed Central

    2011-01-01

    Background In rebuilding devastated health services, the government of Afghanistan has provided access to basic services mainly by contracting with non-government organisations (NGOs), and more recently the Strengthening Mechanism (SM) of contracting with Provincial Health Offices. Community-based information about the public's views and experience of health services is scarce. Methods Field teams visited households in a stratified random sample of 30 communities in two districts in Kabul province, with health services mainly provided either by an NGO or through the SM and administered a questionnaire about household views, use, and experience of health services, including payments for services and corruption. They later discussed the findings with separate community focus groups of men and women. We calculated weighted frequencies of views and experience of services and multivariate analysis examined the related factors. Results The survey covered 3283 households including 2845 recent health service users. Some 42% of households in the SM district and 57% in the NGO district rated available health services as good. Some 63% of households in the SM district (adjacent to Kabul) and 93% in the NGO district ordinarily used government health facilities. Service users rated private facilities more positively than government facilities. Government service users were more satisfied in urban facilities, if the household head was not educated, if they had enough food in the last week, and if they waited less than 30 minutes. Many households were unwilling to comment on corruption in health services; 15% in the SM district and 26% in the NGO district reported having been asked for an unofficial payment. Despite a policy of free services, one in seven users paid for treatment in government facilities, and three in four paid for medicine outside the facilities. Focus groups confirmed people knew payments were unofficial; they were afraid to talk about corruption. Conclusions

  8. Does contracting of health care in Afghanistan work? Public and service-users' perceptions and experience.

    PubMed

    Cockcroft, Anne; Khan, Amir; Md Ansari, Noor; Omer, Khalid; Hamel, Candyce; Andersson, Neil

    2011-12-21

    In rebuilding devastated health services, the government of Afghanistan has provided access to basic services mainly by contracting with non-government organisations (NGOs), and more recently the Strengthening Mechanism (SM) of contracting with Provincial Health Offices. Community-based information about the public's views and experience of health services is scarce. Field teams visited households in a stratified random sample of 30 communities in two districts in Kabul province, with health services mainly provided either by an NGO or through the SM and administered a questionnaire about household views, use, and experience of health services, including payments for services and corruption. They later discussed the findings with separate community focus groups of men and women. We calculated weighted frequencies of views and experience of services and multivariate analysis examined the related factors. The survey covered 3283 households including 2845 recent health service users. Some 42% of households in the SM district and 57% in the NGO district rated available health services as good. Some 63% of households in the SM district (adjacent to Kabul) and 93% in the NGO district ordinarily used government health facilities. Service users rated private facilities more positively than government facilities. Government service users were more satisfied in urban facilities, if the household head was not educated, if they had enough food in the last week, and if they waited less than 30 minutes. Many households were unwilling to comment on corruption in health services; 15% in the SM district and 26% in the NGO district reported having been asked for an unofficial payment. Despite a policy of free services, one in seven users paid for treatment in government facilities, and three in four paid for medicine outside the facilities. Focus groups confirmed people knew payments were unofficial; they were afraid to talk about corruption. Households used government health

  9. Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability.

    PubMed

    Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel

    2017-01-01

    Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.

  10. Stakeholder Perceptions of the Positive Benefits and Critical Challenges Involved in Student Service-Learning Experiences

    ERIC Educational Resources Information Center

    Hohenthal, K. Darcy

    2010-01-01

    The Bolman and Deal (2003) Four-Frame Model was adapted in this qualitative phenomenological research study to describe how stakeholders experience student service-learning. The study presents how students perceive the positive benefits and critical challenges encountered in their service-learning experience; how professors perceive the positive…

  11. The lived experience of volunteering in a palliative care biography service.

    PubMed

    Beasley, Elizabeth; Brooker, Joanne; Warren, Narelle; Fletcher, Jane; Boyle, Christopher; Ventura, Adriana; Burney, Susan

    2015-10-01

    Many patients approaching death experience hopelessness, helplessness, and a depressed mood, and these factors can contribute to a difficult end-of-life (EoL) period. Biography services may assist patients in finding meaning and purpose at this time. The aim of our study was to investigate the lived experience of volunteers involved in a biography service in Melbourne, Australia, using a qualitative methodology. The participants were 10 volunteers who had participated in a biography service within a private palliative care service. Each volunteer was interviewed separately using a study-specific semistructured interview guide. The transcripts of these interviews were then subjected to thematic analysis. Analysis yielded the following themes: motivations for volunteering; dealing with death, dying, and existential issues; psychosocial benefits of volunteering; and benefits and challenges of working with patients and their families. Our results indicated that volunteering gave the volunteers a deeper appreciation of existential issues, and helped them to be more appreciative of their own lives and gain a deeper awareness of the struggles other people experience. They also suggested that volunteers felt that their involvement contributed to their own personal development, and was personally rewarding. Furthermore, the results highlighted that volunteers found that encounters with family members were sometimes challenging. While some were appreciative, others imposed time limits, became overly reliant on the volunteers, and were sometimes offended, hurt, and angered by what was included in the final biography. It is hoped that the findings of the current study will provide direction for improvements in the biography services that will benefit patients, family members, and volunteers. In particular, our findings highlight the need to provide ongoing support for volunteers to assist them in handling the challenges of volunteering in a palliative care setting.

  12. Improving the Work-Integrated Learning Experience through a Third-Party Advisory Service

    ERIC Educational Resources Information Center

    Jackson, Denise; Ferns, Sonia; Rowbottom, David; Mclaren, Diane

    2017-01-01

    This study trialled a Work-Integrated Learning (WIL) Advisory Service, provided by the Chamber of Commerce and Industry of Western Australia (CCIWA) in collaboration with four WA universities. The service was established to broker relationships between industry and universities, support employers engaged in WIL and enhance the WIL experience for…

  13. Impacte des maladies immunitaires sur la grossesse expérience du Service de Gynécologie Obstétrique de l'hôpital Militaire Moulay Ismail

    PubMed Central

    Laghzaoui, Omar

    2016-01-01

    L'influence du statut hormonal au cours des maladies auto-immunes est clairement établie, avec une prévalence maximale pendant la période d'activité génitale d'où l'intérêt de notre étude rétrospective de 32 dossiers de patientes enceintes présentant des pathologies auto-immunes. Les rechutes de la maladie au cours de la grossesse sont surtout observées chez les gestantes présentant le Lupus érythémateux disséminé et la maladie de Behçet alors qu'en poste partum les complications sont observées en cas de polyarthrite rhumatoïde, sclérose en plaque et la sclérodermie. Les complications fœtales dépendent du stade et du type de la maladie auto immune ainsi que l'association à d'autres pathologies. La prise en charge multi disciplinaire et l'ajustement du traitement abouti à stabiliser la maladie auto immune et améliore le pronostique fœtale. PMID:27648118

  14. Brain stem hypoplasia associated with Cri-du-Chat syndrome.

    PubMed

    Hong, Jin Ho; Lee, Ha Young; Lim, Myung Kwan; Kim, Mi Young; Kang, Young Hye; Lee, Kyung Hee; Cho, Soon Gu

    2013-01-01

    Cri-du-Chat syndrome, also called the 5p-syndrome, is a rare genetic abnormality, and only few cases have been reported on its brain MRI findings. We describe the magnetic resonance imaging findings of a 1-year-old girl with Cri-du-Chat syndrome who showed brain stem hypoplasia, particularly in the pons, with normal cerebellum and diffuse hypoplasia of the cerebral hemispheres. We suggest that Cri-du-Chat syndrome chould be suspected in children with brain stem hypoplasia, particularly for those with high-pitched cries.

  15. Blogs as a Representation of Student Experiences in a Service Learning Course

    ERIC Educational Resources Information Center

    Gerstenblatt, Paula

    2014-01-01

    Research on service learning has demonstrated positive outcomes in several areas of student learning; however, there is a scarcity of research examining the lived experiences of students. This study consisted of seventeen students from two cohorts enrolled in a service learning class working in a rural town. The current study suggests the…

  16. Information non précise sur la taille du pénis en République Démocratique du Congo: à propos de 21 sources

    PubMed Central

    Mulenga, Philippe Cilundika; Kazadi, Alex Bukasa

    2016-01-01

    Introduction La taille du pénis constitue une préoccupation de beaucoup des gens actuellement et certains ne sont pas satisfaits de la dimension de leur pénis comme le montre l’étude de Tiggemann en 2008. Il existe relativement peu d'études sur le pénis en érection. Cela peut refléter les tabous culturels des chercheurs ou des médecins en interaction avec les hommes qui sont dans un état d’excitation sexuelle. Toutes fois, il est important pour les personnes qui annoncent des détails sur la taille du pénis d’annoncer d’abord les repères de la mesure du pénis puis ensuite donner les chiffres que proposent les chercheurs. Méthodes Notre enquête de type descriptif transversale s’est effectuée dans les deux grandes villes de la République Démocratique du Congo à savoir la ville de Kinshasa et la ville de Lubumbashi, pendant une période de deux ans soit de Mai 2014 à Mai 2016. Au total, 21 sources d’information ont constitué notre échantillon dont 8 à Kinshasa et 13 à Lubumbashi et nous avons trouvé cela suffisant car les sujets à caractère sexuel sont souvent rares chez nous. Les paramètres étudiés étaient: la nature de la source, la précision de la technique de la mesure, la présence de référence bibliographique, la longueur annoncée du pénis. Résultats La majorité des sources d’information sont faites des émissions de radio et de télévision (23,8%), ceci pourra s’expliquer par le fait que dans notre milieu il y a de plus en plus des chaines de radio et télévision et surtout dans les grandes villes. Concernant la précision de la technique de la mesure du pénis lors du partage du message sur la taille du pénis, l’étude nous montre que la majorité des sources d’information ne signale pas cela lorsqu’elles annoncent la taille du pénis au public soit 85,7%. Plusieurs sources ne déclarent pas les références bibliographiques (57,1%). Lorsqu’on regarde même les chiffres de la taille du p

  17. Cholestéatome du méat acoustique externe

    PubMed Central

    Azeddine, Lachkar; Aabach, Ahmed; Chouai, Mohamed; Elayoubi, Fahd; Ghailan, Mohamed Rachid

    2016-01-01

    Le cholestéatome du méat acoustique externe se définit comme une accumulation de kératine en regard d’une érosion osseuse de nature ostéitique. C’est une entité otologique rare ou peut diagnostiquée. Le but de notre travail est d’illustrer sur la base d’un cas un cholestéatome du méat acoustique externe. Il s’agit d’un patient âgé de 65 ans diabétique et hypertendu sous traitement, présentant depuis 3 mois une otalgie droite intense, insomniante, avec hypoacousie, otorrhée purulente minime et paralysie faciale droite grade V. Le diagnostic évoqué était dans un premier temps celui d’otite externe maligne. Il a été mis sous traitement antibiotique sans amélioration. L’examen otologique a trouvé une lésion ulcéro-bourgeonnante de la paroi postérieure du méat acoustique externe droit, une biopsie systématique de la lésion a été pratiquée et a conclu à un cholestéatome. Le patient a bénéficié d’une tympanoplastie en technique ouverte. Le cholestéatome du méat acoustique externe est rare, la symptomatologie clinique n’est pas spécifique, le scanner des rocher est d’un grand apport pour le diagnostic positif montrant un cratère osseux du méat acoustique externe. Le traitement dépend de l’extension des lésions allant des simples soins locaux à une tympanoplastie en technique ouverte. Le cholestéatome du méat acoustique externe peut revêtir plusieurs aspects, et prêter confusion avec d’autres pathologies du méat acoustique externe. PMID:28154624

  18. Interim Service ISDN Satellite (ISIS) hardware experiment development for advanced ISDN satellite designs and experiments

    NASA Technical Reports Server (NTRS)

    Pepin, Gerard R.

    1992-01-01

    The Interim Service Integrated Service Digital Network (ISDN) Satellite (ISIS) Hardware Experiment Development for Advanced Satellite Designs describes the development of the ISDN Satellite Terminal Adapter (ISTA) capable of translating ISDN protocol traffic into Time Division Multiple Access (TDMA) signals for use by a communications satellite. The ISTA connects the Type 1 Network Termination (NT1) via the U-interface on the line termination side of the CPE to the RS-499 interface for satellite uplink. The same ISTA converts in the opposite direction the RS-499 to U-interface data with a simple switch setting.

  19. Interim Service ISDN Satellite (ISIS) hardware experiment design for advanced ISDN satellite design and experiments

    NASA Technical Reports Server (NTRS)

    Pepin, Gerard R.

    1992-01-01

    The Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) Hardware Experiment Design for Advanced Satellite Designs describes the design of the ISDN Satellite Terminal Adapter (ISTA) capable of translating ISDN protocol traffic into time division multiple access (TDMA) signals for use by a communications satellite. The ISTA connects the Type 1 Network Termination (NT1) via the U-interface on the line termination side of the CPE to the V.35 interface for satellite uplink. The same ISTA converts in the opposite direction the V.35 to U-interface data with a simple switch setting.

  20. Cancer du sein au Maroc: profil phénotypique des tumeurs

    PubMed Central

    Khalil, Ahmadaye Ibrahim; Bendahhou, Karima; Mestaghanmi, Houriya; Saile, Rachid; Benider, Abdellatif

    2016-01-01

    Le cancer du sein est le plus fréquent chez la femme et figure parmi les principales causes de mortalité liées au cancer. La curabilité de ce type tumoral est en augmentation, grâce aux programmes de dépistage et aux progrès thérapeutiques, qui ont certes augmenté la survie des patients. Mais des défis restent à relever en rapport avec l’instabilité phénotypique des cellules cancéreuses. L’objectif de ce travail est d’étudier le profil phénotypique du cancer du sein chez les patients pris en charge au Centre Mohammed VI pour le traitement des Cancers, durant les années 2013-2014. Il s’agit d’une étude transversale sur deux années, incluant les cas du cancer du sein pris en charge au Centre. Le recueil des données était fait à partir des dossiers des patients et analysés par le logiciel Epi Info. 1277 patients ont été pris en charge au sein de notre centre. 99,5% des cas de sexe féminin, l’âge moyen était 50,20 ± 11,34 ans. Le type histologique le plus fréquent était le carcinome canalaire infiltrant (80,7% des cas). Le stade diagnostic était précoce (56,9%). Le phénotype moléculaire le plus fréquent était le luminal A (41,4% des cas). Le luminal B, le HER2 et les triples négatifs étaient dans respectivement 10,4%, 6,3%, 11,2% des cas. L’étude du phénotype tumoral des patients atteints du cancer du sein permet l’orientation du clinicien dans le choix du traitement, et des décideurs dans la planification de programmes de lutte contre cette pathologie. PMID:28292037

  1. Experience from mental health clinics held during medical service camps in Fiji.

    PubMed

    Sivakumaran, Hemalatha; George, Kuruvilla; Naker, Gunu; Nadanachandran, Kathir

    2015-12-01

    We aim to describe the experience and findings of mental health clinics held during medical service camps in the rural settings of Fiji. Descriptive data collated at the end of the medical camps across 2011-2014 are used to highlight the main findings. The exposure to mental health assessments and brief interventions at these camps was a validating experience for both individuals and medical students attending the clinics. The most common presentations can be categorised under symptoms of depression, anxiety and relationship problems. The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  2. Identification d'une loi thermo-élasto-viscoplastique en vue de la modélisation du laminage à chaud du cuivre

    NASA Astrophysics Data System (ADS)

    Moureaux, P.; Moto Mpong, S.; Remy, M.; Bouffioux, C.; Lecomte-Beckers, J.; Habraken, A. M.

    2002-12-01

    la mise au point d'un modèle de simulation de la dernière passe du laminage à chaud du cuivre ne présente à priori pas de problème du point de vue numérique pour un code d'éléments finis non linéaire. La collecte d'informations précises tant sur le procédé industriel que sur le comportement du matériau est par contre une opération non triviale. Cet article présente les diverses méthodes expérimentales mises en œuvre pour caractériser le matériau : essais de compression à chaud, mesures d'analyse thermique différentielle, essais de dilatométrie et de diffusivité. Les méthodes permettant d'identifier les paramètres de la loi élasto-visco-plastique de type Norton-Hoff à partir des essais sont présentées et une analyse bibliographique investigue le problème de la détermination du module de Young à haute température. Tant les hypothèses supplémentaires relatives au procédé et nécessaires au modèle que les résultats finaux sont résumés.

  3. Deconstructing Pre-Service Teachers' Field Experience Narratives: The Role of Epistemological Beliefs

    ERIC Educational Resources Information Center

    Bays, Rebecca B.; Ashong, Carol; Ward, Teresa E.; Commander, Nannette E.

    2014-01-01

    Teacher development programs incorporate field experiences for pre-service teachers (PTs) to gain first hand teaching experiences. The purpose of this study is to examine PTs' perceptions of field experiences, and more specifically, to investigate whether these perceptions relate to PTs epistemological beliefs. A sample of 115 undergraduate…

  4. Structuring a palliative care service in Brazil: experience report.

    PubMed

    Garcia, João Batista Santos; Rodrigues, Rayssa Fiterman; Lima, Sara Fiterman

    2014-01-01

    in Brazil, palliative care (PC) is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. the hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. this experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  5. [Structuring a palliative care service in Brazil: experience report].

    PubMed

    Garcia, João Batista Santos; Rodrigues, Rayssa Fiterman; Lima, Sara Fiterman

    2014-01-01

    In Brazil, palliative care (PC) is not properly structured and that reality transforms this theme in a public health problem; therefore, initiatives become relevant in this context. This paper aims to share the experience that occurred in an oncology referral hospital in the State of Maranhão and present initiatives that helped in the development of PC Service. The hospital had an outpatient Pain and PC Service, but without specialized beds. The terminally ill patients stayed in common wards, which caused much unrest. A sensitization process was initiated in the hospital through initiatives, such as a photo contest called Flashes of Life and a ward called Room of Dreams, designed in partnership with the architecture course at the Universidade Estadual do Maranhão. The process culminated in the granting of wards to the PC and in the commitment of the Foundation, sponsor of the hospital, to run the project. This experience was a reproducible local initiative for the establishment of PC in a cancer hospital. Local initiatives are valuable in Brazil because they favor a significant number of patients and show its effectiveness in practice to governments and society. To structure a PC service, it is essential to establish priorities that include the assignment of drugs for management of symptoms, humanization, multidisciplinarity, sensitization and education of professionals. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Student Experiences Utilizing Disability Support Services in a University Setting

    ERIC Educational Resources Information Center

    Abreu, Marlene; Hillier, Ashleigh; Frye, Alice; Goldstein, Jody

    2016-01-01

    Students with disabilities are a growing population in post-secondary institutions, yet present poorer academic outcomes compared to students without disabilities. The current study examined university students' own perceptions and experiences with disability support services (SDS) including how helpful they found the accommodations they were…

  7. Properties, use and health effects of depleted uranium (DU): a general overview.

    PubMed

    Bleise, A; Danesi, P R; Burkart, W

    2003-01-01

    Depleted uranium (DU), a waste product of uranium enrichment, has several civilian and military applications. It was used as armor-piercing ammunition in international military conflicts and was claimed to contribute to health problems, known as the Gulf War Syndrome and recently as the Balkan Syndrome. This led to renewed efforts to assess the environmental consequences and the health impact of the use of DU. The radiological and chemical properties of DU can be compared to those of natural uranium, which is ubiquitously present in soil at a typical concentration of 3 mg/kg. Natural uranium has the same chemotoxicity, but its radiotoxicity is 60% higher. Due to the low specific radioactivity and the dominance of alpha-radiation no acute risk is attributed to external exposure to DU. The major risk is DU dust, generated when DU ammunition hits hard targets. Depending on aerosol speciation, inhalation may lead to a protracted exposure of the lung and other organs. After deposition on the ground, resuspension can take place if the DU containing particle size is sufficiently small. However, transfer to drinking water or locally produced food has little potential to lead to significant exposures to DU. Since poor solubility of uranium compounds and lack of information on speciation precludes the use of radioecological models for exposure assessment, biomonitoring has to be used for assessing exposed persons. Urine, feces, hair and nails record recent exposures to DU. With the exception of crews of military vehicles having been hit by DU penetrators, no body burdens above the range of values for natural uranium have been found. Therefore, observable health effects are not expected and residual cancer risk estimates have to be based on theoretical considerations. They appear to be very minor for all post-conflict situations, i.e. a fraction of those expected from natural radiation.

  8. The Customer Service Experience.

    ERIC Educational Resources Information Center

    Bell, Chip R.

    2001-01-01

    Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

  9. Experiences of selected countries in the use of public-private partnership in hospital services provision.

    PubMed

    Sadeghi, Ahmad; Barati, Omid; Bastani, Peivand; Jafari, Davood Danesh; Etemadian, Masoud

    2016-11-01

    To review the experiences of selected countries in the use of public-private partnership in the provision of hospital services. This comparative study was conducted in 2015 in Iran. To collect data, valid databases as well as articles, theses, reports and related books in the field of private-sector partnership in hospital services were employed. Using purposive sampling, countries such as the United Kingdom, Spain, Canada, Turkey, Australia and Lesotho, which had successful experiences in the field of application of the public-private partnership in hospital services, were included. Likewise, the only experience in Iran in this field was also reviewed. Studies done between 1980 and 2015 were examined. The results obtained from each country were compared. Implementing public-private partnership had great and valuable outcomes and achievements for governmental hospitals. Moreover, clinical and nonclinical service delivery, hospital utilisation and management along with building, repairing and supportive operations through public-private partnership contracts can be differently divided among the partners. Furthermore, duration of the projects ranged from 12 to 40 years in different countries, depending on the type of the model used. A successful experience in the use of the public-private partnership in the provision of hospital services was observed.

  10. Probing Pre-and In-Service Physics Teachers' Knowledge Using the Double-Slit Thought Experiment

    ERIC Educational Resources Information Center

    Asikainen, Mervi A.; Hirvonen, Pekka E.

    2014-01-01

    This study describes the use of the double-slit thought experiment as a diagnostic tool for probing physics teachers' understanding. A total of 9 pre-service teachers and 18 in-service teachers with a variety of different experience in modern physics teaching at the upper secondary level responded in a paper-and-pencil test and three of these…

  11. The Use of Service Blueprinting as a Method of Improving Non-Academic College Student Experiences

    ERIC Educational Resources Information Center

    Roberts, J. Will

    2017-01-01

    Service blueprinting offers a method for analyzing and improving service experiences. This service design technique is commonly used in many service industries, but research exploring its application within a higher education context is very limited. The purpose of this case study was to describe the use and effects of extensive service…

  12. Marketing Library and Information Services: Comparing Experiences at Large Institutions.

    ERIC Educational Resources Information Center

    Noel, Robert; Waugh, Timothy

    This paper explores some of the similarities and differences between publicizing information services within the academic and corporate environments, comparing the marketing experiences of Abbot Laboratories (Illinois) and Indiana University. It shows some innovative online marketing tools, including an animated gif model of a large, integrated…

  13. Older LGBT people's experiences and concerns with healthcare professionals and services in Ireland.

    PubMed

    Sharek, Danika Burke; McCann, Edward; Sheerin, Fintan; Glacken, Michele; Higgins, Agnes

    2015-09-01

    The specific healthcare needs and concerns for older lesbian, gay, bisexual and transgender (LGBT) persons have not been explored to any degree within Ireland. The aim of this paper, which is part of a larger study, is to detail older LGBT persons' usage, experiences and concerns with accessing healthcare services, disclosing their LGBT identity to professionals, preferences for care and their suggestions for improvement in services, including nursing services. A mixed methods research design combining quantitative survey and qualitative interview approaches of equal significance was used. 144 respondents completed an 84-item questionnaire concerning their use of healthcare services, experiences and needs. The qualitative phase involved in-depth interviews where 36 participants' experiences and concerns around health services were explored more in-depth. Quantitative data were analysed using descriptive statistics. Qualitative analysis employed the constant comparative process to generate the leading themes. Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues, and less than half (43%) felt respected as an LGBT person by healthcare professionals. Although 26% had chosen not to reveal their LGBT status for fear of a negative response, many positive encounters of coming out to healthcare professionals were relayed in the interviews. LGBT persons have specific concerns around residential care, particularly in relation to the perception that the Irish healthcare services emanate a heteronormative culture. Irish healthcare services need to reflect on how they currently engage with older LGBT persons at both an organisational and practitioner level. Consideration needs to be given to the specific concerns of ageing LGBT persons, particularly in relation to long-term residential care. Healthcare practitioners need to be knowledgeable of, and sensitive to, LGBT issues. © 2014 John Wiley & Sons Ltd.

  14. Preservice Teachers as Change Agents: Going the Extra Mile in Service-Learning Experiences

    ERIC Educational Resources Information Center

    Marchel, Carol A.; Shields, Carol; Winter, Linda

    2011-01-01

    Educational psychologists involved in teacher education are expected to develop professional teacher dispositions of preservice students. The professional disposition "teacher as change agent" is used to frame actions in service-learning field experiences in a teacher preparation program. Preservice teacher service-learning journals, self-ratings,…

  15. Pre-Service English Teachers' Perceptions and Practice of Field Experience and Professional Learning from Expert Teachers' Mentoring

    ERIC Educational Resources Information Center

    Chien, Chin-Wen

    2015-01-01

    Though it is well known that pre-service teachers' field experiences are recognized as key to enhancing teaching practice, Taiwanese pre-service teachers who take "Teaching Methods and Materials" in elementary school's seven areas often complain that they lack field experience. They do not have the opportunity to experience teaching…

  16. Service user experiences of specialist mental health supported accommodation: A systematic review of qualitative studies and narrative synthesis.

    PubMed

    Krotofil, Joanna; McPherson, Peter; Killaspy, Helen

    2018-04-02

    Specialist supported accommodation services have become a key component of most community-based mental healthcare systems. While mental health policies highlight the importance of service user involvement in service development and care planning, there are no comprehensive literature reviews synthesising services users' perspectives on, or experiences of, supported accommodation services. This systematic review was undertaken to fill this gap. We searched electronic databases (January 2015, updated June 2017), conducted hand searches and used forward-backward snowballing to identify 13,678 papers. We inspected the full-text of 110 papers and included 50 of these in the final review. Data extraction and quality assessments were conducted. We used narrative synthesis to develop a conceptual model of service users' experiences that included structural, process, relational and contextual factors, such as the characteristics of the service, relationships with staff and other service users, the intensity and nature of support, the physical environment, and social and community integration. The review highlights the complex interplay of individual, service-level and community factors in shaping the lived experience of service users and their impact on personal identity and recovery. Our approach addressed some of the widely reported limitations of the quantitative research in this field, providing a conceptual model relevant to service user experiences across supported accommodation service types, population groups and countries. © 2018 John Wiley & Sons Ltd.

  17. Stakeholder experiences with general practice pharmacist services: a qualitative study.

    PubMed

    Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

    2013-09-11

    To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

  18. La santé des Premières nations, des Inuits et des Métis: les facteurs que doivent envisager les leaders en santé canadiens dans la foulée du rapport de la Commission de vérité et réconciliation du Canada.

    PubMed

    McNally, Mary; Martin, Debbie

    2017-03-01

    Les peuples des Premières nations, inuits et métis qui habitent au Canada sont aux prises avec de profondes disparités en matière de santé par rapport aux Canadiens non autochtones, et ce, dans presque toutes les mesures liées à la santé et au bien-être. Pour faire progresser les services de santé auprès des peuples autochtones, il faut passer à l'action dans tous les ordres de prestation des soins et des politiques en santé. Il est donc essentiel que les leaders et les prestataires des établissements, des systèmes et des installations de santé du Canada comprennent et prennent en main les déterminants de la santé propres aux peuples autochtones, y compris l'héritage du colonialisme et le racisme ancien et actuel. La Commission de vérité et réconciliation du Canada est le point de départ pour réagir de manière positive aux injustices.

  19. Limb shape observations at the Pic du Midi Observatory. Determination of the solar gravitational moments

    NASA Astrophysics Data System (ADS)

    Rozelot, J. P.; Lefebvre, S.

    The accurate shape of the Sun has been actively debated since 1974. So far, balloon and satellite experiments achieved the required sensibility to measure the expected small asphericities of the solar limb shape. However, exceptional good meteorological conditions encountered during several missions at the Pic du Midi Observatory have permitted to measure the coefficients shape of the solar limb on the two first Legendre polynomials expansion. In theory, this photospheric outer shape is sensitive to the interior rate, and asphericities can be explained both in terms of gravitational moments and thermal wind. We present observations made at the Pic du Midi Observatory and we compare results with these obtained by SDS (Sofia et al., 1994, 1996) and SOHO/MDI (Kuhn, 1999). The accepted and dedicated PICARD space mission on this subject is briefly presented.

  20. Can patient experience with service quality predict survival in colorectal cancer?

    PubMed

    Gupta, Digant; Lis, Christopher G; Rodeghier, Mark

    2013-01-01

    Despite the recognized relevance of symptom burden in colorectal cancer, there has been limited exploration of whether an individual patient's assessment of the overall quality-of-care received might influence outcome. We evaluated the relationship between patient-reported experience with service quality and survival in 702 returning colorectal cancer patients treated at our institution between July 2007 and December 2010. Overall patient experience "considering everything, how satisfied are you with your overall experience?" was measured on a 7-point Likert scale ranging from completely dissatisfied to completely satisfied. It was dichotomized into two categories: top box response (7) versus all others (1-6). Cox regression was used to evaluate the association between patient experience and survival. Of 702 patients, 506 were "completely satisfied" while 196 were not. On univariate analysis, "completely satisfied" patients had a significantly lower risk of mortality compared to those "not completely satisfied" (hazard ratio [HR] = 0.78; 95% confidence interval [CI]: 0.61-0.98; p = .04). Similarly, on multivariate analysis controlling for stage at diagnosis, treatment history, age, and gender, "completely satisfied" patients demonstrated significantly lower mortality (HR = 0.74; 95% CI: 0.58-0.95; p = .02). Patient experience with service quality was an independent predictor of survival in colorectal cancer, a novel finding in the literature. © 2012 National Association for Healthcare Quality.

  1. Annealing of (DU-10Mo)-Zr Co-Rolled Foils

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pacheco, Robin Montoya; Alexander, David John; Mccabe, Rodney James

    2017-01-20

    Producing uranium-10wt% molybdenum (DU-10Mo) foils to clad with Al first requires initial bonding of the DU-10Mo foil to zirconium (Zr) by hot rolling, followed by cold rolling to final thickness. Rolling often produces wavy (DU-10Mo)-Zr foils that should be flattened before further processing, as any distortions could affect the final alignment and bonding of the Al cladding to the Zr co-rolled surface layer; this bonding is achieved by a hot isostatic pressing (HIP) process. Distortions in the (DU-10Mo)-Zr foil may cause the fuel foil to press against the Al cladding and thus create thinner or thicker areas in the Almore » cladding layer during the HIP cycle. Post machining is difficult and risky at this stage in the process since there is a chance of hitting the DU-10Mo. Therefore, it is very important to establish a process to flatten and remove any waviness. This study was conducted to determine if a simple annealing treatment could flatten wavy foils. Using the same starting material (i.e. DU-10Mo coupons of the same thickness), five different levels of hot rolling and cold rolling, combined with five different annealing treatments, were performed to determine the effect of these processing variables on flatness, bonding of layers, annealing response, microstructure, and hardness. The same final thickness was reached in all cases. Micrographs, textures, and hardness measurements were obtained for the various processing combinations. Based on these results, it was concluded that annealing at 650°C or higher is an effective treatment to appreciably reduce foil waviness.« less

  2. The Effect of Teaching Experience on Service-Learning Beliefs of Dental Hygiene Educators

    ERIC Educational Resources Information Center

    Burch, Sharlee Shirley

    2013-01-01

    The purpose of this non-experimental causal-comparative study was to determine if service-learning teaching experience affects dental hygiene faculty perceptions of service-learning benefits and barriers in the United States. Dental hygiene educators from entry-level dental hygiene education programs in the United States completed the Web-based…

  3. Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention.

    PubMed

    Wallace, Genevieve; Bird, Victoria; Leamy, Mary; Bacon, Faye; Le Boutillier, Clair; Janosik, Monika; MacPherson, Rob; Williams, Julie; Slade, Mike

    2016-09-01

    Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships. Interviews (n = 24) and two focus groups (n = 13) were conducted as part of a process evaluation and included a purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data. Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention. Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured.

  4. Mental Health Services for Children and Adolescents with Learning Disabilities: A Review of Research on Experiences of Service Users and Providers

    ERIC Educational Resources Information Center

    Jacobs, Myrthe; Downie, Helen; Kidd, Gill; Fitzsimmons, Lorna; Gibbs, Susie; Melville, Craig

    2016-01-01

    Background: Children and young people with learning disabilities experience high rates of mental health problems. Methods: The present study reviewed the literature on mental health services for children with learning disabilities, to identify known models of service provision and what has been experienced as effective or challenging in providing…

  5. Immigrant women's experiences of maternity-care services in Canada: a systematic review using a narrative synthesis.

    PubMed

    Higginbottom, Gina M A; Morgan, Myfanwy; Alexandre, Mirande; Chiu, Yvonne; Forgeron, Joan; Kocay, Deb; Barolia, Rubina

    2015-02-11

    Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. Our focus was on (a) the accessibility and acceptability of maternity-care services for immigrant women and (b) the effects of the perceptions and experiences of these women on their birth and postnatal outcomes. We conducted a systematic review using a systematic search and narrative synthesis of peer-reviewed and non-peer-reviewed reports of empirical research, with the aim of providing stakeholders with perspectives on maternity-care services as experienced by immigrant women. We partnered with key stakeholders ('integrated knowledge users') to ensure the relevancy of topics and to tailor recommendations for effective translation into future policy, practice and programming. Two search phases and a three-stage selection process for published and grey literature were conducted prior to appraisal of literature quality and narrative synthesis of the findings. Our knowledge synthesis of maternity care among immigrants to Canada provided a coherent evidence base for (a) eliciting a better understanding of the factors that generate disparities in accessibility, acceptability and outcomes during maternity care; and (b) improving culturally based competency in maternity care. Our synthesis also identified pertinent issues in multiple sectors that should be addressed to

  6. Les campagnes communautaires de promotion du depistage VIH en Afrique de l’Ouest : perceptions des usagers au Burkina Faso

    PubMed Central

    Desclaux, Alice; Ky-Zerbo, Odette; Somé, Jean-François; Makhlouf-Obermeyer, Carla

    2014-01-01

    Résumé La politique actuelle de lutte contre le sida qui repose sur l’extension de l’accès aux traitements et à la prévention exige qu’une proportion élevée de la population connaisse son statut en matière de VIH. Pour cela, l’OMS a proposé le développement de stratégies communautaires délivrant le dépistage et le conseil au-delà des services de soins, comme le test à domicile ou les campagnes de sensibilisation et dépistage de grande envergure, appliqués en Afrique australe et de l’Est. Pour définir les stratégies pertinentes dans des régions de basse prévalence comme l’Afrique de l’Ouest, les expériences communautaires de promotion du dépistage doivent y être évaluées. Cet article présente une évaluation des campagnes au Burkina Faso du point de vue des usagers. Dans le cadre d’un projet sur les pratiques et l’éthique du dépistage dans quatre pays africains (MATCH), une enquête qualitative spécifique a été menée pendant la campagne de 2008, auprès de personnes ayant fait le test pendant la campagne, ayant fait le test hors campagne ou n’ayant pas fait le test. Les appréciations sont globalement très favorables aux campagnes, notamment à cause de l’information dispensée, l’accessibilité des sites, la gratuité du test, la qualité des services et l’effet d’entrainement. Les limites ou critiques sont essentiellement liées à l’affluence ou à la crainte de ne pas être soutenu en cas de résultat positif. La démarche de recours au test ne fait plus l’objet de suspicion, au moins pendant la campagne. Cette « normalisation » du recours au test et la mobilisation collective facilitent des pratiques en groupe, ce qui peut rendre difficile de garder son statut VIH secret. L’évaluation des campagnes par les usagers les présente comme une opportunité pour accéder facilement au test et pour communiquer à ce sujet dans divers espaces sociaux à partir des informations délivrées sur le VIH

  7. Practicum Experiences as Sources of Pre-Service Teachers' Self-Efficacy

    ERIC Educational Resources Information Center

    Martins, Maria; Costa, João; Onofre, Marcos

    2015-01-01

    This study examines physical education pre-service teachers' (PTs) self-efficacy and practicum experiences as self-efficacy sources through a mixed-method approach. For the quantitative phase, a self-efficacy questionnaire was applied to 141 PTs. Results showed a stronger self-efficacy in the relationship with students and discipline promotion.…

  8. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study.

    PubMed

    Hovish, Kimberly; Weaver, Tim; Islam, Zoebia; Paul, Moli; Singh, Swaran P

    2012-01-01

    The aim of this study was to describe the experiences of child and adolescent mental health service (CAMHS) users, parents and professionals in relation to transition between CAMHS and adult mental health services (AMHS) in the United Kingdom. Young people were sampled from an observational study population of people reaching the transition boundary between CAMHS and AMHS. We thematically analyzed qualitative interviews with service users, parents and clinicians. Eleven service users were interviewed and linked interviews were completed with parents (n=6), and responsible clinicians in CAMHS (n=3) and AMHS (n=6). Informal and gradual preparation, transfer planning meetings, periods of parallel care, and consistency in key-workers promoted positive experiences of transition. Transfers between AMHS, changes of key-worker and waiting lists were viewed negatively. Other life transitions, including changes in housing, pregnancy, physical illness, and the involvement of parents or other services were sometimes powerful extraneous influences on transition experiences. The cumulative effect of multiple transitions is a complex and unsettling experience for many service users. Service user experiences are more likely to be positive if healthcare transition is a gradual process, tailored to the young person's needs and managed in the context of the other simultaneous practical, developmental and psychosocial transitions. Transfer planning meetings and parallel care were valued by all parties and should be standard practice at transition. CAMHS and AMHS need to work jointly to improve the transition process in these ways in order to enhance the outcomes for young people.

  9. An alternative for cost-effective remediation of depleted uranium (DU) at certain environmental restoration sites.

    PubMed

    Miller, M; Galloway, B; VanDerpoel, G; Johnson, E; Copland, J; Salazar, M

    2000-02-01

    Numerous sites in the United States and around the world are contaminated with depleted uranium (DU) in various forms. A prevalent form is fragmented DU originating from various scientific tests involving high explosives and DU during weapon development programs, at firing practice ranges, or war theaters where DU was used in armor-piercing projectiles. The contamination at these sites is typically very heterogeneous, with discreet, visually identifiable DU fragments mixed with native soil. That is, the bulk-averaged DU activity is quite low, while specific DU fragments, which are distinct from the soil matrix, have much higher specific activity. DU is best known as a dark, black metal that is nearly twice as dense as lead, but DU in the environment readily weathers (oxidizes) to a distinctive bright yellow color that is readily visible. While the specific activity (amount of radioactivity per mass of soil) of DU is relatively low and presents only a minor radiological hazard, the fact that it is radioactive and visually identifiable makes it desirable to remove the DU "contamination" from the environment. The typical approach to conducting this DU remediation is to use radiation detection instruments to identify the contaminant and separate it from the adjacent soil, packaging it for disposal as radioactive waste. This process can be performed manually or by specialized, automated equipment. Alternatively, in certain situations a more cost-effective approach might be simple mechanical or gravimetric separation of the DU fragments from the host soil matrix. At SNL/NM, both the automated and simple mechanical approaches have recently been employed. This paper discusses the pros/cons of the two approaches.

  10. Cognitive Disequilibrium and Service-Learning in Physical Education Teacher Education: Perceptions of Pre-Service Teachers in a Study Abroad Experience

    ERIC Educational Resources Information Center

    Ward, Stephen; Pellet, Heidi Henschel; Perez, Mark I.

    2017-01-01

    Purpose: The purpose of this study was to explore preservice teachers' experiences of cognitive disequilibrium (CD) theory during a service-learning project in a study abroad experience. Method: A case study with 8 participants was used. Data sources consisted of: Formal interviews, videos of planning, videos of teaching, videos of reflection…

  11. Prioritising wheelchair services for children: a pilot discrete choice experiment to understand how child wheelchair users and their parents prioritise different attributes of wheelchair services.

    PubMed

    Bray, Nathan; Yeo, Seow Tien; Noyes, Jane; Harris, Nigel; Edwards, Rhiannon Tudor

    2016-01-01

    Approximately 95 million children worldwide are disabled; 10 % use a wheelchair. In the UK, an estimated 770,000 children are disabled. National Health Service Wheelchair Services are the largest provider of wheelchairs in the UK; however, recent reports have highlighted issues with these services. This study explores the use of discrete choice experiment methods to inform wheelchair service provision for disabled children based on service user preferences. The aim was to explore how disabled children and their parents prioritise different attributes of wheelchair services. The secondary aims were to compare priorities between parents and disabled children and to explore marginal rate of substitution for incremental changes in attributes. Discrete choice experiments are a method of attribute-based stated preference valuation used by health economists to understand how individuals prioritise different attributes of healthcare services and treatments. We conducted the first pilot discrete choice experiment to explore how disabled children (aged 11 to 18) and their parents prioritise different attributes of hypothetical wheelchair services. Eleven disabled children (aged 11 to 18) and 30 parents of disabled children completed eight pairwise choice tasks based on five service attributes: wheelchair assessment, cost contribution, training, delivery time and frequency of review. Data were analysed using conditional logistic regression. For each pairwise choice, the participants were asked to choose which service scenario (A or B) they preferred. Comprehensiveness of wheelchair assessment and wheelchair delivery time significantly ( P  < 0.05) affected service preferences of children ( β -coefficients = 1.43 [95 % bootstrapped CI = 1.42 to 2.08] and -0.92 [95 % bootstrapped CI = -1.41 to -0.84], respectively) and parents ( β -coefficients = 1.53 [95 % bootstrapped CI = 1.45 to 2.16] and -1.37 [95 % bootstrapped CI = -1.99 to -1

  12. W.E.B. DuBois and the Concepts of Race and Class.

    ERIC Educational Resources Information Center

    Green, Dan S.; Smith, Earl

    1983-01-01

    Summarizes and analyzes W.E.B. DuBois's publications on race and class, particularly as he observed the relationships between White and Black Americans from about 1890 to the 1960s. Contends that DuBois's work has been seriously underrated and cites William J. Wilson's work as corroborating and extending DuBois's theories. (CJM)

  13. Meeting of the Minds: Perceptions of and Experiences with School-Based Health Services

    ERIC Educational Resources Information Center

    Amati, Jill Priest

    2011-01-01

    The purpose of this research is to understand the meanings and perceptions that families, teachers, and school-based service providers on the Westside in Syracuse, New York ascribe to school-based mental health services. The Westside is an economically disadvantaged and under-resourced neighborhood where children experience a great deal of stress…

  14. Midwives' perceptions and experiences of engaging fathers in perinatal services.

    PubMed

    Rominov, Holly; Giallo, Rebecca; Pilkington, Pamela D; Whelan, Thomas A

    2017-08-01

    The active engagement of fathers in maternity care is associated with long-term benefits for the father, their partner, and their child. Midwives are ideally placed to engage fathers, but few studies have explored midwives' experiences of working with men. Therefore, the aim of this study was to describe midwives' perceptions and experiences of engaging fathers in perinatal services. A multi-method approach was utilised. Registered midwives (N=106) providing perinatal services to families in Australia participated in an online survey. Of these, 13 also participated in semi-structured telephone interviews. Descriptive analyses summarised the online survey data. The interview data were coded using semantic thematic analysis. Survey results indicated that midwives unanimously agreed that engaging fathers is part of their role and acknowledged the importance of receiving education to develop knowledge and skills about fathers. Analysis of the telephone interviews led to the identification of a range of strategies, facilitators and barriers to engaging fathers in midwifery services. Some of these were related to characteristics of midwives, factors related specifically to fathers, and several external factors relating to organisational policies. Findings from this study could inform maternity health care policies, as well the development of resources, education and ongoing professional training for midwives to promote father-inclusive practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  15. The steam laboratory of the Institut de Médecine Navale du Service de Santé des Armées: a set of tools in the service of the French Navy.

    PubMed

    Desruelle, Anne-Virginie; Schmid, Bruno

    2004-09-01

    Accidental exposure to hot water steam is a potential risk in the French Navy, and particularly on nuclear submarines or ships. Direct human exposure to this extreme environment during an accident leads to death in a short time. In order to protect the crew members of the French Navy, a laboratory was created at the Institut de Médecine Navale du Service de Santé des Armées (IMNSSA). A set of tools was developed to study the effects of exposure to hot water steam atmospheres on human physiology and on the protective capacities of textile fabrics and equipment. A testing device allows the quantification of the protective capacities of fabrics under steam stresses. A thermal manikin and a steam climatic chamber allow the evaluation of the protective capacities of equipment. The tests on fabrics and on garments were in good agreement. Water vapour impermeable fabrics and garments provide greater protection in steamy conditions. Moreover, the thicker the sample or garment, the higher the protection it gives. Care should be taken to verify that fabrics keep their thermal characteristics under steam stress. These characteristics, measured under standard comfortable conditions, are not always indicative of the protective abilities of the fabrics under steamy conditions.

  16. Sustainable growth, the DuPont way.

    PubMed

    Holliday, C

    2001-09-01

    Like many manufacturers, DuPont traditionally has grown by making more and more "stuff." And its business growth has been proportional to the amount of raw materials and energy used--as well as the resulting waste and emissions from operations. Over the years, though, DuPont became aware that cheap supplies of nonrenewable resources wouldn't be endlessly available and that the earth's ecosystems couldn't indefinitely absorb the waste and emissions of production and consumption. Chad Holliday, chairman and CEO of DuPont, believes strongly in the challenge of sustainable growth and makes the business case for it: By using creativity and scientific knowledge effectively, he says, companies can provide strong returns for shareholders and grow their businesses--while also meeting the human needs of societies around the world and reducing the environmental footprint of their operations and products. In fact, a focus on sustainability can help identify new products, markets, partnerships, and intellectual property and lead to substantial business growth. Holliday describes how DuPont developed a three-pronged strategy to translate the concept of sustainability into nuts-and-bolts business practices. Focusing on integrated science, knowledge intensity, and productivity improvement, the strategy was accompanied by a new way to measure progress quantitatively. Sustainable growth should be viewed not as a program for stepped-up environmental performance but as a comprehensive way of doing business, one that delivers tremendous economic value and opens up new opportunities. Ultimately, companies will find that they can generate substantial business value through sustainability while both enhancing the quality of life around the world and protecting the environment.

  17. Sexual Health Services and Education: Young People's Experiences and Preferences

    ERIC Educational Resources Information Center

    Reeves, C.; Whitaker, R.; Parsonage, R. K.; Robinson, C. A.; Swale, K.; Bayley, L.

    2006-01-01

    Objective: To examine young people's requirements and perceptions of sexual health services and education in the context of their experience of sexual relationships and knowledge of sexual health. Design: A questionnaire based cohort study. Setting: Three hundred and sixty Year 11 students (aged 15-16 years) surveyed in three Secondary Schools.…

  18. Facteurs de risque de mortalité chez les nouveaux-nés transférés au service de néonatologie de l'Hôpital Jason Sendwe de Lubumbashi, République Démocratique du Congo

    PubMed Central

    Katamea, Tina; Mukuku, Olivier; Kamona, Lewis; Mukelenge, Kethye; Mbula, Otikeke; Baledi, Lambert; Ntambwe, Emile; Mutombo, Augustin Mulangu; Wembonyama, Stanis Okitotsho; Luboya, Oscar Numbi

    2014-01-01

    Introduction La mortalité néonatale reste préoccupante dans notre milieu et plusieurs facteurs dont ceux liés à l'organisation du transfert de nouveau-nés au niveau des structures de prise en charge y contribuent. Les objectifs de notre étude sont de déterminer la fréquence du transfert néonatal extrahospitalier à l'unité de néonatologie et identifier les facteurs de risque de mortalité dans notre milieu. Méthodes Il s'agit d'une étude prospective et analytique menée sur une période de douze mois allant du 1er Janvier 2012 au 31 décembre 2012 ayant ciblé tous les nouveau-nés transférés des maternités extérieurs, traités et suivis dans le service de néonatologie de l'hôpital Sendwe. Les caractéristiques maternelles (âge, parité, état-civil, profession, niveau d’étude, antécédents médicaux et toxicologiques) et perpartales (âge gestationnel, état de la poche des eaux, voie d'accouchement) et néonataux (âge lors du transfert, sexe, poids de naissance, moyen de transfert, motif de transfert et évolution (guérison ou décès)) ont été étudiés. La saisie et l'analyse des données ont été faites sur le logiciel Epi Info 2011 (version 7.0.8.3) et le seuil de signification de 5%. Résultats La fréquence du transfert néonatal extrahospitalier est de 12,9%. La mortalité était significativement liée à la profession (vendeuse ou travailleuse) de la mère (OR = 7,43 (1,38-39,97)), au niveau d’étude élevé (OR = 4,22 (1,18-15,10)), à l’âge gestationnel <37 SA (OR=3,21 (1,46-7,06)), à l’accouchement par voie basse de manière dystocique (OR=6,50 (1,54-27,38)), au sexe masculin du nouveau-né (OR=2,43 (1,08-5,46)), au poids de naissance <1500 grammes (OR=15,3 (5,73-40,78)) et à la prématurité comme motif de transfert (OR=5,56 (1,47-20,98)). Conclusion Le bilan de la mortalité néonatale est lourd dans les pays en développement où les nouveau-nés continuent de mourir pour des causes souvent évitables. La r

  19. A descriptive phenomenology study of newcomers’ experience of maternity care services: Chinese women’s perspectives

    PubMed Central

    2014-01-01

    Background Maternity health care available in Canada is based on the needs of women born in Canada and often lacks the flexibility to meet the needs of immigrant women. The purpose of this study was to explore immigrant Chinese women’s experiences in accessing maternity care, the utilization of maternity health services, and the obstacles they perceived in Canada. Methods This descriptive phenomenology study used in-depth semi-structured interviews to examine immigrant Chinese women’s experiences. Fifteen participants were recruited from the Chinese community in Toronto, Canada by using purposive sampling. The interviews were digitally recorded and transcribed verbatim into written Chinese. The transcripts were analyzed using Colaizzi’s (1978) phenomenological method. Results Six themes were extracted from the interviews: (1) preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, (2) strategies to deal with the inconvenience of the Canadian healthcare system (3) multiple resources to obtain pregnancy information, (4) the merits of the Canadian healthcare system, (5) the need for culturally sensitive care, and (6) the emergence of alternative supports and the use of private services. Conclusions The findings provide new knowledge and understanding of immigrant Chinese women’s experiences in accessing maternity health services within a large metropolitan Canadian city. Participants described two unique experiences within the themes: preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, and the emergence of alternative supports and the use of private services. Few studies of immigrant maternity service access have identified these experiences which may be linked to cultural difference. Further investigation with women from different cultural backgrounds is needed to develop a comprehensive understanding of immigrant women’s experiences with

  20. An introductory pharmacy practice experience based on a medication therapy management service model.

    PubMed

    Agness, Chanel F; Huynh, Donna; Brandt, Nicole

    2011-06-10

    To implement and evaluate an introductory pharmacy practice experience (IPPE) based on the medication therapy management (MTM) service model. Patient Care 2 is an IPPE that introduces third-year pharmacy students to the MTM service model. Students interacted with older adults to identify medication-related problems and develop recommendations using core MTM elements. Course outcome evaluations were based on number of documented medication-related problems, recommendations, and student reviews. Fifty-seven older adults participated in the course. Students identified 52 medication-related problems and 66 medical problems, and documented 233 recommendations relating to health maintenance and wellness, pharmacotherapy, referrals, and education. Students reported having adequate experience performing core MTM elements. Patient Care 2 may serve as an experiential learning model for pharmacy schools to teach the core elements of MTM and provide patient care services to the community.

  1. Women's experiences seeking publicly funded family planning services in Texas.

    PubMed

    Hopkins, Kristine; White, Kari; Linkin, Fran; Hubert, Celia; Grossman, Daniel; Potter, Joseph E

    2015-06-01

    Little is known about low-income women's and teenagers' experiences accessing publicly funded family planning services, particularly after policy changes are made that affect the cost of and access to such services. Eleven focus groups were conducted with 92 adult women and 15 teenagers in nine Texas metropolitan areas in July-October 2012, a year after legislation that reduced access to subsidized family planning was enacted. Participants were recruited through organizations that serve low-income populations. At least two researchers independently coded the transcripts of the discussions and identified main themes. Although most women were not aware of the legislative changes, they reported that in the past year, they had had to pay more for previously free or low-cost services, use less effective contraceptive methods or forgo care. They also indicated that accessing affordable family planning services had long been difficult, that applying and qualifying for programs was a challenge and that obtaining family planning care was harder than obtaining pregnancy-related care. As a result of an inadequate reproductive health safety net, women experienced unplanned pregnancies and were unable to access screening services and follow-up care. Teenagers experienced an additional barrier, the need to obtain parental consent. Some women preferred to receive family planning services from specialized providers, while others preferred more comprehensive care. Women in Texas have long faced challenges in obtaining subsidized family planning services. Legislation that reduced access to family planning services for low-income women and teenagers appears to have added to those challenges. Copyright © 2015 by the Guttmacher Institute.

  2. Too close to home? Experiences of Kurdish refugee interpreters working in UK mental health services.

    PubMed

    Green, Hannah; Sperlinger, David; Carswell, Kenneth

    2012-06-01

    Despite their essential role in the National Health Service, there is limited research on the experiences of refugee interpreters. To explore Kurdish refugee interpreters' experiences of working in UK mental health services. Six participants were interviewed and data collected were analysed using interpretative phenomenological analysis. The results showed that interpreters often felt overwhelmed by the emotional impact of interpreting in mental health services, particularly at the beginning of their careers. Interpreters struggled to negotiate complex and unclear roles and responsibilities. Interpreting for refugees with shared histories was particularly challenging. The study recommends that interpreters working in mental health services receive training on mental health issues and self-care and are assisted by frameworks to help make sense of the impact of the work, such as supervision.

  3. Centralization of a regional clinical microbiology service: The Calgary experience

    PubMed Central

    Church, Deirdre L; Hall, Paula

    1999-01-01

    Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS) in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA) and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL). Because the HVL is not located in a hospital, rapid response laboratories (RRLs) are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service. PMID:22346397

  4. Parents with mental illness - a qualitative study of identities and experiences with support services.

    PubMed

    Jones, M; Pietilä, I; Joronen, K; Simpson, W; Gray, S; Kaunonen, M

    2016-10-01

    WHAT IS KNOWN ON THE SUBJECT?: According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature. Parental mental illness can often be viewed from a risk perspective. Parents with mental illness and their families have unmet support needs. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Parents with mental illness want acknowledgement that they can be able and responsible. Many parents adopt an expert by experience identity. Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Adult mental health services need to recognize and support parental role of service users. Joint care planning and family oriented care should be promoted. Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development. Introduction Parental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. Aim This study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. Method Three focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. Results Adult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. Discussion Being able to see oneself as a 'good' parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families

  5. Creating Space for Teacher Activism in Environmental Education: Pre-Service Teachers' Experiences

    ERIC Educational Resources Information Center

    Campigotto, Rachelle; Barrett, Sarah E.

    2017-01-01

    Ontario, Canada mandates integrating environmental education (EE) into all subject areas from K-12, but pre-service teachers receive little to no instruction on how to do so. This study focusses on the experiences of 13 pre-service students who demonstrated their passion for EE through their own activism and volunteerism. Findings include the…

  6. In-Service Physical Educators' Experiences of Online Adapted Physical Education Endorsement Courses.

    PubMed

    Sato, Takahiro; Haegele, Justin A; Foot, Rachel

    2017-04-01

    The purpose of this study was to investigate in-service physical education (PE) teachers' experiences during online adapted physical education (APE) graduate courses. Based on andragogy theory (adult learning theory) we employed a descriptive qualitative methodology using an explanatory case study design. The participants (6 female and 3 male) were in-service PE teachers enrolled in an online graduate APE endorsement program. Data collection included journal reflection reports and face-to-face interviews. A constant comparative method was used to interpret the data. Three interrelated themes emerged from the participants' narratives. The first theme, instructor communication, exposes the advantages and disadvantages the participants perceived regarding communication while enrolled in the online APE graduate courses. The second theme, bulletin board discussion experiences, described participants' perceptions of the use of the bulletin board discussion forum. Lastly, the final theme, assessment experiences, described how the participants learned knowledge and skills through online courses related to assessment and evaluation.

  7. High-Performance Scalable Information Service for the ATLAS Experiment

    NASA Astrophysics Data System (ADS)

    Kolos, S.; Boutsioukis, G.; Hauser, R.

    2012-12-01

    The ATLAS[1] experiment is operated by a highly distributed computing system which is constantly producing a lot of status information which is used to monitor the experiment operational conditions as well as to assess the quality of the physics data being taken. For example the ATLAS High Level Trigger(HLT) algorithms are executed on the online computing farm consisting from about 1500 nodes. Each HLT algorithm is producing few thousands histograms, which have to be integrated over the whole farm and carefully analyzed in order to properly tune the event rejection. In order to handle such non-physics data the Information Service (IS) facility has been developed in the scope of the ATLAS Trigger and Data Acquisition (TDAQ)[2] project. The IS provides a high-performance scalable solution for information exchange in distributed environment. In the course of an ATLAS data taking session the IS handles about a hundred gigabytes of information which is being constantly updated with the update interval varying from a second to a few tens of seconds. IS provides access to any information item on request as well as distributing notification to all the information subscribers. In the latter case IS subscribers receive information within a few milliseconds after it was updated. IS can handle arbitrary types of information, including histograms produced by the HLT applications, and provides C++, Java and Python API. The Information Service is a unique source of information for the majority of the online monitoring analysis and GUI applications used to control and monitor the ATLAS experiment. Information Service provides streaming functionality allowing efficient replication of all or part of the managed information. This functionality is used to duplicate the subset of the ATLAS monitoring data to the CERN public network with a latency of a few milliseconds, allowing efficient real-time monitoring of the data taking from outside the protected ATLAS network. Each information

  8. Survie au cancer du sein à Rabat (Maroc) 2005-2008

    PubMed Central

    Mechita, Nada Bennani; Tazi, Mohammed Adnane; Er-Raki, Abdelouahed; Mrabet, Mustapha; Saadi, Asma; Benjaafar, Noureddine; Razine, Rachid

    2016-01-01

    Introduction Le cancer du sein représente un problème de santé publique au Maroc. L’objectif de ce travail était d’estimer le taux de survie au cancer du sein chez les patientes habitant la ville de Rabat. Méthodes Etude pronostique réalisée chez les patientes diagnostiquées pour cancer du sein de 2005 à 2008, habitant la ville de Rabat et enregistrées au registre des cancers de Rabat. La date d’inclusion dans l’étude correspondait à la date de confirmation histologique du cancer. L’estimation de la survie a été réalisée par la méthode de Kaplan Meier, et la comparaison entre les différentes classes d’une variable a été réalisée par le test de log rank. L’étude des facteurs associés à la survie a été effectuée par le modèle de Cox. Résultats Durant la période d’étude 628 cas de cancer du sein ont été collectés. Le pourcentage de décès était de 19,9%. La survie globale à un an était de 97,1%, elle était de 89,2% à 3 ans et de 80,6 % à 5 ans. En analyse multivariée la survie au cancer du sein était statistiquement moins bonne chez les patientes âgées de plus de 70 ans (p<0,001), ayantune grande taille de tumeur (p<0,001), un stade avancé d’adénopathies (p=0,007), présentant des métastases (p<0,001) et non traitées par hormonothérapie (p=0,002). Conclusion Une grande taille de la tumeur et la présence de métastases sont des facteurs de mauvais pronostic du cancer du sein d’où la nécessité de renforcer les programmes de dépistage. PMID:28292106

  9. Digital Storytelling Experiences of Pre-Service Teachers: An Action Research

    ERIC Educational Resources Information Center

    Göçen Kabaran, Güler; Aldan Karademir, Çigdem

    2017-01-01

    The purpose of this research is to examine the digital storytelling experiences of preschool pre-service teachers. In the study, an action research from qualitative research designs was used. Furthermore, collaborative action research from the types of action research in the research was used. The research group of the study was formed in the…

  10. Playing by the Rules: Agency Policy and Procedure in Service Experience of IPV Survivors.

    PubMed

    Wood, Leila; Cook Heffron, Laurie; Voyles, Molly; Kulkarni, Shanti

    2017-06-01

    More than 1,800 programs exist in the United States, providing not only shelter but also transitional housing, advocacy and support, transportation, legal aid, and group and individual counseling for women who have experienced intimate partner violence (IPV). Shelter and transitional housing provide critical support for survivors, but have also been critiqued for having too many restrictive rules and code of conduct. More information is needed about the impact of rules and agency policy on women seeking services in IPV residential settings. This qualitative study explored the central research question, "How do rules shape IPV residential environment and survivor experiences in services?" Twenty-five women in four programs in two states who were currently residing in IPV residential services were interviewed about their experiences. Data were analyzed using grounded theory methods. Findings indicated rules affect individual survivors' and families' experiences and responses in services and of healing from IPV (micro), the relationships among residents and between residents and staff (mezzo), and participants' relationships with the agency as an institution and the help-seeking community (macro). An intriguing paradox is noted in that at their best, rules provide stability and motivation for some survivors. At their worst, rules create isolation and force exit from shelter into unsafe circumstances, causing a ripple effect of impact. Implications include the need to restructure rules and policies collaboratively with residents, and reduce the amount of rules used in services. Addressing rules will better enable IPV services to be survivor-centered and trauma-informed, ultimately increasing safety and healing.

  11. The use of patient experience survey data by out-of-hours primary care services: a qualitative interview study.

    PubMed

    Barry, Heather E; Campbell, John L; Asprey, Anthea; Richards, Suzanne H

    2016-11-01

    English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done. We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS). A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews. Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form. The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. DU Processing Efficiency and Reclamation: Plasma Arc Melting

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Imhoff, Seth D.; Aikin, Jr., Robert M.; Swenson, Hunter

    The work described here corresponds to one piece of a larger effort to increase material usage efficiency during DU processing operations. In order to achieve this goal, multiple technologies and approaches are being tested. These technologies occupy a spectrum of technology readiness levels (TRLs). Plasma arc melting (PAM) is one of the technologies being investigated. PAM utilizes a high temperature plasma to melt materials. Depending on process conditions, there are potential opportunities for recycling and material reclamation. When last routinely operational, the LANL research PAM showed extremely promising results for recycling and reclamation of DU and DU alloys. The currentmore » TRL is lower due to machine idleness for nearly two decades, which has proved difficult to restart. This report describes the existing results, promising techniques, and the process of bringing this technology back to readiness at LANL.« less

  13. Parents' Experiences with Services and Treatment for Their Children Diagnosed with Cerebral Palsy

    ERIC Educational Resources Information Center

    Knis-Matthews, Laurie; Falzarano, Mary; Baum, Deborah; Manganiello, Jennifer; Patel, Sargam; Winters, Laura

    2011-01-01

    While there is a considerable body of knowledge investigating the efficacy of constraint-induced movement therapy (CIMT), there is a need for information focusing on parents' experiences when their children receive these services. This qualitative research study initially explored the experiences of four parents with children who are diagnosed…

  14. Exploring the experiences of pregnant women using an NHS stop smoking service: a qualitative study.

    PubMed

    Pledger, Anne B

    2015-05-01

    The purpose of this article was to explore women's experiences of attempting to stop smoking while pregnant using National Health Service (NHS) support. A qualitative methodological approach was adopted to enable the researcher to develop an understanding of the women's experiences. Six individual semi-structured interviews were conducted with women who accessed an NHS stop smoking service while pregnant. The data were analysed using comparative analysis. Five themes were identified: health risks, motivations to stop smoking, influences on smoking behaviour, feelings about smoking and experiences of using NHS stop smoking support. Motivation to stop smoking was predominantly due to concerns about their unborn baby's health, and knowledge of health risks was generally good. Limited information relating to the associated health risks of continued smoking in pregnancy from healthcare professionals appeared to be a common experience. External pressures both positively and negatively influenced the smoking status of the women. Stress was cited by all the women as a significant challenge to smoking cessation and something which they all struggled with. The women's experiences of using NHS support while pregnant was varied; some felt it adequately met their needs, while others felt that their expectations were not met. Continued smoking in pregnancy is complex, and it appears that successful smoking cessation is related to a number of internal and external factors which present significant challenges for expectant mothers who smoke. Stress was found to be a major contributor in continued smoking; therefore, NHS stop smoking services should incorporate stress management techniques into stop smoking interventions. In addition, services should be flexible, adapting service provision to meet women's needs. © Royal Society for Public Health 2015.

  15. When Service-Learning Is Not a "Border-Crossing" Experience: Outcomes of a Graduate Spanish Online Course

    ERIC Educational Resources Information Center

    Carracelas-Juncal, Carmen

    2013-01-01

    Research on Spanish service-learning has focused mainly on the outcomes of service-learning for undergraduate students learning Spanish as a second language. This article examines the role of service-learning in a graduate online course for practicing Spanish teachers and the outcomes of the service-learning experience for three participants who…

  16. Mental health service users' experiences of mental health care: an integrative literature review.

    PubMed

    Newman, D; O'Reilly, P; Lee, S H; Kennedy, C

    2015-04-01

    A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person-centred practice. The authors completed an in-depth search of the literature to answer the question: What are service users' experiences of the mental health service? Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care. The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support. This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider-service user relationship to facilitate true service-user engagement in their care. The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host (Academic Search Complete, MEDLINE, CINAHL Plus

  17. Adult patients' experiences of NHS specialist services for chronic fatigue syndrome (CFS/ME): a qualitative study in England.

    PubMed

    Broughton, Jessica; Harris, Sarah; Beasant, Lucy; Crawley, Esther; Collin, Simon M

    2017-06-02

    Few studies have explored patients' experiences of treatment for CFS/ME. This study aims to fill this gap by capturing the perspective of patients who have been treated by NHS specialist CFS/ME services in England. Semi-structured interviews were conducted during the period June-September 2014 with 16 adults who were completing treatment at one of three outpatient NHS specialist CFS/ME services. Interviews were analysed thematically using constant comparison techniques, with particular attention paid to contrasting views. Three themes were identified: 'Journey to specialist services'; 'Things that help or hinder treatment'; and 'Support systems'. Within these themes nine sub-themes were identified. A wide range of factors was evident in forming participants' experiences, including personal characteristics such as perseverance and optimism, and service factors such as flexibility and positive, supportive relationships with clinicians. Participants described how specialist services played a unique role, which was related to the contested nature of the condition. Many participants had experienced a lack of validation and medical and social support before attending a specialist service. Patients' experiences of life before referral, and the concerns that they expressed about being discharged, highlighted the hardship and obstacles which people living with CFS/ME continue to experience in our society. The experiences of CFS/ME patients in our study showed that NHS specialist CFS/ME services played a vital role in patients' journeys towards an improved quality of life. This improvement came about through a process which included validation of patients' experiences, acceptance of change, practical advice and support, and therapeutic outcomes.

  18. Graduate nurses' experiences of mental health services in their first year of practice: An integrative review.

    PubMed

    Hooper, Mary-Ellen; Browne, Graeme; O'Brien, Anthony Paul

    2016-08-01

    New graduate nurses have reported negative experiences in mental health settings, particularly during the transitional period of practice. Previous research has focused on addressing the undergraduate preparation of nurses for practice instead of the experiences and outcomes of the transitional period. Recently, there has been growing interest in exploring the experiences of graduate nurses in transition and the implementation of promising interventions to facilitate new graduates' assimilation to practice. Despite these initiatives, the overall shortage of mental health nurses continues to rise, and graduates still report negative experiences in the mental health setting. The purpose of this study was to identify and explore the experiences of new graduate nurses in mental health services in their first year of clinical practice. An integrative review was conducted with 22 studies sourced from the CINAHL, PubMed, Scopus, and PsychINFO electronic databases, as well as through hand-searching the literature. Literature review findings have highlighted negative clinical experiences and increased attrition from mental health services for graduate nurses. These experiences were closely linked with the changes in the training of mental health nurses, role ambiguity, inadequate clinical preceptorship, encountering the reality of mental health services, and the role of health services in transitioning graduate nurses into clinical practice. Established research into organizational cultures demonstrates that negative organizational outcomes result from negative workplace experiences. Therefore, further research into new graduate nurses' experiences of mental health nursing and its culture might clarify the reasons why they might not be attracted to the discipline and/or are leaving early in their career. © 2016 Australian College of Mental Health Nurses Inc.

  19. Quels sont les problemes ethiques souleves par l’augmentation des capacites cognitives dans le cadre de la defense : cadre legal francais, position ethique du service de sante des armees francais

    DTIC Science & Technology

    2009-10-01

    pourtant été systématisée. L’observation que, même si chaque homme est unique, il n’en partage pas moins un certain nombre de caractéristiques avec ses...occidental du comportement normal d’un homme , c’est-à-dire ce en deçà de quoi il ne peut déroger au risque de sortir du statut d’homme. Ainsi, le... de garantir les conditions de vie harmonieuse dans la société des hommes . Ainsi, l’éthique individuelle du citoyen français se niche dans un ensemble

  20. Providing Authentic Research Experiences for Pre-Service Teachers through UNH's Transforming Earth System Science Education (TESSE) Program

    NASA Astrophysics Data System (ADS)

    Varner, R. K.; Furman, T.; Porter, W.; Darwish, A.; Graham, K.; Bryce, J.; Brown, D.; Finkel, L.; Froburg, E.; Guertin, L.; Hale, S. R.; Johnson, J.; von Damm, K.

    2007-12-01

    The University of New Hampshire's Transforming Earth System Science Education (UNH TESSE) project is designed to enrich the education and professional development of in-service and pre-service teachers, who teach or will teach Earth science curricula. As part of this program, pre-service teachers participated in an eight- week summer Research Immersion Experience (RIE). The main goal of the RIE is to provide authentic research experiences in Earth system science for teachers early in their careers in an effort to increase future teachers` comfort and confidence in bringing research endeavors to their students. Moreover, authentic research experiences for teachers will complement teachers` efforts to enhance inquiry-based instruction in their own classrooms. Eighteen pre-service teachers associated with our four participating institutions - Dillard University (4), Elizabeth City State University (4), Pennsylvania State University (5), and University of New Hampshire (UNH) (5) participated in the research immersion experience. Pre-service teachers were matched with a faculty mentor who advised their independent research activities. Each pre-service teacher was expected to collect and analyze his or her own data to address their research question. Some example topics researched by participants included: processes governing barrier island formation, comparison of formation and track of hurricanes Hugo and Katrina, environmental consequences of Katrina, numerical models of meander formation, climatic impacts on the growth of wetland plants, and the visual estimation of hydrothermal vent properties. Participants culminated their research experience with a public presentation to an audience of scientists and inservice teachers.

  1. Enhancing Intercultural Understanding for Pre-Service Teachers through Developing and Sustaining Education Abroad Experiences

    ERIC Educational Resources Information Center

    Marcus, Alan S.; Moss, David M.

    2015-01-01

    This article discusses two education abroad programs that afford pre-service teachers with purposeful opportunities to enhance their intercultural competence through immersion in teaching internships in British schools. The programs, in London and Nottingham, provide pre-service teachers with direct experiences that engage them with diverse…

  2. (Re)telling: A Narrative Inquiry into Pre-Service TESOL Teachers' Study Abroad Experiences

    ERIC Educational Resources Information Center

    Marquardt, Sheila K.

    2011-01-01

    Learning to teach ESL entails not only knowledge of linguistics, pedagogy, and curriculum, but it also entails negotiating challenges to identity, cultural sensibilities, and emotional relations. In order to make sense of these challenges, I inquire into the experiences of pre-service TESOL teachers teaching and learning experiences in a study…

  3. Pre-Service Teachers' Perceptions of a Short-Term International Experience Programme

    ERIC Educational Resources Information Center

    Barkhuizen, Gary; Feryok, Anne

    2006-01-01

    Short-term international experiences (STIE) are becoming a regular, sometimes required, feature of pre-service language teacher education programmes. Often inappropriately termed "immersion programmes", they aim to give teachers the opportunity to improve their language proficiency in the language they will teach, to develop their…

  4. Psychological Well-Being in Parents of Children with Angelman, Cornelia de Lange and Cri du Chat Syndromes

    ERIC Educational Resources Information Center

    Griffith, G. M.; Hastings, R. P.; Oliver, C.; Howlin, P.; Moss, J.; Petty, J.; Tunnicliffe, P.

    2011-01-01

    Background: The current study focuses on mothers and fathers of children with three rare genetic syndromes that are relatively unexplored in terms of family experience: Angelman syndrome, Cornelia de Lange syndrome and Cri du Chat syndrome. Method: Parents of children with Angelman syndrome (n = 15), Cornelia de Lange syndrome (n = 16) and Cri du…

  5. Experiences of Mental Health Services by People with Intellectual Disabilities from Different Ethnic Groups: A Delphi Consultation

    ERIC Educational Resources Information Center

    Bonell, S.; Underwood, L.; Radhakrishnan, V.; McCarthy, J.

    2012-01-01

    Background: Patient experience of those accessing mental health services has been found to be different between ethnic groups. Although the needs of people with intellectual disabilities (ID) from different ethnic communities are being increasingly recognised, little has been published about their experiences of mental health services. The aim of…

  6. Interim Service ISDN Satellite (ISIS) network model for advanced satellite designs and experiments

    NASA Technical Reports Server (NTRS)

    Pepin, Gerard R.; Hager, E. Paul

    1991-01-01

    The Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) Network Model for Advanced Satellite Designs and Experiments describes a model suitable for discrete event simulations. A top-down model design uses the Advanced Communications Technology Satellite (ACTS) as its basis. The ISDN modeling abstractions are added to permit the determination and performance for the NASA Satellite Communications Research (SCAR) Program.

  7. Les inconvénients de perdre du poids

    PubMed Central

    Bosomworth, N. John

    2012-01-01

    Résumé Objectif Explorer les raisons pour lesquelles la perte de poids à long terme échoue la plupart du temps et évaluer les conséquences de diverses trajectoires pondérales, y compris la stabilité, la perte et le gain. Source des données Les études qui évaluent les paramètres pondéraux dans la population sont en majorité observationnelles. Des données probantes de niveau I ont été publiées pour évaluer l’influence des interventions relatives au poids sur la mortalité et la qualité de vie. Message principal Seulement un petit pourcentage des personnes qui désirent perdre du poids réussissent à le faire de manière durable. La mortalité est la plus faible chez les personnes se situant dans la catégorie de poids élevé-normal et surpoids. La trajectoire pondérale la plus sécuritaire est la stabilité du poids avec une optimisation de la condition physique et métabolique. Il est démontré que la mortalité est plus faible chez les personnes ayant des comorbidités reliées à l’obésité si elles perdent du poids. Il est aussi établi que la qualité de vie sur le plan de la santé est meilleure chez les personnes obèses qui perdent du poids. Par contre, la perte de poids chez une personne obèse autrement en santé est associée à une mortalité accrue. Conclusion La perte de poids est recommandable seulement chez les personnes qui ont des comorbidités reliées à l’obésité. Les personnes obèses en santé qui veulent perdre du poids devraient être informées qu’il peut y avoir des risques à le faire. Une stratégie qui se traduit par un indice de masse corporelle stable avec une condition physique et métabolique optimisée, peu importe le poids, est l’option d’intervention la plus sécuritaire en ce qui concerne le poids.

  8. 'Recovery' in the Real World: Service User Experiences of Mental Health Service Use and Recommendations for Change 20 Years on from a First Episode Psychosis.

    PubMed

    O'Keeffe, Donal; Sheridan, Ann; Kelly, Aine; Doyle, Roisin; Madigan, Kevin; Lawlor, Elizabeth; Clarke, Mary

    2018-02-06

    Little is known about how recovery oriented policy and legislative changes influence service users' perceptions of mental health care over time. Although the recovery approach is endorsed in many countries, qualitative research examining its impact on service use experiences has been lacking. This study aimed to explore this impact as well as experiences of service utilisation and suggestions for change with people diagnosed with a First Episode Psychosis between 1995 and 1999. Participants had used services during the 10 year period prior to, and 10 years post, policy and legislative shifts to the recovery approach. Semi-structured interviews were conducted with 10 participants who met criteria for 'full functional recovery' and 10 who did not. Data were analysed using Thematic Networks Analysis to develop Basic, Organising, and Global Themes. Over time, recovered participants perceived an improvement in service quality through the 'humanising' of treatment and non-recovered participants experienced their responsibility in recovery being recognised, but felt abandoned to the recovery approach. Findings suggest the importance of viewing service users as demonstrating personhood and having societal value; examining the personal meaning of psychotic experiences; and matching expectations with what services can feasibly provide. The implementation and the principal tenets of the recovery approach warrant further investigation.

  9. Elementary Pre-Service Teachers: Can They Experience Mathematics Teaching Anxiety without Having Mathematics Anxiety?

    ERIC Educational Resources Information Center

    Brown, Amy Bingham; Westenskow, Arla; Moyer-Packenham, Patricia S.

    2011-01-01

    Elementary pre-service teachers report high levels of mathematics anxiety (MA), but the construct less widely addressed is their mathematics teaching anxiety (MTA). This study investigated the frequency with which MA stemming from prior experiences leads to MTA. Fifty-three elementary pre-service teachers' written reflections were analyzed, using…

  10. More than just a bed: mental health service users' experiences of self-referral admission.

    PubMed

    Olsø, Turid Møller; Gudde, Camilla Buch; Moljord, Inger Elise Opheim; Evensen, Gretha Helen; Antonsen, Dag Øivind; Eriksen, Lasse

    2016-01-01

    Several community mental health centres and mental hospitals in Norway now allow users with a diagnosis of severe mental illness to self-refer for admission. This give a group of service users who are well-known to service providers the opportunity to refer themselves for short inpatient stays without contacting their doctor, a duty doctor or emergency department. Evidence on self-referral admissions is lacking. To explore service users' experiences of having the opportunity to refer themselves for a short inpatient stay. Forty-two qualitative semi-structured interviews were undertaken between 2010 and 2014 in a group of 28 service users with serious mental illness and with or without substance abuse problems. All respondents had a contract which allowed them to self-refer for inpatient treatment. Systematic text condensation was applied in the analyses. Self-referral inpatient admission is more than just a bed. It was perceived as a new, unconventional health service, which differed substantially from earlier experiences of inpatient care and was characterised by different values and treatment principles. The differences were related to the content, quality and organisation of treatment. Having the option to decide about admission for oneself and having access to services focusing on individual needs seem to enhance service users' confidence, both in the services they use and in their own ability to cope with everyday life. Self-referral inpatient admission is a concrete example of how a user involvement policy can be implemented in mental health services. It is important to emphasise that the self-referral admission process described here is an offer in development and that we are awaiting findings from a larger RCT study. More evidence is needed to determine what aspects of the service are helpful to service users, the long-term effects, appropriateness and cost-effectiveness, and how the service can be integrated into the mental health system.

  11. Dépistage précoce des retards du développement moteur

    PubMed Central

    Harris, Susan R.

    2016-01-01

    Résumé Objectif Décrire le test HINT (Harris Infant Neuromotor Test), un test d’évaluation du développement neuromoteur chez les nourrissons publié en 2010, qui s’appuie sur les normes canadiennes et peut être utilisé pour dépister les retards du développement moteur durant la première année de la vie. Qualité des données D’abondantes recherches ont été publiées sur la fiabilité intra-évaluateur, inter-évaluateur et test-retest ainsi que sur la validité convergente, prédictive, du contenu et des groupes connus du test HINT, de même que sur la sensibilité, la spécificité et les valeurs prédictives négatives et positives des inquiétudes des parents, telles qu’évaluées par le test HINT. La plupart des données probantes sont de niveau II. Message principal Il est important de diagnostiquer les retards du développement moteur durant la première année de vie, car ils sont souvent le signe de retards du développement généralisés ou de déficiences précises, telles que la paralysie cérébrale. Les inquiétudes des parents quant au développement moteur de leur enfant sont une valeur prédictive robuste de diagnostics subséquents de retard du développement moteur. Conclusion Seul le dépistage précoce des retards du développement moteur, initialement par l’entremise d’outils de dépistage comme le test HINT, permet de recommander le patient à une intervention précoce qui profiterait tant à l’enfant qu’à sa famille. PMID:27521405

  12. Hazardous Waste Cleanup: DuPont Imaging Department in Parlin, New Jersey

    EPA Pesticide Factsheets

    DuPont has owned and operated a chemical manufacturing plant on Cheesequake Road in Parlin, New Jersey, since 1904. DuPont manufactured a variety of products at the plant including, photographic films, automotive paints, pigments, adhesives, thinners,

  13. The Influence of Formal and Informal Formative Pre-Service Experiences on Teacher Self-Efficacy

    ERIC Educational Resources Information Center

    Tuchman, Elie; Isaacs, Jenny

    2011-01-01

    Formal pre-service training has been shown to be effective in building teacher self-efficacy beliefs. However, the impact of other, less formal, "teacher-like" pre-service experiences on the formation of efficacy beliefs has not previously been investigated. This study examines the associations between both formal and informal formative…

  14. Experiences of Asian Indian Families with Special Education and Disability-Related Services in America

    ERIC Educational Resources Information Center

    Walz, Amber

    2013-01-01

    The American disability service system is predicated on underlying assumptions and beliefs which are dominant in the majority culture. Consequently, minority families, such as families from India, living in America sometimes experience dissonance with respect to the services provided to their family due to their varying cultural values. As such,…

  15. An Examination of Technology Training Experiences from Teacher Candidacy to In-Service Professional Development

    ERIC Educational Resources Information Center

    Williams, Mable Evans

    2017-01-01

    The purpose of this qualitative study was to explore the perceptions of in-service teachers concerning the effectiveness of technology training from a teacher education preparation program to in-service professional development. The findings of the study revealed that inservice teachers have had varying degrees of technology experiences from their…

  16. Flood-inundation maps for the DuPage River from Plainfield to Shorewood, Illinois, 2013

    USGS Publications Warehouse

    Murphy, Elizabeth A.; Sharpe, Jennifer B.

    2013-01-01

    Digital flood-inundation maps for a 15.5-mi reach of the DuPage River from Plainfield to Shorewood, Illinois, were created by the U.S. Geological Survey (USGS) in cooperation with the Will County Stormwater Management Planning Committee. The inundation maps, which can be accessed through the USGS Flood Inundation Mapping Science Web site at http://water.usgs.gov/osw/flood_inundation/ depict estimates of the areal extent of flooding corresponding to selected water levels (gage heights or stages) at the USGS streamgage at DuPage River at Shorewood, Illinois (sta. no. 05540500). Current conditions at the USGS streamgage may be obtained on the Internet at http://waterdata.usgs.gov/usa/nwis/uv?05540500. In addition, the information has been provided to the National Weather Service (NWS) for incorporation into their Advanced Hydrologic Prediction Service (AHPS) flood warning system (http://water.weather.gov/ahps/). The NWS forecasts flood hydrographs at many places that are often colocated with USGS streamgages. The NWS-forecasted peak-stage information, also shown on the DuPage River at Shorewood inundation Web site, may be used in conjunction with the maps developed in this study to show predicted areas of flood inundation. In this study, flood profiles were computed for the stream reach by means of a one-dimensional step-backwater model. The hydraulic model was then used to determine nine water-surface profiles for flood stages at 1-ft intervals referenced to the streamgage datum and ranging from NWS Action stage of 6 ft to the historic crest of 14.0 ft. The simulated water-surface profiles were then combined with a Digital Elevation Model (DEM) (derived from Light Detection And Ranging (LiDAR) data) by using a Geographic Information System (GIS) in order to delineate the area flooded at each water level. These maps, along with information on the Internet regarding current gage height from USGS streamgages and forecasted stream stages from the NWS, provide emergency

  17. Information Technology Manager's Perspective on Experiences with Service Quality and Customer Satisfaction: A Phenomenology Study

    ERIC Educational Resources Information Center

    Porter, Sherry A.

    2016-01-01

    The general problem was that, in the competitive telecommunications industry, information technology service providers have to develop ways to improve on customer satisfaction and service quality during service disruptions to meet service level agreements. A descriptive phenomenological study was used to explore the lived experiences and…

  18. Haute prévalence du Burnout dans les unités Tunisiennes prenant en charge des patients en fin de vie

    PubMed Central

    Amamou, Badii; Bannour, Ahmed Souhaiel; Ben Hadj Yahia, Meriem; Ben Nasr, Selma; Ben Hadj Ali, Bechir

    2014-01-01

    Introduction Chez le personnel soignant, le burnout touche un infirmier sur trois. Ce taux est plus élevé dans les unités prenant en charge des patients en fin de vie. L'objectif de notre travail était d'évaluer la fréquence du burnout chez les infirmiers qui travaillent en soins de fin de vie. Méthodes Il s'agit d'une étude descriptive transversale réalisée entre le 1er Avril et le 31 Mai 2010. 60 infirmiers de six services de Sousse et de Monastir (Tunisie) ont été recrutés. L'évaluation du burnout a été réalisée par deux échelles: MBI (Maslach Burnout Inventory) et BMS (Burnout Measure Short version). Résultats La prévalence du burnout était de 70%; il était élevé chez 81.7%. 80% avaient un niveau élevé d'épuisement émotionnel, 70% avaient un niveau élevé de dépersonnalisation et 17% avaient un niveau bas de sentiment d'accomplissement personnel. Le burnout était plus élevé chez les hommes (70,8% vs 69,4%; p=0,013); ceux qui voulaient améliorer les conditions du travail (70.2% vs. 66.7%; p= 0.017); du salaire (70.2% vs. 66.7%; p= 0.017) et chez les infirmiers suivi en psychiatrie (71.4% vs. 69.8%; p= 0.008). Conclusion Dans notre étude le niveau de burnout était élevé chez les infirmiers prenant en charge des patients en fin de vie. Il était associé au sexe masculin et à l'insatisfaction des conditions de travail et du salaire. D'autres études longitudinales sont nécessaires pour suivre l'évolution de ce syndrome et mettre des stratégies de prévention adéquates. PMID:25584122

  19. Running a postmortem service--a business case and clinical experience.

    PubMed

    Cohen, Marta C; Whitby, Elspeth; Fink, Michelle A; Collett, Jacquelene M; Offiah, Amaka C

    2015-04-01

    The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia.

  20. [6-year experience with a drug information service for patients].

    PubMed

    Huber, Martin; Kullak-Ublick, Gerd A; Kirch, Wilhelm

    2009-03-15

    Many patients are inadequately informed about their drug therapy. There is thus a need for providing additional drug information to patients. The authors here report on a 6-year experience with a drug information service for patients. The information service was available by telephone, e-mail or regular mail and was addressed initially to patients in Saxony and since 2005 to patients throughout Germany. Demographic and drug therapy data of the patients were registered and analyzed using a relational database. All enquiries to the information service between August 2001 and January 2007 were evaluated. 5,587 enquiries were registered. 61.4% of the persons calling were female and 33.8% male (sex was unknown in 4.8% by anonymous calls). The most frequent reasons for an enquiry were a general need for information about drugs and therapy (27.5%) and adverse drug reactions (24.7%). The drug group most frequently enquired about were cardiovascular drugs, accounting for 34.4%, followed by neuropsychiatric drugs (15.1%). The results of this analysis show an evident need for a drug information service for patients. This need is possibly caused by the shortage of time that physicians can devote to patients. An independent and competent drug information service may improve the quality of medical care and the satisfaction of the patients involved.

  1. A global service-learning experience for nursing students in Tanzania: a model for collaboration.

    PubMed

    Kreye, Judy; Oetker-Black, Sharon

    2013-01-01

    This article addresses a model for creating a short-term global service-learning program. The Global Standards for the Initial Education of Professional Nurses and Midwives guided the development of a collaborative program involving a school of nursing in the Midwestern United States and one in Tanzania. Evaluation of the school of nursing and subsequent collaborative planning led to development and implementation of a 3-week global service-learning experience for nursing students. International academic partnerships, developed in accordance with WHO standards, will enhance educational experiences for nursing students both in the United States and abroad. © 2013 Wiley Periodicals, Inc.

  2. [How a brand strategy strengthen the public service mission].

    PubMed

    Ouazan, J-M; Blaise-Pagès, L; Le Failler, F

    2013-05-01

    Commercial companies or public service mission, today all organizations must manage their brand. For a public service organization, also, the brand is an asset that enhances its visibility to the various partners. A brand is a collection of signs that distinguishes it, it or the products and services it offers. In recent years, we are witnessing the valorization of public service mission brand in an objective of visibility but also for internal cohesion. Developing a brand brings benefits in its identification and knowledge by users but also within the institutional environment. This value can also be an economic booster. With a strong brand, the organization may reduce communication expenses. In recent years, we attend an important development of the territory marks. Concerning the Établissement français du sang (EFS) when it was created in 2000, it is the act of donation of blood, which was enhanced by the "Don du sang" logotype and not the institution. As a consequence, the logotype "EFS" was very discreet. But more than 10 years after, this situation has to evolve. The EFS is not just a blood transfusion organization. Beyond blood donations, the EFS has developed other activities (cell and tissue therapy, IHR, clinics, research, etc.). With the "new generation" blood centers, it is an opportunity to think over the brand EFS. This is why EFS has decided to develop a brand strategy, the ground of all communication policies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  3. Etude Bacteriologique sur 30 Mois dans un Service de Brulés

    PubMed Central

    Chaibdraa, A.; Bentakouk, M.C.

    2008-01-01

    Summary Le pronostic des brûlures est souvent tributaire de complications infectieuses. Les objectifs de cette étude préliminaire rétrospective sont une évaluation de la flore microbienne et ses fluctuations selon la durée d'hospitalisation chez les patients du Centre des brûlés adultes de Annaba (Algérie). Ce travail porte sur 633 prélèvements microbiologiques positifs obtenus entre juin 2003 (inauguration du service) et décembre 2005. Selon le site de prélèvement la répartition est: cutané (78%), hémoculture (9%), prélèvement trachéo-bronchique (4%), uroculture (3%), sonde urinaire (3%), cathéter(3%). Les germes isolés sont: les staphylocoques (58%), les Pseudomonas (20%), le Candida albicans (5%), l'Acinetobacter (3%) et les autres germes (14%). Parmi les staphylocoques et les Pseudomonas recensés, respectivement 19% et 11% sont isolés la première semaine, contre 43% et 52% au-delà de 21 jours. Ces résultats confrontés aux données de la littérature confirment la prédominance du staphylocoque et du Pseudomonas. Le risque de contamination à partir des techniques invasives de réanimation est commun à toutes les équipes. La prolifération bactérienne est en relation avec la durée d'hospitalisation. Ces constatations doivent nous inciter à tirer bénéfice de l'expérience des autres services, en particulier sur les moyens, accessibles, de prévention de l'infection nosocomiale. PMID:21991102

  4. U.S. experience in satellite servicing and linkage to the Space Station era

    NASA Technical Reports Server (NTRS)

    Browning, R. K.

    1986-01-01

    A history of on-orbit servicing and repair is given with emphasis placed on the Solar Maximum Repair Mission. The experience gained thus far in on-orbit servicing and the design of the Space Station's servicing capabilities impose the following requirements on users: (1) satellites must have a standard grapple for capture and a standard berthing interface, (2) Space Station safety requirements must meet to preclude damage to the Space Station or injury to the EVA crew, (3) sensitive instruments will need to implement remotely controlled protective devices to prevent damage, and (4) satellite thermal systems must be designed to maintain survival temperatures during transfer from orbit to the Space Station servicing facility.

  5. Pre-Service Teachers' Knowledge of Language Concepts: Relationships to Field Experiences

    ERIC Educational Resources Information Center

    Tetley, Deborah; Jones, Caroline

    2014-01-01

    Acquisition of language concepts by pre-service teachers (PSTs) is likely influenced by university coursework and field experiences, but little research has examined how. Knowledge of phonics and phonological awareness and confidence to teach reading were surveyed among primary PSTs at one New South Wales university, most in second year following…

  6. Towards Improved Student Experiences in Service Learning in Information Systems Courses

    ERIC Educational Resources Information Center

    Petkova, Olga

    2017-01-01

    The paper explores relevant past research on service-learning in Information Systems courses since 2000. One of the conclusions from this is that most of the publications are not founded on specific theoretical models and are mainly about sharing instructor or student experiences. Then several theoretical frameworks from Education and other…

  7. Impact of Service-Learning Experiences in Culinary Arts and Nutrition Science

    ERIC Educational Resources Information Center

    Daugherty, Jamie B.

    2015-01-01

    A grant from a regional nonprofit organization for the 2012-2013 academic year facilitated the revision of an existing course learning objective in a Culinary Nutrition lab course--performing effective culinary demonstrations--to include a service-learning experience. This course is a graduation requirement in a research- and science-based…

  8. A Study of Guided Urban Field Experiences for Pre-Service Teachers

    ERIC Educational Resources Information Center

    White, Meg

    2017-01-01

    This research examined pre-service teachers' perceptions of urban schools and urban students before and after an 80-hour field experience in an urban K-12 district. The fieldwork placements were structured through a school-university partnership, and supported by university coursework. Quantitative data collected from 150 students over three…

  9. Experiences of service users involved in recruitment for nursing courses: A phenomenological research study.

    PubMed

    Stevens, Katie; Bernal, Cathy; Devis, Kate; Southgate, Andrew

    2017-11-01

    The aim of this study was to gain insight into service users' experiences of participating in recruitment for Adult, Mental Health and Child nursing studies at the authors' university; to establish potential motivations behind such participation; and to make suggestions for improved future practice. The involvement of service users in nurse education and recruitment has for some years been required by the Nursing and Midwifery Council, but there is a dearth of publications on the meaning of that involvement to participating service users. It is hoped that this study will contribute to this body of knowledge. A phenomenological approach was selected, field-specific focus groups of service users being facilitated using a semi-structured interview format; these were audio recorded and transcribed. The data was analysed using thematic analysis. Participation was subject to the service users having been involved in recruitment to nursing studies at the authors' university and the focus groups took place either at the university or at the child participants' school. Themes identified demonstrated largely positive experiences and a sense of meaningful involvement for all concerned. Findings indicated a close link between the values of the participants and those of the wider NHS, benefits to a sense of wellbeing and achievement, as well as the need for greater ownership of the recruitment process by service users. Potential lessons for academics wishing to promote greater service user involvement in student recruitment are articulated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. 76 FR 68124 - Television Broadcasting Services; Fond du Lac, WI

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-03

    ...- engineered proposal that would result in the replacement translators covering the projected analog loss area. The document finds that the re-engineered translators sufficiently address any loss of service, and...

  11. Pre-Service Teachers' Evaluation of Their Mentor Teachers, School Experiences, and Theory-Practice Relationship

    ERIC Educational Resources Information Center

    Alemdag, Ecenaz; Simsek, Pinar Özdemir

    2017-01-01

    This case study investigated practicum experiences of pre-service teachers by focusing on their evaluation of mentor teachers, school experiences, and theory-practice relationships. Interviews were conducted with six teacher candidates, and observations in the participants' practice schools were made. The results revealed that mentor teachers had…

  12. An Exploration of Pre-Service Teachers' Experiences in Outdoor `Places' and Intentions for Teaching in the Outdoors

    NASA Astrophysics Data System (ADS)

    Blatt, Erica; Patrick, Patricia

    2014-09-01

    This study explores pre-service teachers' past interactions with 'place' in outdoor settings and how these experiences contribute to their current perceptions of the importance of taking their own students into the outdoors. Specifically, the researchers were interested in investigating if current pre-service teachers are part of the 'nature-deficit disorder' generation described by Louv in his book, Last child in the woods: Saving our children from nature-deficit disorder (2005), as a generation of children growing up without direct experiences in nature. Study participants included 148 undergraduate pre-service elementary teachers enrolled in science teaching methods instructional courses at an urban college in the Northeastern United States and two suburban universities in the Southeastern United States. Participants wrote essay responses after reading Louv's Last Child in the Woods in which they were asked to relate the reading to their own past experiences and their ideas about elementary science education. Results indicate that a large majority of participants (97%) describe significant youth experiences in the outdoors, view nature as important in varying ways (89.9%), and express a desire to expose their own students to the outdoors (65.5%). Key findings are illustrated with direct quotations from the pre-service teachers' essay responses, as they write vividly of their interactions in outdoor places, referred to as 'place meanings'. Implications are presented for teacher educators working with pre-service teachers to build upon their outdoor experiences and prepare them for implementing nature-based instruction.

  13. Simulation of Coast Guard Vessel Traffic Service Operations by Model and Experiment

    DOT National Transportation Integrated Search

    1980-09-01

    A technique for computer simulation of operations of U.S. Coast Guard Vessel Traffic Services is described and verified with data obtained in four field studies. Uses of the Technique are discussed and illustrated. A field experiment is described in ...

  14. Mountain Plains Learning Experience Guide: Automotive Repair. Course: Detailing and Servicing.

    ERIC Educational Resources Information Center

    Schramm, C.; Osland, Walt

    One of twelve individualized courses included in an automotive repair curriculum, this course covers the techniques of minor automotive servicing. The course is comprised of four units: (1) Oil Changing, (2) Chassis Lubrication, (3) Tires, and, (4) Minor Body Adjustments. Each unit begins with a Unit Learning Experience Guide that gives directions…

  15. Hazardous Waste Cleanup: E.I. DuPont de Nemours & Company in Pompton Lakes, New Jersey

    EPA Pesticide Factsheets

    E.I. DuPont De Nemours & Company is located at 2000 Cannonball Road, Pompton Lakes, New Jersey. The DuPont Pompton Lakes Works site (DuPont) occupies approximately 570 acres of land in Pompton Lakes and Wanaque.

  16. Preservice Physical Education Teachers' Service Learning Experiences Related to Comprehensive School Physical Activity Programming

    ERIC Educational Resources Information Center

    Webster, Collin A.; Nesbitt, Danielle; Lee, Heesu; Egan, Cate

    2017-01-01

    Purpose: The purpose of this study was to examine preservice physical education teachers' (PPET) service learning experiences planning and implementing course assignments aligned with comprehensive school physical activity program (CSPAP) recommendations. Methods: Based on service learning principles, PPETs (N = 18) enrolled in a physical…

  17. Women’s Experiences Seeking Publicly Funded Family Planning Services in Texas

    PubMed Central

    Hopkins, Kristine; White, Kari; Linkin, Fran; Hubert, Celia; Grossman, Daniel; Potter, Joseph E.

    2015-01-01

    CONTEXT Little is known about low-income women’s and teenagers’ experiences accessing publicly funded family planning services, particularly after policy changes are made that affect the cost of and access to such services. METHODS Eleven focus groups were conducted with 92 adult women and 15 teenagers in nine Texas metropolitan areas in July–October 2012, a year after legislation that reduced access to subsidized family planning was enacted. Participants were recruited through organizations that serve low-income populations. At least two researchers independently coded the transcripts of the discussions and identified main themes. RESULTS Although most women were not aware of the legislative changes, they reported that in the past year, they had had to pay more for previously free or low-cost services, use less effective contraceptive methods or forgo care. They also indicated that accessing affordable family planning services had long been difficult, that applying and qualifying for programs was a challenge and that obtaining family planning care was harder than obtaining pregnancy-related care. As a result of an inadequate reproductive health safety net, women experienced unplanned pregnancies and were unable to access screening services and follow-up care. Teenagers experienced an additional barrier, the need to obtain parental consent. Some women preferred to receive family planning services from specialized providers, while others preferred more comprehensive care. CONCLUSION Women in Texas have long faced challenges in obtaining subsidized family planning services. Legislation that reduced access to family planning services for low-income women and teenagers appears to have added to those challenges. PMID:25639913

  18. Localisation inhabituelle de la tuberculose: ostéoarthrite tuberculose du pouce

    PubMed Central

    Mortaji, Aziz; Koulali, Khalid; Galuia, Farid

    2014-01-01

    L'ostéoarthrite tuberculose est rare au niveau des doigts. Nous rapportons une observation d'atteinte du pouce chez un patient de 55 ans. Il avait présenté une tuméfaction douloureuse du pouce droit suite à un traumatisme du pouce. L’étude bactériologique et une biopsie avaient permis de confirmer le diagnostic. Un traitement antibacillaire de 12 mois avait donné des résultats satisfaisants. Les particularités de la prise en charge sont discutées par rapport aux données de la littérature. PMID:25932075

  19. Receipt of Preventive Services After Oregon’s Randomized Medicaid Experiment

    PubMed Central

    Marino, Miguel; Bailey, Steffani R.; Gold, Rachel; Hoopes, Megan J.; O’Malley, Jean P.; Huguet, Nathalie; Heintzman, John; Gallia, Charles; McConnell, K. John; DeVoe, Jennifer E.

    2015-01-01

    Introduction It is predicted that gaining health insurance via the Affordable Care Act will result in increased rates of preventive health services receipt in the U.S, primarily based on self-reported findings from previous health insurance expansion studies. This study examined the long-term (36-month) impact of Oregon’s 2008 randomized Medicaid expansion (“Oregon Experiment”) on receipt of 12 preventive care services in community health centers using electronic health record data. Methods Demographic data from adult (aged 19–64 years) Oregon Experiment participants were probabilistically matched to electronic health record data from 49 Oregon community health centers within the OCHIN community health information network (N=10,643). Intent-to-treat analyses compared receipt of preventive services over a 36-month (2008–2011) period among those randomly assigned to apply for Medicaid versus not assigned, and instrumental variable analyses estimated the effect of actually gaining Medicaid coverage on preventive services receipt (data collected in 2012–2014; analysis performed in 2014–2015). Results Intent-to-treat analyses revealed statistically significant differences between patients randomly assigned to apply for Medicaid (versus not assigned) for eight of 12 assessed preventive services. In intent-to-treat[MM1] analyses, Medicaid coverage significantly increased the odds of receipt of most preventive services (ORs ranging from 1.04 [95% CI=1.02, 1.06] for smoking assessment to 1.27 [95% CI=1.02, 1.57] for mammography). Conclusions Rates of preventive services receipt will likely increase as community health center patients gain insurance through Affordable Care Act expansions. Continued effort is needed to increase health insurance coverage in an effort to decrease health disparities in vulnerable populations. PMID:26497264

  20. Etude thermo-hydraulique de l'ecoulement du moderateur dans le reacteur CANDU-6

    NASA Astrophysics Data System (ADS)

    Mehdi Zadeh, Foad

    Etant donne la taille (6,0 m x 7,6 m) ainsi que le domaine multiplement connexe qui caracterisent la cuve des reacteurs CANDU-6 (380 canaux dans la cuve), la physique qui gouverne le comportement du fluide moderateur est encore mal connue de nos jours. L'echantillonnage de donnees dans un reacteur en fonction necessite d'apporter des changements a la configuration de la cuve du reacteur afin d'y inserer des sondes. De plus, la presence d'une zone intense de radiations empeche l'utilisation des capteurs courants d'echantillonnage. En consequence, l'ecoulement du moderateur doit necessairement etre etudie a l'aide d'un modele experimental ou d'un modele numerique. Pour ce qui est du modele experimental, la fabrication et la mise en fonction de telles installations coutent tres cher. De plus, les parametres de la mise a l'echelle du systeme pour fabriquer un modele experimental a l'echelle reduite sont en contradiction. En consequence, la modelisation numerique reste une alternative importante. Actuellement, l'industrie nucleaire utilise une approche numerique, dite de milieu poreux, qui approxime le domaine par un milieu continu ou le reseau des tubes est remplace par des resistances hydrauliques distribuees. Ce modele est capable de decrire les phenomenes macroscopiques de l'ecoulement, mais ne tient pas compte des effets locaux ayant un impact sur l'ecoulement global, tel que les distributions de temperatures et de vitesses a proximite des tubes ainsi que des instabilites hydrodynamiques. Dans le contexte de la surete nucleaire, on s'interesse aux effets locaux autour des tubes de calandre. En effet, des simulations faites par cette approche predisent que l'ecoulement peut prendre plusieurs configurations hydrodynamiques dont, pour certaines, l'ecoulement montre un comportement asymetrique au sein de la cuve. Ceci peut provoquer une ebullition du moderateur sur la paroi des canaux. Dans de telles conditions, le coefficient de reactivite peut varier de maniere

  1. Patients' experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care.

    PubMed

    Chung, Vincent Ch; Yip, Benjamin Hk; Griffiths, Sian M; Yu, Ellen Lm; Liu, Siya; Ho, Robin St; Wu, Xinyin; Leung, Albert Wn; Sit, Regina Ws; Wu, Justin Cy; Wong, Samuel Ys

    2015-12-21

    Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients' experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients' perspective; and (ii) to investigate how quality varies with patients' demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of "coordination of patient information", "continuity of care", and "range of service provided". Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services.

  2. Nurses on a mission: a professional service learning experience with the inner-city homeless.

    PubMed

    Lashley, Mary

    2007-01-01

    Nursing students can play a vital role in addressing the health care needs of the homeless. Through professional service learning experiences in community-based settings, students learn how to partner with key community leaders and agencies to meet the needs of underserved populations and provide culturally competent care to diverse populations. This article describes the development of a professional service learning experience with the homeless in which a community-academic partnership was created to meet community needs. In an era of declining health care resources, such innovative partnerships serve to reduce health disparities and improve access to care while preparing students for community-based practice with at-risk and vulnerable populations.

  3. Fostering Pre-service Teachers' Self-Determined Environmental Motivation Through Green Chemistry Experiments

    NASA Astrophysics Data System (ADS)

    Karpudewan, Mageswary; Ismail, Zurida; Roth, Wolff-Michael

    2012-10-01

    The global environmental crisis intensifies particularly in developing nations. Environmental educators have begun to understand that changing the environmental impact requires not only changes in pro-environmental knowledge and attitudes but also in associated, self-determined motivation. This study was designed to test the hypothesis that a green chemistry curriculum changes Malaysian pre-service teachers' environmental motivation. Two comparable groups of pre-service teachers participated in this study. The students in the experimental group ( N = 140) did green chemistry experiments whereas the control group ( N = 123) did equivalent experiments in a traditional manner. Posttest results indicate that there is significant difference between both the groups for intrinsic motivation, integration, identification, and introjections scales and no differences for external regulation and amotivation scales. The qualitative analysis of interview data suggests that the changes are predominantly due to the personal satisfaction that participants derived from engaging in pro-environmental behavior.

  4. Rethinking Library Service: Improving the User Experience with Service Blueprinting

    ERIC Educational Resources Information Center

    Pretlow, Cassi; Sobel, Karen

    2015-01-01

    Service blueprinting is a process that businesses use for analyzing and improving service. Originally presented in the Harvard Business Review in 1984, it has retained a strong following ever since. At present, it is experiencing a revival at numerous academic institutions. The authors of this article present the process of service blueprinting.…

  5. Dangerous Practices: The Practicum Experiences of Non-Indigenous Pre-Service Teachers in Remote Communities

    ERIC Educational Resources Information Center

    Auld, Glenn; Dyer, Julie; Charles, Claire

    2016-01-01

    This paper seeks to explore the risks of providing preservice teachers with professional experiences in remote communities. In particular this paper focuses on the risks associated with this kind of professional experience. Twelve pre-service teachers were interviewed whilst on a three-week practicum around Katherine and in Maningrida in the…

  6. Mothers with mental health problems: Contrasting experiences of support within maternity services in the Republic of Ireland.

    PubMed

    Higgins, Agnes; Tuohy, Teresa; Murphy, Rebecca; Begley, Cecily

    2016-05-01

    to explore the views and experiences of women with mental health difficulties, in the Republic of Ireland, accessing and receiving care from publicly-funded maternity care services during pregnancy, childbirth and immediate postnatal period in hospital. in total 20 women with a range of mental health problems were recruited. The women had given birth within maternity services with and without specialist perinatal mental health services. a qualitative descriptive design using in-depth face to face interviews was used to explore women׳s experience. Data were analysed using an inductive thematic process. the study offers valuable insights into the maternity care experiences of women with mental health problems, and highlights the deficits and fragmentation of care in maternity units that do not have a specialist mental health service. Even when the women voluntarily disclosed their difficulties, midwives appeared to lack the knowledge and skills to respond sensitively and responsively. there is a need to expand perinatal mental health services in the Republic of Ireland, so that quality service provision is not dependent on geography. In addition, there is a need for education to address the lack of knowledge and understanding of perinatal mental health problems amongst maternity care practitioners. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Science and craftsmanship: the art of experiment and instrument making.

    PubMed

    Dierig, Sven

    2006-01-01

    In his two-volume monograph Untersuchungen über thierische Elektricität, the Berlin physiologist Emil du Bois-Reymond described the relation between nervous electricity and muscle mechanics by way of a long series of experiments. This work is a key text in the history of the experimental life sciences. But it not only contains new findings about the functioning of muscles and its nerves. Du Bois-Reymond practiced an art of experimentation in which aesthetics of mechanical craftsmanship allied itself with the science of physiology. Experimentation, as du Bois-Reymond understood it, was simultaneously an epistemic and an aesthetic practice. The goal of his science was thus producing both knowledge and aesthetic success. To cite this article: S. Dierig, C. R. Biologies 329 (2006).

  8. Le schwannome malin du nerf grand sciatique chez l'enfant

    PubMed Central

    Lechqar, Maryem; Elbiache, Imad; Atarraf, Karima; Bouabdellah, Youssef; Afifi, My Abderahman

    2012-01-01

    Le schwannome malin est une tumeur très rare chez l'enfant (1 à 2% des tumeurs des tissus mous), elle se développe au dépend des cellules de schwanne. Dans ce travail, les auteurs rapportent un cas de schwannome malin développé au dépend du nerf grand sciatique. La radiographie de la cuisse de face et de profil était normale. L'imagerie par résonance magnétique a identifié une lésion le long du trajet du nerf grand sciatique. La tumeur a été réséquée en totalité emportant le nerf grand sciatique. L'examen anatomo-pathologique a confirmé le diagnostic. PMID:23133710

  9. The Impact of a Social Justice Service-Learning Field Experience in a Social Foundations Course

    ERIC Educational Resources Information Center

    Tinkler, Barri; hannah, c. lynne; Tinkler, Alan; Miller, Elizabeth

    2015-01-01

    This interpretive study examines the outcomes of using a social justice service-learning field experience in a social foundations course to help illuminate for teacher candidates the often "invisible" institutionalized inequities of public schools. The findings demonstrate how social justice service-learning can be used as a field…

  10. The Experiences of Older Students' Use of Web-Based Student Services

    ERIC Educational Resources Information Center

    Ho, Katy W.

    2012-01-01

    The purpose of this phenomenological case study was to understand the experiences of older students' use of web-based student services in a community college setting. For the purpose of this study the term "older student" was defined as people born between the years 1943 and 1960. This group of people, often described as the Baby Boomer…

  11. Primary Pre-Service Teachers' Epistemological Beliefs and Their Teaching and Learning Experiences

    ERIC Educational Resources Information Center

    Çam, Aylin

    2015-01-01

    The epistemological beliefs of pre-service teachers influence both their teaching experiences and their students' content understanding. Little research has been devoted to the interaction between teachers' epistemological beliefs and teaching practices (Schraw & Olafson, 2002). To address this gap, this study investigated primary pre-service…

  12. Experience-based design: from redesigning the system around the patient to co-designing services with the patient.

    PubMed

    Bate, Paul; Robert, Glenn

    2006-10-01

    Involving patients in service improvement and listening and responding to what they say has played a key part in the redesign of healthcare processes over the past five years and more. Patients and users have attended stakeholder events, participated in discovery interviews, completed surveys, mapped healthcare processes and even designed new hospitals with healthcare staff. However, to date efforts have not necessarily focused on the patient's experience, beyond asking what was good and what was not. Questions were not asked to find out details of what the experience was or should be like ("experience" being different from "attitudes") and the information then systematically used to co-design services with patients. Knowledge of the experience, held only by the patient, is unique and precious. In this paper, attention is drawn to the burgeoning discipline of the design sciences and experience-based design, in which the traditional view of the user as a passive recipient of a product or service has begun to give way to the new view of users as integral to the improvement and innovation process.

  13. Les accidents du travail dans le transport urbain en commun de la ville province de Kinshasa, République Démocratique du Congo: une étude transversale descriptive

    PubMed Central

    Wangata, Jemima; Elenge, Myriam; De Brouwer, Christophe

    2014-01-01

    Introduction Le transport en commun urbain constitue un secteur où les travailleurs sont très exposés aux accidents du travail. Cette étude visait une description épidémiologique des accidents du travail dans le secteur informel du transport en commun à Kinshasa en vue d'apporter les pistes d'amélioration de la sécurité des travailleurs dans cette activité. Méthodes Un questionnaire sur les accidents du travail, administré en Décembre 2012 a permis d'explorer les tendances significatives entre les accidents et leurs circonstances, leurs facteurs associés, leurs conséquences au sein d'une population des travailleurs (n = 472) du transport en commun à Kinshasa. Résultats Durant les 12 derniers précédant l’étude 76.5% des travailleurs ont connu au moins un accident du travail, 54,8% ont connu un arrêt d'au moins 1jour. Les accidents liés à la circulation routière étaient plus important suivis des chutes. Les facteurs ayant montré des différences significatives étaient le travail sous l'influence de l'alcool et le port des équipements de protection individuelle. Les plaies (46,3%) et les contusions (39,4%) étaient les lésions les plus courantes. Les membres supérieurs (51,3%) et inférieurs (30,7%) étaient les plus atteints. 76,6% des travailleurs ont assumé seuls leur prise en charge médicale. Conclusion L'incidence des accidents du travail dans ce secteur est très élevée. La mise en place d'une politique de prévention et gestion de différents facteurs associés ainsi qu'un système de déclaration d'accidents est nécessaire dans ce secteur. Les patrons ainsi que les politiques devraient veiller à une prise en charge médicale correcte pour des travailleurs accidentés. PMID:25667703

  14. Les fractures luxations du cotyle: prise en charge et pronostic à long terme; étude rétrospective portant sur 40 cas

    PubMed Central

    Chagou, Aniss; Hmouri, Ismail; Rhanim, Abdelkarim; Lahlou, Abdou; Berrada, Mohammed Saleh; Yaacoubi, Moradh

    2014-01-01

    Les fractures luxations du cotyle sont le plus souvent dues à des traumatismes de haute énergie. Elles constituent une urgence thérapeutique, l'association de la luxation à une fracture du cotyle fait apparaître la question du choix thérapeutique entre traitement orthopédique et traitement médical. L'objectif de l’étude est de mettre le point sur l'aspect thérapeutique dans ces lésions mais aussi leurs pronostics à long terme. Nous rapportons une étude rétrospective portant sur 40 cas colligés au service d'orthopédie du centre hospitalier universitaire de Rabat. Nous avons évalué les résultats de notre prise en charge mais aussi le pronostic à court et à long terme. Dans notre série, vingt cinq patients ont bénéficié d'un traitement orthopédique alors que les quinze restants ont été opérés, la voie d'abord la plus utilisée est la voie postérieure. Les résultats fonctionnels ont été évalués, après un recul de 3 à 8 ans, selon la cotation de Merle d'Aubigné. Nous avons obtenu 90% de résultats satisfaisants. La comparaison de nos résultats à ceux de la littérature montre que le résultat des traitements orthopédiques et chirurgicaux dépend essentiellement du type de fracture. Le pronostic à long terme reste imprévisible. La survenue des complications tardives telle que la nécrose céphalique et de l'arthrose reste toujours imprévisible, ce qui impose un suivi régulier et prolongé des patients. PMID:25722763

  15. Une forme exceptionnelle de la luxation perilunaire du carpe

    PubMed Central

    Elouakili, Issam; Ouchrif, Younes; Najib, Abdeljaouad; Ouakrim, Redouane; Lamrani, Omar; Kharmaz, Mohammed; Ismael, Farid; Lahlou, Abdo; Elouadghiri, Mohammed; El Bardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohammed Saleh; El Yaccoubi, Mouradh

    2014-01-01

    Les luxations périlunaires (LPL) du carpe sont des lésions extrêmement rares, qui peuvent passer inaperçue en raison d'un tableau clinique souvent trompeur, des radiographies en profil non strict ou d'interprétation difficile. Nous rapportons l'observation d'une luxation périlunaire stade III selon la classification de Witvoët et Allieu chez un patient de 32 ans, il s'agit d'une forme encore plus rare voire exceptionnelle et qui peut induire de sérieux problèmes en raison de la sévérité des dommages ligamentaires et du risque de nécrose du semilunaire plus important dans ce type de lésions. Le traitement est toujours chirurgical et doit être réalisé dans les plus brefs délais afin d’éviter les complications. PMID:25404968

  16. Marihuana: A Conversation with NIDA's Robert L. DuPont.

    PubMed

    Maugh, T H

    1976-05-14

    Robert L. DuPont, director of the National Institute on Drug Abuse (NIDA), made headlines recently when he became one of the first Administration officials publicly to recommend a liberalization of marihuana laws. The occasion was a press conference accompanying the release of Marihuana and Health, NIDA's fifth annual report to the Congress on marihuana research. Recently, Science talked with DuPont and asked him to elaborate on those views. DuPont, a 40-year-old Harvard M.D., served as Director of the District of Columbia's Narcotics Treatment Administration from 1970 to 1973, where he conducted a comprehensive program for treatment of heroin addiction. In June 1973, Richard Nixon appointed him director of the White House Special Action Office for Drug Abuse Prevention. He held that position until the office was terminated on 30 June 1975. He has been director of NIDA since September 1973.

  17. Preferences for Early Intervention Mental Health Services: A Discrete-Choice Conjoint Experiment.

    PubMed

    Becker, Mackenzie P E; Christensen, Bruce K; Cunningham, Charles E; Furimsky, Ivana; Rimas, Heather; Wilson, Fiona; Jeffs, Lisa; Bieling, Peter J; Madsen, Victoria; Chen, Yvonne Y S; Mielko, Stephanie; Zipursky, Robert B

    2016-02-01

    Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation. Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization. Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model. Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

  18. Service Learning: A Valuable Experience

    ERIC Educational Resources Information Center

    Fowler, William E.; Stovall, O. Scott; Neill, John D.

    2005-01-01

    In this paper, we describe how our department recently incorporated a major service learning component into the curriculum. Specifically, we employed participation in the IRS's Volunteer Income Tax Assistance (VITA) program as an effective means of experiential and service learning for the past two years for Masters of Accountancy students. We…

  19. Examining clinicians’ experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice

    PubMed Central

    Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.

    2014-01-01

    Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth’s experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians’ experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency—either implicitly (e.g. by describing heteronormative practices) or explicitly (e.g. by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. PMID:24412811

  20. The right location? Experiences of refugee adolescents seen by school-based mental health services.

    PubMed

    Fazel, Mina; Garcia, Jo; Stein, Alan

    2016-07-01

    Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services. © The Author(s) 2016.

  1. Investigation of the Perceived Causes of Pre-Service Physics Teachers' Problems Encountered in School Experience

    ERIC Educational Resources Information Center

    Körhasan, Nilüfer Didis; Didis, M. Gözde

    2015-01-01

    This study investigates a group of pre-service physics teachers' perceptions about the causes of problems in school experience through the attribution theory. The participants were thirteen pre-service physics teachers from a public university in Turkey. Data were collected through the interviews by requesting the participants to reflect their own…

  2. Development Unit Configuration and Current Status of the MIP/MTERC Experiment

    NASA Technical Reports Server (NTRS)

    Juanero, K. J.; Johnson, K. R.

    1999-01-01

    The Mars In-Situ Propellant Production (ISPP) Precursor (MIP) experiment package is planned for inclusion on the Mars 2001 Lander. This experiment package consists of five experiments whose purpose is to demonstrate the performance of various ISPP processes in-situ on Mars. The demonstrated ability to produce propellant for Mars Return Vehicles (MRV) is considered to be a necessary precursor to any future manned mission to Mars. The Mars Thermal Environment/Radiator Characterization (MTERC) experiment is part of the MIP package and is intended to determine the Mars night sky temperature as well as to characterize the performance degradation of radiators caused by environmental exposure on Mars over time. Radiators are needed as part of the ISPP process to remove heat from the Mars Atmosphere Acquisition and Compression (MAAC) C02 sorption compressor. MTERC will provide the data needed to optimize the design of radiators for ISPP and other processes. A MTERC Development Unit (DU) has been fabricated and tested at JPL. The MTERC DU consists of: (1) a radiator subassembly, (2) a motor/cover subassembly, (3) a differential temperature control circuit and motor control electronics circuit board, and (4) a command and data handling electronics circuit board. This paper will describe the operational theory and the configuration of the MTERC DU and will discuss the current status of the MTERC experiment development including some selected results of performance testing that has been completed prior to the ISRU III meeting.

  3. Development Unit Configuration and Current Status of the MIP/MTERC Experiment

    NASA Technical Reports Server (NTRS)

    Juanero, K. J.; Johnson, K. R.

    1999-01-01

    The Mars In-Situ Propellant Production (ISPP) Precursor (MIP) experiment package is planned for inclusion on the Mars 2001 Lander. This experiment package consists of five experiments whose purpose is to demonstrate the performance of various ISPP processes in-situ on Mars. The demonstrated ability to produce propellant for Mars Return Vehicles (MRV) is considered to be a necessary precursor to any future manned mission to Mars. The Mars Thermal Environment/Radiator Characterization (MTERC) experiment is part of the MIP package and is intended to determine the Mars night sky temperature as well as to characterize the performance degradation of radiators caused by environmental exposure on Mars over time. Radiators are needed as part of the ISPP process to remove heat from the Mars Atmosphere Acquisition and Compression (MAAC) CO2 sorption compressor. MTERC will provide the data needed to optimize the design of radiators for ISPP and other processes. A MTERC Development Unit (DU) has been fabricated and tested at JPL. The MTERC DU consists of 1) a radiator subassembly, 2) a motor/cover subassembly, 3) a differential temperature control circuit and motor control electronics circuit board, and 4) a command and data handling electronics circuit board. This paper will describe the operational theory and the configuration of the MTERC DU and will discuss the current status of the MTERC experiment development including some selected results of performance testing that has been completed prior to the ISRU III meeting.

  4. Young People’s Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment

    PubMed Central

    Michaels-Igbokwe, Christine; Terris-Prestholt, Fern; Lagarde, Mylene; Chipeta, Effie; Cairns, John

    2015-01-01

    Objective To quantify the impact of service provider characteristics on young people’s choice of family planning (FP) service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth. Methods and Findings A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15–24). Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP) and described by six attributes (the distance between participants’ home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers’ attitude, availability of FP commodities and price). A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA) services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01) and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01). Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth. Conclusions Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available. PMID

  5. Important first encounter: Service user experience of pathways to care and early detection in first-episode psychosis.

    PubMed

    Jansen, Jens Einar; Pedersen, Marlene Buch; Hastrup, Lene Halling; Haahr, Ulrik Helt; Simonsen, Erik

    2018-04-01

    Long duration of untreated psychosis is associated with poor clinical and functional outcomes. However, few systematic attempts have been made to reduce this delay and little is known of service users' experience of early detection efforts. We explored service users' experience of an early detection service and transition to specialized treatment service, including pathway to care, understanding of illness and barriers to adequate assessment and treatment. In-depth interviews were conducted with 10 service users (median age 21, range 18-27, five males and five females) who were diagnosed with a first-episode non-affective psychosis and who were seen by an early detection team (TOP) and currently enrolled in a specialized early intervention service for this disorder (OPUS). Stigma and fear of the 'psychiatric system' were reported as significant barriers to help seeking, while family members were seen as a crucial support. Moreover, the impact of traumatic events on the experience and development of psychosis was highlighted. Finally, participants were relieved by the prospect of receiving help and the early detection team seemed to create a trusting relationship by offering a friendly, 'anti-stigmatized' space, where long-term symptomatology could be disclosed through accurate and validating questioning. Early detection services have two important functions. One is to make accurate assessments and referrals. The other is to instil hope and trust, and to facilitate further treatment by forming an early therapeutic alliance. The findings in this study provide important insights into the way in which early detection efforts and pathways to care are experienced by service users, with direct implications for improving psychiatric services. © 2015 Wiley Publishing Asia Pty Ltd.

  6. A Cultural Immersion Field Experience: Examining Pre-Service Music Teachers' Beliefs about Cultural Differences

    ERIC Educational Resources Information Center

    VanDeusen, Andrea J.

    2017-01-01

    With the intent of informing music teacher education practices and developing more culturally responsive and relevant teachers, the purpose of this research was to explore pre-service music teachers' understandings of culture and diversity, and to examine the impact of a short-term cultural immersion field experience on pre-service music teachers'…

  7. Mental health consumers' with medical co‐morbidity experience of the transition through tertiary medical services to primary care

    PubMed Central

    Cranwell, Kate; Polacsek, Meg

    2016-01-01

    Abstract Medical comorbidity in people with long‐term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health‐care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video‐recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers’ experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments. PMID:26735771

  8. 'What makes an excellent mental health doctor?' A response integrating the experiences and views of service users with critical reflections of psychiatrists.

    PubMed

    Gunasekara, Imani; Patterson, Sue; Scott, James G

    2017-11-01

    While therapeutic relationships are appropriately recognised as the foundation of mental health service, service users commonly report suboptimal experiences. With shared understanding critical to improvement in practice, we explored service users' experiences and expectations of psychiatrists and consultations, engaging psychiatrists throughout the process. Using an iterative qualitative approach we co-produced a response to the question 'what makes an excellent mental health doctor?' Experiences and expectations of psychiatrists were explored in interviews with 22 service users. Data collection, analysis and interpretation were informed by consultation with peer workers. Findings were contextualised in formal consultations with psychiatrists. As 'masters of their craft', excellent mental health doctors engage authentically with service users as people (not diagnoses). They listen, validate experiences and empathise affectively and cognitively. They demonstrate phronesis, applying clinical knowledge compassionately. Psychiatrists share service users' aspiration of equitable partnership but competing demands and 'professional boundaries' constrain engagement. Consistent delivery of the person-centred, recovery-oriented care promoted by policy and sought by service users will require substantial revision of the structure and priorities of mental health services. The insights and experiences of service users must be integral to medical education, and systems must provide robust support to psychiatrists. © 2017 John Wiley & Sons Ltd.

  9. A Professional Experience Model for Primary Pre-Service Teachers Specialising in Mathematics

    ERIC Educational Resources Information Center

    McMaster, Heather; Cavanagh, Michael

    2016-01-01

    Many primary pre-service teachers (PSTs) who are enthused by tertiary courses that espouse and model a socio-constructivist approach to teaching mathematics, revert to a traditional approach when they encounter mathematics teaching during professional experience. An intervention was designed to translate the initial pedagogical intent of four…

  10. Developing a framework for gathering and using service user experiences to improve integrated health and social care: the SUFFICE framework.

    PubMed

    Ward, Vicky; Pinkney, Lisa; Fry, Gary

    2016-09-08

    More people than ever receive care and support from health and social care services. Initiatives to integrate the work of health and social care staff have increased rapidly across the UK but relatively little has been done to chart and improve their impact on service users. Our aim was to develop a framework for gathering and using service user feedback to improve integrated health and social care in one locality in the North of England. We used published literature and interviews with health and social care managers to determine the expected service user experiences of local community-based integrated teams and the ways in which team members were expected to work together. We used the results to devise qualitative data collection and analysis tools for gathering and analyzing service user feedback. We used developmental evaluation and service improvement methodologies to devise a procedure for developing service improvement plans. We identified six expected service user experiences of integrated care and 15 activities that health and social care teams were expected to undertake. We used these to develop logic models and tools for collecting and analysing service user experiences. These include a narrative interview schedule, a plan for analyzing data, and a method for synthesizing the results into a composite 'story'. We devised a structured service improvement procedure which involves teams of health and social care staff listening to a composite service user story, identifying how their actions as a team may have contributed to the story and developing a service improvement plan. This framework aims to put service user experiences at the heart of efforts to improve integration. It has been developed in collaboration with National Health Service (NHS) and Social Care managers. We expect it to be useful for evaluating and improving integrated care initiatives elsewhere.

  11. Disability Experiences and Perspectives Regarding Reproductive Decisions, Parenting, and the Utility of Genetic Services: a Qualitative Study.

    PubMed

    Roadhouse, C; Shuman, C; Anstey, K; Sappleton, K; Chitayat, D; Ignagni, E

    2018-06-16

    Genetic counselors adopt seemingly contradictory roles: advocating for individuals with genetic conditions while offering prenatal diagnosis and the option of selective termination to prevent the birth of a child with a disability. This duality contributes to the tension between the disability and clinical genetics communities. Varying opinions exist amongst the disability community: some value genetic services while others are opposed. However, there is limited research exploring the opinions of individuals with a disability regarding issues related to reproduction and genetic services in the context of personal experience. This exploratory qualitative study involved interviews with seven women and three men who self-identify as having a disability. We sought to gain their perspectives on experiences with disability, thoughts about reproduction and parenting, and perceptions of genetic services. Transcripts of the interviews were analyzed thematically using qualitative content analysis. Data analysis showed that societal views of disability affected the lived experience and impacted reproductive decision-making for those with a disability. It also showed differing interest in genetic services. Concerns about the perceived collective implications of genetic services were also raised. These findings contribute to the understanding of the disability perspective toward reproductive decision-making and genetic services. A further goal is to promote a meaningful dialogue between the genetics and disability communities, with the potential to enhance the genetic and reproductive care provided to individuals with disabilities.

  12. Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

    2007-05-01

    In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

  13. Patient preferences for community pharmacy asthma services: a discrete choice experiment.

    PubMed

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John M; Saini, Bandana

    2012-10-01

    Specialized community pharmacy services, involving the provision of disease state management and care by pharmacists, have been developed and trialled and have demonstrated very good health outcomes. Most of these services have been developed from a healthcare professional perspective. However, for the future uptake and long-term sustainability of these services as well as for better and sustained health outcomes for patients, it is vital to gain an understanding of patients' preferences. We can then structure healthcare services to match these preferences and needs rather than around clinical viewpoints alone. The aim of this study was to elicit patient preferences for pharmacy-based specialized asthma services using a discrete choice experiment and to explore the value/importance that patients place on the different attributes of the asthma service. The existence of preference heterogeneity in the population was also investigated. The study was conducted with asthma patients who had recently experienced a specialized asthma management service at their pharmacy in New South Wales, Australia. Pharmacists delivering the asthma service mailed out the discrete choice questionnaires to participating patients at the end of 6 months of service provision. A latent class (LC) model was used to investigate each patient's strength of preference and preference heterogeneity for several key attributes related to asthma service provision: frequency of visits, access to pharmacist, interaction with pharmacy staff, availability of a private area for consultation, provision of lung function testing, type and depth of advice provision, number of days with asthma symptoms and cost of service. Eighty useable questionnaires (of 170 questionnaires sent out) were received (response rate 47.1%). The study identified various key elements of asthma services important to patients. Further, the LC analysis revealed three classes with differing patient preferences for levels of asthma service

  14. Learning from Our Own Lessons: Pre-Service Teachers' Narratives of Teaching as an Experiment

    ERIC Educational Resources Information Center

    Wickstrom, Megan H.; Wilm, Stephanie; Mills, Emily; Johnson, Alexis; Leonard, Nicole; Larberg, Raegan

    2018-01-01

    Pre-service teachers need to develop habits of mind that allow them to grow as new teachers. This article describes an elementary mathematics methods course in which teaching as an experiment was used a framework for pre-service teachers to participate in action research by developing learning goals, observing and analyzing student thinking,…

  15. Kyste épidermoïde du testicule : Étude de cas

    PubMed Central

    Diarra, Alkadri; Elammari, Jalal Eddine; Kassogue, Amadou; El Fassi, Mohammed Jamal; Farih, My Hassan

    2013-01-01

    Résumé Le kyste épidermoïde (KE) du testicule est une tumeur bénigne rare. Le diagnostic peut être évoqué par l’échographie et l’IRM. En cas de lésion unique de petite taille, il est possible d’effectuer une chirurgie conservatrice. Ce traitement nécessite une confirmation anatomopathologique. Le présent article fait état de l’observation d’un patient de 34 ans ayant été admis en consultation d’urologie pour désir d’enfant. Le diagnostic de KE associé à une varicocèle gauche a été retenu. L’énucléation du kyste avec cure de varicocèle a été réalisée sans complications postopératoires. Une revue de la littérature nous a permis de mettre en évidence les différents aspects du KE du testicule et les méthodes thérapeutiques envisageables. PMID:24282476

  16. Des proprietes de l'etat normal du modele de Hubbard bidimensionnel

    NASA Astrophysics Data System (ADS)

    Lemay, Francois

    Depuis leur decouverte, les etudes experimentales ont demontre que les supra-conducteurs a haute temperature ont une phase normale tres etrange. Les proprietes de ces materiaux ne sont pas bien decrites par la theorie du liquide de Fermi. Le modele de Hubbard bidimensionnel, bien qu'il ne soit pas encore resolu, est toujours considere comme un candidat pour expliquer la physique de ces composes. Dans cet ouvrage, nous mettons en evidence plusieurs proprietes electroniques du modele qui sont incompatibles avec l'existence de quasi-particules. Nous montrons notamment que la susceptibilite des electrons libres sur reseau contient des singularites logarithmiques qui influencent de facon determinante les proprietes de la self-energie a basse frequence. Ces singularites sont responsables de la destruction des quasi-particules. En l'absence de fluctuations antiferromagnetiques, elles sont aussi responsables de l'existence d'un petit pseudogap dans le poids spectral au niveau de Fermi. Les proprietes du modele sont egalement etudiees pour une surface de Fermi similaire a celle des supraconducteurs a haute temperature. Un parallele est etabli entre certaines caracteristiques du modele et celles de ces materiaux.

  17. Short-Term International Experience (STIE) and Students' Understanding of Quality Early Childhood Service Provision

    ERIC Educational Resources Information Center

    Sims, Margaret; Nishida, Yukiyo

    2018-01-01

    Exposing pre-service teachers to international professional experiences through a short-term visiting programme serves to challenge their understandings of good quality practice through disturbing assumptions and expectations previously formed through experiences in their own country/culture. Much of the research in international study focuses on…

  18. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services?

    PubMed

    Dunn, Matthew; Henshaw, Richard; McKay, Fiona H

    2016-07-01

    To understand health service access and needs of people who use performance and image enhancing drugs (PIED) in regional Queensland. Semi-structured interviews were conducted with 21 people (n = 19 men) who reported the use of a range of PIEDs, including anabolic-androgenic steroids, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin and peptides. Participants reported accessing a range of services, including needle and syringe programs and pharmacies, for sterile injecting equipment. While PIEDs users attributed some stigma to needle and syringe programs, they were seen as an important service for injecting equipment. Participants reported receiving either positive care from health-care providers, such as general practitioners (GP), or having negative experiences due to the stigma attached with PIED use. Few participants reported disclosing their PIED use to their GP not only because of the concerns that their GP would no longer see them but also because they felt their GP was not knowledgeable about these substances. Participants in the study reported no difficulty in accessing health services based on living in a regional area, with their concern focused more upon how they were viewed and treated by service staff. [Dunn M, Henshaw R, Mckay F. H. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services? Drug Alcohol Rev 2016;35:377-382]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  19. Examining clinicians' experiences providing sexual health services for LGBTQ youth: considering social and structural determinants of health in clinical practice.

    PubMed

    Knight, R E; Shoveller, J A; Carson, A M; Contreras-Whitney, J G

    2014-08-01

    Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians' experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency-either implicitly (e.g., by describing heteronormative practices) or explicitly (e.g., by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Two-generation reproductive toxicity study of implanted depleted uranium (DU) in CD rats.

    PubMed

    Arfsten, D P; Still, K R; Wilfong, E R; Johnson, E W; McInturf, S M; Eggers, J S; Schaeffer, D J; Bekkedal, M Y-V

    2009-01-01

    Depleted uranium (DU) munitions and armor plating have been used in several conflicts over the last 17 yr, including the Persian Gulf War and the Iraq War. Because of its effectiveness and availability, DU will continue to be used in military applications into the foreseeable future. There is much controversy over the use of DU in weapons and equipment because of its potential radiological and toxic hazards, and there is concern over the chronic adverse health effects of embedded DU shrapnel in war veterans and bystanders. This study evaluated the effects of long-term implantation of DU on the reproductive success of F0 generation adults and development and survival of subsequent F1 and F2 generations in a two-generation reproductive toxicity study. F0 generation Sprague-Dawley rats, 8 wk of age, were surgically implanted with 0, 4, 8, 12, or 20 DU pellets (1 x 2 mm). Inert implant control animals were implanted with 12 or 20 tantallum (Ta) pellets. The F0 generation was then mated at 120 d post DU implantation. In the F0 generation, when measured on postimplantation d 27 and 117, uranium was present in the urine of DU-implanted animals in a dose-dependent manner. F0 reproductive success was similar across treatment groups and the maternal retrieval test revealed no changes in maternal behavior. DU implantation exerted no effect on the survival, health, or well-being of the F0 generation. Necropsy results of F0 animals were negative with the exception of a marked inflammatory response surrounding the implanted DU pellets. For the F1 generation, measures of F1 development through postnatal day (PND) 20 were unremarkable and no gross abnormalities were observed in F1 offspring. No uranium was detected in whole-body homogenates of PND 4 or PND 20 pups. Necropsy findings of F1 PND 20 pups were negative and no instances of ribcage malformation were observed in F1 PND 20 pups. Body weight and body weight gain of F1 rats through PND 120 were similar across treatment

  1. Speaking Truth to Power: Du Bois as Educator and Community Activist

    ERIC Educational Resources Information Center

    Grant, Carl A.; Grant, Paul D.

    2017-01-01

    This article uses W. E. B. Du Bois's work as an education and community activist to discuss race, oppression, and speaking-back to power in this time of racialized policies enacted by the Trump administration. This article centers a comparative discussion of the racialization of democracy by presidents Wilson and Trump to show the ways Du Bois was…

  2. Modeling the mental health service utilization decisions of university undergraduates: A discrete choice conjoint experiment.

    PubMed

    Cunningham, Charles E; Zipursky, Robert B; Christensen, Bruce K; Bieling, Peter J; Madsen, Victoria; Rimas, Heather; Mielko, Stephanie; Wilson, Fiona; Furimsky, Ivana; Jeffs, Lisa; Munn, Catharine

    2017-01-01

    We modeled design factors influencing the intent to use a university mental health service. Between November 2012 and October 2014, 909 undergraduates participated. Using a discrete choice experiment, participants chose between hypothetical campus mental health services. Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling. E-Mental Health options could engage students who may not wait for standard services.

  3. Assessing Pre-Service Teachers' Computer Phobia Levels in Terms of Gender and Experience, Turkish Sample

    ERIC Educational Resources Information Center

    Ursavas, Omer Faruk; Karal, Hasan

    2009-01-01

    In this study it is aimed to determine the level of pre-service teachers' computer phobia. Whether or not computer phobia meaningfully varies statistically according to gender and computer experience has been tested in the study. The study was performed on 430 pre-service teachers at the Education Faculty in Rize/Turkey. Data in the study were…

  4. Commerce de detail de l'essence automobile: Modelisation de l'impact a court terme des facteurs endogenes et exogenes sur les ventes d'essence dans les stations-service a Montreal

    NASA Astrophysics Data System (ADS)

    Nguimbus, Raphael

    La determination de l'impact des facteurs sous controle et hors controle qui influencent les volumes de vente des magasins de detail qui vendent des produits homogenes et fortement substituables constitue le coeur de cette these. Il s'agit d'estimer un ensemble de coefficients stables et asymtotiquement efficaces non correles avec les effets specifiques aleatoires des sites d'essence dans le marche de Montreal (Quebec, Canada) durant is periode 1993--1997. Le modele econometrique qui est ainsi specifie et teste, isole un ensemble de quatre variables dont le prix de detail affiche dans un site d'essence ordinaire, la capacite de service du site pendant les heures de pointe, les heures de service et le nombre de sites concurrents au voisinage du site dans un rayon de deux kilometres. Ces quatre facteurs influencent les ventes d'essence dans les stations-service. Les donnees en panel avec les methodes d'estimation robustes (estimateur a distance minimale) sont utilisees pour estimer les parametres du modele de vente. Nous partons avec l'hypothese generale selon laquelle il se developpe une force d'attraction qui attire les clients automobilistes dans chaque site, et qui lui permet de realiser les ventes. Cette capacite d'attraction varie d'un site a un autre et cela est du a la combinaison de l'effort marketing et de l'environnement concurrentiel autour du site. Les notions de voisinage et de concurrence spatiale expliquent les comportements des decideurs qui gerent les sites. Le but de cette these est de developper un outil d'aide a la decision (modele analytique) pour permettre aux gestionnaires des chaines de stations-service d'affecter efficacement les ressources commerciales dans ies points de vente.

  5. A Specialist Professional Experience Learning Community for Primary Pre-Service Teachers Focussed on Mathematical Problem Solving

    ERIC Educational Resources Information Center

    Cavanagh, Michael; McMaster, Heather

    2017-01-01

    Problem solving has been identified as an important approach to learning and teaching mathematics, yet many primary pre-service teachers (PSTs) struggle to implement it during their professional experience. In this paper, we report the experiences of a group of four primary PSTs who, in an additional professional experience placement, formed a…

  6. The experience of receiving a kidney transplant from a deceased donor: Implications for renal services.

    PubMed

    Lonargáin, Diarmaid Ó; Brannigan, Dawn; Murray, Craig

    2017-02-01

    The study aimed to explore the psychological experiences of receiving a kidney transplant from a deceased donor and to examine resulting implications for renal services. A qualitative design was utilised within an interpretative phenomenological analysis (IPA) framework. Semi-structured interviews were conducted with six adults (male = 5, mean age = 45 yrs) on their experiences of receiving a kidney transplant from a deceased donor. All participants had their transplant within the preceding 21 months. Data were analysed using IPA. The four elicited themes incorporate recipients' positive feelings about receiving a transplant, mainly arising from the newfound freedom that this entails, in addition to strong feelings of gratitude towards their donors. They also capture challenges, such as the uncertainty of living with a transplanted kidney, and highlight the increased dependence on others throughout the transplant process. The findings indicate a range of psychological, social and occupational experiences for participants. It is concluded that optimal care in renal services would incorporate a holistic approach to pre and post-transplant care; identifying and supporting the needs of transplant recipients. A biopsychosocial model of care may enhance service user well-being. Potential areas of future research are explored.

  7. Parents' Experiences and Perceptions when Classifying their Children with Cerebral Palsy: Recommendations for Service Providers.

    PubMed

    Scime, Natalie V; Bartlett, Doreen J; Brunton, Laura K; Palisano, Robert J

    2017-08-01

    This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families. A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis. Seven themes encompassing parents' experiences and perspectives reflect a process of increased understanding when classifying their children, with perceptions of utility evident throughout this process. Six recommendations for service providers emerged, including making the child a priority and being a dependable resource. Knowledge of parents' experiences when using the GMFCS, MACS, and CFCS can provide useful insight for service providers collaborating with parents to classify function in children with CP. Using the recommendations from these parents can facilitate family-provider collaboration for goal setting and intervention planning.

  8. Watershed Data Management (WDM) database for West Branch DuPage River streamflow simulation, DuPage County, Illinois, January 1, 2007, through September 30, 2013

    USGS Publications Warehouse

    Bera, Maitreyee

    2017-10-16

    The U.S. Geological Survey (USGS), in cooperation with the DuPage County Stormwater Management Department, maintains a database of hourly meteorological and hydrologic data for use in a near real-time streamflow simulation system. This system is used in the management and operation of reservoirs and other flood-control structures in the West Branch DuPage River watershed in DuPage County, Illinois. The majority of the precipitation data are collected from a tipping-bucket rain-gage network located in and near DuPage County. The other meteorological data (air temperature, dewpoint temperature, wind speed, and solar radiation) are collected at Argonne National Laboratory in Argonne, Ill. Potential evapotranspiration is computed from the meteorological data using the computer program LXPET (Lamoreux Potential Evapotranspiration). The hydrologic data (water-surface elevation [stage] and discharge) are collected at U.S.Geological Survey streamflow-gaging stations in and around DuPage County. These data are stored in a Watershed Data Management (WDM) database.This report describes a version of the WDM database that is quality-assured and quality-controlled annually to ensure datasets are complete and accurate. This database is named WBDR13.WDM. It contains data from January 1, 2007, through September 30, 2013. Each precipitation dataset may have time periods of inaccurate data. This report describes the methods used to estimate the data for the periods of missing, erroneous, or snowfall-affected data and thereby improve the accuracy of these data. The other meteorological datasets are described in detail in Over and others (2010), and the hydrologic datasets in the database are fully described in the online USGS annual water data reports for Illinois (U.S. Geological Survey, 2016) and, therefore, are described in less detail than the precipitation datasets in this report.

  9. Rapport sur l'état du patrimoine astronomique dans les observatoires français de la fin du XIXè siècle

    NASA Astrophysics Data System (ADS)

    Damm, E.; Pécontal, E.

    2012-12-01

    Suite au colloque sur la sauvegarde du patrimoine astronomique organisé par le MAEE et la SAF, sous l'égide de l'UNESCO, qui a conduit à l'adoption de la Déclaration de Paris, les directeurs d'observatoires institutionnels qui étaient absents du colloque ont ressenti le besoin de discuter de ces conclusions prises en leur nom. L'initiative d'organiser une réunion des directeurs des Observatoires des Sciences de l'Univers (OSU) à ce sujet le 30 janvier 2012 a été prise par François Vernotte, directeur de l'Observatoire de Besançon. Le présent compte-rendu de visite résulte d'une initiative spontanée d'Emmanuel Pécontal, astronome responsable du Patrimoine à l'observatoire de Lyon, et d'Evelyne Damm, membre de la Commission Nationale de classement des Monuments Historiques (CNMH) et élue à la communauté d'agglomération des Portes de l'Essonne oû est sis l'observatoire de Camille Flammarion.

  10. Facilitating Middle Level Pre-Service Teachers' Literacy Integration in Early Field Experiences

    ERIC Educational Resources Information Center

    Leckie, Alisa; Wall, Amanda

    2016-01-01

    This study explored how pre-service teachers integrated literacy in middle level social studies. This study was conducted in the context of the Common Core State Standards (CCSS) and their focus on disciplinary literacy, the Council for the Accreditation of Educator Preparation (CAEP) Standards and their focus on rich clinical experiences, and…

  11. Career Intentions and Experiences of Pre- and In-Service Female Band Teachers

    ERIC Educational Resources Information Center

    Fischer-Croneis, Sarah H.

    2016-01-01

    The purpose of this study was to examine pre- and in-service female band teachers' perspectives regarding their experiences in realizing their professional goals. Domains guiding this inquiry included (a) gaining entry into the profession of band teaching, (b) navigating the profession, and (c) gender issues. Findings from this multiple case study…

  12. Community action research track: Community-based participatory research and service-learning experiences for medical students.

    PubMed

    Gimpel, Nora; Kindratt, Tiffany; Dawson, Alvin; Pagels, Patti

    2018-04-01

    Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences. This article provides an overview of CART and reports the program impact based on students' participation, preliminary evaluations and accomplishments. CART is an optional 4‑year service-learning experience for medical students interested in community health. The curriculum includes a coordinated longitudinal program of electives, community service-learning and lecture-based instruction. From 2009-2015, 146 CART students participated. Interests in public health (93%), community service (73%), primary care (73%), CBPR (60%) and community medicine (60%) were the top reasons for enrolment. Significant improvements in mean knowledge were found when measuring the principles of CBPR, levels of prevention, determining health literacy and patient communication strategies (all p's < 0.05). Most students (73%) were satisfied with CART. Projects were disseminated by at least 65 posters and four oral presentations at local, national and international professional meetings. Six manuscripts were published in peer-reviewed journals. CART is an innovative curriculum for training future physicians to be community-responsive physicians. CART can be replicated by other medical schools interested in offering a longitudinal CBPR and service-learning track in an urban metropolitan setting.

  13. Locke and Du Bois: Two Major Black Voices Muzzled by Philanthropic Organizations.

    ERIC Educational Resources Information Center

    Fitchue, M. Anthony

    1997-01-01

    In 1935, the Howard University philosopher Alain Locke asked W. E. B. Du Bois to contribute to an adult education project for African Americans. Censorship by white-controlled foundations forced Locke to reject the Du Bois essay to protect contributions for causes of great importance to blacks. (Author/SLD)

  14. Using VITA Service Learning Experiences to Teach Hypothesis Testing and P-Value Analysis

    ERIC Educational Resources Information Center

    Drougas, Anne; Harrington, Steve

    2011-01-01

    This paper describes a hypothesis testing project designed to capture student interest and stimulate classroom interaction and communication. Using an online survey instrument, the authors collected student demographic information and data regarding university service learning experiences. Introductory statistics students performed a series of…

  15. Collaborative Science Learning in Three-Dimensional Immersive Virtual Worlds: Pre-Service Teachers' Experiences in Second Life

    ERIC Educational Resources Information Center

    Nussli, Natalie; Oh, Kevin; McCandless, Kevin

    2014-01-01

    The purpose of this mixed methods study was to help pre-service teachers experience and evaluate the potential of Second Life, a three-dimensional immersive virtual environment, for potential integration into their future teaching. By completing collaborative assignments in Second Life, nineteen pre-service general education teachers explored an…

  16. Served through Service: Undergraduate Students' Experiences in Community Engaged Learning at a Catholic and Marianist University

    ERIC Educational Resources Information Center

    Fogle, Elizabeth M.; Franco, Savio D.; Jesse, Edel M.; Kondritz, Brent; Maxam, Lindsay; Much-McGrew, Heidi; McMillen, Cody; Ridenour, Carolyn S.; Trunk, Daniel J.

    2017-01-01

    Students participating in sustained community service at an urban Catholic and Marianist university were volunteer informants in this qualitative exploration of the meaning they make of their service experiences. A PhD student research team (nine members) interviewed fourteen undergraduate students (10 of whom were seniors). Findings were…

  17. [Expectations and user experiences of older Roma women with health services in primary care].

    PubMed

    Ramos-Morcillo, Antonio Jesús; Ruzafa-Martínez, María; Fernández-Salazar, Serafín; Del-Pino-Casado, Rafael

    2015-04-01

    To know the expectations and user experiences of older Roma women with health services in primary care (PC). Phenomenological qualitative study. Using focus groups (4-9 women/group) and semistructured interviews. Audio recorded from March to November 2011. Performed in Úbeda and Linares (Spain). Roma women over 50years. A purposive sample stratified by age and area of residence was carried out. Woman were recruited through community leaders. Process of qualitative content analysis: coding, triangulation, obtain and verify results. Supported whit the software Nvivo 8. Three focus groups and four interviews were conducted, including 23 women. The expectations for the PC are focus exclusively on their physician, being invisible other professionals. They look for a relationship with their physician based on trust. In their user experience with the PC coexist three types of user: who goes to their appointments, demands attention only in acute disease and does not attend appointments and reviews. There are socio-cultural factors related to accessibility. Older Roma women set their expectations and experiences with health service in PC around the binomial disease/physician. Expect attention based on trust and a high instrumentalization. A speech with signs of change directed towards a more active and demanding participation in PC services is observed. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. Voluntary community service in medical school: A qualitative study on student leaders' motivations, experiences, and outcomes.

    PubMed

    Loh, Alvona Zi Hui; Tan, Julia Shi Yu; Lee, Jeannette Jen-Mai; Koh, Gerald Choon-Huat

    2016-07-01

    Participation in community service within underprivileged communities among medical students is associated with numerous positive outcomes, such as promoting empathy, enhancing leadership qualities, and fostering civic and social responsibility. We conducted a qualitative study to understand the experiences, motivations and student-reported outcomes on personal growth, when medical students in a developed Asian country participate in local and overseas community services. We recruited medical students from Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, who were leaders of a community service project organized in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Interviews were audio-recorded and transcribed into free-flow text. Thematic analysis was performed independently by three researchers. Motivations to participate in community service include past-positive community service experience and present motivations such as compassion, self-discovery etc. Students reported higher empathy levels, improved communication, organization, decision-making, interpersonal, and leadership skills. The degree of influence on academic work and residency choice were varied. Community service in medical school enriches medical students by bringing about improved self-reported outcomes, leadership skills, and interpersonal skills. It has some bearing on residency choice and academic work.

  19. Pre-Service Students' Perceptions and Experiences of Digital Storytelling in Diverse Classrooms

    ERIC Educational Resources Information Center

    Condy, Janet; Chigona, Agnes; Gachago, Daniela; Ivala, Eunice; Chigona, Agnes

    2012-01-01

    The purpose of this paper is to analyse an innovative teaching and learning practice in which pre-service student teachers at the CPUT used digital stories to reflect on their experiences of diversity in their classroom. Managing diverse classrooms is one of the main challenges for all teachers. Digital storytelling can help manage such…

  20. Coalition Battle Management Language (C-BML) (Language de gestion du champ de bataille (C-BML)

    DTIC Science & Technology

    2012-02-01

    de gestion du champ de bataille (C-BML)) NMSG-048 Final Report. This document...BML) (Langage de gestion du champ de bataille (C-BML)) NMSG-048 Final Report. This document contains information authorized by NATO RTA for...Technical Readiness Level (TRL) that is consistent with an operational deployment. ES - 2 RTO-TR-MSG-048 Langage de gestion du champ de

  1. Hématome spontané du méso de l'angle colique droit et du colon transverse compliquant un traitement par anti vitamine K: à propos d'un cas et revue de la littérature

    PubMed Central

    Traoré, Ibrahim Alain; Zaré, Cyprien; Barro, Sié Drissa; Guibla, Ismaël

    2016-01-01

    L'hématome spontané du méso de l'angle colique droit et du transverse est une complication rare du traitement anticoagulant par antivitamine K. Nous rapportons un cas d'hématome spontané du méso de l'angle colique droit et du transverse associé à un hémopéritoine de grande abondance chez un patient traité par antivitamine K pour embolie pulmonaire consécutive à une fracture des plateaux tibiaux droits. Le diagnostic doit être fait en urgence. L’échographie abdominale et la tomodensitométrie confirment le diagnostic. Le traitement non opératoire est la règle. Le traitement chirurgical est indiqué en cas de complications telles que la rupture de l'hématome. PMID:27217878

  2. Characterization of FaDu-R, a radioresistant head and neck cancer cell line, and cancer stem cells.

    PubMed

    Cho, Kwang-Jae; Park, Eun-Ji; Kim, Min-Sik; Joo, Young-Hoon

    2018-06-01

    The aim of this study was to evaluate the impact of CSC on insensitivity to radiotherapy in HNSCC. A radioresistant cell line, FaDu-R, was established using fractionated ionizing radiation. Cells with high and low CD44/ALDH activity were isolated. FaDu-R cells demonstrated significantly increased cell viability after radiation exposure compared with parental cells. CD44 high /ALDH high FaDu-R cells demonstrated significantly faster wound closure (p<0.05) and more efficient invasion (p<0.05) compared to the CD44 high /ALDH high FaDu cells or the CD44 low /ALDH low FaDu-R cells. There was a significant difference in tumor volume between the CD44 high /ALDH high FaDu-R cells and the CD44 high /ALDH high FaDu cells (p<0.05) as well as the CD44 low /ALDH low FaDu-R cells (p<0.05). Cancer stem cells (CSC) were associated with invasion and tumorigenesis in a radioresistant head and neck squamous cell carcinoma (HNSCC) cell line. This concept might help to improve the understanding of these mechanisms and to develop drugs that can overcome radioresistance during radiotherapy. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Genetics Home Reference: cri-du-chat syndrome

    MedlinePlus

    ... Pinkel D. High-resolution mapping of genotype-phenotype relationships in cri du chat syndrome using array comparative ... for Links Data Files & API Site Map Subscribe Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

  4. Assessing Dispositions in Pre-Service Teachers: Does Setting or Experience Affect Dispositions? A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Frederiksen, Heidi

    2010-01-01

    The purpose of this study was to determine whether there was a significant difference between the perceived dispositions in pre-service teachers in urban settings versus non-urban settings. It was also the intent of this study to describe the change in perceived dispositions throughout pre-service teachers' internship experiences. Graduate…

  5. Interprofessional learning in primary care: an exploration of the service user experience leads to a new model for co-learning.

    PubMed

    Worswick, Louise; Little, Christine; Ryan, Kath; Carr, Eloise

    2015-01-01

    Research about service user involvement in research and education focuses on the purpose, the methods, the barriers and the impact of their involvement. Few studies report on the experience of the service users who get involved. This paper reports an exploration of the experience of service users who participated in an interprofessional educational initiative in primary care - the Learning to Improve the Management of Back Pain in the Community (LIMBIC) project. Service users attended workshops with practice teams and assisted them in developing small scale quality improvement projects to improve their provision of care for people with back pain. To explore the experience of service users involved in the LIMBIC project. Using the philosophical and methodological approaches of pragmatism this study analysed data from the wider LIMBIC project and collected primary data through semi structured interviews with service users. Secondary data were reanalysed and integrated with primary data to address the research question. The study was undertaken in the primary health care setting. Patients participated as service users in workshops and quality improvement projects with members from their practice teams. Interviews with service users were transcribed and analysed thematically. Document and thematic analyses of secondary data from the LIMBIC project included focus group transcripts, patient stories, film, emails, meeting notes, a wiki and educational material such as presentations. Themes identified through the analyses illustrated the importance, to the service users, of the sense of community, of clear communication, and of influencing change through involvement. A model for co-learning with service users resulted from the analyses. The experience of service users can be optimised by planning, preparation and support so that their wealth of expertise can be recognised and utilised. A model for co-learning was developed and is presented in this paper. Copyright © 2014

  6. Differential response of DU145 and PC3 prostate cancer cells to ionizing radiation: role of reactive oxygen species, GSH and Nrf2 in radiosensitivity.

    PubMed

    Jayakumar, Sundarraj; Kunwar, Amit; Sandur, Santosh K; Pandey, Badri N; Chaubey, Ramesh C

    2014-01-01

    Radioresistance is the major impediment in radiotherapy of many cancers including prostate cancer, necessitating the need to understand the factors contributing to radioresistance in tumor cells. In the present study, the role of cellular redox and redox sensitive transcription factor, Nrf2 in the radiosensitivity of prostate cancer cell lines PC3 and DU145, has been investigated. Differential radiosensitivity of PC3 and DU145 cells was assessed using clonogenic assay, flow cytometry, and comet assay. Their redox status was measured using DCFDA and DHR probes. Expression of Nrf2 and its dependent genes was measured by EMSA and real time PCR. Knockdown studies were done using shRNA transfection. PC3 and DU145 cells differed significantly in their radiosensitivity as observed by clonogenic survival, apoptosis and neutral comet assays. Both basal and inducible levels of ROS were higher in PC3 cells than that of DU145 cells. DU145 cells showed higher level of basal GSH content and GSH/GSSG ratio than that of PC3 cells. Further, significant increase in both basal and induced levels of Nrf2 and its dependent genes was observed in DU145 cells. Knock-down experiments and pharmacological intervention studies revealed the involvement of Nrf2 in differential radio-resistance of these cells. Cellular redox status and Nrf2 levels play a causal role in radio-resistance of prostate cancer cells. The pivotal role Nrf2 has been shown in the radioresistance of tumor cells and this study will further help in exploiting this factor in radiosensitization of other tumor cell types. © 2013.

  7. Modelisation frequentielle de la permittivite du beton pour le controle non destructif par georadar

    NASA Astrophysics Data System (ADS)

    Bourdi, Taoufik

    Le georadar (Ground Penetrating Radar (GPR)) constitue une technique de controle non destructif (CND) interessante pour la mesure des epaisseurs des dalles de beton et la caracterisation des fractures, en raison de ses caracteristiques de resolution et de profondeur de penetration. Les equipements georadar sont de plus en plus faciles a utiliser et les logiciels d'interpretation sont en train de devenir plus aisement accessibles. Cependant, il est ressorti dans plusieurs conferences et ateliers sur l'application du georadar en genie civil qu'il fallait poursuivre les recherches, en particulier sur la modelisation et les techniques de mesure des proprietes electriques du beton. En obtenant de meilleures informations sur les proprietes electriques du beton aux frequences du georadar, l'instrumentation et les techniques d'interpretation pourraient etre perfectionnees plus efficacement. Le modele de Jonscher est un modele qui a montre son efficacite dans le domaine geophysique. Pour la premiere fois, son utilisation dans le domaine genie civil est presentee. Dans un premier temps, nous avons valide l'application du modele de Jonscher pour la caracterisation de la permittivite dielectrique du beton. Les resultats ont montre clairement que ce modele est capable de reproduire fidelement la variation de la permittivite de differents types de beton sur la bande de frequence georadar (100 MHz-2 GHz). Dans un deuxieme temps, nous avons montre l'interet du modele de Jonscher en le comparant a d'autres modeles (Debye et Debye-etendu) deja utilises dans le domaine genie civil. Nous avons montre aussi comment le modele de Jonscher peut presenter une aide a la prediction de l'efficacite de blindage et a l'interpretation des ondes de la technique GPR. Il a ete determine que le modele de Jonscher permet de donner une bonne presentation de la variation de la permittivite du beton dans la gamme de frequence georadar consideree. De plus, cette modelisation est valable pour differents

  8. Prediction du profil de durete de l'acier AISI 4340 traite thermiquement au laser

    NASA Astrophysics Data System (ADS)

    Maamri, Ilyes

    Les traitements thermiques de surfaces sont des procedes qui visent a conferer au coeur et a la surface des pieces mecaniques des proprietes differentes. Ils permettent d'ameliorer la resistance a l'usure et a la fatigue en durcissant les zones critiques superficielles par des apports thermiques courts et localises. Parmi les procedes qui se distinguent par leur capacite en terme de puissance surfacique, le traitement thermique de surface au laser offre des cycles thermiques rapides, localises et precis tout en limitant les risques de deformations indesirables. Les proprietes mecaniques de la zone durcie obtenue par ce procede dependent des proprietes physicochimiques du materiau a traiter et de plusieurs parametres du procede. Pour etre en mesure d'exploiter adequatement les ressources qu'offre ce procede, il est necessaire de developper des strategies permettant de controler et regler les parametres de maniere a produire avec precision les caracteristiques desirees pour la surface durcie sans recourir au classique long et couteux processus essai-erreur. L'objectif du projet consiste donc a developper des modeles pour predire le profil de durete dans le cas de traitement thermique de pieces en acier AISI 4340. Pour comprendre le comportement du procede et evaluer les effets des differents parametres sur la qualite du traitement, une etude de sensibilite a ete menee en se basant sur une planification experimentale structuree combinee a des techniques d'analyse statistiques eprouvees. Les resultats de cette etude ont permis l'identification des variables les plus pertinentes a exploiter pour la modelisation. Suite a cette analyse et dans le but d'elaborer un premier modele, deux techniques de modelisation ont ete considerees, soient la regression multiple et les reseaux de neurones. Les deux techniques ont conduit a des modeles de qualite acceptable avec une precision d'environ 90%. Pour ameliorer les performances des modeles a base de reseaux de neurones, deux

  9. Learning by Helping? Undergraduate Communication Outcomes Associated with Training or Service-Learning Experiences

    ERIC Educational Resources Information Center

    Katz, Jennifer; DuBois, Melinda; Wigderson, Sara

    2014-01-01

    This study investigated communication outcomes after training or applied service-learning experiences. Pre-practicum trainees learned active listening skills over 10 weeks. Practicum students were successful trainees who staffed a helpline. Community interns were trained and supervised at community agencies. Undergraduate students in psychology…

  10. An Updated Status of the Experiments with Sensor Webs and OGC Service-Oriented Architectures to Enable Global Earth Observing System of Systems (GEOSS)

    NASA Technical Reports Server (NTRS)

    Mandl, Dan; Sohlberg, Rob; Frye, Stu; Cappelaere, P.; Derezinski, L.; Ungar, Steve; Ames, Troy; Chien, Steve; Tran, Danny

    2007-01-01

    A viewgraph presentation on experiments with sensor webs and service oriented architectures is shown. The topics include: 1) Problem; 2) Basic Service Oriented Architecture Approach; 3) Series of Experiments; and 4) Next Experiments.

  11. The Effect of Student Teaching Experiences on the Motivation and Planned Persistence of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Leverett, Avis

    2016-01-01

    This study investigated the motivation to teach and planned persistence of pre-service teachers during two phases of their student teaching experience by using a mixed methods study design. The quantitative design sought to evaluate if the motivation and planned persistence of pre-service teachers changed during the course of the supervised…

  12. L'Abondance du Deutérium, de l'Ultraviolet au Visible

    NASA Astrophysics Data System (ADS)

    Hébrard, Guillaume

    2000-12-01

    Dans le cadre du modèle standard du Big Bang, le deutérium est l'élément dont l'abondance primordiale est la plus sensible à la densité baryonique de l'Univers. Cet élément est uniquement créé lors de la nucléosynthèse primordiale, quelques minutes après le Big Bang ; aucune théorie standard n'en prédit actuellement d'autres sources significatives. Au contraire, étant brûlé dans les étoiles, son abondance D/H décroît au cours de l'évolution cosmique. Les mesures de D/H apportent ainsi des contraintes sur les modèles de Big Bang et d'évolution chimique des galaxies. On peut distinguer trois types de mesures de D/H: les abondances primordiale, proto-solaire et interstellaire, respectivement représentatives de l'Univers il y a environ 15 milliards d'années, 4.5 milliards d'années et à l'époque actuelle. Si l'évolution du deutérium semble qualitativement claire, les résultats concernant ces trois types d'abondance ne convergent pas pour l'instant vers trois valeurs bien définies. Les travaux entrepris durant cette thèse sont reliés à la mesure de l'abondance interstellaire du deutérium. Celle-ci s'obtient habituellement par l'observation spectroscopique en absorption des séries de Lyman de l'hydrogène et du deutérium. Ces observations se font dans le domaine ultraviolet, au moyen d'observatoires spatiaux. Les résultats présentés ici ont été obtenus avec le Télescope spatial Hubble puis le satellite FUSE, récemment mis en orbite. D'autre part, une nouvelle méthode d'observation du deutérium a été proposée, dans le domaine visible à partir de télescopes au sol. Ce travail a mené aux premières détections et à l'identification de la série de Balmer du deutérium, observée en émission dans des régions HII avec le Télescope Canada-France-Hawaii et le Very Large Telescope. On-line Thesis, Guillaume Hébrard

  13. Factors Related to Adoption and Non-Adoption of Technical and Organizational Recommendations by Farmers Involved with Societe de Developpement du Cacao (SO.DE.CAO) in Cameroon. A Research Summary.

    ERIC Educational Resources Information Center

    Kamga, Andre; Cheek, Jimmy G.

    In order to promote cocoa production and assist cocoa farmers in overcoming diseases in this crop, the government of Cameroon created an experimental corporation called Societe de Developpement du Cacao (SO.DE.CAO) in 1974. This organization functioned much like an extension service to provide information about crop production and disease control.…

  14. Poumon du puisatier

    PubMed Central

    Elidrissi, Amal Moustarhfir; Zaghba, Nahid; Benjelloun, Hanane; Yassine, Najiba

    2016-01-01

    Le puisatier a pour profession le creusement et l'entretien des puits pour fournir de l'eau. Il est au contact de divers minerais, particulièrement la silice, particule qui présente un risque certain de développement des maladies pulmonaires connues sous le nom de silicose. Le but de notre travail est de préciser le profil épidémiologique, clinique, radiologique et évolutif des patients puisatiers silicotiques. C'est une étude rétrospective concernant 54 cas de puisatiers ayant une silicose, colligés au service des maladies respiratoires du CHU Ibn Rochd de Casablanca, de Mars 1997 à Janvier 2016. Tous les malades étaient des puisatiers, de sexe masculin, avec une moyenne d'âge de 50 ans. Le tabagisme était retrouvé dans 36 cas et un antécédent de tuberculose était noté dans huit cas. La radiographie thoracique retrouvait des grandes opacités dans 39 cas, des petites opacités dans 15 cas, et un épaississement des septats dans 11 cas. Ce tableau de silicose s'était compliqué d'une surinfection bactérienne dans 37% des cas, d' un pneumothorax dans 4% des cas et d'une tuberculose dans 20% des cas. La prise en charge thérapeutique était celle des complications. La déclaration de la maladie professionnelle et de l'indemnisation était faite. L'évolution était bonne dans 12 cas, stationnaire dans 17 cas et mauvaise dans 16 cas. La silicose est une pneumoconiose fréquente chez les puisatiers. Elle retentit sur la fonction respiratoire. Nous soulignons l'association fréquente de tuberculose et nous insistons sur la prévention qui reste le meilleur traitement. PMID:28292119

  15. Managing preconceived expectations: mental health service users experiences of going home from hospital: a grounded theory study.

    PubMed

    Keogh, B; Callaghan, P; Higgins, A

    2015-11-01

    What is known on the subject? The time of discharge from a mental health hospital can be challenging for mental health service users, with high rates of readmission in the immediate months following discharge. Although some research exists that explores service users' perspectives of being discharged, little evidence exists that explores the processes influencing or used by service users' to adapt to the transition from in-patient acute mental health service. What this papers adds to existing knowledge? The findings of this grounded theory study demonstrates the strategies service users used to managed their own, as well as their social audiences, preconceived expectations arising from their new identity as 'psychiatric patients' following their discharge from hospital. While there is a move to develop recovery-orientated mental health services, key indicators of recovery-oriented practices were often absent from service users' experiences of service provision. What are the implications for practice? Nurses and other mental health professionals need to recognize their contribution to the architecture of stigma that transcends the physical structures of hospital or ward and are entrenched within attitudes, interactions and practices. The findings of this study can provide guidance to those working with service users and help them to understand the complexities of their experiences when using mental health services, which go far beyond the management of their symptoms. Following a period of hospitalization, the transition to home can result in increased vulnerability and a source of stress for mental health service users. Readmission rates have been suggested as one indicator of the success of the transition from hospital to community care. Despite knowledge of some of the factors that impact on service users following discharge, no coherent model or theoretical framework could be located in the literature, which explains or aides an in-depth understanding of the

  16. Examining Clinicians' Experiences Providing Sexual Health Services for LGBTQ Youth: Considering Social and Structural Determinants of Health in Clinical Practice

    ERIC Educational Resources Information Center

    Knight, R. E.; Shoveller, J. A.; Carson, A. M.; Contreras-Whitney, J. G.

    2014-01-01

    Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and…

  17. Contribution a la comprehension de la durabilite a l'ecaillage des betons contenant de la cendre volante et du laitier

    NASA Astrophysics Data System (ADS)

    Houehanou, Ernesto C.

    similaires apres 4 et 6 annees de service. La microstructure des betons en service a ete analysee au moyen du microscope a balayage electronique (MEB). Les resultats montrent que la qualite du murissement influence grandement la durabilite a l'ecaillage des betons contenant de la cendre volante et de laitier surtout lorsqu'ils sont soumis ' aux essais acceleres en laboratoire. La duree du pretraitement humide est un parametre cle de la durabilite a l'ecaillage des betons testes en laboratoire. Le pretraitement humide correspond a la duree totale du murissement humide (100% HR) et de la periode de presaturation. Pour les deux methodes d'essai, l'allongement du pretraitement humide a 28 jours ameliore la resistance a l'ecaillage de tous les types de betons et en particulier celle des betons avec cendres volantes. Pour les deux methodes d'essai, l'allongement du pretraitement humide a 28 jours ameliore la resistance a l'ecaillage de tous les types de betons et en particulier celle des betons avec cendres volantes. La periode de presaturation de 7 jours de la procedure NQ 2621-900 a un effet similaire a celui d'un murissement humide de meme longueur. Un murissement humide de 28 jours apparait optimal et conduit a une estimation plus realiste de la resistance a l'ecaillage reelle des betons. Pour une meme duree de pretraitement humide, les procedures NQ 2621-900 et ASTM C672 donnent des resultats equivalents. L'utilisation d'un moule a fond drainant n'a pas d'effet sur la resistance a l'ecaillage des betons de cette etude. Bien que le murissement dans l'eau saturee de chaux offre toute l'eau requise pour favoriser le developpement des proprietes du beton et l'amelioration de sa durabilite a l'ecaillage, elle lessive cependant les ions alcalins ce qui diminue defavorablement l'alcalinite et le pH de la solution interstitielle de la pate de ciment pres de la surface exposee. L'utilisation d'un agent de murissement protege mieux les betons contenant de la cendre volante et ameliore

  18. Experience and Consequences on the Deployments of the Medical Services of the German Army in Foreign Countries - Surgical Aspects

    DTIC Science & Technology

    2004-09-01

    RTO-MP-HFM-109 41 - 1 Experience and Consequences on the Deployments of the Medical Services of the German Army in Foreign Countries...army medical services lead to new experiences concerning personal, training, preparation, support, equipment and standardisation. The consequences...are not only important for the surgical work but also for anaesthesiology , intensive care, internal medicine and neurology and psychiatry. The

  19. Is Your Interventional Radiology Service Ready for SARS?: The Singapore Experience

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lau, Te-Neng; Teo, Ngee; Tay, Kiang-Hiong

    2003-09-15

    The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR.

  20. Making the case for a fracture liaison service: a qualitative study of the experiences of clinicians and service managers.

    PubMed

    Drew, Sarah; Gooberman-Hill, Rachael; Farmer, Andrew; Graham, Laura; Javaid, M Kassim; Cooper, Cyrus; Judge, Andrew

    2015-10-01

    To develop services, healthcare professionals must make business cases to managerial bodies within Hospital Trusts and if approved, to commissioning bodies. Patients with hip fracture are at high risk of subsequent fracture. To prevent this, guidance recommends structuring fracture prevention services around coordinator based models. These are known as Fracture Liaison Services (FLS). 33 semi-structured qualitative interviews were conducted with healthcare professionals with experience of making business cases for FLS. Data was analysed thematically. Challenges in the development of business cases included collecting all the relevant data and negotiating compartmentalised budgets that impeded service development. Participants described communication and cooperation between providers and commissioners as variable. They felt financial considerations were the most important factor in funding decisions, while improved quality of care was less influential. Other factors included national guidelines and political priorities. The personalities of clinicians championing services, and the clinical interests of commissioners were seen to influence the decision-making process, suggesting that participants felt that decisions were not always made on the basis of evidence-based care. Effective strategies included ways of providing support, demonstrating potential cost effectiveness and improved quality of care. Using a range of sources including audit data collected on the successful Glasgow FLS, and improving cooperation between stakeholders was advocated. Participants felt that the work of commissioners and providers should be better integrated and suggested strategies for doing this. This study provides information to healthcare professionals about how best to develop business cases for FLS. We conclude with recommendations on how to develop effective cases. These include using guidance such as toolkits, aligning the aims of FLS with national priorities and benchmarking

  1. College of DuPage Planning Process: College of DuPage Planning, the Foundation for Decision Making.

    ERIC Educational Resources Information Center

    College of DuPage, Glen Ellyn, IL. Office of Research and Planning.

    At College of DuPage (CD), in Glen Ellyn, Illinois, institutional planning is a multi-level, on-going process involving continuous college-wide input. The nine schematic levels in the CD planning process are interconnected and progress from global and broad-based issues, answering such questions as why the college exists, to concrete levels…

  2. 'It's the system working for the system': carers' experiences of learning disability services in Ireland.

    PubMed

    Power, Andrew

    2009-02-01

    The aim of this article is to examine the experiences of families with young adults with learning disabilities trying to access services. The landscape of disability services for this group is made up of day care, special vocational training and respite places. It aims to identify the extent of an implementation gap between government rhetoric and the degree to which services are characterised as being non-supportive interactions on the ground. Using Ireland as a case study, during a time when the economy is booming and government rhetoric claims unparalleled developments in allocating resources and extra respite 'places', this article identifies the main challenges faced by family carers associated with accessing appropriate services for their disabled adult child, in their attempt to achieve greater independence. This article reports the findings of a qualitative study in which individual semistructured interviews were held with family carers (n = 25) and representatives from national carer organisations (n = 6) in Ireland. These were people caring for an adult (18-30 years) with a learning disability and their experiences were also useful in cross-checking the carer organisation interviews. The findings show that there is limited flexibility, choice and availability in meeting the preferences of the service-users, and throughout the study, services were characterised as being non-supportive interactions. This is not simply symptomatic of a lack of resources. Despite improved funding, supportive attitudes and flexibility are still crucial in meeting user requirements at the level of delivery; thus highlighting that often the system works for the system, not for the user.

  3. Exploring Distance Learning Experiences of In-Service Music Teachers from Puerto Rico in a Master's Program

    ERIC Educational Resources Information Center

    Vega-Martinez, Juan Carlos

    2013-01-01

    The purpose of this study was to explore the experiences of in-service music teachers who chose to pursue a master's degree in music education through distance learning. In this study, I examined the motivations of in-service music teachers for choosing to pursue a master's degree in music education through distance learning; the benefits teachers…

  4. "The worst journey of our lives": parents' experiences of a specialised paediatric retrieval service.

    PubMed

    Colville, Gillian; Orr, Fiona; Gracey, David

    2003-04-01

    In this retrospective study, a sample of 233 parents were surveyed, by means of a postal questionnaire, about their experience of a specialised paediatric retrieval service (median time interval after child's retrieval=10 months). Although all parents were routinely provided with written information about the retrieval service, only 46% remember receiving it. Also, although generally high, satisfaction ratings relating to the period of the child's transit were significantly lower (P<0.005) than those relating to the other stages of the transfer. Two main reasons were given by parents for their dissatisfaction: distress at being separated from their critically ill child and logistic problems locating and parking at the new hospital. Implications for future service provision are considered.

  5. Activity-based funding for National Health Service hospitals in England: managers' experience and expectations.

    PubMed

    Sussex, Jonathan; Farrar, Shelley

    2009-05-01

    Activity-based funding of hospital services has been introduced progressively since 2003 in the National Health Service (NHS) in England, under the name 'Payment by Results' (PbR). It represents a major change from previous funding arrangements based on annual "block" payments for large bundles of services. We interviewed senior local NHS managers about their experience and expectations of the impact of PbR. A high degree of 'NHS solidarity' was apparent, and competition between NHS hospitals was muted. PbR has been introduced against a background of numerous other efficiency incentives, and managers did not detect a further PbR-specific boost to efficiency. No impact on care quality, either positive or negative, is yet evident.

  6. Stigma Experiences in Marginalized People Living With HIV Seeking Health Services and Resources in Canada.

    PubMed

    Donnelly, Leeann R; Bailey, Lauren; Jessani, Abbas; Postnikoff, Jonathan; Kerston, Paul; Brondani, Mario

    HIV stigma may prevent people from obtaining a timely diagnosis and engaging in life-saving care. It may also prevent those who are HIV infected from seeking health and education resources, particularly if they are from marginalized communities. We inductively explored the roots of stigma and its impact on health services and resource seeking as experienced by HIV-infected members of marginalized communities in Vancouver, British Columbia, Canada, using a community-based participatory research framework. Five peer-facilitated focus groups were conducted with 33 Aboriginal, Latino, Asian, and African participants. Thematic analysis of the experiences revealed four dominant themes: beginnings of stigma, tensions related to disclosure, experiences of service seeking, and beyond HIV stigma and discrimination. Persons living with HIV from Aboriginal and refugee communities continue to experience disproportionate rates of stigma and discrimination. Fear remains a prime obstacle influencing these groups' abilities and willingness to access care in various settings. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  7. W.E.B. Du Bois and Caste Education: Racial Capitalist Schooling from Reconstruction to Jim Crow

    ERIC Educational Resources Information Center

    Pierce, Clayton

    2017-01-01

    This essay provides the first account and examination of caste education in the work of W.E.B. Du Bois. In so doing, I argue that caste education plays a central role in realizing the political and social goals of racial capitalist society for Du Bois. Using Du Bois's caste analytic, I take up and articulate three biopolitical governing strategies…

  8. Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.

    PubMed

    Pindus, Dominika M; Mullis, Ricky; Lim, Lisa; Wellwood, Ian; Rundell, A Viona; Abd Aziz, Noor Azah; Mant, Jonathan

    2018-01-01

    To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. Systematic review and meta-ethnography. Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not

  9. The experiences of survivors and trauma counselling service providers in northern Uganda: Implications for mental health policy and legislation.

    PubMed

    Liebling, H; Davidson, L; Akello, G F; Ochola, G

    Previous research in northern Uganda found high levels of trauma-related difficulties amongst the conflict-affected population. There is international evidence that psychological therapy can reduce depression, as one of the psychological effects of trauma, but very limited literature regarding the experiences of trauma counselling in Sub-Saharan Africa. The current British Academy and Leverhulme-funded research investigated the experiences of service users and providers of trauma services in Kitgum and Gulu, northern Uganda. It also examined their implications for mental health policy and legislation. A decision was made to utilise qualitative methodology to highlight the in-depth experiences of participants. The researcher's carried out interviews with 10 women and 10 men survivors attending trauma services in Kitgum and Gulu. The researchers also interviewed 15 key informants in Kitgum, Gulu and Kampala including trauma counselling service providers, ministers, cultural leaders and mental health professionals. The authors report the findings of the research based on thematic analysis of the interviews. Themes included the experiences of survivors, bearing witness and instilling hope, constraints to service provision, stigma and abuse, holistic approach, service providers doing their best, specialist populations, limited understanding, training and skills development, gaps in service provision and mental health policy and legislation. The interviews resulted in a clear indication that counselling and medication was valued by service users, and that service providers felt the treatments that were provided improved depression, and increased empowerment and engagement in social activities. However, the authors argue that there was a limit to the benefits that could be achieved without using the holistic approach that the survivors requested. Thus, in cases of trauma arising from conflict, there is a clear need for the state to ensure reparation and/or justice for the

  10. Making International Experiences Accessible to In-Service Teachers through East Meets West Program

    ERIC Educational Resources Information Center

    An, Shuhua; Wu, Zhonghe

    2015-01-01

    The goal of this study was to examine the impact of the integration of global experiences on in-service teachers' international perspectives in mathematics classroom teaching through offering a graduate course "Global Perspectives in Mathematics Teaching" in the form of the East Meets West Program. This program engages teachers in an…

  11. Prise en charge des traumatismes graves du rein

    PubMed Central

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  12. A 160 kJ dual plasma focus (DuPF) for fusion-relevant materials testing and nano-materials fabrication

    NASA Astrophysics Data System (ADS)

    Saw, S. H.; Damideh, V.; Chong, P. L.; Lee, P.; Rawat, R. S.; Lee, S.

    2014-08-01

    This paper summarizes PF-160 Dual Plasma Focus (DuPF) numerical experiments using the Lee Model code and preliminary 3D design drawings using SolidWorks software. This DuPF consists of two interchangeable electrodes enabling it to be optimized for both Slow Pinch Mode (SFM) and Fast Pinch Mode (FFM); the latter using a speed factor (SF) of 90 kA cm-1 Torr-0.5 for FFM in deuterium [S Lee et al, IEEE Trans Plasma Science 24, 1101-1105 (1996)]; and the former with SF of less than half that value for SFM. Starting with available 6 × 450 µF capacitors rated at 11kV (10% reversal), numerical experiments indicate safe operation at 9 kV, 6 Torr deuterium with FFM anode of 5 cm radius; producing intense ion beam and streaming plasma pulses which would be useful for studies of potential fusion reactor wall materials. On the other hand operating at 5 kV, 10 Torr deuterium with SFM anode of 10 cm radius leads to long-duration, uniform large-area flow which could be more suitable for synthesis of nano-materials. The dual plasma focus design is illustrated here with two figures showing FFM and SFM electrodes.

  13. Devolution and public perceptions and experience of health services in Pakistan: linked cross sectional surveys in 2002 and 2004

    PubMed Central

    2011-01-01

    Background The government of Pakistan introduced devolution in 2001. Responsibility for delivery of most health services passed from provincial to district governments. Two national surveys examined public opinions, use, and experience of health services in 2001 and 2004, to assess the impact of devolution on these services from the point of view of the public. Methods A stratified random cluster sample drawn in 2001 and revisited in 2004 included households in all districts. Field teams administered a questionnaire covering views about available health services, use of government and private health services, and experience and satisfaction with the service. Focus groups in each community discussed reasons behind the findings, and district nazims (elected mayors) and administrators commented about implementation of devolution. Multivariate analysis, with an adjustment for clustering, examined changes over time, and associations with use and satisfaction with services in 2004. Results Few of 57,321 households interviewed in 2002 were satisfied with available government health services (23%), with a similar satisfaction (27%) among 53,960 households in 2004. Less households used government health services in 2004 (24%) than in 2002 (29%); the decrease was significant in the most populous province. In 2004, households were more likely to use government services if they were satisfied with the services, poorer, or less educated. The majority of users of government health services were satisfied; the increase from 63% to 67% between 2002 and 2004 was significant in two provinces. Satisfaction in 2004 was higher among users of private services (87%) or private unqualified practitioners (78%). Users of government services who received all medicines from the facility or who were given an explanation of their condition were more likely to be satisfied. Focus groups explained that people avoid government health services particularly because of bad treatment from staff, and

  14. An Exploration of Pre-Service Teachers' Experiences in Outdoor "Places" and Intentions for Teaching in the Outdoors

    ERIC Educational Resources Information Center

    Blatt, Erica; Patrick, Patricia

    2014-01-01

    This study explores pre-service teachers' past interactions with "place" in outdoor settings and how these experiences contribute to their current perceptions of the importance of taking their own students into the outdoors. Specifically, the researchers were interested in investigating if current pre-service teachers are part of the…

  15. Service seeking experiences of college-aged sexual and intimate partner violence victims with a mental health and/or behavioral disability.

    PubMed

    Nichols, Emily M; Bonomi, Amy; Kammes, Rebecca; Miller, Elizabeth

    2018-02-15

    To examine mental health service experiences following sexual violence (SV) and intimate partner violence (IPV) victimization among college women with a disability. College women (n = 27, ages 19 to 24) with a disability who experienced at least one SV/IPV occurrence; interviewed July/August 2016. Qualitative study using in-depth interviews, with thematic analysis. Women tended to wait several months (or did not seek care at all) following SV/IPV, because they downplayed their experience (e.g., not wanting to label an experience as "rape"). Those seeking services primarily did so because of escalating mental health concerns. Among service seekers, women were satisfied when professionals validated their experiences/concerns; and were dissatisfied when faced with extended wait time for care and/or professionals unskilled with SV/IPV and mental health. However, women still sought care following negative experiences. Improved access to integrated care for SV/IPV and mental health, along with skilled professionals, is essential.

  16. Expression, purification, and characterization of almond (Prunus dulcis) allergen Pru du 4.

    PubMed

    Zhang, Yuzhu; Du, Wen-Xian; Fregevu, Cécile; Kothary, Mahendra H; Harden, Leslie; McHugh, Tara H

    2014-12-31

    Biochemical characterizations of food allergens are required for understanding the allergenicity of food allergens. Such studies require a relatively large amount of highly purified allergens. The level of Pru du 4 in almond is low, and its expression in a soluble form in Escherichia coli required an expression tag. An MBP tag was used to enhance its expression and solubility. Sumo was used for the first time as a peptidase recognition site. The expression tag was removed with a sumo protease, and the resulting wild-type Pru du 4 was purified chromatographically. The stability of the allergen was investigated with chemical denaturation. The Gibbs free energy of Pru du 4 folding-unfolding transition was determined to be 5.4 ± 0.7 kcal/mol.

  17. Being pragmatic about healthcare complexity: our experiences applying complexity theory and pragmatism to health services research.

    PubMed

    Long, Katrina M; McDermott, Fiona; Meadows, Graham N

    2018-06-20

    The healthcare system has proved a challenging environment for innovation, especially in the area of health services management and research. This is often attributed to the complexity of the healthcare sector, characterized by intersecting biological, social and political systems spread across geographically disparate areas. To help make sense of this complexity, researchers are turning towards new methods and frameworks, including simulation modeling and complexity theory. Herein, we describe our experiences implementing and evaluating a health services innovation in the form of simulation modeling. We explore the strengths and limitations of complexity theory in evaluating health service interventions, using our experiences as examples. We then argue for the potential of pragmatism as an epistemic foundation for the methodological pluralism currently found in complexity research. We discuss the similarities between complexity theory and pragmatism, and close by revisiting our experiences putting pragmatic complexity theory into practice. We found the commonalities between pragmatism and complexity theory to be striking. These included a sensitivity to research context, a focus on applied research, and the valuing of different forms of knowledge. We found that, in practice, a pragmatic complexity theory approach provided more flexibility to respond to the rapidly changing context of health services implementation and evaluation. However, this approach requires a redefinition of implementation success, away from pre-determined outcomes and process fidelity, to one that embraces the continual learning, evolution, and emergence that characterized our project.

  18. Nouvelles approches en theorie du champ moyen dynamique: le cas du pouvoir thermoelectrique et celui de l'effet orbital d'un champ magnetique

    NASA Astrophysics Data System (ADS)

    Arsenault, Louis-Francois

    Les applications reliees a la generation d'energie motivent la recherche de materiaux ayant un fort pouvoir thermoelectrique (S). De plus, S nous renseigne sur certaines proprietes fondamentales des materiaux, comme, par exemple, la transition entre l'etat coherent et incoherent des quasi-particules lorsque la temperature augmente. Empiriquement, la presence de fortes interactions electron-electron peut mener a un pouvoir thermoelectrique geant. Nous avons donc etudie le modele le plus simple qui tient compte de ces fortes interactions, le modele de Hubbard. La theorie du champ moyen dynamique (DMFT) est tout indiquee dans ce cas. Nous nous sommes concentres sur un systeme tridimensionnel (3d) cubique a face centree (fcc), et ce, pour plusieurs raisons. A) Ce type de cristal est tres commun dans la nature. B) La DMFT donne de tres bons resultats en 3d et donc ce choix sert aussi de preuve de principe de la methode. C) Finalement, a cause de la frustration electronique intrinseque au fcc, celui-ci ne presente pas de symetrie particule-trou, ce qui est tres favorable a l'apparition d'une grande valeur de S. Ce travail demontre que lorsque le materiau est un isolant a demi-remplissage a cause des fortes interactions (isolant de Mott), il est possible d'obtenir de grands pouvoirs thermoelectriques en le dopant legerement. C'est un resultat pratique important. Du point de vue methodologique, nous avons montre comment la limite de frequence infinie de S et l'approche dite de Kelvin, qui considere la limite de frequence nulle avant la limite thermodynamique pour S, donnent des estimations fiables de la vraie limite continue (DC) dans les domaines de temperature appropriee. Ces deux approches facilitent grandement les calculs en court-circuit ant la necessite de recourir a de problematiques prolongements analytiques. Nous avons trouve que la methode de calcul a frequence infinie fonctionne bien lorsque les echelles d'energie sont relativement faibles. En d'autres termes

  19. Personal Voices in Higher Education: A Digital Storytelling Experience for Pre-Service Teachers

    ERIC Educational Resources Information Center

    Kocaman-Karoglu, Aslihan

    2016-01-01

    Digital storytelling (DST) has recently emerged as a new tool in instructional environments. DST involves the combination of media and technology with traditional storytelling to help students learn. This paper examines the use of DST in a university course and pre-service teachers' perceptions of their learning experiences using this tool.…

  20. Pharmacy students’ experiences in provision of community pharmacy mental health services

    PubMed Central

    Szumilas, Magdalena; Rowe, Denise; Landry, Kathryn; Martin-Misener, Ruth; Kutcher, Stan; Gardner, David

    2014-01-01

    Background: Little information is available describing the pharmacy student’s experience working in community practice with people with lived experience of mental illness. Students’ perspectives as observers, learners, technical staff and future pharmacists are important. Objective: To gain a better understanding of the pharmacy student experience in community pharmacy–based service provision to people with lived experience of mental illness. Methods: We conducted a qualitative study using interpretive description and application of the Theoretical Domains Framework. Focus groups were held with third- and fourth-year undergraduate pharmacy students from one Canadian university. Results: Two student focus groups were held in the fall of 2012 with 11 students (7 third year and 4 fourth year), 6 women and 5 men, mean age 24.5 (range, 21 to 30) years, averaging 3.2 years (range, 2 weeks to 7 years) of cumulative, mostly part-time, community pharmacy experience. Three broad themes emerged from the pharmacy student experience: (1) business tension; (2) roles, responsibilities and relationships; and (3) stigma. Students discussed their own roles, responsibilities and relationships in a pluralistic identity experience (i.e., pharmacy student, technician, future pharmacist). Application of the Theoretical Domains Framework demonstrated numerous influences on behaviour. Conclusions: From the students’ description of community pharmacy–based care of people with lived experience of mental illness, significant issues exist with current practices and behaviours. Advancing the role of pharmacists and pharmacy students to meet the needs of people with mental illness will require strategies to address multifactorial influences on behaviour. PMID:24494016

  1. The experiences of detained mental health service users: issues of dignity in care

    PubMed Central

    2014-01-01

    Background When mental health service users are detained under a Section of the Mental Health Act (MHA), they must remain in hospital for a specific time period. This is often against their will, as they are considered a danger to themselves and/or others. By virtue of being detained, service users are assumed to have lost control of an element of their behaviour and as a result their dignity could be compromised. Caring for detained service users has particular challenges for healthcare professionals. Respecting the dignity of others is a key element of the code of conduct for health professionals. Often from the service user perspective this is ignored. Methods This paper reports on the experiences of 19 adult service users who were, at the time of interview, detained under a Section of the MHA. These service users had experienced coercive interventions and they gave their account of how they considered their dignity to be protected (or not), and their sense of self respected (or not). Results The service users considered their dignity and respect compromised by 1) not being ‘heard’ by staff members, 2) a lack of involvement in decision-making regarding their care, 3) a lack of information about their treatment plans particularly medication, 4) lack of access to more talking therapies and therapeutic engagement, and 5) the physical setting/environment and lack of daily activities to alleviate their boredom. Conclusions Dignity and respect are important values in recovery and practitioners need time to engage with service user narratives and to reflect on the ethics of their practice. PMID:24972627

  2. Survivors' Experiences of Dysphagia-Related Services Following Head and Neck Cancer: Implications for Clinical Practice

    ERIC Educational Resources Information Center

    Nund, Rebecca L.; Ward, Elizabeth C.; Scarinci, Nerina A.; Cartmill, Bena; Kuipers, Pim; Porceddu, Sandro V.

    2014-01-01

    Background: It is known that people with dysphagia experience a number of negative consequences as a result of their swallowing difficulties following head and neck cancer management (HNC). However their perceptions and experiences of adjusting to dysphagia in the post-treatment phase, and the services received to assist this process, has not been…

  3. DuSable High School Program Flourishes.

    ERIC Educational Resources Information Center

    Graff, Pat

    1995-01-01

    Describes the fall and rise of the Panther Press, the scholastic newspaper of the DuSable High School in Chicago. States that despite being located in the midst of public housing projects, the school's newspaper is thriving where others in similar circumstances have failed. Describes how the school's principal and an advisor revitalized and…

  4. Prejudice: From Allport to DuBois.

    ERIC Educational Resources Information Center

    Gaines, Stanley O., Jr.; Reed, Edward S.

    1995-01-01

    Examines the differences between Gordon Allport's and W. E. B. DuBois's theories on the origins of prejudice and the impact of discrimination on the personality and social development of blacks. The article argues that prejudice is a historically developed process, not a universal feature of human psychology. Implications for U.S. race relations…

  5. Australian Community Pharmacists' Experience of Implementing a Chronic Kidney Disease Risk Assessment Service.

    PubMed

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

    2018-06-14

    Community pharmacists are well positioned to deliver chronic kidney disease (CKD) screening services. However, little is known about the challenges faced by pharmacists during service implementation. This study aimed to explore community pharmacists' experiences and perceived barriers of implementing a CKD risk assessment service. Data collection was performed by using semistructured, open-ended interview questions. Pharmacists who had implemented a CKD screening service in Tasmania, Australia, were eligible to participate. A purposeful sampling strategy was used to select pharmacists, with variation in demographics and pharmacy location. A conventional content analysis approach was used to conduct the qualitative study. Transcripts were thematically analyzed by using the NVivo 11 software program. Initially, a list of free nodes was generated and data were coded exhaustively into relevant nodes. These nodes were then regrouped to form highly conceptualized themes. Five broad themes emerged from the analysis: contextual fit within community pharmacy; perceived scope of pharmacy practice; customer perception toward disease prevention; CKD - an underestimated disease; and remuneration for a beneficial service. Pharmacists found the CKD service efficient, user-friendly, and of substantial benefit to their customers. However, several pharmacists observed that their customers lacked interest in disease prevention, and had limited understanding of CKD. More importantly, pharmacists perceived the scope of pharmacy practice to depend substantially on interprofessional collaboration between pharmacists and general practitioners, and customer acknowledgment of pharmacists' role in disease prevention. Community pharmacists perceived the CKD service to be worth incorporating into pharmacy practice. To increase uptake, future CKD services should aim to improve customer awareness about CKD before providing risk assessment. Further research investigating strategies to enhance

  6. A design of 30/20 GHz flight communications experiment for NASA. [satellite and earth segments for high data rate commercial service

    NASA Technical Reports Server (NTRS)

    Kawamoto, Y.

    1982-01-01

    The objective of the 30/20 GHz Flight Experiment System is to develop the required technology and to experiment with the communication technique for an operational communication satellite system. The system uses polarization, spatial, and frequency isolations to maximize the spectrum utilization. The key spacecraft technologies required for the concept are the scan beam antenna, the baseband processor, the IF switch matrix, TWTA, SSPA, and LNA. The spacecraft communication payload information will be telemetered and monitored closely so that these technologies and performances can be verified. Two types of services, a trunk service and a customer premise service, are demonstrated in the system. Many experiments associated with these services, such as synchronization, demand assignment, link control, and network control will be performed to provide important information on the operational aspect of the system.

  7. User-experience surveys with maternity services: a randomized comparison of two data collection models.

    PubMed

    Bjertnaes, Oyvind Andresen; Iversen, Hilde Hestad

    2012-08-01

    To compare two ways of combining postal and electronic data collection for a maternity services user-experience survey. Cross-sectional survey. Maternity services in Norway. All women who gave birth at a university hospital in Norway between 1 June and 27 July 2010. Patients were randomized into the following groups (n= 752): Group A, who were posted questionnaires with both electronic and paper response options for both the initial and reminder postal requests; and Group B, who were posted questionnaires with an electronic response option for the initial request, and both electronic and paper response options for the reminder postal request. Response rate, the amount of difference in background variables between respondents and non-respondents, main study results and estimated cost-effectiveness. The final response rate was significantly higher in Group A (51.9%) than Group B (41.1%). None of the background variables differed significantly between the respondents and non-respondents in Group A, while two variables differed significantly between the respondents and non-respondents in Group B. None of the 11 user-experience scales differed significantly between Groups A and B. The estimated costs per response for the forthcoming national survey was €11.7 for data collection Model A and €9.0 for Model B. The model with electronic-only response option in the first request had lowest response rate. However, this model performed equal to the other model on non-response bias and better on estimated cost-effectiveness, and is the better of the two models in large-scale user experiences surveys with maternity services.

  8. Facteurs de risque cardiovasculaires au cours du lupus systémique

    PubMed Central

    Harzallah, Amel; Hajji, Mariem; Kaaroud, Hayet; Hamida, Fethi Ben; Abdallah, Taieb Ben

    2015-01-01

    Cette étude a pour objectif d’évaluer la fréquence des facteurs de risque cardiovasculaires au cours du lupus et de préciser leur prévalence. Etude rétrospective portant sur 250 patients ayant un lupus, diagnostiqué selon les critères de l'ACR, hospitalisés entre 1970 et 2013. Les données cliniques et para cliniques ont été recueillies à partir des observations médicales. Il s'agit de 228 femmes et 22 hommes d’âge moyen au diagnostic du lupus de 30, 32 ans (extrêmes: 16-69). La durée moyenne du suivi des patients était de 64 mois (extrêmes: 7 jours- 382mois). Quatre vingt dix patients (36%) étaient hypertendus, 74% avaient une hypercholestérolémie et 22% étaient diabétiques. Pour les autres facteurs de risque cardiovasculaire traditionnels, un âge > 50 ans a été retrouvé dans 40% des cas, le sexe masculin dans 8% des cas, l'obésité dans 76% des cas et le tabagisme dans 11% des cas. Les facteurs de risque surajoutés sont représentés par la présence des anticorps antiphospholipides (47% des cas), la néphropathie lupique (49% des cas), l'insuffisance rénale (42% des cas), la corticothérapie au long cours (74% des cas) et la chronicité de la maladie dans 35% des cas. Les complications cardiovasculaires retrouvées dans notre série étaient: les accidents vasculaires cérébraux (2%) et l'insuffisance coronarienne (5,6%). Devant l'importance du risque cardiovasculaire au cours du lupus, une surveillance rapprochée des facteurs de risque cardio-vasculaires semble primordiale chez les lupiques. PMID:27022427

  9. Improving Community Involvement and Citizenship among Elementary School Students through Service Learning Experiences

    ERIC Educational Resources Information Center

    Smith, Mandi

    2007-01-01

    This Action Research Project was designed to increase student awareness and involvement of socio-economic differences and how the children can make a difference in their community. Service learning projects were non-existent at the Academy causing the young children to miss out on learning experiences that would teach them how to make a difference…

  10. World heritage site - Bien du Patrimoine Mondial - Kluane/Wrangell-St. Elias/Glacier Bay/Tatshenshini-Alsek

    USGS Publications Warehouse

    Labay, Keith A.; Wilson, Frederic H.

    2004-01-01

    The four parks depicted on this map make up a single World Heritage Site that covers 24.3 million acres. Together, they comprise the largest internationally protected land-based ecosystem on the planet. The United Nations Educational, Scientific and Cultural Organization (UNESCO) established the World Heritage Program in 1972 for the identification and protection of the world?s irreplaceable natural and cultural resources. World Heritage Sites are important as storehouses of memory and evolution, as anchors for sustainable tourism and community, and as laboratories for the study and understanding of the earth and culture. This World Heritage Site protects the prominent mountain ranges of Kluane, Wrangell, Saint Elias, and Chugach. It includes many of the tallest peaks on the continent, the world's largest non-polar icefield, extensive glaciers, vital watersheds, and expanses of dramatic wilderness. [Les quatre parcs figurant sur cette carte ne constituent qu?un seul site du patrimoine mondial recouvrant plus de 99 millions de km2, ce qui en fait le plus grand ecosysteme terrestre protege par loi internationale. En 1972, L?UNESCO (l?organisation des Nations Unies pour les sciences, l'education et la culture) a etabli le programme du patrimoine mondial afin d?identifier et de proteger les ressources naturelles et culturelles irremplacables de notre plan?te. Si les sites du patrimoine mondial sont si importants c'est parce qu'ils representent a la fois des livres ouverts sur l?histoire de la Terre, le point de depart du tourisme durable et du developpement des collectivites, des laboratoires pour etudier et comprendre la nature et la culture. Ce site du patrimoine mondial assure la protection des chaines de montagnes de Kluane, Wrangell, Saint Elias, et Chugach. On y trouve plusieurs des plus hauts sommets du continent, le plus grand champ de glace non-polaire du monde, d?immenses glaciers, des bassins hydrologiques essentiels, et de la nature sauvage a perte de vue.

  11. Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

    PubMed

    Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda

    2015-09-02

    The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC

  12. Évaluation des caractéristiques mécaniques du polissoir en polyuréthanne utilisé comme porte abrasifs durant le processus du polissage du verre optique

    NASA Astrophysics Data System (ADS)

    Aliouane, T.; Bouzid, D.; Belkhir, N.; Bouzid, S.; Herold, V.

    2005-05-01

    La fabrication des composants en verre optique nécessite des moyens de grande précision dans les procédés de finition vue l'importance accordée à leur qualité.
Durant le processus de polissage des verres optiques, le polissoir est un élément clé et a un impact direct sur les performances des composants optiques, non seulement il est utilisé comme support de grains abrasifs mais il doit posséder la fonction de transmission de la pression aux grains. La connaissance de ses propriétés, essentiellement mécanique, est impérative afin d'obtenir un état de surface optimal des composants optiques destinés à remplir des fonctions très précises dans des appareils optiques très performants.
Dans cette étude, nous avons constaté que les propriétés des polissoirs en polyuréthanne tel que la dureté, le module d'élasticité et la densité varient au cours du polissage. Ce changement a des effets sur l'état de surface de verre optique, causé par le changement microstructural de la surface du polissoir (distribution et dimensions des pores) et par conséquent sur la quantité des abrasifs (en oxyde de cérium) insérée dans les pores, ce qui influe sur la quantité de verre enlevée et sur l'état de surface du composant.
Sur la base des résultats obtenus, il a été prouvé que le polissoir subit des modifications très importantes ce qui influe considérablement sur son efficacité de polissage.

  13. Association between Fatigue and Autistic Symptoms in Children with Cri du Chat Syndrome

    ERIC Educational Resources Information Center

    Claro, Anthony; Cornish, Kim; Gruber, Reut

    2011-01-01

    In the current study, the authors examined whether the fatigue level of children diagnosed with cri du chat syndrome was associated with the expression of autistic symptoms. Sixty-nine children with cri du chat syndrome were compared with 47 children with moderate to severe intellectual disabilities who did not differ on intellectual severity.…

  14. Denial of service to same-sex and interracial couples: Evidence from a national survey experiment.

    PubMed

    Powell, Brian; Schnabel, Landon; Apgar, Lauren

    2017-12-01

    Legislatures and courts are debating whether businesses can deny services to same-sex couples for religious reasons. Yet, little is known about public views on this issue. In a national survey experiment, Americans ( n = 2035) responded to an experimental vignette describing a gay or interracial couple refused service. Vignettes varied the reason for refusal (religion/nonreligious) and by business type (individual/corporation). Results confirm greater support of service refusal by the self-employed than by corporations and to gay couples than to interracial couples. However, religious reasons for refusal to gay couples elicit no more support than do nonreligious reasons. In the first national study to experimentally analyze views on service refusal to sexual minorities, we demonstrate that views vary by several factors but not by whether the refusal was for religious reasons.

  15. Attending to physical health in mental health services in Australia: a qualitative study of service users' experiences and expectations.

    PubMed

    Young, Sarah J; Praskova, Anna; Hayward, Nicky; Patterson, Sue

    2017-03-01

    Evidence is unequivocal: the premature death of people with severe mental health problems is attributable primarily to cardiovascular disease, and healthcare provided is often suboptimal. With the overarching aim of improving outcomes, policies and guidelines oblige mental health services and psychiatrists to monitor cardio-metabolic health of patients and intervene as appropriate. Practice is highly variable; however, with ongoing debate about resourcing and responsibilities dominated by clinicians who have identified disinterest among patients as influencing practice. Seeking to balance discussion, we posed the question 'what do patients experience and expect of mental health services in relation to their physical health?' To answer it, we interviewed a convenience sample of 40 service users recruited from a mental health service in Australia, early in 2015. Data were analysed using the framework approach. With few regarding themselves as healthy, participants were commonly concerned about side effects of medication, weight and fitness but rarely mentioned tobacco smoking. Participants' accounts reinforce extensive research demonstrating variability in attention to physical health in mental health services. Reports by some participants of comprehensive care are encouraging, but widespread uncertainty about reasons for various assessments and denial of requests for management of medication side effects, including weight gain, gives cause for concern. Although participants in this study wanted to improve their health and health-related quality of life, they acknowledged that their motivation and ability to do so fluctuated with mental health. They expected clinicians to work proactively, especially when symptoms compromised capacity for self-care, and mental health services to provide or enable access to health-promoting interventions. Attention should be given, as a matter of priority, to creating conditions (culture and infrastructure) needed to support sustained

  16. Interim Service ISDN Satellite (ISIS) simulator development for advanced satellite designs and experiments

    NASA Technical Reports Server (NTRS)

    Pepin, Gerard R.

    1992-01-01

    The simulation development associated with the network models of both the Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) and the Full Service ISDN Satellite (FSIS) architectures is documented. The ISIS Network Model design represents satellite systems like the Advanced Communications Technology Satellite (ACTS) orbiting switch. The FSIS architecture, the ultimate aim of this element of the Satellite Communications Applications Research (SCAR) Program, moves all control and switching functions on-board the next generation ISDN communications satellite. The technical and operational parameters for the advanced ISDN communications satellite design will be obtained from the simulation of ISIS and FSIS engineering software models for their major subsystems. Discrete event simulation experiments will be performed with these models using various traffic scenarios, design parameters, and operational procedures. The data from these simulations will be used to determine the engineering parameters for the advanced ISDN communications satellite.

  17. Understanding the experiences and service needs of siblings of individuals with first-episode psychosis: a phenomenological study.

    PubMed

    Sin, Jacqueline; Moone, Nicki; Harris, Paul; Scully, Elizabeth; Wellman, Nigel

    2012-02-01

    Despite recent focus on developing family-inclusive services to meet the needs of young people with first-episode psychosis, the needs of their siblings are often overlooked. This study explored the experiences and needs of siblings of young adults with first-episode psychosis receiving support from two Early Intervention in Psychosis Services in South-East England. Thirty-one siblings aged 11-35 years, were given a semi-structured interview to gather their perspectives and accounts of their lived experiences. The resultant rich qualitative data was analysed using responsive-reader and framework methods. Six themes were identified: siblings' roles and involvement; emotions; impact on relationships; coping patterns; resilience; and siblings' service needs. All participants had been greatly affected by the onset of the psychosis in their brother or sister. Most siblings did not identify themselves as carers, although most played a significant part in their brother's or sister's life. Participants wanted dynamic, robust and accessible services, especially information and peer support to meet their needs. © 2011 Blackwell Publishing Asia Pty Ltd.

  18. Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management.

    PubMed

    Cheung, Kerry K W; Wong, Ian C K; Ip, Patrick; Chan, Phyllis K L; Lin, Candy H Y; Wong, Lisa Y L; Chan, Esther W

    2015-05-01

    Specialist services for the treatment of attention deficit hyperactivity disorder (ADHD) in adulthood in Hong Kong are yet to be developed. This study aims to explore the experiences of adolescents and young adults with ADHD in accessing treatment and services, coping with ADHD-related impairment, and their expectations of future treatment in Hong Kong. Qualitative interviews were conducted with a semi-structured guide. Forty young adult patients aged between 16 and 23 were included in the study. The interview recordings were transcribed verbatim and anonymised. Data were analysed with a thematic approach based on key principles of Grounded Theory. Four meta-themes were developed: Accessing ADHD diagnosis and treatment services; ADHD-related impairment; Experience of ADHD treatments; and Attitudes and expectations of future ADHD treatment. The role of parents and schools were highly significant in accessing services for patients diagnosed with ADHD in childhood. In general, ADHD affected every aspect of patients' lives including academic outcome, employment, family and social relationships. Medications were the principal treatment for ADHD amongst the interviewees and were reported to be generally effective. Half of the patients received non-pharmacological treatments in childhood but these effects were reported to be temporary. There was general consensus that the needs of patients with ADHD could not be met by the current service. In particular, there is a lack of specialist service for adults with ADHD, follow-up by different clinicians, and insufficient provision of non-pharmacological treatments. The findings suggest that further development of specialist ADHD services and non-pharmacological options for young adults are essential to meet their diverse needs with a holistic approach.

  19. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey.

    PubMed

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-04-29

    To investigate the experience of users of out of hours general practitioner services in England, UK. Population based cross sectional postal questionnaire survey. General Practice Patient Survey 2012-13. Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. The overall response rate was 35%; 971,232/2,750,000 patients returned surveys. Data from 902,170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of -3.13 (95% confidence interval -4.96 to -1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care -3.62, -4.36 to -2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care -4.73, -5.29 to -4.17). Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and

  20. Effet paradoxal du type d’excision sur la prise et le délai de cicatrisation des greffes expansées pour le traitement des brûlures aiguës: a propos de 1129 cas

    PubMed Central

    Guibert, M.; Chaouat, M.; Boccara, D.; Marco, O.; Lavocat, R.; Alameri, O.; Deslandes, E.; Montlahuc, C.; Mimoun, M.

    2016-01-01

    Summary La greffe de peau mince expansée est très employée dans le traitement des brûlures aiguës. Nous avons étudié l’influence de la préparation du sous-sol sur le taux de prise et le délai de cicatrisation des greffes expansées. Nous avons analysé rétrospectivement les 1 129 greffes expansées réalisées dans notre service entre 1995 et 2005 pour le traitement des brûlures aiguës. Leur taux de prise a été significativement meilleur après une préparation du sous-sol par avulsion (82%) par rapport à une préparation du sous-sol par excision tangentielle (75%). Ce taux était meilleur lorsque l’avulsion était pratiquée dans les 7 jours suivant la brûlure (83% vs 73%). Pour une prise en charge entre 7 et 21 jours, ce taux a semblé être meilleur après excision tangentielle, mais de façon non significative. La durée d’évolution jusqu’à cicatrisation était significativement raccourcie pour une préparation du sous-sol par excision tangentielle par rapport à une préparation du sous-sol par avulsion. Ces résultats montrent, paradoxalement, qu’une préparation du sous-sol par avulsion favorise la prise des greffes expansées mais rallonge leur délai de cicatrisation au contraire de l’excision tangentielle. PMID:28149235

  1. Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.

    PubMed

    Bao, Yuhua; Fan, Guanrong; Zou, Dongdong; Wang, Tong; Xue, Di

    2017-01-01

    Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care. To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments. Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals. 7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014. Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week) and hospital outpatient volume in the first half of 2014. Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only. Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.

  2. Residents’ Preferences for Household Kitchen Waste Source Separation Services in Beijing: A Choice Experiment Approach

    PubMed Central

    Yuan, Yalin; Yabe, Mitsuyasu

    2014-01-01

    A source separation program for household kitchen waste has been in place in Beijing since 2010. However, the participation rate of residents is far from satisfactory. This study was carried out to identify residents’ preferences based on an improved management strategy for household kitchen waste source separation. We determine the preferences of residents in an ad hoc sample, according to their age level, for source separation services and their marginal willingness to accept compensation for the service attributes. We used a multinomial logit model to analyze the data, collected from 394 residents in Haidian and Dongcheng districts of Beijing City through a choice experiment. The results show there are differences of preferences on the services attributes between young, middle, and old age residents. Low compensation is not a major factor to promote young and middle age residents accept the proposed separation services. However, on average, most of them prefer services with frequent, evening, plastic bag attributes and without instructor. This study indicates that there is a potential for local government to improve the current separation services accordingly. PMID:25546279

  3. A Conversation with Lee Alvin DuBridge - Part I

    NASA Astrophysics Data System (ADS)

    Goodstein, Judith R.

    Physicist Lee A. DuBridge became president of the California Institute of Technology in 1946. In this interview he recalls the immediate problems he faced, including his dealings with Robert A. Millikan, whom he replaced as chief administrator of the institute; institute financing and inadequate salaries. DuBridge also talks about the advent of federal support for peacetime science and Millikan's distaste for it; his close working relationship with Robert F. Bacher, who came to the institute in 1949 as chairman of the Division of Physics, Mathematics, and Astronomy; his recollections of the meteorologist Irving P. Krick, the physicist Alexander Goetz, and the chemist Linus Pauling; and his attempts to build up the Humanities Division.

  4. Integrating mental health services: the Finnish experience

    PubMed Central

    Lehtinen, Ville; Taipale, Vappu

    2001-01-01

    Abstract The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in which mental

  5. Touch and relate: body experience among staff in habilitation services.

    PubMed

    Råsmark, Görel; Richt, Bengt; Rudebeck, Carl Edvard

    2014-01-01

    In habilitation centres staff meet children with different impairments, children who need extensive support and training while growing up. A prevailing biomedical view of the body in habilitation services is gradually becoming supplemented by a perspective on the body as constantly involved in experiencing and communicating, the latter involving also the bodies of the therapists. Investigating body experience in habilitation staff in their encounters with the children may provide concepts that make it easier to reflect on what is going on in the interaction. When shared among larger number of peers and supported by further research in the field, reflected body experience may become a substantial aspect of professional self-knowledge. Our aim with this study was to contribute to the understanding of what it means to be a body for other bodies in the specific relational context of child habilitation, and more specifically to investigate what role the therapists' body experience may play for professional awareness and practice. In the study, five physiotherapists and three special-education teachers spoke of physical and emotional closeness (the body as affection) but also of a provoking closeness (the body as provoked) with the children and of how their own body experience made them more attentive to the children's experience (the body as reference). Situations that included bodily limitations (the body as restriction) were described, as were situations where the body came into focus through the gazes of others or one's own (the body as observed). The body was described as a flexible tool (the body as tool), and hands were given an exclusive position as a body part that was constantly communicating. Three shifts of intentionality that form a comprehensive structure for this body experience were discerned. When professional reflection is evoked it may further body awareness, deepen reflection in practice and strengthen intercorporeality.

  6. Service user and family member perspectives on services for mental health, substance use/addiction, and violence: a qualitative study of their goals, experiences and recommendations.

    PubMed

    Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha

    2016-01-01

    Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members. We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care. Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users. The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.

  7. Tensions entre rationalité technique et intérêts politiques : l’exemple de la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux au Québec

    PubMed Central

    Contandriopoulos, D.; Hudon, Raymond; Martin, Elisabeth; Thompson, Daniel

    2013-01-01

    Sommaire L’objet de cet article est constitué par les processus décisionnels entourant la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux (Loi 25). Nous entendons mettre en lumière les stratégies des groupes ou institutions de diverses natures qui ont fait valoir leurs préférences et ont tenté, avec un succès inégal, d’influencer les décisions relatives à cette réforme majeure de la structure du système de santé québécois. Au plan théorique, nous nous appuyons principalement sur les modèles d’analyse du lobbying qui, depuis les travaux fondateurs de Milbrath (1960, 1963), présentent cette pratique comme un processus fondamental d’échange d’information. Selon les données colligées dans les retranscriptions d’entrevues, les stratégies observées correspondent effectivement aux caractéristiques constitutives du lobbying et, dans quelques situations, à celles du patronage. La combinaison de ces divers éléments révèle que la mise en œuvre de la Loi 25 s’avère être avant tout un processus proprement politique. Ainsi, furent relégués au second plan les arguments techniques qui composaient initialement les objectifs de la Loi. PMID:23509412

  8. Diagnostic et prévalence du syndrome métabolique chez les diabétiques suivis dans un contexte de ressources limitées: cas du Burkina-Faso

    PubMed Central

    Marceline, Yaméogo Téné; Issiaka, Sombié; Gilberte, Kyélem Carole; Nadège, Rouamba; Macaire, Ouédraogo Sampawindé; Arsène, Yaméogo Aimé; Djingri, Lankoandé; Apollinaire, Sawadogo; Joseph, Drabo Youssouf

    2014-01-01

    Introduction Les conséquences du syndrome métabolique impliquent son diagnostic effectif pour une prise en charge globale des comorbidités dépistées. Objectif: Déterminer la capacité à diagnostiquer le syndrome métabolique en routine, sa prévalence chez les diabétiques, leurs connaissances et pratiques vis-à-vis du risque cardio-métabolique. Méthodes Il s'est agi d'une étude transversale auprès de 388 diabétiques au CHU de Bobo-Dioulasso. Les critères de la fédération internationale du diabète (2009) ont été utilisés. Résultats l’âge moyen était de 53,5±13,5 ans, le sex ratio de 0,7. L'obésité abdominale était présente dans 61,9% des cas; L'HTA l’était dans 56,4% des cas. La prescription du bilan lipidique a été documentée dans 55,4% des cas pour le HDL et 56,2% pour les triglycérides pour un taux de réalisation de 49,3% et 62,9%. Le taux de dépistage des critères lipidiques était de 26,8%. Un taux de HDL bas a été noté dans 46 cas (43,4%) et une hypertriglycéridémie dans 24 cas (17,6%). In fine, la prévalence du syndrome métabolique était de 48,9% (n = 190). Seuls 27,4% savaient que d'autres facteurs de risque cardiovasculaire pouvaient être associés au diabète et seulement 6,7% pratiquaient une activité physique régulière. Conclusion Malgré la faible contribution du laboratoire, le syndrome métabolique est fréquent parmi nos diabétiques. Les patients sont peu sensibilisés sur le risque vasculaire et la pratique d'une activité physique régulière reste faible. Un programme d’éducation adaptée contribuerait à un meilleur dépistage et à une prise en charge optimale des cas. PMID:25932077

  9. The demand for physician services. Evidence from a natural experiment.

    PubMed

    Cockx, Bart; Brasseur, Carine

    2003-11-01

    This study exploits a natural experiment in Belgium to estimate the effect of copayment increases on the demand for physician services. It shows how a differences-in-differences (DD) estimator of the price effects can be decomposed into effects induced by the common average proportional price increase (income effects) and by the change in relative prices (substitution effects). The price elasticity of a uniform proportional price increase is relatively small (-0.13 for men and -0.03 for women). Substitution effects are large, especially for women, but imprecisely estimated. Despite the substantial price increases, the efficiency gain of the reform, if any, is modest.

  10. Toward a Holistic View: Analysis of Pre-Service Teachers' Professional Vision in Field Experiences and Its Implications

    ERIC Educational Resources Information Center

    Lee, Ji-Eun

    2016-01-01

    This study investigated the aspects of learning and teaching that pre-service teachers examined at distinct time periods while taking on different roles. Participants reported on what they noticed from their past learning experiences as students, as well as their current field experiences as student teachers. Their reflective critique was created…

  11. Prevalence of Autism Spectrum Phenomenology in Cornelia de Lange and Cri du Chat Syndromes

    ERIC Educational Resources Information Center

    Moss, Joanna F.; Oliver, Chris; Berg, Katy; Kaur, Gurmeash; Jephcott, Lesley; Cornish, Kim

    2008-01-01

    Autism spectrum disorder characteristics have not been evaluated in Cornelia de Lange and Cri du Chat syndromes using robust assessments. The Autism Diagnostic Observation Schedule and Social Communication Questionnaire were administered to 34 participants with Cornelia de Lange syndrome and a comparison group of 23 participants with Cri du Chat…

  12. [Herbal textual research of common Mongolian medicine "Du Ge Mo Nong"].

    PubMed

    Xi, Jie; Zhong, Hua-Rong; Wucharila-Tu; Buhe Bater; Li, Hui-Hu; Zhong, Guo-Yue

    2016-11-01

    This study is aimed to provide the source for clinical medication by clarifing the common base of Mongolia medicinal materials "Du Ge Mo Nong". In this paper literature research and plant taxonomy method were adopted combined with investigation of the markets and clinical use status to clarify the origin of common traditional Mongolian medicine "Du Ge Mo Nong". The results showed that the Mongolian medicine "Du Ge Mo Nong" and Tibetan medicine "Du Mu Niu" were the same crude drug and originated from the seeds of Holarrhena antidysenteriaca of family Apocynaceae in earliest time. In Mongolian medicine clinic, the seed of Cynanchum thesioides of family Asclepiadaceae and the fruit of Forsythia suspense of family Oleaceae was used respectively about 18 century and recent time, as the substitutes of H. antidysenteriaca. In present standards on Mongolian material medicine, C. thesioides is including only, and H. antidysenterica is not used almost. In Tibetan medicine clinic, H. antidysenterica is being used so far. But there are various substitutes including the seeds, fruits or grass of many species classified to family Apocynaceae, Asclepiadaceae and Onagraceae from ancient time to the present, and C. forrestii and C. komarovii may be used at present. It's necessary to strengthen the arrangement on Mongolian medicine's varieties by the multidisciplinary methods including literature research, investigation of resources and the use state, and comparison of active substances and biological activities between the different substitutes,and so on. Copyright© by the Chinese Pharmaceutical Association.

  13. Single Mothers' Experiences with Pregnancy and Child Rearing in Korea: Discrepancy between Social Services/Policies and Single Mothers' Needs.

    PubMed

    Kim, Jung-Eun; Lee, Jin Yong; Lee, Sang Hyung

    2018-05-10

    This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences in significant periods of their lives: pregnancy, childbirth, and parenting. Findings from the qualitative thematic analysis show discrepancies between the direction of social services/policies and single mothers’ needs, in terms of difficulties in healthcare, childcare, housing, employment, and income security. To the single mothers in this study, the social safety net is not inclusive, compared to that which is available to two-parent families or adoptive families. It is necessary to intervene in current blind spots of services/policies for single mothers, and to provide a social safety net to strengthen single mothers’ self-reliance and their children’s social security in the long term.

  14. Single Mothers’ Experiences with Pregnancy and Child Rearing in Korea: Discrepancy between Social Services/Policies and Single Mothers’ Needs

    PubMed Central

    Kim, Jung-Eun; Lee, Sang Hyung

    2018-01-01

    This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences in significant periods of their lives: pregnancy, childbirth, and parenting. Findings from the qualitative thematic analysis show discrepancies between the direction of social services/policies and single mothers’ needs, in terms of difficulties in healthcare, childcare, housing, employment, and income security. To the single mothers in this study, the social safety net is not inclusive, compared to that which is available to two-parent families or adoptive families. It is necessary to intervene in current blind spots of services/policies for single mothers, and to provide a social safety net to strengthen single mothers’ self-reliance and their children’s social security in the long term. PMID:29748484

  15. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

    PubMed Central

    Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-01-01

    Objective To investigate the experience of users of out of hours general practitioner services in England, UK. Design Population based cross sectional postal questionnaire survey. Setting General Practice Patient Survey 2012-13. Main outcome measures Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users’ experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users’ experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. Results The overall response rate was 35%; 971 232/2 750 000 patients returned surveys. Data from 902 170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of −3.13 (95% confidence interval −4.96 to −1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care −3.62, −4.36 to −2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care −4.73, −5.29 to −4.17). Conclusions Commercial providers of out of hours GP care were associated with poorer experience of care

  16. W. E. B. Du Bois at the center: from science, civil rights movement, to Black Lives Matter.

    PubMed

    Morris, Aldon

    2017-03-01

    I am honoured to present the 2016 British Journal of Sociology Annual Lecture at the London School of Economics. My lecture is based on ideas derived from my new book, The Scholar Denied: W.E.B. Du Bois and the Birth of Modern Sociology. In this essay I make three arguments. First, W.E.B. Du Bois and his Atlanta School of Sociology pioneered scientific sociology in the United States. Second, Du Bois pioneered a public sociology that creatively combined sociology and activism. Finally, Du Bois pioneered a politically engaged social science relevant for contemporary political struggles including the contemporary Black Lives Matter movement. © London School of Economics and Political Science 2017.

  17. Les traces matérielles de la Carte du Ciel. Le cas des observatoires d'Alger et de Bordeaux.

    NASA Astrophysics Data System (ADS)

    Le Guet Tully, F.; Davoigneau, J.; Lamy, J.; de La Noë, J.; Rousseau, J.-M.; Sadsaoud, H.

    2008-06-01

    Le chapitre évoque les traces matérielles de la Carte du ciel subsistant dans les observatoires d'Alger et de Bordeaux. Les auteurs examinent d'abord l'opération d'inventaire du patrimoine astronomique entreprise à partir du milieu des années 1990. Ils examinent ensuite les éléments concrets constituant aujourd'hui le patrimoine de la Carte du Ciel : lunettes, abris, accessoires, laboratoires, réseaux, plaques de verre, registres, machines à mesurer les clichés, et cartes.

  18. Prenatal drug exposure and teratological risk: one-year experience of an Italian Teratology Information Service.

    PubMed

    De Santis, Marco; Cesari, Elena; Ligato, Maria Serena; Nobili, Elena; Straface, Gianluca; Cavaliere, Annafranca; Caruso, Alessandro

    2008-02-01

    Concern about exposure to drugs, radiation, or infection during pregnancy occur often because pregnancy is not always planned. A teratology information service offers rapid scientific counseling to all those worried about prenatal exposure. The aim of this study is to present data on the most common pharmaceutical products responsible for teratogenic risk in the one-year experience of a teratology information service in Italy. The survey was conducted among 8664 callers who contacted our Teratology Information Service in Rome between January and December 2006. Data on maternal age, gravidity, parity, maternal health status, and details of exposure (dose and timing) were collected and stored in a specific data base. Scientific counseling on prenatal exposure was given to the caller by a specialized service operator, specifying the type of risk and suggesting appropriate tests for prenatal diagnosis. Most of the people called regarding drug exposure; increased risk was present in only 5% of the pregnant women calling during pregnancy. Selective serotonin reuptake inhibitors (SSRIs) are the first category that are actually considered of increased risk to the fetus. The second category is represented by antiepileptic drugs. This experience confirms previous data that there is a high teratological risk perception among both women and physicians. The drugs estimated to present increased risk are medications used for chronic neurological diseases, mainly mood disorders and epilepsy. Preconceptional counseling for these women could be an effective strategy to prevent such exposure and to improve maternal and fetal outcome.

  19. The Effect of Student Teaching Experience and Teacher Beliefs on Pre-Service Teachers' Self-Efficacy and Intention to Use Technology in Teaching

    ERIC Educational Resources Information Center

    Han, Insook; Shin, Won Sug; Ko, Yujung

    2017-01-01

    The student teaching experience has been considered important in establishing pre-service teachers' beliefs and attitudes towards their teaching. However, few studies have investigated the effect of student teaching experiences as an educational intervention for increasing technology integration--especially pre-service teachers' pedagogical…

  20. Family Carers' Experiences Using Support Services in Europe: Empirical Evidence from the EUROFAMCARE Study

    ERIC Educational Resources Information Center

    Lamura, Giovanni; Mnich, Eva; Nolan, Mike; Wojszel, Beata; Krevers, Barbro; Mestheneos, Liz; Dohner, Hanneli

    2008-01-01

    Purpose: This article explores the experiences of family carers of older people in using support services in six European countries: Germany, Greece, Italy, Poland, Sweden, and the UK. Design and Methods: Following a common protocol, data were collected from national samples of approximately 1,000 family carers per country and clustered into…

  1. The Beliefs and Perceived Experiences of Preservice and Early Service Teachers Who Use Facebook

    ERIC Educational Resources Information Center

    Foss, Nathan D.

    2012-01-01

    The purpose of this qualitative research study was to identify commonly held beliefs and perceived experiences of preservice and early service teachers with regard to their use of the social networking site Facebook. This study included recorded and transcribed interviews of 14 participants as well as observations of their Facebook accounts. The…

  2. Key stakeholders' experiences of respite services for people with dementia and their perspectives on respite service development: a qualitative systematic review.

    PubMed

    Shea, Emma O'; Timmons, Suzanne; Shea, Eamon O'; Fox, Siobhan; Irving, Kate

    2017-12-07

    Respite services provide a break in the caregiving relationship for people with dementia and their carers, however they are often under-used and service acceptability can be low. This study aims to understand key stakeholders' experiences of respite services for people with dementia, with a view to informing respite service development. A systematic search was conducted of the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science, and Cochrane databases (1980-2016, English) with fixed search terms relating to 'respite' and 'dementia', following PRISMA guidelines. Noblit and Hare's approach to meta-ethnography was employed. Key concepts were identified across the papers and reciprocal and refutational translation techniques were applied to primary studies; findings were synthesized into third order interpretations and finally, a 'line-of-argument' was developed. In total 23 papers were reviewed, which described 20 independent samples across 12 countries. The views of 889 participants were synthesized (13 people with dementia, 690 carers, 44 'service providers', 52 frontline staff, 70 managers, 12 volunteers, six academic/policy-makers, and two independent consultants). Five key concepts were identified and outlined i.e. 1) the transition to service use 2) expanding organizational capacity 3) dementia care quality 4) building a collaborative care partnership and 5) dyad restoration. There was broad agreement around the key areas for service development across the range of stakeholders (flexible and responsive person-centred care, meaningful activity for people with dementia, enhanced client-service communication and informational support). However, there was clear divergence in stakeholder perspectives around the barriers to implementation of such developments. Organizational tension was evident between frontline staff and management in respite services, hindering the cultural change necessary to facilitate service development in line with dyad's needs

  3. An Examination of Pre-Service Agricultural Science Teachers' Interest and Participation in International Experiences: Motivations and Barriers

    ERIC Educational Resources Information Center

    Murphrey, Theresa Pesl; Lane, Katy; Harlin, Julie; Cherry, Audie

    2016-01-01

    The importance of creating global mindedness within pre-service agricultural science teachers through international experiences cannot be overstated. However, providing opportunities for international experiences and college students selecting to participate in these opportunities are two very different actions. Mechanisms must be put in place…

  4. Tracking health care service use and the experiences of adults with autism spectrum disorder without intellectual disability: A longitudinal study of service rates, barriers and satisfaction.

    PubMed

    Vogan, Vanessa; Lake, Johanna K; Tint, Ami; Weiss, Jonathan A; Lunsky, Yona

    2017-04-01

    Adults with Autism Spectrum Disorder (ASD) encounter many difficulties finding and accessing health care services. Despite this, few studies have considered the health service use patterns of adults with ASD without intellectual disability (ID). The current study examines a diverse range of medical and mental health services and supports, as well as adults' personal experiences accessing and using these services, barriers to service use, and reported unmet service needs. Forty adults (ages 18-61 years) with ASD without ID completed surveys every two months about their health service use for a total of 12-18 months. Bivariate analyses were conducted to understand the individual demographic and clinical factors associated with rate of service use, satisfaction with services, and barriers to health care. Results indicated that, beyond a family doctor, the most commonly used services were dentistry, individual counseling, and psychiatry. Individuals who had medical problems experienced significantly more barriers to service use than those who did not, and those who had medical and mental health problems were less satisfied with services. Findings highlight the challenges adults with ASD without ID face accessing appropriate, quality services to meet their needs, particularly those with complex medical and mental health issues. Service providers must strive to provide adequate health care to this population who may become distressed if their needs are left unmet. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Cirque du Monde as a health intervention: perceptions of medical students and social circus experts.

    PubMed

    Fournier, Cynthia; Drouin, Mélodie-Anne; Marcoux, Jérémie; Garel, Patricia; Bochud, Emmanuel; Théberge, Julie; Aubertin, Patrice; Favreau, Gil; Fleet, Richard

    2014-11-01

    To present Cirque du Soleil's social circus program, Cirque du Monde, to explore its potential as a primary health care tool for family physicians. A review of the literature in PubMed, the Cochrane Library, PsycINFO, LaPresse, Eureka, Google Scholar, and Érudit using the key words circus, social circus, Cirque du Monde, and Cirque du Soleil; a Montreal-based initiative, Espace Transition, modeled on Cirque du Monde; and personal communication with Cirque du Soleil's Social Circus Training Advisor. The first 50 articles or websites identified for each key word in each of the databases were examined on the basis of their titles and abstracts in the case of articles, and on the basis of their titles and page content in the case of websites. Articles and websites that explored an aspect of social circuses or that described an intervention that involved circuses were then retained for analysis. Because all literature on social circuses was searched, no criterion for year of publication was used. No articles on the social circus as a health intervention were found. One study on the use of the circus as an intervention in schools was identified. It demonstrated an increase in self-esteem in the children who took part. One study on the use of the circus in a First Nations community was found; it contained nonspecific, qualitative findings. The other articles identified were merely descriptions of social circuses. One website was identified on the use of the social circus to help youth who had been treated in a hospital setting for major psychiatric disorders to re-enter the community. The team in the pediatric psychiatry department at Centre Hospitalier Universitaire Sainte-Justine, the children's hospital in Montreal, Que, was contacted; they were leading this project, called Espace Transition. The unpublished preliminary findings of its pilot project demonstrate substantial improvements in overall patient functioning. According to Cirque du Soleil, there are several

  6. Students mentoring students in a service-learning clinical supervision experience: an educational case report.

    PubMed

    Lattanzi, Jill Black; Campbell, Sandra L; Dole, Robin L; Palombaro, Kerstin M

    2011-10-01

    Service-learning projects present the opportunity to combine academic skill practice and peer mentorship with meaningful community service. Implicit learning outcomes include an enhanced understanding of social responsibility and professional development-concepts difficult to teach in the classroom. The purpose of this educational case report is to describe the development, application, and outcomes of a service-learning project designed to facilitate peer mentorship and the development of social responsibility. DEVELOPMENT OF THE PROCESS: Widener University mandated that all programs offer student community service opportunities on Martin Luther King Day. In response, the physical therapy program developed a plan to clean and screen assistive and mobility devices and provide blood pressure screening at designated community sites. APPLICATION OF THE PROCESS: All faculty and all members of the first-year and third-year Doctor of Physical Therapy (DPT) classes participated. The students and a faculty member traveled to designated community sites in teams. First-year students were able to practice newly acquired skills under the supervision and peer mentorship of third-year students. Outcomes of the service-learning project were assessed through a tally of services rendered, measurement of curricular goal achievement, a survey of the community partners' satisfaction with the event, and consideration of both first-year and third-year DPT student reflection papers. The service-learning project was effective in meeting a community need, enhancing community partner relationships, fostering student understandings of social responsibility, and creating a valuable peer mentorship experience.

  7. Mental health service users' experiences of diabetes care by Mental Health Nurses: an exploratory study.

    PubMed

    Nash, M

    2014-10-01

    This paper is a report of a study exploring mental health service users' (MHSUs') experiences of diabetes care. Diabetes is a growing clinical concern in mental health nursing practice. However, little is known about MHSUs' experience of diabetes care. This is a descriptive qualitative study. Semi-structured telephone interviews were held between June and October 2011, with seven MHSUs who had diabetes. Participants reported experiences of stigma and diagnostic overshadowing (DO) when reporting symptoms of diabetes or when feeling unwell. Participants also encountered a split between their mental health and diabetes care needs, which resulted in a lack of holistic or integrated care. All participants mentioned experiencing complications of diabetes even to the extent of diabetic ketoacidosis. Mental health nurses (MHNs) must critically reflect on their attitudes towards service users that report physical symptoms to ensure that stigma and DO do not constitute barriers to appropriate screening and treatment. The complex relationship that exists between mental illness and diabetes requires MHNs to ensure physical and mental health care are wholly integrated and not split. Education needs are apparent so that symptoms and complications can be recognized and treated accordingly. © 2014 John Wiley & Sons Ltd.

  8. Experiences of girls with hearing impairment in accessing reproductive health care services in Ibadan, Nigeria.

    PubMed

    Arulogun, Oyedunni S; Titiloye, Musibau A; Afolabi, Nathanael B; Oyewole, Oyediran E; Nwaorgu, Onyekwere G B

    2013-03-01

    Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.

  9. Analyse de la prise en charge du nouveau-né dans le cadre de la stratégie nationale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou (Burkina Faso)

    PubMed Central

    Ouédraogo, Solange Odile Yugbaré; Yougbaré, Nestor; Kouéta, Fla; Dao; Ouédraogo, Moussa; Lougué, Claudine; Ludovic, Kam; Traoré, Ramata Ouédraogo; Yé, Diarra

    2015-01-01

    Introduction Il s'agit d'analyser la prise en charge du nouveau-né dans le cadre de la stratégie na-tionale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence mis en place par le gouvernement du Burkina Faso en 2006. Méthodes Nous avons menée une étude à visée descriptive et analytique comportant un volet ré-trospectif du 01 janvier 2006 au 31 décembre 2010 portant sur les paramètres épidémiologiques, cliniques des nouveau-nés hospitalisés et un volet prospectif du 3 octobre 2011 au 29 février 2012 par une entrevue des accompagnateurs des nouveau-nés et des prestataires des services de santé. Résultats Les hospitalisations ont augmenté de 43,65% entre 2006 à 2010 Le taux de mortalité néo-natale hospitalière qui était de 11,04% a connu une réduction moyenne annuelle de 3,95%. L'entrevue a porté sur 110 accompagnateurs et 76 prestataires. La majorité des prestataires (97,44%) et des ac-compagnateurs (88,18%) étaient informés de la stratégie mais n'avait pas une connaissance exacte de sa définition. Les prestataires (94,74%) ont signalé des ruptures de médicaments, consommables médicaux et des pannes d’ appareils de laboratoire et d'imagerie. Parmi les accompagnateurs (89%) disaient être satisfaits des services offerts et (72,89%) trouvaient les coûts abordables mais évoquaient les difficultés du transport. Conclusion: La subvention a amélioré la prise en charge du nou-veau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. Conclusion La subvention a amélioré la prise en charge du nouveau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. PMID:26161166

  10. The primary health care service experiences and needs of homeless youth: a narrative synthesis of current evidence.

    PubMed

    Dawson, Angela; Jackson, Debra

    2013-04-01

    Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.

  11. Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

    PubMed

    O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

    2017-12-01

    Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

  12. Wide-area technologies and services in the Trans-Pacific High Data Rate (HDR) satellite communications experiments

    NASA Technical Reports Server (NTRS)

    Hsu, E.; Hung, C.; Kadowaki, N.; Yoshimura, N.; Takahashi, T.; Shopbell, P.; Walker, G.; Wellnitz, D.; Gary, P.; Clark, G.; hide

    2000-01-01

    This paper describes the technologies and services used in the experiments and demonstrations using the Trans-Pacific high data rate satellite communications infrastructure, and how the environment tasked protocol adaptability, scalability, efficiency, interoperability, and robustness.

  13. Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences.

    PubMed

    Darwin, Zoe; Green, Josephine; McLeish, Jenny; Willmot, Helen; Spiby, Helen

    2017-03-01

    Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England. A mixed methods multi-site evaluation was conducted with women (total n = 137) who received the service before December 2012, using a combination of questionnaires (n = 136), and individual or group interviews (n = 12). Topics explored with women included the timing and nature of support, its impact, the relationship with the doula and negative experiences. Most women valued volunteer support, describing positive impacts for emotional health and well-being, and their relationships with their partners. Such impacts did not depend upon the volunteer's presence during labour and birth. Indeed, only half (75/137; 54.7%) had a doula attend their birth. Many experienced volunteer support as a friendship, distinct from the relationships offered by healthcare professionals and family. This led to potential feelings of loss in these often isolated women when the relationship ended. Volunteer doula support that supplements routine maternity services is potentially beneficial for disadvantaged women in the UK even when it does not involve birth support. However, the distress experienced by some women at the conclusion of their relationship with their volunteer doula may compromise the service's impact. Greater consideration is needed for managing the ending of a one-to-one relationship with a volunteer

  14. More than what the eye can see: the emotional journey and experience of powerlessness of integrated care service users and their carers

    PubMed Central

    Boudioni, Markella; Hallett, Nina; Lora, Cristina; Couchman, Wendy

    2015-01-01

    Purpose This article presents the emotional journey and experience of powerlessness of integrated care service users and carers. Materials and methods The experiences of seven integrated care service users and carers affected by complex conditions in a London borough were captured as video stories. The integrated care service coordinated a system of health and social care: primary care, community matrons, social workers, and the voluntary sector. The service was designed to respond to identified cases of high-risk individuals with long-term, multiple, and age-related conditions needing preventive interventions. The video stories were analyzed by researchers in collaboration with service users using a visual thematic qualitative approach. This report is part of an independent analysis of the integrated care service evaluation that used the experience-based codesign model. Results The findings are presented in the respective contexts of people with complex conditions and their carers. The overwhelming feelings and emotions of both were loss of control and power throughout their emotional journey, with family carers adopting a protective attitude toward the patients. Their experience of powerlessness was variable throughout their emotional journey. They were affected more strongly when in need of extra help and support and while they were undergoing the process of receiving extra services. When they were receiving help and support outside and within hospitals, some participants were empowered, gaining skills and knowledge by being provided with the mechanisms to cope with their condition at present and in the future. Conclusion Feelings of powerlessness were very common among integrated care service users and their carers. Powerless/empowerment has been poorly investigated to date. Visual methods and collaborative visual analysis with service users have proved to be powerful methods too, but have been rarely reported. PMID:25848232

  15. Transition to adult mental health services for young people with attention deficit hyperactivity disorder in Italy: Parents' and clinicians' experiences.

    PubMed

    Reale, Laura; Frassica, Simona; Gollner, Astrid; Bonati, Maurizio

    2015-01-01

    The aim of this study was to describe the experiences of parents and clinicians in relation to the transition from child and adolescent neuropsychiatric services (CANPS) to adult services for people with attention deficit hyperactivity disorder (ADHD) in Italy. Parents of people with ADHD who reached the transition boundary for CANPS were sampled from the A.I.F.A. association (Italian Association of ADHD Families). We thematically analyzed informative and qualitative questionnaires completed by parents and clinicians. Parents' (n = 24) and clinicians' (n = 27) experiences differed slightly on challenges and unmet needs, whereas clinicians agreed on the variables required for an optimal transition process. Poor transition and multiple barriers to such care were identified. Specifically, far fewer people received services, especially public health services, after reaching the age of 18, and perceived barriers included problems with user access, limited transition protocols, poor service coordination, and possible lack of ADHD-related knowledge on the part of adult practitioners. Care continuity in mental healthcare remains a need to be prioritized and better defined also for ADHD patients (and their parents). Parents' and clinicians' experiences are more likely to be positive if transition management is characterized by a gradual preparation, a period of parallel care, and commonly acknowledged, clear information on available services and how to access them. Identifying the needs and barriers of the people representing the different roles (clinicians, parents, and users) involved in the transition to adult mental health services is of particular importance in designing effective, shared transfer planning procedures.

  16. Restauration fonctionnelle du rachis : effet du niveau initial de douleur sur les performances des sujets lombalgiques chroniques

    PubMed Central

    Caby, Isabelle; Olivier, N; Mendelek, F; Kheir, R Bou; Vanvelcenaher, J; Pelayo, P

    2014-01-01

    HISTORIQUE : La lombalgie chronique est une douleur lombaire persistante d’origine multifactorielle. Le niveau de douleur initial reste faiblement utilisé pour analyser et comparer les réponses des patients lombalgiques au programme de reconditionnement. OBJECTIFS : Apprécier et évaluer les réponses des sujets lombalgiques chroniques très douloureux à une prise en charge dynamique et intensive. MÉTHODOLOGIE : 144 sujets atteints de lombalgie chronique ont été inclus dans un programme de restauration fonctionnelle du rachis de 5 semaines. Les sujets ont été classés en deux groupes de niveau de douleur: un groupe atteint de douleur sévère (n = 28) et un groupe atteint de douleur légère à modérée (n = 106). L’ensemble des sujets ont bénéficié d’une prise en charge identique comprenant principalement de la kinésithérapie, de l’ergothérapie, du reconditionnement musculaire et cardio-vasculaire ainsi qu’un suivi psychologique. Les paramètres physiques (flexibilité, force musculaire) et psychologiques (qualité de vie) ont été mesurés avant (T0) et après le programme (T5sem). RÉSULTATS : L’ensemble des performances physiques et fonctionnelles des sujets très douloureux sont moins bonnes et le retentissement de la lombalgie sur la qualité de vie, pour ces mêmes sujets, est majoré à T0. Toutes les différences significatives constatées à T0 entre les deux groupes s’effacent à T5sem. CONCLUSIONS : Les sujets lombalgiques chroniques très douloureux répondent favorablement au programme dynamique et intensif. L’intensité douloureuse de la lombalgie n’aurait pas d’effet sur les réponses au programme. La restauration fonctionnelle du rachis apporterait aux sujets la possibilité de mieux gérer leur douleur quel que soit son niveau. PMID:25299476

  17. Etude des facteurs de risque du retard de croissance intra-utérin à Lubumbashi

    PubMed Central

    Moyambe, Jules Ngwe Thaba; Bernard, Pierre; Khang'Mate, Faustin; Nkoy, Albert Mwembo Tambwe A; Mukalenge, Faustin Chenge; Makanda, Daudet; Twite, Eugene; Ndudula, Arthur Munkana; Lubamba, Cham; Kadingi, Arnauld Kabulu; Kayomb, Mutach; Kayamba, Prosper Kalenga Muenze

    2013-01-01

    Introduction Dans notre milieu, il n'existe aucune politique de prévention du Retard de Croissance Intra-Utérin (RCIU) clairement défini. L'objectif de ce travail était d'identifier les facteurs de risque de RCIU afin de proposer une stratégie de lutte contre cette pathologie en agissant surtout sur des facteurs pouvant faire l'objet d'une action préventive. Méthodes Une étude cas-témoins a été menée dans 11 centres hospitaliers de Lubumbashi en République Démocratique du Congo, de Janvier 2010 à Juin 2011, dans le but d'identifier les facteurs de risque du retard de croissance intra-utérin (RCIU). Au total 420 gestantes (cas et témoins) avec grossesse monofoetale d'au moins 24 semaines d'aménorrhée ont été inclues dans l'étude. Les cas correspondaient aux gestantes dont le poids du fœtus était resté inférieur au 10 eme percentile des courbes de référence d'Alexander, après 2 échographies successives réalisées à intervalle de 4 semaines. Les témoins correspondaient aux gestantes dont le poids du fœtus était supérieur ou égal au 10 eme percentile de mêmes courbes. A chaque cas a été apparié un témoin de même parité porteur d'une grossesse de même âge. Résultats L'analyse univariée a identifié comme facteurs de risque: la taille maternelle. Conclusion L'amélioration du niveau socio-économique des populations, la lutte contre le paludisme et les consultations prénatales mieux organisées couplées à une meilleure éducation sanitaire et nutritionnelle peuvent contribuer sensiblement à la réduction de la fréquence du RCIU à Lubumbashi. PMID:23504392

  18. CIEMAT EXTERNAL DOSIMETRY SERVICE: ISO/IEC 17025 ACCREDITATION AND 3 Y OF OPERATIONAL EXPERIENCE AS AN ACCREDITED LABORATORY.

    PubMed

    Romero, A M; Rodríguez, R; López, J L; Martín, R; Benavente, J F

    2016-09-01

    In 2008, the CIEMAT Radiation Dosimetry Service decided to implement a quality management system, in accordance with established requirements, in order to achieve ISO/IEC 17025 accreditation. Although the Service comprises the approved individual monitoring services of both external and internal radiation, this paper is specific to the actions taken by the External Dosimetry Service, including personal and environmental dosimetry laboratories, to gain accreditation and the reflections of 3 y of operational experience as an accredited laboratory. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Health services experiences of parents of recently diagnosed visually impaired children

    PubMed Central

    Rahi, J S; Manaras, I; Tuomainen, H; Lewando Hundt, G

    2005-01-01

    Aim: To investigate the health service experiences and needs of parents in the period around diagnosis of ophthalmic disorders in their children. Methods: Parents of children newly diagnosed with visual impairment and/or ophthalmic disorders at a tertiary level hospital in London participated in a questionnaire survey, using standard instruments, followed by in-depth individual interviews, to elicit their views about the processes of care, their overall level of satisfaction, and their unmet needs. Results: 67% (147) of eligible families (135 mothers, 76 fathers) participated. Overall satisfaction with care was high, being greater among parents of children with milder visual loss or isolated ophthalmic disorders than those with more severe visual loss or multiple impairments. Nevertheless, parents’ reported greatest need was the provision of general information, including about their child’s ophthalmic disorder and educational and social services and support. Mothers reported greater information needs than fathers, as did white parents compared to those from ethnic minorities. White parents also regarded the processes of care to be less comprehensive and coordinated, as well as less enabling, than did parents from ethnic minorities. Conclusions: Although parents reported high overall satisfaction with services, improving the medium, content, and scope of general information provided by professionals to parents of visually impaired children emerges as a priority. Equitable planning and provision of health services for families of children with visual impairment needs to take into account that informational and other needs vary by whether the parent is the primary carer or not and their ethnicity, as well as by the severity and complexity of their child’s visual loss. PMID:15665355

  20. Modelisation par elements finis du muscle strie

    NASA Astrophysics Data System (ADS)

    Leonard, Mathieu

    Ce present projet de recherche a permis. de creer un modele par elements finis du muscle strie humain dans le but d'etudier les mecanismes engendrant les lesions musculaires traumatiques. Ce modele constitue une plate-forme numerique capable de discerner l'influence des proprietes mecaniques des fascias et de la cellule musculaire sur le comportement dynamique du muscle lors d'une contraction excentrique, notamment le module de Young et le module de cisaillement de la couche de tissu conjonctif, l'orientation des fibres de collagene de cette membrane et le coefficient de poisson du muscle. La caracterisation experimentale in vitro de ces parametres pour des vitesses de deformation elevees a partir de muscles stries humains actifs est essentielle pour l'etude de lesions musculaires traumatiques. Le modele numerique developpe est capable de modeliser la contraction musculaire comme une transition de phase de la cellule musculaire par un changement de raideur et de volume a l'aide des lois de comportement de materiau predefinies dans le logiciel LS-DYNA (v971, Livermore Software Technology Corporation, Livermore, CA, USA). Le present projet de recherche introduit donc un phenomene physiologique qui pourrait expliquer des blessures musculaires courantes (crampes, courbatures, claquages, etc.), mais aussi des maladies ou desordres touchant le tissu conjonctif comme les collagenoses et la dystrophie musculaire. La predominance de blessures musculaires lors de contractions excentriques est egalement exposee. Le modele developpe dans ce projet de recherche met ainsi a l'avant-scene le concept de transition de phase ouvrant la porte au developpement de nouvelles technologies pour l'activation musculaire chez les personnes atteintes de paraplegie ou de muscles artificiels compacts pour l'elaboration de protheses ou d'exosquelettes. Mots-cles Muscle strie, lesion musculaire, fascia, contraction excentrique, modele par elements finis, transition de phase

  1. Art engagement and mental health: experiences of service users of a community-based arts programme at Tate Modern, London.

    PubMed

    McKeown, Eamonn; Weir, Hannele; Berridge, Emma-Jane; Ellis, Liz; Kyratsis, Yiannis

    2016-01-01

    To examine the experiences of mental health service users who took part in an arts-based programme at Tate Modern, a major London art gallery. Exploratory qualitative design. Data were collected using in-depth semi-structured interviews with 10 mental health service users who had taken part in a community-based programme at Tate Modern. Additionally, six art educators from Tate Modern were interviewed. Concepts that emerged from the text were identified using thematic analysis. All participants valued the gallery-based programme. The three overarching thematic areas were: the symbolic and physical context in which the programme workshops were located; the relational and social context of the programme workshops; and reflections on the relationship between the arts-based programme and subsequent mental health. Art galleries are increasingly seen to function as vehicles for popular education with mental health service users. This study adds to the growing body of evidence related to how mental health service users experience and reflect on arts-related programmes targeted at them. This study indicates that emphasis on how users experience gallery-based programmes may contribute to a more nuanced understanding of the relationship between art and mental health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  2. Views of Pre-Service Teachers Following Teaching Experience on Use of Dynamic Geometry Software

    ERIC Educational Resources Information Center

    Günes, Kardelen; Tapan-Broutin, Menekse Seden

    2017-01-01

    The study aims to determine the views of final-year pre-service mathematics teachers towards their experience of the use of dynamic geometry software in teaching, following the implementation processes that they carried out when using this software in a real classroom environment. The study was designed as a case study, which is one of the…

  3. Not sick enough: Experiences of carers of people with mental illness negotiating care for their relatives with mental health services.

    PubMed

    Olasoji, M; Maude, P; McCauley, K

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Existing literature provides insight into the general experience of carers of people with a mental illness. Previous studies have found that carers experience a range of emotions when looking after their relatives with a mental illness. However, experiences of carers as they engage with the healthcare system is largely absent from the literature. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper identified the experiences of carers when their relatives are experiencing a crisis or acutely unwell. Carers found themselves in the middle between mental health services and their relatives. Strategies employed by carers to ensure their relatives receive adequate care were identified from this study. This paper identified how carers needed to become more assertive in order to receive adequate care for their relatives, and this finding has implications for any future carer education. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The participants identified the need to work more collaboratively with carers of people with a mental illness as they seek treatment for their relatives in order to achieve better health outcomes for the patients. Improved health service engagement of carers was seen by participants to assist them to better care for their relative. The study also found that there needs to be a clearer definition as to what constitutes mental health crisis and how carers are able to intervene during this period. Services could provide clear information concerning crisis services and in particular triage. Aim The literature reporting experiences of relatives of people with mental illness regarding their interactions with mental health services identifies many commonalities. However, the actual experience of carers engaging the services and understanding healthcare systems remains a gap in the literature. The aim of this study was to explore the experiences of carers (of people with a severe mental illness) in a major area mental health

  4. Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

    PubMed Central

    2012-01-01

    Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as

  5. EPA may modify Du Pont waiver for methanol fuel blends

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Anderson, E.V.

    1985-09-02

    The Environmental Protection Agency (EPA) granted a Clean Air ACt waiver to DuPont's blendstock of methanol and other cosolvent alcohols for use in unleaded gasoline. The waiver included some stringent fuel volatility requirements to control evaporative emissions that have kept the waiver from becoming the marketing tool for fuel alcohols that everyone expected it to be. EPA seems willing to amend the waiver as long as evaporative emissions controls are kept, but there are some difficult procedural issues to resolve first. To date, only small amounts of alcohol blends have been sold under the DuPont waiver because the blendstock tendsmore » to increase the volatility of gasoline.« less

  6. Cancer du sein au Cameroun, profil histo-épidémiologique: à propos de 3044 cas

    PubMed Central

    Engbang, Jean Paul Ndamba; Essome, Henri; Koh, Valère Mve; Simo, Godefroy; Essam, Jean Daniel Sime; Mouelle, Albert Sone; Essame, Jean Louis Oyono

    2015-01-01

    Décrire les caractéristiques épidémiologiques et histo-pathologiques des tumeurs malignes du sein au Cameroun. Il s'agissait d'une étude rétrospective descriptive portant sur les tumeurs malignes du sein, colligées, dans les registres des différents laboratoires d'Anatomie Pathologique publiques et privés repartis dans cinq régions (centre, littoral, Ouest, Nord-ouest, Sud-ouest), pendant une période de 10 ans (2004-2013). Les paramètres étudiés étaient la fréquence, l’âge, le sexe, la localisation, le type et le grade histologique, et les récepteurs hormonaux. Un total de 3044 cas de cancers du sein a été recensé, soit une fréquence annuelle de 304,4 cas en moyenne. Le sexe féminin était le plus représenté avec 2971 cas (97,60%) et les hommes avec 73 cas (2,40%), soit un sexe ratio (H/F) de 0,02. L’âge moyen des patients était de 46±15,87 ans, avec des extrêmes de 13 et 95 ans. Selon la localisation, le sein gauche était atteint dans 1244 cas (52%) et le sein droit dans 1115 cas (47%). Au plan histologique, on retrouvait essentiellement des carcinomes avec 96,50% des cas, des sarcomes 1,39%, des lymphomes 1,07% et la maladie de Paget du mamelon, 1,03%. Les tumeurs épithéliales étaient infiltrantes dans 2049 cas (84,46%), avec une prédominance du carcinome canalaire infiltrant (1870 cas) et non infiltrantes dans 377 cas (15,54%). Le grade histo-pronostic de SBR avait révélé une prédominance du grade II dans 66% des cas. Les cancers du sein restent une pathologie fréquente au Cameroun et atteignent principalement la population féminine en âge de procréer. Ils sont caractérisés par la prédominance du carcinome canalaire infiltrant. PMID:26523182

  7. The individualized service plan as a clinical integration tool: qualitative analysis in the Quebec PRISMA experiment

    PubMed Central

    Somme, Dominique; Hébert, Réjean; Bravo, Gina; Blanchard, François; Saint-Jean, Olivier

    2007-01-01

    Introduction One aspect of clinical integration involves case managers' tools and particularly the individualized service plan. Methods We examined individualized service plan content and use in the PRISMA experiment. We analyzed 50 charts, and conducted and recorded interviews regarding individualized service plan use with all the case managers concerned (n=13). Results Delays between starting case management and writing the individualized service plan were long and varied (0–596 days, mean: 117 days). During the interviews, the individualized service plan was described as the ‘last step’ once the active planning phase was over. The reasons for formulating plans were mainly administrative. From a clinical viewpoint, individualized service plans were used as memoranda and not to describe services (842 interventions not mentioned in the plans) or needs (694 active problems not mentioned). Case managers felt uncomfortable with the individualized planning task and expected a tool more adapted to their needs. Conclusion Although a majority of the case managers' charts contained an individualized service plan, implementation of this tool seems tenuous. Because of the discrepancy between the potential usefulness expected by case managers and their actual use, a working committee was created to develop proposals for modifying the instrument. PMID:19503736

  8. Children's experiences of domestic violence: developing an integrated response from police and child protection services.

    PubMed

    Stanley, Nicky; Miller, Pam; Foster, Helen Richardson; Thomson, Gill

    2011-08-01

    Police notifications of incidents of domestic violence to child protection services constitute an acknowledgement of the harm that domestic violence inflicts on children. However, these notifications represent a substantial demand on child welfare services and the outcomes for children and victims of domestic violence have been questioned. This paper presents findings from the first UK study to examine these notifications in depth and examines the interface between the police and child protection services in responding to domestic violence incidents. The research reports on police interventions in 251 incidents of domestic violence involving children; the communication of information to child protection services and the subsequent filtering and service response. Social workers found that notifications conveyed little information on children's experiences of domestic violence. Forty per cent of families notified had had no previous contact with child protection services in that area, but those cases most likely to receive social work assessment or intervention were those where the case was already open. Notifications triggered a new social work intervention in only 5% of cases. The study also identified a range of innovative approaches for improving the co-ordination of police and child protective services in relation to children's exposure to domestic violence. Arrangements that maximized opportunities for police and social workers to share agency information appeared to offer the best option for achieving informed decisions about the appropriate level of service response to children and families experiencing domestic violence.

  9. Theoretical Frames and Teaching Styles of Physical Therapy Faculty Who Lead International Service-Learning Experiences

    ERIC Educational Resources Information Center

    Audette, Jennifer Gail

    2011-01-01

    Purpose: International service-learning (ISL) is popular in higher education, and many physical therapy educational programs are adding ISL opportunities to their curricula because doing so aligns with student interest and the increasingly global nature of the profession. The faculty leading these experiences have not been studied. Nearly all…

  10. Etude des phenomenes dynamiques ultrarapides et des caracteristiques impulsionnelles d'emission terahertz du supraconducteur YBCO

    NASA Astrophysics Data System (ADS)

    Savard, Stephane

    Les premieres etudes d'antennes a base de supraconducteurs a haute temperature critique emettant une impulsion electromagnetique dont le contenu en frequence se situe dans le domaine terahertz remontent a 1996. Une antenne supraconductrice est formee d'un micro-pont d'une couche mince supraconductrice sur lequel un courant continu est applique. Un faisceau laser dans le visible est focalise sur le micro-pont et place le supraconducteur dans un etat hors-equilibre ou des paires sont brisees. Grace a la relaxation des quasiparticules en surplus et eventuellement de la reformation des paires supraconductrices, nous pouvons etudier la nature de la supraconductivite. L'analyse de la cinetique temporelle du champ electromagnetique emis par une telle antenne terahertz supraconductrice s'est averee utile pour decrire qualitativement les caracteristiques de celle-ci en fonction des parametres d'operation tels que le courant applique, la temperature et la puissance d'excitation. La comprehension de l'etat hors-equilibre est la cle pour comprendre le fonctionnement des antennes terahertz supraconductrices a haute temperature critique. Dans le but de comprendre ultimement cet etat hors-equilibre, nous avions besoin d'une methode et d'un modele pour extraire de facon plus systematique les proprietes intrinseques du materiau qui compose l'antenne terahertz a partir des caracteristiques d'emission de celle-ci. Nous avons developpe une procedure pour calibrer le spectrometre dans le domaine temporel en utilisant des antennes terahertz de GaAs bombarde aux protons H+ comme emetteur et detecteur. Une fois le montage calibre, nous y avons insere une antenne emettrice dipolaire de YBa 2Cu3O7-delta . Un modele avec des fonctions exponentielles de montee et de descente du signal est utilise pour lisser le spectre du champ electromagnetique de l'antenne de YBa 2Cu3O7-delta, ce qui nous permet d'extraire les proprietes intrinseques de ce dernier. Pour confirmer la validite du modele

  11. Teleconsultation for Clinicians Who Provide Human Immunodeficiency Virus Care: Experience of the National HIV Telephone Consultation Service

    PubMed Central

    Neff, Sarah; Goldschmidt, Ronald H.

    2011-01-01

    Abstract Objective To examine the infrastructure, successes, and challenges of a teleconsultation service for human immunodeficiency virus (HIV) clinicians. Materials and Methods The HIV Warmline is a telephone consultation service providing free, live HIV/AIDS management advice to U.S. clinicians. We present descriptive data about callers, patients, and consultation topics gathered by electronic query of the HIV Warmline database for 2009. Caller satisfaction survey results for 2009 are also presented. Results The HIV Warmline has provided more than 37,000 consultations since its inception in 1992. The service provides consultations to clinicians from all 50 states, from a variety of professional backgrounds, and with a wide range of HIV experience levels. The majority of call topics concern antiretroviral therapy. Callers are generally pleased with the service, giving a mean Likert scale rating of 4.7 on satisfaction survey questions. Conclusion The experience of the HIV Warmline can serve as a model for other programs planning to develop remote consultation systems. HIV teleconsultation has been relatively simple to implement and can be useful for many types of clinicians. HIV teleconsultation should continue to be evaluated as a way to improve HIV care, especially in areas without easy access to HIV expertise. PMID:21612517

  12. Preferences for physician services in Ukraine: a discrete choice experiment.

    PubMed

    Danyliv, Andriy; Pavlova, Milena; Gryga, Irena; Groot, Wim

    2015-01-01

    Evidence on preferences of Ukrainian consumers for healthcare improvements can help to design reforms that correspond to societal priorities. This study aims to elicit and to place monetary values on public preferences for out-patient physician services in Ukraine. The method of discrete choice experiment is used on a sample of 303 respondents, representative of the adult Ukrainian population. The random effect logit model with interactions provides the best fit for the data and is used to calculate the marginal willingness to pay (MWTP) for quality and access improvements. At a sample level, there is no clear preference to pay formally rather than informally or vice versa. We also do not find that visiting a general practitioner is preferred over direct access to a medical specialist. However, there are differences between population groups. Quality-related attributes of physician services appear important to respondents, especially the attitude of medical staff. Thus, interpersonal aspects of out-patient care should be given priority in decisions about investments in quality improvements. Other aspects, that is social quality and access, are important as well but their improvement brings fewer social gains. Measures should be taken to eradicate the informal payment channels and to strengthen the gate-keeping role of primary care. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Experiences of Multidisciplinary Development Team Members During User-Centered Design of Telecare Products and Services: A Qualitative Study

    PubMed Central

    2014-01-01

    Background User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. Objective The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Methods Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Results Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members

  14. Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study.

    PubMed

    Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P

    2014-05-19

    User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often

  15. Using Metaphors to Investigate the Personal Frameworks of Pre-Service Science Teachers as They Experience a Science in Society Course

    ERIC Educational Resources Information Center

    Campbell, Todd

    2011-01-01

    This research presents a multiple case study investigating the personal frameworks of pre-service science teachers as they experience a science in society course. Through examining the metaphors employed by the participants' student experiences were illuminated. These experiences revealed shifts in frameworks over time that were more consistent…

  16. Experience with Multi-Tier Grid MySQL Database Service Resiliency at BNL

    NASA Astrophysics Data System (ADS)

    Wlodek, Tomasz; Ernst, Michael; Hover, John; Katramatos, Dimitrios; Packard, Jay; Smirnov, Yuri; Yu, Dantong

    2011-12-01

    We describe the use of F5's BIG-IP smart switch technology (3600 Series and Local Traffic Manager v9.0) to provide load balancing and automatic fail-over to multiple Grid services (GUMS, VOMS) and their associated back-end MySQL databases. This resiliency is introduced in front of the external application servers and also for the back-end database systems, which is what makes it "multi-tier". The combination of solutions chosen to ensure high availability of the services, in particular the database replication and fail-over mechanism, are discussed in detail. The paper explains the design and configuration of the overall system, including virtual servers, machine pools, and health monitors (which govern routing), as well as the master-slave database scheme and fail-over policies and procedures. Pre-deployment planning and stress testing will be outlined. Integration of the systems with our Nagios-based facility monitoring and alerting is also described. And application characteristics of GUMS and VOMS which enable effective clustering will be explained. We then summarize our practical experiences and real-world scenarios resulting from operating a major US Grid center, and assess the applicability of our approach to other Grid services in the future.

  17. The experience of clinical supervision for nurses and healthcare assistants in a secure adolescent service: Affecting service improvement.

    PubMed

    McCarron, R H; Eade, J; Delmage, E

    2018-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Regular and effective clinical supervision for mental health nurses and healthcare assistants (HCAs) is an important tool in helping to reduce stress and burnout, and in ensuring safe, effective and high-quality mental health care. Previous studies of clinical supervision within secure mental health environments have found both a low availability of clinical supervision, and a low level of staff acceptance of its value, particularly for HCAs. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In previous studies, the understanding shown by HCAs and nurses around the benefits of clinical supervision may have been limited by the methods used. This study was specifically designed to help them best express their views. In contrast to previous studies, both nurses and HCAs showed a good understanding of the function and value of clinical supervision. Significant improvements in the experience of, and access to, clinical supervision for nurses and HCAs working in secure mental health services may be achieved by raising staff awareness, demonstrating organizational support and increasing monitoring of clinical supervision. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Organizations should consider reviewing their approach to supervision to include raising staff awareness, multidisciplinary supervision, group supervision, and recording and tracking of supervision rates. Organizations should be mindful of the need to provide effective clinical supervision to HCAs as well as nurses. Introduction Studies have found a low availability and appreciation of clinical supervision, especially for healthcare assistants (HCAs). Qualitative research is needed to further understand this. Aims Increase understanding of nurses' and HCAs' experiences of, and access to, clinical supervision. Identify nurses' and HCAs' perceptions of the value and function of clinical supervision. Assess how interventions affect staff's experiences of clinical supervision. Methods In

  18. 'Take my hand, help me out': mental health service recipients' experience of the therapeutic relationship.

    PubMed

    Shattell, Mona M; Starr, Sharon S; Thomas, Sandra P

    2007-08-01

    The purpose of this study was to describe mental health service recipients' experience of the therapeutic relationship. The research question was 'what is therapeutic about the therapeutic relationship?' This study was a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health-care provider. Data were analysed using an existential phenomenological approach. Individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counsellors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants' own words: 'relate to me', 'know me as a person', and 'get to the solution'. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such as the use of touch, self-disclosure, and blunt feedback. A therapeutic relationship for persons with mental illness requires in-depth personal knowledge, which is acquired only with time, understanding, and skill. Knowing the whole person, rather than knowing the person only as a service recipient, is key for practising nurses and nurse educators interested in enhancing the therapeutic potential of relationships.

  19. Profil anatomopathologique du cancer du sein dans le cap bon tunisien

    PubMed Central

    Sahraoui, Ghada; Khanchel, Fatma; Chelbi, Emna

    2017-01-01

    Le cancer du sein est le cancer le plus fréquent de la femme en Tunisie et dans le monde. Dans le Cap Bon tunisien, les particularités anatomopathologiques de ce cancer n'ont pas été précisées auparavant. Leur connaissance est nécessaire pour l'adaptation des systèmes de prévention et de soins dans la région. Le but de notre étude était de déterminer le profil anatomopathologique des carcinomes mammaires dans l'unique laboratoire d'anatomie pathologique publique de la région. Il s'agissait d'une étude descriptive rétrospective des carcinomes mammaires diagnostiqués chez 116 malades dans notre laboratoire sur une période de 5 ans de Juillet 2010 à Juillet 2015. Notre étude a inclus 116 patientes. L'âge moyen était de 51 ans. La taille tumorale histologique moyenne était de 31 mm. Le diagnostic initial était posé sur pièce de tumorectomie dans 83% des cas. Le carcinome infiltrant de type non spécifique était le type histologique le plus fréquent. Le grade SBR III était majoritaire. L'invasion lympho-vasculaire était présente dans 33% des cas. Le curage axillaire était positif dans 72% des cas. Les récepteurs hormonaux étaient positifs dans 73% des cas. Les récepteurs de l'Her2-Neu étaient surexprimés dans 19% des cas. Le ki67 était ≥ 14% dans 38%. Le sous-type moléculaire le plus fréquent était le luminal A. Le carcinome mammaire dans la région du Cap Bon se caractérise par sa survenue à un âge jeune, son importante taille tumorale et la fréquence de facteurs histopronostiques péjoratifs. PMID:28450990

  20. 'In some ways it all helps but in some ways it doesn't': The complexities of service users' experiences of inpatient mental health care in Australia.

    PubMed

    Isobel, Sophie

    2018-06-13

    Recovery-oriented mental health care requires active involvement of service users in the evaluation of care. While experience of care surveys is routinely given out upon discharge, capturing the depth and detail of service users' experiences in such a way to meaningfully improve services may require more in-depth and targeted approaches. This study aimed to gather voluntary and involuntary service users' experiences of care during hospitalization in two acute adult mental health inpatient units, through the collaborative completion of a purpose designed tool. The purpose of the study was to examine broad experiences of care and to identify the utility of proactive approaches to ongoing service evaluation. Overall, 67 participants were interviewed. Findings highlight the complexity of experiences of care including how an admission can seemingly facilitate clinical recovery while not being recovery-oriented. The findings also detail areas for improvement in the way that care is delivered and evaluated. The implications are particularly pertinent for mental health nurses to consider how, within the existing constraints of their roles, they can provide therapeutic care to all service users. © 2018 Australian College of Mental Health Nurses Inc.

  1. Service Providers’ Experiences and Perspectives on Recovery-Oriented Mental Health System Reform

    PubMed Central

    Piat, Myra; Lal, Shalini

    2016-01-01

    Objective With the use of a qualitative approach, this study focuses on service providers’ experiences and perspectives on recovery-oriented reform. Methods Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. PMID:22491368

  2. Pre-Service Post Graduate Teachers' First Time Experience with Constructivist Learning Environment (CLE) Using MOODLE

    ERIC Educational Resources Information Center

    Boopathiraj, C.; Chellamani, K.

    2015-01-01

    The aim of this study is to enlighten and discuss Post Graduate student teachers' first time experiences and their level of satisfaction with the use of Moodle Learning Management System (LMS) during their "Research Methods in Education" course offered online. This study investigated 30 pre-service Post Graduate student teachers' to…

  3. Pre-Service Teachers' Experiences of Scaffolded Learning in Science through a Computer Supported Collaborative Inquiry

    ERIC Educational Resources Information Center

    Kukkonen, Jari; Dillon, Patrick; Kärkkäinen, Sirpa; Hartikainen-Ahia, Anu; Keinonen, Tuula

    2016-01-01

    Scaffolding helps the novice to accomplish a task goal or solve a problem that otherwise would be beyond unassisted efforts. Scaffolding firstly aims to support the learner in accomplishing the task and secondly in learning from the task and improving future performance. This study has examined pre-service teachers' experiences of…

  4. 1. Historic American Buildings Survey, drawn by Pierre du Simitiere ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey, drawn by Pierre du Simitiere (papers in Philadelphia Library) DRAWING OF REDWOOD LIBRARY IN 1768. - Redwood Library, 50 Bellevue Avenue, Newport, Newport County, RI

  5. The Role of Student Support Services in Encouraging Student Involvement and Its Impact on Student Perceptions and Academic Experiences

    ERIC Educational Resources Information Center

    Kelley-Hall, Caren

    2010-01-01

    The purpose of this study was to explore the role of Student Support Services (SSS) in encouraging student involvement and its impact on student perceptions and academic experiences in three technical colleges in upstate South Carolina. By examining Alexander Astin's theory of student involvement in the services provided by the program, a better…

  6. Etude de facteurs de risque de la transmission du VIH de la mère à l'enfant dans la stratégie « option A » à Lubumbashi, République Démocratique du Congo

    PubMed Central

    Ngwej, Dieudonné Tshikwej; Mukuku, Olivier; Mudekereza, Rachel; Karaj, Eugénie; Odimba, Etienne Bwana Fwamba; Luboya, Oscar Numbi; Kakoma, Jean-Baptiste Sakatolo; Wembonyama, Stanis Okitotshio

    2015-01-01

    Introduction L'infection à VIH chez la femme enceinte a pour principal risque la contamination du nouveau-né. L'objectif est de déterminer le taux de transmission du VIH de la mère à l'enfant (TME) dans la ville de Lubumbashi et en évaluer les facteurs de risque. Méthodes Il s'agissait d'une étude prospective transversale à visée analytique de 157 accouchées séropositives au VIH et de leurs enfants dans 12 structures sanitaires de Lubumbashi (RDCongo) du 1er octobre 2012 au 31 décembre 2013. Les paramètres sociodémographiques, cliniques et les données relatives aux activités de PTME du VIH ont été étudiés. Les statistiques usuelles ont été utilisées pour analyser les résultats. Le seuil de significativité a été fixé à une valeur de p < 0,05. Résultats Le taux de transmission verticale du VIH était de 12,7% (20/157). Il n'y avait pas d'association significative entre les caractéristiques sociodémographiques maternelles telles que l’âge, la parité, le niveau d’étude, la profession et l’état-civil et la TME (p>0,05). La transmission verticale du VIH était significativement associée aux facteurs suivants: le stade clinique 3 de l'OMS (OR=5,18 (1,5-18,1)), la présence d'infection opportuniste (OR=8,7 (2,7-27,8)), le dépistage lors de l'accouchement (OR=6,3 (1,0-39,0)) ou au cours de l'allaitement (OR=7,1 (1,1-76,7)), au taux de CD4 maternel <350/mm3 (OR=2,9 (1,1-7,7)), l'absence de thérapie antirétrovirale chez la mère (OR=19,9 (4,8-81,9)), la naissance avant terme (OR=4,7 (1,4-16,0)), la rupture prématurée de membranes (OR=45,0 (7,4-454,6)), le faible poids de naissance (OR=5,6 (1,9-16,7)), la notion de réanimation néonatale (OR=12,4 (3,8-40,1)), la non administration de la névirapine à la naissance (OR=26,4 (7,6-92,3)) et l'alimentation mixte (OR=12,6 (1,3-115,9)). Le sexe du nourrisson et le mode d'accouchement n’étaient pas non plus associés à la transmission verticale du VIH (p>0,05). Conclusion Le taux

  7. Miners, masculinity and the "Bataille du Charbon" in France, 1944-1948.

    PubMed

    Diamond, Hanna

    2011-01-01

    In 1944, the French provisional government, backed by the Parti communiste français and the Confédération générale du travail, undertook an aggressive propaganda campaign to persuade miners to embark upon a 'battle for coal' which raised their efforts in extracting coal to that of a national endeavour. At the same time, miners had great hopes that nationalisation of the coal industry, under discussion at this time, would bring significant improvement to their working lives. In identifying the ways in which publicists posited miners as an ideal of working-class manhood, this article will argue that "la bataille du charbon" marks a crucial moment in the celebration of working-class masculinity and that the "statut des mineurs" which was passed in 1946 as a part of nationalisation enshrined many of the existing gender assumptions about mining life. What does an incorporation of gender to an analysis of the treatment of miners in the years 1944-1948 add to our understandings of the various economic, political and social dynamics around "la bataille du charbon"? How do these insights inform our perceptions of French coalfield societies in the mid-twentieth century?

  8. Characteristics of Two-Year College Students on the Autism Spectrum and Their Support Services Experiences

    PubMed Central

    Roux, Anne M.; Shattuck, Paul T.; Rast, Jessica E.; Rava, Julianna A.; Edwards, Amy D.; Wei, Xin; McCracken, Mary; Yu, Jennifer W.

    2015-01-01

    Approximately 80% of college-going youth with autism in the US attend a 2-year college at some point. These community-based, universally accessible institutions offer both academic and vocational courses and have experience in teaching diverse learners. This study used nationally representative survey data from the National Longitudinal Transition Study-2 to describe the characteristics and services experiences of adults with autism who attended postsecondary education after high school, focusing on those who attended a 2-year college. Over 60% of those who attended 2-year colleges had little to no trouble conversing or performing functional skills like counting change during high school, and extracurricular participation was common (93.8%). Most 2-year college attenders (85.7%) were able to navigate to places outside the home versus 43.9% of those with no postsecondary education. Over half took vocational courses at 2-year colleges, while one-quarter pursued academic study. Less than half (48.6%) of those who disclosed their disability to the school reported receiving services, accommodations, or other help. Most (87.3%) felt they received enough help, but fewer (68.0%) felt the services they received were useful. Future research should delineate specific needs of students with autism in 2-year college settings and identify what supports are needed to improve persistence and completion rates. PMID:26649197

  9. Race towards Freedom: W.E.B. Du Bois and the Tradition of Fugitive Black Study

    ERIC Educational Resources Information Center

    Tinson, Christopher M.

    2017-01-01

    This essay centers the defense of black educational possibility in the work of historian, pioneering sociologist, and scholar, W.E.B. Du Bois (1868-1963) as a conduit igniting what critical social theorists Stefano Harney and Fred Moten (2013) call Fugitive Black Study. The critical appreciation of Du Bois forces us to consider the weight of…

  10. Analyse de la dégradation thermique du Poly(éther éther cétone)

    NASA Astrophysics Data System (ADS)

    Courvoisier, Emilie; Bicaba, Yoann; Colin, Xavier

    2018-03-01

    La dégradation thermique du PEEK a été étudiée à l'état caoutchoutique dans de larges intervalles de température (entre 180 et 320 °C) et de pression partielle d'oxygène (entre 0,21 et 50 bars). Tout d'abord, les mécanismes de vieillissement thermique ont été analysés et élucidés par spectroscopie IRTF et par calorimétrie différentielle (DSC) sur des films de PEEK suffisamment minces (entre 10 et 60 μm d'épaisseur) pour s'affranchir totalement des effets de la diffusion d'oxygène. L'oxydation se produit sur les cycles aromatiques provoquant la croissance de cinq nouvelles bandes d'absorption IR centrées à 3650, 3525, 1780, 1740 et 1718 cm-1 et attribuées aux vibrations d'élongation des liaisons O-H du phénol et de l'acide benzoïque, et des liaisons C-O de l'anhydride benzoïque, du benzoate de phényle et de la fluorénone respectivement. De plus, l'oxydation conduit à une large prédominance de la réticulation sur les coupures de chaîne (augmentation de Tg) empêchant le recuit du PEEK, en particulier lorsque la température d'exposition est supérieure au pied du pic de fusion. Enfin, les conséquences de l'oxydation sur les propriétés élastiques ont été analysées et élucidées par micro-indentation sur des sections droites préalablement polies de plaquettes de PEEK de 3 mm d'épaisseur. Les variations du module d'Young et du taux de cristallinité se corrèlent parfaitement, vérifiant ainsi la relation de Tobolsky.

  11. Partial purification and characterization of bacteriocin produced by Enterococcus faecalis DU10 and its probiotic attributes.

    PubMed

    Perumal, Venkatesh; Repally, Ayyanna; Dasari, Ankaiah; Venkatesan, Arul

    2016-10-02

    A novel bacteriocin produced by avian duck isolated lactic acid bacterium Enterococcus faecalis DU10 was isolated. This bacteriocin showed a broad spectrum of antibacterial activity against important food-borne pathogens and was purified by size exclusion chromatography followed by reverse-phase high-performance liquid chromatography in a C-18 column. Tricine-SDS PAGE revealed the presence of a band with an estimated molecular mass of 6.3 kDa. The zymogram clearly linked the antimicrobial activity with this band. This result was further confirmed by mass-assisted laser desorption ionization time-of-flight mass spectrometry, since a sharp peak corresponding to 6.313 kDa was detected and the functional groups were revealed by Fourier transform infrared spectroscopy. Bacteriocin DU10 activity was found sensitive to proteinase-K and pepsin and partially affected by trypsin and α-chymotrypsin. The activity of bacteriocin DU10 was partially resistant to heat treatments ranging from 30 to 90°C for 30 min. It also withstood a treatment at 121°C for 10 min. Cytotoxicity of bacteriocin DU10 by methyl-thiazolyl-diphenyl-tetrazolium bromide assay showed that the viability of HT-29 and HeLa cells decreased 60 ± 0.7% and 43 ± 4.8%, respectively, in the presence of 3,200 AU/mL of bacteriocin. The strain withstood 0.3% w/v of bile oxgall and pH 2 affected the bacterial growth between 2 and 4 hr of incubation. Adhesion properties examined with HT-29 cell line showed 69.85% initial population of strain E. faecalis DU10, which was found to be strongly adhered to this cell line. These results conclude bacteriocin DU10 may be used as a potential biopreservative and E. faecalis DU10 may be used as a potential probiont to control Salmonella infections.

  12. Performance-Based Services Acquisition

    DTIC Science & Technology

    2011-02-01

    47  DoD’s acquisition workforce lacks training and experience in services contracting ... 47  Selecting correct metrics...services more effectively; vii (2) the DoD’s acquisition workforce lacks training and experience in services contracting; (3) selecting correct...private sector; (2) improve the training of government services acquisition personnel; and (3) the USD(AT&L) should incentivize the existing workforce

  13. Dysplasie fibreuse polyostotique unilatérale du membre supérieur

    PubMed Central

    Boufettal, Monsef; Azouz, Mohamed; Mahfoud, Mustapha; El Bardouni, Ahmed; Berrada, Mohamed Saleh; El Yaacoubi, Moradh

    2014-01-01

    La dysplasie fibreuse est une maladie osseuse sporadique rare d’étiologie inconnue qui représente environ 2,5% des maladies osseuses et 7% des tumeurs osseuses bénignes. Cette lésion bénigne pseudotumorale se caractérise par la présence dans l'os d'une prolifération de tissu fibreux et de tissu osseux immature dépourvu de couronne ostéoblastique. Elle peut atteindre un ou plusieurs os; l'atteinte du membre supérieur est rarement décrite, nous rapportons ici un cas rare de dysplasie fibreuse polyostotique unilatérale du membre supérieure. PMID:25709739

  14. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    PubMed

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  15. Mental Health and Service Issues Faced by Older Immigrants in Canada: A Scoping Review.

    PubMed

    Guruge, Sepali; Thomson, Mary Susan; Seifi, Sadaf Grace

    2015-12-01

    RÉSUMÉ Une population vieillissante et la croissance de la population sur la base de l'immigration nécessitent que la recherche, la pratique et la politique doivent se concentrer sur la santé mentale des immigrants âgés, surtout parce que leur santé mentale semble se détériorer au fil du temps. Cette revue se concentre sur: Qu'est-ce que l'on sait sur les déterminants sociaux de la santé mentale chez les immigrants âgés, et quels sont les obstacles à l'accès aux services de santé mentale confrontés par les immigrants âgés? Les résultats révèlent que (1) les déterminants sociaux décisifs de la santé mentale sont la culture, le sexe et les services de santé; (2) que les immigrants plus âgés utilisent les services de santé mentale de moins que leurs homologues nés au Canada à cause des obstacles tels que, par exemple, les croyances et les valeurs culturelles, un manque de services culturellement et linguistiquement appropriées, des difficultés financières, et l'âgisme; et (3) quelles que soient les sous-catégories dans cette population, les immigrants âgés éprouvent des inégalités en matière de la santé mentale. La preuve des recherches disponibles indique que de combler les lacunes des service de santé mentale devrait devenir une priorité pour la politique et la pratique du système de soins de santé au Canada.

  16. Experience, Knowledge, and Concerns About Long-Term Services and Supports: Implications for Financing Reform.

    PubMed

    Khatutsky, Galina; Wiener, Joshua M; Greene, Angela M; Thach, Nga T

    2017-01-01

    Using the 2014 Survey of Long-Term Care Awareness and Planning, this article examines Americans' experiences, knowledge, and concerns about long-term services and supports (LTSS) and actions they are willing to take if they become disabled. The survey included 15,298 non-institutionalized respondents aged 40 to 70 years drawn from a nationally representative sample. Although many reported some experience with LTSS, knowledge of how LTSS worked was low. Respondents reported widespread concerns about becoming disabled. They preferred informal care over paid care, with a strong desire to remain in their homes. These results can be used to design reform initiatives and to motivate political support.

  17. Challenges in New Service Development and Value Creation through Service

    NASA Astrophysics Data System (ADS)

    Edvardsson, Bo; Gustafsson, Anders; Enquist, Bo

    Many companies are at a crossroad where they try to' stay competitive by creating customer value through service development. This combination produces the prerequisites that are necessary for favorable customer experiences. Our focus is not on issues directly related to the new service development process as such, which has often been the case in the service literature (Gupta and Wilemon 1990; Martin and Home 1993, Martin and Home 1995; Edvardsson et al., 1995, Edvardsson et al., 2000; John and Storey 1998; Scheuing and Johnson 1989; Kelly and Storey 2000). First we focus on challenges in the new business landscape where service competition, IT, and value creation through service, put pressure on companies and markets to develop service offerings preferredby demanding customers. Secondly, we focus on service value creation through favorable customer experiences.

  18. Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

    PubMed Central

    Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

    2006-01-01

    The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance. PMID:17143460

  19. Contracting but not without caution: experience with outsourcing of health services in countries of the Eastern Mediterranean Region.

    PubMed

    Siddiqi, Sameen; Masud, Tayyeb Imran; Sabri, Belgacem

    2006-11-01

    The public sector in developing countries is increasingly contracting with the non-state sector to improve access, efficiency and quality of health services. We conducted a multicountry study to assess the range of health services contracted out, the process of contracting and its influencing factors in ten countries of the Eastern Mediterranean Region: Afghanistan, Bahrain, Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, the Syrian Arab Republic and Tunisia. Our results showed that Afghanistan, Egypt, Islamic Republic of Iran and Pakistan had experience with outsourcing of primary care services; Jordan, Lebanon and Tunisia extensively contracted out hospital and ambulatory care services; while Bahrain, Morocco and the Syrian Arab Republic outsourced mainly non-clinical services. The interest of the non-state sector in contracting was to secure a regular source of revenue and gain enhanced recognition and credibility. While most countries promoted contracting with the private sector, the legal and bureaucratic support in countries varied with the duration of experience with contracting. The inherent risks evident in the contracting process were reliance on donor funds, limited number of providers in rural areas, parties with vested interests gaining control over the contracting process, as well as poor monitoring and evaluation mechanisms. Contracting provides the opportunity to have greater control over private providers in countries with poor regulatory capacity, and if used judiciously can improve health system performance.

  20. Development Unit Configuration Status of the MIP/MAAC Experiment

    NASA Technical Reports Server (NTRS)

    Karlmann, P. B.; Johnson, K. R.; Rapp, D.; Wu, J. J.

    1999-01-01

    The Mars In-Situ Propellant Production (ISPP) Precursor (MIP) experiment package is planned for inclusion on the Mars 2001 Lander. This experiment package consists of five experiments whose purpose is to demonstrate the performance of various ISPP processes in-situ on Mars. The demonstrated ability to produce propellant for Mars Return Vehicles (MRV) is considered to be a necessary precursor to any future manned mission to Mars. The Mars Atmosphere Acquisition and Compression (MAAC) experiment is part of the MIP package and is intended to demonstrate that, by using a sorption compressor, CO2 can be preferentially adsorbed at about 6 torr from the Mars atmosphere during the night when the bed is cold then subsequently compressed to about 800 torr by heating the bed and desorbing C02 during the day. The compressed CO2 produced by MAAC is to be fed to the Oxygen Generator Subsystem (OGS) where pure oxygen is to be produced. Pure oxygen is considered to be one of the primary constituents of a future manned MRV propellant system. A MAAC Development Unit (DU) has been fabricated and tested at JPL. The MAAC DU consists of: (1) a sorption bed filled with a CO2 selective sorbent material; (2) a purge system to be used to periodically backflush non-CO2 gases from the sorbent bed during adsorption; (3) a JPL-developed gas-gap heat switch that allows heat transfer to a radiator for heat removal from the bed during the night time adsorption period and that impedes heat transfer during the day time desorption period; (4) a radiator to radiate heat to the night sky during the adsorption period; (5) a set of three isolation valves and connecting tubing; (6) two pressure transducers and several thermocouples for monitoring the MAAC operating conditions, and command and data handling electronics. This paper will describe the operational theory and the configuration of the MAAC DU and will discuss the current status of the MAAC experiment development including some selected results

  1. MISSE PEACE Polymers: An International Space Station Environmental Exposure Experiment Being Conducted

    NASA Technical Reports Server (NTRS)

    deGroh, Kim K.; Banks, Bruce A.; Hammerstrom, Anne; Youngstrom, Erica; Kaminski, Carolyn; Marx, Laura; Fine, Elizabeth; Gummow, Jonathan D.; Wright, Douglas

    2002-01-01

    As part of the Materials International Space Station Experiment (MISSE), 41 different polymers are being exposed for approximately 1 1/2 years to the low-Earth-orbit (LEO) environment on the exterior of the International Space Station. MISSE is a materials flight experiment sponsored by the Air Force Research Lab/Materials Lab and NASA, and is the first external experiment on the space station. A similar set of 41 polymers will be flown as part of the Polymer Erosion and Contamination Experiment (PEACE) a shuttle flight experiment that is being developed at the NASA Glenn Research Center collaboratively with the Hathaway Brown School for girls. Therefore, these 41 polymers are collectively called the MISSE PEACE Polymers. The purpose of the MISSE PEACE Polymers experiment is to determine how durable polymers are in the LEO space environment where spacecraft, such as the space station, orbit. Polymers are commonly used as spacecraft materials because of their desirable properties such as good flexibility, low density, and certain electrical properties or optical properties (such as a low solar absorptance and high thermal emittance). Two examples of the use of polymers on the exterior of spacecraft exposed to the space environment include metalized Teflon FEP (fluorinated ethylene propylene, DuPont) thermal control materials on the Hubble Space Telescope, and polyimide Kapton (DuPont) solar array blankets.

  2. Episode-Based Payment and Direct Employer Purchasing of Healthcare Services: Recent Bundled Payment Innovations and the Geisinger Health System Experience.

    PubMed

    Slotkin, Jonathan R; Ross, Olivia A; Newman, Eric D; Comrey, Janet L; Watson, Victoria; Lee, Rachel V; Brosious, Megan M; Gerrity, Gloria; Davis, Scott M; Paul, Jacquelyn; Miller, E Lynn; Feinberg, David T; Toms, Steven A

    2017-04-01

    One significant driver of the disjointed healthcare often observed in the United States is the traditional fee-for-service payment model which financially incentivizes the volume of care delivered over the quality and coordination of care. This problem is compounded by the wide, often unwarranted variation in healthcare charges that purchasers of health services encounter for substantially similar episodes of care. The last 10 years have seen many stakeholder organizations begin to experiment with novel financial payment models that strive to obviate many of the challenges inherent in customary quantity-based cost paradigms. The Patient Protection and Affordable Care Act has allowed many care delivery systems to partner with Medicare in episode-based payment programs such as the Bundled Payments for Care Improvement (BPCI) initiative, and in patient-based models such as the Medicare Shared Savings Program. Several employer purchasers of healthcare services are experimenting with innovative payment models to include episode-based bundled rate destination centers of excellence programs and the direct purchasing of accountable care organization services. The Geisinger Health System has over 10 years of experience with episode-based payment bundling coupled with the care delivery reengineering which is integral to its ProvenCare® program. Recent experiences at Geisinger have included participation in BPCI and also partnership with employer-purchasers of healthcare through the Pacific Business Group on Health (representing Walmart, Lowe's, and JetBlue Airways). As the shift towards value-focused care delivery and patient experience progresses forward, bundled payment arrangements and direct purchasing of healthcare will be critical financial drivers in effecting change. Copyright © 2017 by the Congress of Neurological Surgeons.

  3. Fentes labiopalatines dans la province du Katanga en République Démocratique du Congo: Aspects épidémiologiques, anatomocliniques et thérapeutiques

    PubMed Central

    Sangwa, Cedrick Milindi; Mukuku, Olivier; Tshisuz, Christian; Panda, Jules Mulefu; Kakinga, Mireille; Kitembo, Marius Feruzi; Mutomb, Jean-Felix; Odimba, Bwana Fwamba

    2014-01-01

    Les fentes labiopalatines sont les malformations les plus rencontrées de la sphère orofaciale. L'objectif est de décrire le profil épidémiologique, anatomoclinique et thérapeutique des fentes labiopalatines observées dans la province minière du Katanga au sud-est de la République Démocratique du Congo. Il s'agit d'une étude transversale réalisée dans quatre institutions hospitalières de la province du Katanga dans des districts sanitaires différents (Hôpital Jason Sendwe à Lubumbashi, Hôpital Gécamines Panda à Likasi, Hôpital Gécamines du personnel à Kolwezi, Hôpital General de référence de Kamina) et qui a porté sur 154 cas de fentes labiopalatines enregistrés au cours de la période allant du 1er mai 2010 au 30 septembre 2012. L'âge moyen de consultation était de 11,8 ans et une prédominance masculine (55,2%) était notée. Un pic était noté chez les deux premiers nés de la famille (55,8%). Nous avons enregistré 20,7% des cas de consanguinité dont 54,2% de premier degré. La fréquence des différents types de fentes labiopalatines diminue au fur à mesure que la fente s'étend de la lèvre supérieure au palais en passant par l'alvéole : 72% (labiales), 21,4% (labiopalatines) et 7,7% (palatines). Les variétés unilatérales sont plus fréquentes (76,7%) que les bilatérales (16,1%). Dans les formes unilatérales, le côté gauche est plus concerné (47,1%) par rapport au côté droit (38,6%). L'évaluation de la gravité selon Anastassov montre que 50,6% de nos patients étaient de degré moyen et 16,2% étaient à un degré sévère. Les malformations associées ont été retrouvées dans 5% des cas et elles sont à prédominance squelettique. C'est la technique de Millard qui a été la plus pratiquée (72/130). Les résultats étaient excellents dans 71,5% contre 1,5% de mauvais. Le séjour d'hospitalisation était de 3 jours et le taux de complications post opératoire était de 2,98%. PMID:25328615

  4. The impact of services that offer individualised funds, shared management, person-centred relationships, and self-direction on the lived experiences of consumers with mental illness.

    PubMed

    Peterson, Sunila; Buchanan, Angus; Falkmer, Torbjorn

    2014-01-01

    Mental health service providers across Australia, including Western Australia (WA), have begun to offer individualised funds, shared management, person-centred and self-directed (SPS) services. No research exists on the impact of SPS services on the lived experiences of these particular consumers. This study explored the impact of a SPS service offered for the first time in WA to consumers with mental illness. Data on sixteen consumers' lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed by the consumers, Guides (staff) and an independent evaluator, and most of it had been collected in the past prior to the commencement of the study. Three over-arching categories, and related subcategories, emerged indicating that 1) access to individualised funds enabled practical and psychological benefits to consumers; 2) consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers; and 3) high quality shared management and person-centred relationships with staff and the opportunity to self-direct enabled consumers' change and growth. SPS services enhanced consumers' lived experiences and enabled staff to provide and consumers to experience timely access to recovery resources, consistent contact, responsive and high quality support, and self-direction of services. In this, consumers changed, grew and achieved desired recovery experiences. The overall impact of the SPS service seemed to be founded on the goodness of fit between person characteristics of staff and consumers, which enabled rich support that provided for corrective emotional experiences. This enabled consumers to build meaningful and hopeful lives where they started to live with, and beyond, their mental illness.

  5. Short-Term International Service-Learning: Faculty Perceptions of and Pedagogical Strategies for the Design and Implementation of Successful Learning Experiences

    ERIC Educational Resources Information Center

    Van Cleave, Thomas Jacob

    2013-01-01

    Faculty-led short-term international service-learning (STISL) experiences are thought to have great potential in developing students' global citizenship through combining study abroad and community service pedagogies. However, thorough investigation of the pedagogical strategies employed in STISL courses to achieve such outcomes has yet to be…

  6. Experiences of health care providers with integrated HIV and reproductive health services in Kenya: a qualitative study.

    PubMed

    Mutemwa, Richard; Mayhew, Susannah; Colombini, Manuela; Busza, Joanna; Kivunaga, Jackline; Ndwiga, Charity

    2013-01-11

    There is broad consensus on the value of integration of HIV services and reproductive health services in regions of the world with generalised HIV/AIDS epidemics and high reproductive morbidity. Integration is thought to increase access to and uptake of health services; and improves their efficiency and cost-effectiveness through better use of available resources. However, there is still very limited empirical literature on health service providers and how they experience and operationalize integration. This qualitative study was conducted among frontline health workers to explore provider experiences with integration in order to ascertain their significance to the performance of integrated health facilities. Semi-structured in-depth interviews were conducted with 32 frontline clinical officers, registered nurses, and enrolled nurses in Kitui district (Eastern province) and Thika and Nyeri districts (Central province) in Kenya. The study was conducted in health facilities providing integrated HIV and reproductive health services (post-natal care and family planning). All interviews were conducted in English, transcribed and analysed using Nvivo 8 qualitative data analysis software. Providers reported delivering services in provider-level and unit-level integration, as well as a combination of both. Provider experiences of actual integration were mixed. At personal level, providers valued skills enhancement, more variety and challenge in their work, better job satisfaction through increased client-satisfaction. However, they also felt that their salaries were poor, they faced increased occupational stress from: increased workload, treating very sick/poor clients, and less quality time with clients. At operational level, providers reported increased service uptake, increased willingness among clients to take an HIV test, and reduced loss of clients. But the majority also reported infrastructural and logistic deficiencies (insufficient physical room space, equipment

  7. Etude comparative des complications liées à l'utilisation du cathéter veineux périphérique avec et sans système clos à bouchon hépariné

    PubMed Central

    Liu, Ying Chun; Seydou, Togo; Sadio, Yéna; Liang, Tu Zheng; Ge, jin

    2015-01-01

    Introduction L'utilisation correcte du système clos à bouchon hépariné sur les cathéters périphériques pendant les perfusions est une pratique courante dans les pays développés et aussi dans plusieurs pays en développement selon un consensus international établi. Nous comparons les résultats de la formation de thrombus et de l'infection liées au cathéter veineux périphérique chez les patients ayant bénéficié de perfusion avec système clos à bouchon hépariné (groupe expérimentale) et ceux qui ont été perfusé sans bouchon hépariné (groupe témoin). Méthodes Nous avons colligé 100 patients hospitalisés pendant la période de Juillet 2014 à Décembre 2014 dans le service d'hospitalisation de chirurgie thoracique de l'hôpital du Mali qui ont été repartis en 2 groupes de 50 patients chacun pour une analyse comparative. L'observation du thrombus dans la lumière du cathéter est effectuée puis enregistré et tous les cathéters ont été repris pour réalisation de culture bactérienne au laboratoire dans les 2 groupes. Résultats Dans le groupe témoin, il existe un thrombus dans la lumière du cathéter dans 36 cas (72%) et l'examen de culture bactérienne était positif dans 90%. Tandis que dans le groupe expérimental on retrouve 3 cas (6%) de thrombose du cathéter et on note une absence de germe dans l'examen bactériologique. Conclusion L'utilisation correcte du système clos à bouchon hépariné lors des perfusions peut réduire et prévenir de façon significative les complications liées au cathéter notamment l'occlusion par thrombus, leur migration et la survenue de l'infection. PMID:26600900

  8. Patient Experience and Satisfaction with Inpatient Service: Development of Short Form Survey Instrument Measuring the Core Aspect of Inpatient Experience

    PubMed Central

    Wong, Eliza L. Y.; Coulter, Angela; Hewitson, Paul; Cheung, Annie W. L.; Yam, Carrie H. K.; Lui, Siu fai; Tam, Wilson W. S.; Yeoh, Eng-kiong

    2015-01-01

    Patient experience reflects quality of care from the patients’ perspective; therefore, patients’ experiences are important data in the evaluation of the quality of health services. The development of an abbreviated, reliable and valid instrument for measuring inpatients’ experience would reflect the key aspect of inpatient care from patients’ perspective as well as facilitate quality improvement by cultivating patient engagement and allow the trends in patient satisfaction and experience to be measured regularly. The study developed a short-form inpatient instrument and tested its ability to capture a core set of inpatients’ experiences. The Hong Kong Inpatient Experience Questionnaire (HKIEQ) was established in 2010; it is an adaptation of the General Inpatient Questionnaire of the Care Quality Commission created by the Picker Institute in United Kingdom. This study used a consensus conference and a cross-sectional validation survey to create and validate a short-form of the Hong Kong Inpatient Experience Questionnaire (SF-HKIEQ). The short-form, the SF-HKIEQ, consisted of 18 items derived from the HKIEQ. The 18 items mainly covered relational aspects of care under four dimensions of the patient’s journey: hospital staff, patient care and treatment, information on leaving the hospital, and overall impression. The SF-HKIEQ had a high degree of face validity, construct validity and internal reliability. The validated SF-HKIEQ reflects the relevant core aspects of inpatients’ experience in a hospital setting. It provides a quick reference tool for quality improvement purposes and a platform that allows both healthcare staff and patients to monitor the quality of hospital care over time. PMID:25860775

  9. UK podiatrists' experiences of podiatry services for people living with arthritis: a qualitative investigation.

    PubMed

    McCulloch, Louise; Borthwick, Alan; Redmond, Anthony; Edwards, Katherine; Pinedo-Villanueva, Rafael; Prieto-Alhambra, Daniel; Judge, Andrew; Arden, Nigel K; Bowen, Catherine J

    2018-01-01

    Provision of podiatry services, like other therapies in the UK, is an area that lacks guidance by the National Institute for Health and Care Excellence. Many individuals living with arthritis in the UK are not eligible to access NHS podiatry services. The primary aim of this investigation was to understand the views of podiatry clinicians on their experiences of referral, access, provision and treatment for foot problems for patients who have arthritis. Focus groups were undertaken to explore, in-depth, individual views of podiatrists working in the UK to gain feedback on experiences of barriers and facilitators to referral, access, provision and treatment for foot problems for individuals living with arthritis. A purposive sampling strategy was adopted and two, semi-structured, focus group interviews conducted, involving 12 podiatrists from both NHS and independent sectors. To account for geographical variations one focus group took place in each of 2 predetermined 'zones' of the UK; Yorkshire and Hampshire. Thematic analysis was employed to identify key meanings and report patterns within the data. The key themes derived from the podiatry clinician focus groups suggest a variety of factors influencing demand for, and burden of, foot pain within the UK. Participants expressed frustration on having a service that accepts and treats patients according to their condition, rather than their complaint. Additionally, concern was conveyed over variations in the understanding of stakeholders' views of what podiatry is and what podiatrists aim to achieve for patients. Podiatrists interviewed believed that many individuals living with arthritis in the UK are not eligible to access NHS podiatry services and that this may be, in part, due to confusion over what is known about podiatry and access criteria. Essentially, podiatrists interviewed called for a timely renaissance of current systems, to newer models of care that meet the foot care needs of individual patients

  10. Dedicated Caravan Sites for French Gens du Voyage: Public Health Policy or Construction of Health and Environmental Inequalities?

    PubMed

    Foisneau, Lise

    2017-12-01

    In France, gens du voyage ("people who travel" or "travellers") is a term used by the government to categorize various itinerant populations, the majority of which are diverse Romani groups. People categorized as gens du voyage are legally required to reside in particular locations called "dedicated caravan sites." Parliamentary debates about these dedicated caravan sites have clarified that one of the objectives of such sites is to help fulfill the gens du voyage 's right to health. However, there is a significant gap between the officially stated goals of such sites and the reality of life within them. This paper draws on research finding that the conditions in most dedicated caravan sites do not conform with the rights of gens du voyage to acceptable sanitary conditions and other underlying determinants of health.

  11. U.S. Higher Education Classroom Experiences of Undergraduate Chinese International Students

    ERIC Educational Resources Information Center

    Valdez, Gabriela

    2015-01-01

    The purpose of this study was to explore undergraduate Chinese international students' perceptions about their classroom experiences in the United States institutions of higher education. Double consciousness, introduced by W.E.B. Du Bois, was used as the theoretical framework for this study. After analyzing the 15 interviews to Chinese…

  12. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    PubMed Central

    2012-01-01

    Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian

  13. Guideline on Scenario Development for (Distributed) Simulation Environments (Guide en vue du developpement de scenario dans le cadre de simulation distribuee)

    DTIC Science & Technology

    2015-01-01

    des lacunes de M&S du MORS du NMSG a déterminé que le manque d’interopérabilité de la simulation constituait la lacune prioritaire à combler en...matière de capacité, une équipe exploratoire (ET-027) a été constituée au sein du NMSG pour étudier l’interopérabilité de la simulation. L’ET-027 a...élevés (autrement dit, aux niveaux pratique, dynamique et conceptuel) de même que l’automatisation relative du développement, de

  14. Fibres Optiques En Therapie Laser Au Contact Du Tissu

    NASA Astrophysics Data System (ADS)

    Lenz, P.; Sabben, G.; Lambert, R.; Berger, F.

    1984-03-01

    Les fibres en quartz, non protegees par un courant de gaz et placees au contact du tissu, peuvent etre utilisees pratiquement indefiniment grace a un "autonettoyage" et une "regenera-tion". Elles provoquent des lesions tissulaires semblables a celles obtenues avec les fibres conventionnelles.

  15. Survey of core medical trainees in the United Kingdom 2013 - inconsistencies in training experience and competing with service demands.

    PubMed

    Tasker, Fiona; Newbery, Nina; Burr, Bill; Goddard, Andrew F

    2014-04-01

    There is currently considerable concern about the attractiveness of hospital medicine as a career and experiences in core medical training (CMT) are a key determinant of whether trainees continue in the medical specialties. Little is understood about the quality and impact of the current CMT programme and this survey was designed to assess this. Three key themes emerged. Firstly, the demands of providing service have led to considerable loss of training opportunities, particularly in outpatients and formal teaching sessions. Trainees spend a lot of this service time doing menial tasks and over 90% report that service takes up 80-100% of their time. Secondly, clinical and educational supervision is variable, with trainees sometimes getting little consultant feedback on their clinical performance. Finally, 44% of trainees report that CMT has not prepared them to be a medical registrar and many trainees are put off acute medical specialties by their experiences in CMT.

  16. Children's Views Matter Too! A Pilot Project Assessing Children's and Adolescents' Experiences of Clinical Psychology Services

    ERIC Educational Resources Information Center

    Gordon, Michael; Russo, Kate

    2009-01-01

    This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the…

  17. 'Maternity clinic on the net service' and its introduction into practice: experiences of maternity-care professionals.

    PubMed

    Kouri, Pirkko; Turunen, Hannele; Palomäki, Tuula

    2005-06-01

    To describe the experiences of maternity-care professionals using an Internet-based network service, called Net Clinic, and the opportunities and obstacles they encountered in Net Clinic while organising their work and developing their know-how. Qualitative information gathered from semi-structured thematic interviews. Four maternity care units in Eastern Finland (one antenatal ward in a university hospital, one antenatal ward in a central hospital, two maternity clinics in the community). Five midwives, two public health nurses and three doctors. All participants considered adequate privacy protection a prerequisite for development. They anticipated that because of their computer skills, young people would be able to use information and communication technology (ICT) as part of maternity-care services naturally. Managerial support, such as allocation of time and equipment, was extremely important during the introductory phase. The participants were divided into three groups based on their experiences of implementing Net Clinic: (1) 'doubters' did not believe in their own ICT competence and were afraid of using Net Clinic. They also showed resistance to Net Clinic. Doubters wanted versatile and personal guidance in ICT skills; (2) 'accepters' agreed that progress in ICT would inevitably affect their work. Development was considered difficult without awareness of the benefits of ICT, and Net Clinic was expected to increase their workload. Accepters preferred to have one-to-one ICT training; (3) 'future confidents' saw ICT as a useful tool for developing maternity care. They recognised the opportunities implicit in network collaboration and wanted versatile user training in ICT. They wanted successful network service models and were eager to develop them. IMPLICATIONS FOR THE FUTURE: Families will increase their knowledge levels, as those who will be future parents are learning to use public network services at school. The increasing diversity of family structure

  18. Dysfonctionnements radio-induits du transport colique chez le rat

    NASA Astrophysics Data System (ADS)

    François, A.; Lebrun, F.; Ksas, B.; Aigueperse, J.; Gourmelon, P.; MacNaughton, W. K.; Griffiths, N. M.

    1998-04-01

    The symptom commonly associated with whole body irradiation is diarrhoea, a still quite obscure phenomenon, which leads to decreased chance of cure of irradiated people. The aim of this study was to provide evidence for dysfunction of intestinal water and electrolyte transport regulation by the enteric nervous system after exposure to ionising radiation. This study shows decreased capacity of enteric nervous system to influence colonic transport 3days after irradiation, correlated to a diminished response to a neurotransmitter: serotonin. Radio-induced diarrhea may result from epithelial structural injury but also from impaired regulatory processes of intestinal transport. L'un des symptômes majeurs d'une irradiation corporelle totale ou abdominale est l'apparition de diarrhées, dont les causes sont encore mal connues, et qui mettent en jeu le pronostique vital de l'individu irradié. Cette étude vise à mettre en évidence l'atteinte de la régulation du transport intestinal d'eau et d'électrolytes par les rayonnements ionisants. On observe une diminution de la capacité du système nerveux entérique à influencer le transport colique 3jours après irradiation, corrélée à une diminution de la réponse épithéliale à un neurotransmetteur : la sérotonine. Les diarrhées radio-induites résulteraient d'une atteinte structurelle de l'épithélium mais également des processus de régulation du transport intestinal.

  19. Kyste épidermoïde du quatrième ventricule: à propos d’un cas

    PubMed Central

    El Saqui, Abderrazzak; Aggouri, Mohamed; Benzagmout, Mohamed; Chakour, Khalid; Chaoui, Mohamed El Faiz

    2017-01-01

    Les kystes épidermoïdes sont des tumeurs bénignes rares développées à partir d'inclusions ectodermiques. Ils siègent habituellement au niveau de l'angle ponto-cérébelleux, la région para-sellaire et la fosse temporale. Leur siège au niveau du quatrième ventricule est exceptionnel. Nous rapportons le cas d'une patiente de 47 ans admise pour un syndrome d'hypertension intracrânienne associé à des troubles de la marche. Le diagnostic de kyste épidermoïde du V4 fut évoqué sur les données de l'IRM en séquences de diffusion puis confirmé en per opératoire et en histologie. L'exérèse chirurgicale a été subtotale en raison d'une adhérence de la capsule à la partie supérieure du plancher du V4. Après un recul de 36 mois, la patiente ne manifeste aucun signe de ré-évolution tumorale. PMID:28690753

  20. Diagnostic et prise en charge du psoriasis

    PubMed Central

    Kim, Whan B.; Jerome, Dana; Yeung, Jensen

    2017-01-01

    Résumé Objectif Présenter aux cliniciens en soins primaires un aperçu pratique et à jour du diagnostic et de la prise en charge du psoriasis. Sources des données Une recension a été effectuée dans les bases de données de PubMed, MEDLINE, EMBASE et Cochrane pour trouver des méta-analyses, des études randomisées contrôlées, des revues systématiques et des études observationnelles pertinentes portant sur le diagnostic et la prise en charge du psoriasis. Message principal Le psoriasis est une maladie inflammatoire chronique et multisystémique qui affecte principalement la peau et les articulations. En plus des dimensions physiques de la maladie, le psoriasis a des répercussions émotionnelles et psychosociales considérables sur les patients, et nuit au fonctionnement social et aux relations interpersonnelles. En tant que maladie inflammatoire systémique, le psoriasis est associé à de multiples comorbidités, dont les maladies cardiovasculaires et les cancers. Le diagnostic est principalement d’ordre clinique et une biopsie de la peau est rarement nécessaire. Selon la sévérité de la maladie, un traitement approprié peut être amorcé. Pour les cas de légers à modérés, le traitement de première intention comporte des thérapies topiques, dont les corticostéroïdes, les analogues de la vitamine D3 et des produits combinés. Ces traitements topiques sont efficaces et peuvent être initiés et prescrits en toute sécurité par des médecins de soins primaires. Les patients dont les symptômes sont plus graves et réfractaires pourraient devoir être envoyés en consultation auprès d’un dermatologue pour une évaluation plus approfondie et une thérapie systémique. Conclusion De nombreux patients atteints de psoriasis consultent leur médecin de soins primaires pour une évaluation initiale et pour recevoir un traitement. La reconnaissance du psoriasis, de même que des comorbidités médicales et psychiatriques qui lui sont associ

  1. Évolution nycthémérale des composantes biochimiques du phytoplancton de la retenue du barrage Idriss premier (Fès, Maroc)

    NASA Astrophysics Data System (ADS)

    Bahhou, J.; Alaoui Mhamdi, M.

    1999-03-01

    The diel changes of the biochemical composition of the phytoplankton were studied in the Idriss first reservoir (located on the Inaouen river at thirty Km from the city of Fes, Morrocco) during September 1994. Several biomass and metabolic indicators (proteins, carbohydrates, lipids, chlorophyll a and primary production) were assessed every fourth hour over tow days (7, 8 and 9 September). Since the Protein/Carbohydrates ratio (P/C) is largely recognised as a good integrator of the metabolic functions of the cells, we examined its distribution pattern concomitantly with aforementioned parameters. The results demonstrated enhanced P/C ratios clearly indicating that nutrients were sufficiently available for growth. In addition, this index showed a diel significant variation with levels higher in the night than in the day. Moreover, these results suggest that phytoplankton species during the night used the day-synthesised carbohydrates to insure the cell metabolic functioning. The P/C presents relatively high values in proposition to the ones that have been recorded in temperate regions, and seems to be related to azotic inputs of the Inaouen river. Dans le but de parfaire nos connaissances sur le fonctionnement du sous écosystème phytoplancton, nous nous sommes intéressés à étudier son cycle nycthéméral et son métabolisme cellulaire dans la retenue du barrage Idriss premier. Cette dernière, construite sur l'Oued Inaouène, est située à une trentaine de Km de la ville de Fès. Au cours de ce cycle, les prélèvements ont été effectués selon une séquence temporelle de 4 heures pendant 48 heures, les 7, 8 et 9 septembre 1994. L'étude de l'évolution des composantes biochimiques des cellules phytoplanctoniques à savoir les protéines, les glucides et les lipides a permis de mettre en évidence des variations nycthémérales importantes. Ces variations sont d'autant plus importantes que les variations spatiales observées entre les profondeurs. De plus

  2. How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

    PubMed

    Parkman, Thomas; Neale, Joanne; Day, Ed; Drummond, Colin

    2017-09-19

    People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' socio-demographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

  3. England's time to change antistigma campaign: one-year outcomes of service user-rated experiences of discrimination.

    PubMed

    Henderson, Claire; Corker, Elizabeth; Lewis-Holmes, Elanor; Hamilton, Sarah; Flach, Clare; Rose, Diana; Williams, Paul; Pinfold, Vanessa; Thornicroft, Graham

    2012-01-01

    This study evaluated the progress at one year of England's Time to Change (TTC) program, launched in 2009, toward meeting its target to reduce mental health-related stigma and discrimination by 5%. TTC comprises three national components: antistigma marketing campaign activities, mass physical exercise events (Time to Get Moving) to facilitate social contact between people with and without mental health problems, and an online resource on mental health and employment (Time to Challenge). Part of the TTC evaluation consists of an annual national phone survey of mental health service users. Participants (537 in 2008 and 1,047 in 2009) were current outpatient service users aged 18-65 registered with National Health Service community mental health teams that are selected annually to represent the range of socioeconomic deprivation. Telephone interviews were conducted with service users with the Discrimination and Stigma Scale (DISC) to document experienced discrimination and anticipated discrimination in the past 12 months. One or more experiences of discrimination were reported by 9-1% of participants in 2008 and 87% of participants in 2009 (p = .03). In 2009 significantly less discrimination was reported from a number of common sources, including family (reported by 53% in 2008 and 46% in 2009), friends (53% and 39%), finding employment (24% and 16%), and keeping employment (from 17% to 13%). Experiences of discrimination from mental health professionals did not change significantly (reported by about one-third of participants in both years). Results suggest positive progress toward meeting the program's targeted 5% reduction in discrimination.

  4. Pitfalls in Persuasion: How Do Users Experience Persuasive Techniques in a Web Service?

    NASA Astrophysics Data System (ADS)

    Segerståhl, Katarina; Kotro, Tanja; Väänänen-Vainio-Mattila, Kaisa

    Persuasive technologies are designed by utilizing a variety of interactive techniques that are believed to promote target behaviors. This paper describes a field study in which the aim was to discover possible pitfalls of persuasion, i.e., situations in which persuasive techniques do not function as expected. The study investigated persuasive functionality of a web service targeting weight loss. A qualitative online questionnaire was distributed through the web service and a total of 291 responses were extracted for interpretative analysis. The Persuasive Systems Design model (PSD) was used for supporting systematic analysis of persuasive functionality. Pitfalls were identified through situations that evoked negative user experiences. The primary pitfalls discovered were associated with manual logging of eating and exercise behaviors, appropriateness of suggestions and source credibility issues related to social facilitation. These pitfalls, when recognized, can be addressed in design by applying functional and facilitative persuasive techniques in meaningful combinations.

  5. A professional experience learning community for secondary mathematics: developing pre-service teachers' reflective practice

    NASA Astrophysics Data System (ADS)

    Cavanagh, Michael; McMaster, Heather

    2015-12-01

    This paper reports on the reflective practice of a group of nine secondary mathematics pre-service teachers. The pre-service teachers participated in a year-long, school-based professional experience program which focussed on observing, co-teaching and reflecting on a series of problem-solving lessons in two junior secondary school mathematics classrooms. The study used a mixed methods approach to consider the impact of shared pedagogical conversations on pre-service teachers' written reflections. It also examined whether there were differences in the focus of reflections depending on whether the lesson was taught by an experienced mathematics teacher, or taught by a pair of their peers, or co-taught by themselves with a peer. Results suggest that after participants have observed lessons taught by an experienced teacher and reflected collaboratively on those lessons, they continue to reflect on lessons taught by their peers and on their own lessons when co-teaching, rather than just describe or evaluate them. However, their written reflections across all contexts continued to focus primarily on teacher actions and classroom management rather than on student learning.

  6. Creating an Excellent Patient Experience Through Service Education: Content and Methods for Engaging and Motivating Front-Line Staff.

    PubMed

    Kennedy, Denise M

    2017-12-01

    Service quality and patient satisfaction affect an organization's value-based payments. This new value paradigm calls for a new approach to service education and training for front-line staff. Thoughtfully conceived, department-specific content, infused with patient feedback, value creation, and science of service quality principles, was developed to give front-line staff a deeper understanding of the impact of their performance on patient experience, value creation, and value-based revenue. Feedback from nearly 1500 trainees in 60 educational sessions delivered over 7 years indicates good understanding of the content and appreciation of the targeted approach. On a 5-point scale ranging from 1 (least effective) to 5 (most effective), trainees' ratings of their understanding of service quality concepts and impact on value ranged from 4.7 to 4.9. Verbatim comments showed a positive impact on staff. Employee feedback suggests that value-based service education may be useful in motivating front-line staff, improving service quality, and creating value.

  7. Core services and priority-setting: the New Zealand experience.

    PubMed

    Cumming, J

    1994-01-01

    Like people in other countries, New Zealanders have been struggling with the issue of how to decide which health services should be delivered and to whom. The government has established a Core Services Committee to advise on core services, that is, those health care and disability support services to be made available on affordable terms and without unreasonable waiting time. Such a core has a similar role to a standard package of benefits within a managed competition framework. Services not in the core would be left to individuals' own responsibility. Specific objectives for a core are to promote accountability of purchasers, to make explicit the services that are core and those that are not, to promote an efficient and equitable allocation of resources, to limit government expenditure on health care and to involve the public in decision-making. A number of different options for defining a core are identified, and the work undertaken so far is discussed. The original concept of a core has not been implemented in New Zealand. The Core Services Committee has established broad priorities and facilitated a series of consensus development conferences to provide advice on the effectiveness of services. Some of the committee's recommendations have been incorporated into policy guidelines, which set out what the government expects of purchasers. These guidelines include priority areas for health gains, service obligations and principles for purchasing. Service obligations are not sufficiently detailed to meet the specific objectives of a core and do not meet equity objectives, as they allow in effect each of the four purchasers to develop their own core of services. The key issue for the government now is to decide whether to allow RHAs flexibility in determining their own priorities or whether a national approach to efficiency and equity is to be preferred.

  8. A Reference Model for Sustainable E-Learning Service Systems: Experiences with the Joint University/Teradata Consortium

    ERIC Educational Resources Information Center

    Demirkan, Haluk; Goul, Michael; Gros, Mary

    2010-01-01

    Many e-learning service systems fail. This is particularly true for those sponsored by joint industry/university consortia where substantial economic investments are required up-front. This article provides an industry/university consortia reference model validated through experiences with the 8-year-old Teradata University Network. The reference…

  9. Uncertainty Management and Sensemaking as Precursors to Transformative Learning in an International Immersion Service-Learning Experience

    ERIC Educational Resources Information Center

    Larson, Jan M.; Fay, Martha

    2016-01-01

    This study is based on an international immersion service-learning/research experience in a remote village in Moldova that provided faculty and students an opportunity to teach journalism and help local students and community representatives create their own online news outlet. Students' existing conceptions were challenged, they experienced…

  10. Quality Assurance: Adapting SERVQUAL to Measure the Perceived Quality of Pre-Service Teachers' Teaching Practice Experience

    ERIC Educational Resources Information Center

    Oliver, Henry; Koeberg, Jeremy

    2013-01-01

    This article describes a work in progress study which extends traditional quality assurance mechanisms through the application of the SERVQUAL instrument. It assesses the difference between pre-service teacher expectations and actual experience during a Teaching Practice period. Anecdotal evidence points to students being the recipients of poor…

  11. Mapping the ecosystem service delivery chain: Capacity, flow, and demand pertaining to aesthetic experiences in mountain landscapes.

    PubMed

    Egarter Vigl, Lukas; Depellegrin, Daniel; Pereira, Paulo; de Groot, Rudolf; Tappeiner, Ulrike

    2017-01-01

    Accounting for the spatial connectivity between the provision of ecosystem services (ES) and their beneficiaries (supply-benefit chain) is fundamental to understanding ecosystem functioning and its management. However, the interrelationships of the specific chain links within ecosystems and the actual benefits that flow from natural landscapes to surrounding land have rarely been analyzed. We present a spatially explicit model for the analysis of one cultural ecosystem service (aesthetic experience), which integrates the complete ecosystem service delivery chain for Puez-Geisler Nature Park (Italy): (1) The potential service stock (ES capacity) relies on an expert-based land use ranking matrix, (2) the actual supply (ES flow) is based on visibility properties of observation points along recreational routes, (3) the beneficiaries of the service (ES demand) are derived from socioeconomic data as a measure of the visitation rate to the recreation location, and (4) the supply-demand relationship (ES budget) addresses the spatially explicit oversupply and undersupply of ES. The results indicate that potential ES stocks are substantially higher in core and buffer zones of protected areas than in surrounding land owing to the specific landscape composition. ES flow maps reveal service delivery to 80% of the total area studied, with the highest actual service supply to locations with long and open vistas. ES beneficiary analyses show the highest demand for aesthetic experiences in all-season tourist destinations like Val Badia and Val Gardena, where both recreational amenity and overnight stays are equally high. ES budget maps identify ES hot and cold spots in terms of ES delivery, and they highlight ES undersupply in nature protection buffer zones although they are characterized by highest ES capacity. We show how decision/policy makers can use the presented methodology to plan landscape protection measures and develop specific regulation strategies for visitors based on

  12. La matério-vigilance dans un Centre Hospitalo-Universitaire du Centre-Est tunisien: enquête auprès des médecins

    PubMed Central

    Mahjoub, Mohamed; Jedidi, Maher; Masmoudi, Tasnim; Bouafia, Nabiha; Njah, Mansour

    2016-01-01

    Introduction Pour la meilleure gestion des risques en milieu hospitalier et l’amélioration de la qualité et la sécurité de nos soins, le CHU de Sousse (Tunisie), a mis en place, suite aux recommandations de l’ANCSEP (Agence Nationale de Contrôle Sanitaire et Environnementale des Produits) un système de matério-vigilance (MV). En Tunisie l’absence d’un cadre réglementaire organisant la MV est l’obstacle majeur à l’implication des soignants à ce système. L’objectif de cette étude est de déterminer les connaissances, attitudes et pratiques des médecins du CHU quant à la mise en place du système de MV. Méthodes Etude descriptive de type CAP (connaissances, attitudes et pratiques) transversale auprès de tous les médecins titulaires exerçant au CHU de Sousse (Tunisie) qui sont utilisateurs des dispositifs médicaux (DMs) lors de leur pratique d’activité de soin. Un questionnaire auto-administré, préétabli et pré-testé a été établi. Saisie et l’analysée des données par logiciel SPSS20.0. Résultats Le taux de réponse de 51,9 % (183/95), un manque des connaissances relatif à la MV a été rapporté. Plus de la moitié des répondants ne connaissent pas le correspondant local de son établissement et l’existence d’un formulaire standardisé de signalement. Concernant les attitudes, 89,5 % notifient l’intérêt de mise en place du système de MV et 37,5 % reconnaissent que le signalement doit émaner du soignant constatant l’incident. Pour les pratiques, la majorité confirment l’absence d’une gestion organisée de la maintenance des DMs dans leurs services. 90,5 % expriment leurs souhaits de recevoir une information mais peu d’entre eux expriment leurs désirs de suivre une formation (57,9 %). Conclusion Un manque d’information et de formation dans un domaine pourtant sensible et devant être lourdement réglementé est soulevé. La promulgation de textes réglementaires est nécessaire afin de promouvoir le

  13. An analysis of the health service efficiency and patient experience with two different intravenous iron preparations in a UK anaemia clinic.

    PubMed

    Wilson, Paul D; Hutchings, Adam; Jeans, Aruna; Macdougall, Iain C

    2013-01-01

    Historically, the Renal Unit at King's College Hospital used intravenous (IV) iron sucrose (IS) to treat iron deficiency anaemia in patients with chronic kidney disease who were not on dialysis (CKD-ND). As part of a service initiative to improve patient experience, new products were considered as alternatives. This study investigated the potential impact on patient experience and service costs by switching from IS to ferric carboxymaltose (FCM). A decision analytical model was used to calculate the impact of switching from IS to FCM for a cohort of CKD-ND patients. Service provision data were collected for 365 patients who received 600 mg IS within a 12 month period, creating the IS data set. The service provision data, along with a clinically relevant FCM administration protocol (stipulating total doses of 500 mg FCM), were used to calculate a corresponding theoretical data set for FCM for the same cohort of patients. The FCM protocol saved each patient two hospital visits and 2.66 hours of time (equating to approximately a saving of £36.21 in loss of earnings) and £19 in travel costs. Direct attributable costs for iron administration (which included drug, disposables, nursing staff, and hospital-provided patient transport costs) were £58,646 for IS vs £46,473 for FCM. Direct overhead costs (which included nursing preparation time, administration staff, clinic space, and consultant time costs) were £40,172 for the IS service vs £15,174 for the FCM service. Based on clinical experience with the products, this analysis assumes that 500 mg FCM is therapeutically equivalent to 600 mg IS. Consultant time costs are assumed to be the same between the two treatment groups. IV iron administration protocols and data are specific to King's College Hospital. The design is retrospective and changes to the management of the clinic, including service delivery optimization, may also affect real costs. FCM was associated with fewer hospital visits and reduced transport

  14. EUTELTRACS: The European experience on mobile satellite services

    NASA Technical Reports Server (NTRS)

    Colcy, Jean-Noel; Steinhaeuser, Rafael

    1993-01-01

    EUTELTRACS is Europe's first commercially operated Mobile Satellite Service. Under the overall network operation of EUTELSAT, the European Telecommunications Satellite Organization, EUTELTRACS provides an integrated message exchange and position reporting service. This paper describes the EUTELTRACS system architecture, the message exchange and the position reporting services, including the result of recent analysis of message delivery time and positioning accuracy. It also provides an overview of the commercial deployment, the regulatory situation for its operation within Europe and new applications outside its target market, the international road transportation.

  15. Accessing Sexual and Reproductive Health Information and Services: A Mixed Methods Study of Young Women's Needs and Experiences in Soweto, South Africa.

    PubMed

    Lince-Deroche, Naomi; Hargey, Adila; Holt, Kelsey; Shochet, Tara

    2015-03-01

    Young women and girls in South Africa are at high risk of unintended pregnancy and HIV. Previous studies have reported barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed to assess young women's SRH knowledge and experiences and to determine how they get SRH information and services in Soweto, South Africa using quantitative and qualitative methods. Young women, aged 18-24, recruited from primary health clinics and a shopping mall, reported that they have access to SRH information and know where to obtain services. However there are challenges to accessing and utilizing information and services including providers' unsupportive attitudes, uneven power dynamics in relationships and communication issues with parents and community members. There is a need to assist young women in understanding the significance of SRH information. They need access to age-appropriate, youth-friendly services in order to have healthy sexual experiences.

  16. Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada.

    PubMed

    Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate

    2016-10-01

    Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth.

  17. Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada

    PubMed Central

    Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate

    2016-01-01

    Abstract Purpose: Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Methods: Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Results: Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Conclusion: Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth. PMID:27575593

  18. Comparative study on DuPont analysis and DEA models for measuring stock performance using financial ratio

    NASA Astrophysics Data System (ADS)

    Arsad, Roslah; Shaari, Siti Nabilah Mohd; Isa, Zaidi

    2017-11-01

    Determining stock performance using financial ratio is challenging for many investors and researchers. Financial ratio can indicate the strengths and weaknesses of a company's stock performance. There are five categories of financial ratios namely liquidity, efficiency, leverage, profitability and market ratios. It is important to interpret the ratio correctly for proper financial decision making. The purpose of this study is to compare the performance of listed companies in Bursa Malaysia using Data Envelopment Analysis (DEA) and DuPont analysis Models. The study is conducted in 2015 involving 116 consumer products companies listed in Bursa Malaysia. The estimation method of Data Envelopment Analysis computes the efficiency scores and ranks the companies accordingly. The Alirezaee and Afsharian's method of analysis based Charnes, Cooper and Rhodes (CCR) where Constant Return to Scale (CRS) is employed. The DuPont analysis is a traditional tool for measuring the operating performance of companies. In this study, DuPont analysis is used to evaluate three different aspects such as profitability, efficiency of assets utilization and financial leverage. Return on Equity (ROE) is also calculated in DuPont analysis. This study finds that both analysis models provide different rankings of the selected samples. Hypothesis testing based on Pearson's correlation, indicates that there is no correlation between rankings produced by DEA and DuPont analysis. The DEA ranking model proposed by Alirezaee and Asharian is unstable. The method cannot provide complete ranking because the values of Balance Index is equal and zero.

  19. Creating a Counter-Space through Listening to and Learning from a Korean Pre-Service Teacher's Experiences

    ERIC Educational Resources Information Center

    Kang, Jihea

    2017-01-01

    The author uses a life-historical counter-storytelling approach to examine a Korean female pre-service teacher's experiences in a U.S. teacher preparation program. The participant encountered challenges due to her perceived language proficiency and communication and participation style in a U.S. higher educational context. Further, the author…

  20. Preferences for support services among adolescents and young adults with cancer or a blood disorder: a discrete choice experiment.

    PubMed

    Goodall, Stephen; King, Madeleine; Ewing, Jane; Smith, Narelle; Kenny, Patricia

    2012-10-01

    Life-threatening illnesses in young people are traumatic for patients and their families. Support services can help patients and families deal with various non-medical impacts of diagnosis, disease and treatment. The aim of this study was to determine which types of support are most valued by adolescents and young adults (AYA) with cancer or blood disorders and their families. A discrete choice experiment (DCE). Separate experiments were conducted with AYA and their carers. Completed surveys were returned by 83 patients and 78 carers. AYA preferred emotional support for themselves (either by counsellors and/or peers), emotional support for their family, financial support and assistance returning to school/work over services relating to cultural and spiritual needs. Covariate analysis indicated female AYA were more likely than males to prefer emotional support, while males were more likely to prefer assistance returning to work/school. Carers preferred emotional support for their AYA and assistance returning to school/work. Like AYA, they were indifferent about services relating to cultural and spiritual needs. Providing the types of support services that people prefer should maximise effectiveness. This study suggests that AYA patients require support services that included financial aid, assistance returning to work/study, emotional support for themselves and for their family. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.