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Sample records for reflective capacity clinical

  1. Enhancing the clinical reflective capacities of nursing students.

    PubMed

    Andersen, Elizabeth

    2016-07-01

    The purpose of clinical practicums is to help nursing students learn from real clinical experiences. In clinical settings, nursing instructors set-aside time at the end of each clinical day for reflective, debriefing discussions that are designed to draw the students' attention to relevant information and help them understand their beliefs and experiences. The students' competence and decision-making skills are enhanced when they are able to reflect on critical incidents or everyday practice events. It is sometimes difficult, however, for instructors to engage students meaningfully in discussions and promote reflection when students are fatigued. In this article, I argue that it is possible to refresh, support, and inspire undergraduate nursing students by engaging them in an activity designed to distract them and occupy their conscious attention, so that their more divergent and less accessible ideas are allowed to surface. Less accessible ideas are associated with the default network; regions in the brain that are most active when the brain is allowed to rest and wander. Congruent with the middle range theory of comfort, a distracting activity will provide comfort to students who are fatigued and/or distressed, and at the same time, will enhance their reflective capacities. A distracting activity that is enjoyable, not too demanding, and can be sustained for more than just a few minutes works best for idea generation and reflection. PMID:27428689

  2. Beyond the Margins: Reflective Writing and Development of Reflective Capacity in Medical Education

    PubMed Central

    Reis, Shmuel P.

    2010-01-01

    Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcomes. There has been a proliferation of reflective writing pedagogy within medical education to foster development of reflective capacity, extend empathy with deepened understanding of patients’ experience of illness, and promote practitioner well-being. At Alpert Med, “interactive” reflective writing with guided individualized feedback from interdisciplinary faculty to students’ reflective writing has been implemented in a Doctoring course and Family Medicine clerkship as an educational method to achieve these aims. Such initiatives, however, raise fundamental questions of reflection definition, program design, efficacy of methods, and outcomes assessment. Within this article, we consider opportunities and challenges associated with implementation of reflective writing curricula for promotion of reflective capacity within medical education. We reflect upon reflection. PMID:20407840

  3. Clinical Linguistics: Conversational Reflections

    ERIC Educational Resources Information Center

    Crystal, David

    2013-01-01

    This is a report of the main points I made in an informal "conversation" with Paul Fletcher and the audience at the 14th ICPLA conference in Cork. The observations arose randomly, as part of an unstructured 1-h Q&A, so they do not provide a systematic account of the subject, but simply reflect the issues which were raised by the conference…

  4. Building the Reflective Capacity of Practicing Principals

    ERIC Educational Resources Information Center

    Rich, Robert A.; Jackson, Sherion H.

    2006-01-01

    Reflection is often used as a professional development tool in coaching and mentoring leaders. Outside of education, research is underway to learn how managers can develop as learning facilitators in the workplace. However, the current focus on learning communities and learning organizations within education makes reflective thinking particularly…

  5. Capacity Differences Reflected in the Recall Performance of Adults.

    ERIC Educational Resources Information Center

    Attig, Mary S.

    Recent theories in cognitive psychology have emphasized the role of capacity requirements in encoding tasks. To examine the notion that age-related differences in the recall performance reflect differences in cognitive capacity, 80 adults (40 undergraduates, and 40 senior citizens) recalled newspaper advertisements under free recall and cued…

  6. Experience and Reflection: Preservice Science Teachers' Capacity for Teaching Inquiry

    ERIC Educational Resources Information Center

    Melville, Wayne; Fazio, Xavier; Bartley, Anthony; Jones, Doug

    2008-01-01

    In this article, we investigate the relationship between preservice teachers' inquiry experience and their capacity to reflect on the challenges involved in implementing inquiry into classrooms. For data, we draw on the personal narratives of preservice science teachers enrolled in science instruction courses. Preservice teachers with extensive…

  7. Subitizing Reflects Visuo-Spatial Object Individuation Capacity

    ERIC Educational Resources Information Center

    Piazza, Manuela; Fumarola, Antonia; Chinello, Alessandro; Melcher, David

    2011-01-01

    Subitizing is the immediate apprehension of the exact number of items in small sets. Despite more than a 100 years of research around this phenomenon, its nature and origin are still unknown. One view posits that it reflects a number estimation process common for small and large sets, which precision decreases as the number of items increases,…

  8. Metacognitive Capacities for Reflection in Schizophrenia: Implications for Developing Treatments

    PubMed Central

    Lysaker, Paul H.

    2014-01-01

    Models of schizophrenia, which focus exclusively on discrete symptoms and neurocognitive deficits, risk missing the possibility that a core feature of the disorder involves a reduced capacity to construct complex and integrated representations of self and others. This column details a new methodology that has been used to assess deficits in the metacognitive abilities that allow persons to form complex ideas about themselves and others and to use that knowledge to respond to psychosocial challenges in schizophrenia. Evidence is summarized supporting the reliability and validity of this method, as well as links this work has revealed between metacognition and psychosocial outcomes. It is suggested that this work points to the need to develop interventions which move beyond addressing symptoms and specific skills, and assist persons to recapture lost or atrophied metacognitive capacity and so form the kind of ideas about themselves and others needed, to move meaningfully toward recovery. PMID:24636965

  9. Managing service capacity in an ambulatory care clinic.

    PubMed

    Antle, D W; Reid, R A

    1988-01-01

    Capacity management seeks to improve organizational effectiveness by increasing operational efficiency and reducing patient congestion. A framework for capacity management, including demand-smoothing and supply-matching strategies, provides structure for a manager's approach to effective ambulatory care. A patient flow study of 108 patients at an outpatient medical oncology clinic identified several inefficient patient services. Rather than increase the clinical resource base, a balanced set of relevant, low-cost strategies was proposed to improve performance. PMID:10302492

  10. Reflection-in-Action: Case Study of a Clinical Supervisor.

    ERIC Educational Resources Information Center

    Turner-Muecke, Lee A.

    1986-01-01

    Applies Donald Schon's concept of the "reflective practitioner" to Robert Goldhammer's clinical supervision cycle (pre-observation conference, observation, analysis and strategy, supervision conference, and postconference analysis), stressing personal growth purposes for teacher and supervisor alike. Explores a clinical supervisor's reflection on…

  11. Special Issue on Clinical Supervision: A Reflection

    ERIC Educational Resources Information Center

    Bernard, Janine M.

    2010-01-01

    This special issue about clinical supervision offers an array of contributions with disparate insights into the supervision process. Using a synergy of supervision model, the articles are categorized as addressing the infrastructure required for adequate supervision, the relationship dynamics endemic to supervision, or the process of delivering…

  12. Clinical and symptomatological reflections: the fascial system

    PubMed Central

    Bordoni, Bruno; Zanier, Emiliano

    2014-01-01

    Every body structure is wrapped in connective tissue, or fascia, creating a structural continuity that gives form and function to every tissue and organ. Currently, there is still little information on the functions and interactions between the fascial continuum and the body system; unfortunately, in medical literature there are few texts explaining how fascial stasis or altered movement of the various connective layers can generate a clinical problem. Certainly, the fascia plays a significant role in conveying mechanical tension, in order to control an inflammatory environment. The fascial continuum is essential for transmitting muscle force, for correct motor coordination, and for preserving the organs in their site; the fascia is a vital instrument that enables the individual to communicate and live independently. This article considers what the literature offers on symptoms related to the fascial system, trying to connect the existing information on the continuity of the connective tissue and symptoms that are not always clearly defined. In our opinion, knowing and understanding this complex system of fascial layers is essential for the clinician and other health practitioners in finding the best treatment strategy for the patient. PMID:25258540

  13. Mentoring the Next Researcher Generation: Reflections on Three Years of Building VET Research Capacity and Infrastructure

    ERIC Educational Resources Information Center

    Barratt-Pugh, Llandis Gareth

    2012-01-01

    During 2008-2011, the National Centre for Vocational Education Research (NCVER) funded a programme to build Australian VET research capacity and rejuvenate what has been seen as the existing "greying" researcher pool. This paper is a reflective narrative about experiences of constructing the programme with a specific focus on the mentoring…

  14. Stabilization of clinical samples collected for quantitative bioanalysis--a reflection from the European Bioanalysis Forum.

    PubMed

    Hilhorst, Martijn; van Amsterdam, Peter; Heinig, Katja; Zwanziger, Elke; Abbott, Richard

    2015-01-01

    In bioanalysis of small molecules, the analyte concentration in the measured samples should reflect the concentration during sample collection. Precautions may be needed to prevent over- or under-estimation of the obtained result. This might require the addition of stabilizers to prevent degradation or nonspecific binding. For unstable drugs, it is essential to know how analytes can be stabilized before the start of the clinical study. Although the stabilization methods are well documented, the impact of the stabilization on the clinical workflow is not properly addressed. Already during method development, the clinical implications in terms of personnel safety, ease of use, training possibilities and staff capacity should be taken into account, and validation of the bioanalytical method should reflect collection procedures. PMID:25697191

  15. A model for reflection for good clinical practice.

    PubMed

    Balla, John I; Heneghan, Carl; Glasziou, Paul; Thompson, Matthew; Balla, Margaret E

    2009-12-01

    Rationale and aim The rapidly changing knowledge base of clinical practice highlights the need to keep abreast of knowledge changes that are most relevant for the practitioner. We aimed to develop a model for reflection on clinical practice that identified the key elements of medical knowledge needed for good medical practice. Method The dual theory of cognition, an integration of intuitive and analytic processes, provided the framework for the study. The design looked at the congruence between the clinical thinking process and the dual theory. A one-year study was conducted in general practice clinics in Oxfordshire, UK. Thirty-five general practitioners participated in 20-minute interviews to discuss how they worked through recently seen clinical cases. Over a one-year period 72 cases were recorded from 35 interviews. These were categorized according to emerging themes, which were manually coded and substantiated with verbatim quotations. Results There was a close fit between the dual theory and participants' clinical thinking processes. This included instant problem framing, consistent with automatic intuitive thinking, focusing on the risk and urgency of the case. Salient features accounting for these choices were recognizable. There was a second reflective phase, leading to the review of initial judgements. Conclusions The proposed model highlights the critical steps in decision making. This allows regular recalibration of knowledge that is most critical at each of these steps. In line with good practice, the model also links the crucial knowledge used in decision making, to value judgments made in relation to the patient. PMID:20367693

  16. Scallops show that muscle metabolic capacities reflect locomotor style and morphology.

    PubMed

    Tremblay, Isabelle; Guderley, Helga E

    2014-01-01

    Although all scallops swim using their adductor muscle to close their valves, scallop species differ considerably in how they use their muscle during escape responses, in parallel with the striking interspecific differences in shell morphology. This provides an excellent opportunity to study links between muscle metabolic capacities and animal performance. We found that the capacity for anaerobic glycolysis and aerobic metabolism, as well as phosphoarginine levels in the phasic adductor muscle, differ with escape response strategy. Phosphoarginine contents were high in species that rely on phasic contractions (Amusium balloti, Placopecten magellanicus, and Pecten fumatus). Arginine kinase activities reflect reliance on rapid initial bursts of phasic contractions. Scallops that maintain their valves in a closed position for prolonged periods (P. fumatus, Mimachlamys asperrima, and Crassadoma gigantea) have high activities of enzymes of anaerobic glycolysis in their phasic adductor muscle. Myosin ATPase activity was lower in the nonswimming scallop, C. gigantea, than in swimming scallops. The different patterns and roles of swimming are reflected in interspecific differences in the biochemical attributes of the phasic adductor muscle. These patterns suggest coevolution of muscle metabolic capacities, patterns of adductor muscle use, and shell morphology in scallops. PMID:24642541

  17. Reflections on clinical research in sub-Saharan Africa.

    PubMed

    Kuepfer, Irene; Burri, Christian

    2009-07-15

    The urgent need for new, safe and sustainable interventions against diseases that disproportionally affect the poor is finally receiving global attention and the funding landscape for development projects has significantly improved during the past decade. For the development of new drug and vaccine candidates, clinical trials have become the most important tool to assess their safety and efficacy. Recently, there has been a seismic shift in the number of clinical trials conducted in resource-limited settings. We discuss the current framework of clinical research in sub-Saharan Africa, from building product pipelines to the capacities needed for the conduct of trials according the harmonised Good Clinical Practice (GCP) ICH E6 guideline. We place emphasis on clinical research in neglected tropical diseases which still frequently has to be conducted with limited financial, logistical and human resources. Given those short-comings we recommend minimum standards needed at the local, national and sponsor levels to provide GCP-compliant clinical research. PMID:19324048

  18. Reflections on Speech-Language Therapists' Talk: Implications for Clinical Practice and Education. Clinical Forum

    ERIC Educational Resources Information Center

    Ferguson, Alison; Armstrong, Elizabeth

    2004-01-01

    Background: Research into the practices of speech-language therapists in clinical sessions is beginning to identify the way communication in clinical interactions both facilitates and potentially impedes the achievement of therapy goals. Aims: This target article aims to raise the issues that arise from critical reflections on the communication of…

  19. Building workforce capacity for ethical reflection in health promotion: a practitioner's experience.

    PubMed

    Axford, Annabel; Carter, Drew

    2015-12-01

    Health promotion does not have a code of ethics, although attempts have been made to assist practitioners in their understanding and application of ethical concepts. This article describes and analyses one such attempt, sustained from 2006 to 2014 in rural South Australia. The attempt comprised capacity-building activities that were informed by principles of organisational change management, especially the principle of creating champions. The article also presents a framework (largely comprising ethical questions) that may help practitioners as a prompt and guide to ethical reflection. The framework was developed to be as accessible as possible in light of the diverse educational backgrounds found in rural settings. Finally, the article highlights some philosophical dimensions to the framework and defends its role, proposing that ethical reflection is integral to good practice and never simply the province of theorists. The article does all this with a view to stimulating discussion on how to increase the frequency and quality of ethical reflection undertaken by health promotion practitioners. PMID:26686061

  20. Exploratory study of the characteristics of feedback in the reflective dialogue group given to medical students in a clinical clerkship

    PubMed Central

    Wen, Chin-Chen; Lin, Meei-Ju; Lin, Chi-Wei; Chu, Shao-Yin

    2015-01-01

    Purpose Structured narrative reflective writing combined with guided feedback is an efficient teaching method for enhancing medical students’ reflective capacity. However, what kinds of feedback offered and reflection presented in a reflective group remain unclear. The aim of this study was to investigate the characteristics of feedback in a reflective dialogue group. Methods Fifth-year medical students on a monthly interval rotation at the pediatric department of a medical center in eastern Taiwan during the 2012 academic year completed their reflective writing regarding patient and family psychosocial issues, and were subsequently debriefed in a 2-h group discussion session to receive feedback from a clinical tutor and peers. Content analysis was conducted to explore the characteristics of feedback and reflection presented in the reflective dialogue. The evaluative questionnaire regarding the benefits of reflection with others was administrated following the group session. Results Forty students participated in five reflective groups and 108 psychosocial issues were discussed and identified. The tutor played an initiating role in the group discussion by providing six equal feedback types involving exploring new knowledge, initiating advanced discussion, highlighting the issues, and encouraging the students. The students provided eight types of feedback that involved a substantial deep discussion on psychosocial issues and action plans based on the complex interactive ecological network of clinical encounters. Each student attained 1.25 times the depth or breadth of reflection after receiving feedback and experienced the benefits of reflection with others. Conclusion Through structured narrative reflective writing combined with pluralistic group discussion with a tutor and peers, the medical students had time to think deeply and broadly about psychosocial issues among patients and their family members. Facilitative feedback providing new knowledge, deeper

  1. Preservice Teachers' Reflection on Clinical Experiences: A Comparison of Blog and Final Paper Assignments

    ERIC Educational Resources Information Center

    Harland, Darci J.; Wondra, Joshua D.

    2011-01-01

    This study focused on the depth of reflection in the writing of preservice teachers who completed end-of-the-semester reflective papers or reflective blogs for undergraduate education courses associated with clinical experiences. Coders rated the depth of reflection as one of four categories: non-reflection, understanding, reflection, or critical…

  2. Does Objective Structured Clinical Examinations Score Reflect the Clinical Reasoning Ability of Medical Students?

    PubMed Central

    Park, Wan Beom; Kang, Seok Hoon; Lee, Yoon-Seong

    2015-01-01

    Abstract: Background: Clinical reasoning ability is an important factor in a physician's competence and thus should be taught and tested in medical schools. Medical schools generally use objective structured clinical examinations (OSCE) to measure the clinical competency of medical students. However, it is unknown whether OSCE can also evaluate clinical reasoning ability. In this study, the authors investigated whether OSCE scores reflected students' clinical reasoning abilities. Methods: Sixty-five fourth-year medical students participated in this study. Medical students completed the OSCE with 4 cases using standardized patients. For assessment of clinical reasoning, students were asked to list differential diagnoses and the findings that were compatible or not compatible with each diagnosis. The OSCE score (score of patient encounter), diagnostic accuracy score, clinical reasoning score, clinical knowledge score and grade point average (GPA) were obtained for each student, and correlation analysis was performed. Results: Clinical reasoning score was significantly correlated with diagnostic accuracy and GPA (correlation coefficient = 0.258 and 0.380; P = 0.038 and 0.002, respectively) but not with OSCE score or clinical knowledge score (correlation coefficient = 0.137 and 0.242; P = 0.276 and 0.052, respectively). Total OSCE score was not significantly correlated with clinical knowledge test score, clinical reasoning score, diagnostic accuracy score or GPA. Conclusions: OSCE score from patient encounters did not reflect the clinical reasoning abilities of the medical students in this study. The evaluation of medical students' clinical reasoning abilities through OSCE should be strengthened. PMID:25647834

  3. Assessing Clinical Research Capacity in Vietnam: A Framework for Strengthening Capability for Clinical Trials in Developing Countries.

    PubMed

    Kagan, Jonathan; Giang, Dao Duc; Iademarco, Michael F; Phung, Van Tt; Lau, Chuen-Yen; Quang, Nguyen Ngo

    2016-01-01

    Although improving health systems promises important benefits, most developing nations lack the resources to support nationally driven clinical research. Strengthened clinical research capacity can advance national health goals by supporting greater autonomy in aligning research with national priorities. From March through June 2010, we assessed six elements of clinical research capacity in Vietnam: research agenda; clinical investigators and biostatisticians; donors and sponsors; community involvement; scientific, ethical, safety, and quality oversight; and clinical research institutions. Assessments were drawn from interviews with investigators, Ministry of Health staff members, nongovernment organizations, and U.S. Mission staff members, and document review. Observations and recommendations were shared with collaborators. Reassessment in 2015 found growth in the number of clinical trials, improved regulation in human subjects protection and community engagement, and modest advances in research agenda setting. Training and investment in institutions remain challenging. A framework for assessing clinical research capacity can affirm strengths and weaknesses and guide the coordination of capacity-building efforts. PMID:27252559

  4. Further reflections on the impact of clinical writing on patients.

    PubMed

    Furlong, Allannah

    2006-06-01

    Though it is unlikely that instituting universal guidelines will ever be possible for patient approval of the analyst's use of clinical material outside of the treatment setting, the author offers some supplementary reflections to those already available in the literature. Broadly applied informed consent guidelines would increase the distortion that already exists in our clinical literature due to self-imposed restraints by writers. Moreover, the powerful irrational forces mobilized by consent in the dyad are not easily 'held' by traditional applicable legal categories. Metapsychological formulations of the intrapsychic and intersubjective impact of patient participation in the writing process on individual analytic dyads are needed. Notions of privacy protection, validation, dyadic co-construction, or writing-as-containment by a third as rationales for informed consent fail to encompass the transindividual and external sources of human identity and the ineradicable lack of unity in the unconscious. Nevertheless, theoretical affinity and preferred technique may be mediating factors in positive outcomes of the consent process. Some paradigms not only accommodate more comfortably but also actively seek the intersubjective repercussions of informed consent. As an alternative or complementary viewpoint, the author offers the hypothesis that the clinical ramifications of either disguise or consent are not exclusively, nor even necessarily, concerned with what patients read about themselves, but what they assess or intuit--directly or indirectly through the material presented--of their analyst's unconscious strivings. To truly triangulate the clinical reporting project, it is wisest to consult the third ear of a colleague to assess the potential impact on patients on what might be being unconsciously transmitted by the analyst in the writing and the consent process. PMID:16854736

  5. The use of abstract paintings and narratives to foster reflective capacity in medical educators: a multinational faculty development workshop

    PubMed Central

    Karkabi, Khaled; Wald, Hedy S; Cohen Castel, Orit

    2014-01-01

    Reflective capacity is integral to core healthcare professional practice competencies. Reflection plays a central role in teacher education as reflecting on teaching behaviours with critical analysis can potentially improve teaching practice. The humanities including narrative and the visual arts can serve as a valuable tool for fostering reflection. We conducted a multinational faculty development workshop aiming to enhance reflective capacity in medical educators by using a combination of abstract paintings and narratives. Twenty-three family physicians or physicians-in-training from 10 countries participated in the workshop. Qualitative assessment of the workshop showed that the combined use of art and narrative was well received and perceived as contributing to the reflective exercise. Participants generally felt that viewing abstract paintings had facilitated a valuable mood transformation and prepared them emotionally for the reflective writing. Our analysis found that the following themes emerged from participants’ responses: (1) narratives from different countries are similar; (2) the use of art helped access feelings; (3) viewing abstract paintings facilitated next steps; (4) writing reflective narratives promoted examination of educational challenges, compassion for self and other, and building an action plan; and (5) sharing of narrative was helpful for fostering active listening and appreciating multiple perspectives. Future research might include comparing outcomes for a group participating in arts–narrative-based workshops with those of a control group using only reflective narrative or in combination with figurative art, and implementing a combination of qualitative and quantitative methods of assessment. PMID:24273319

  6. The use of abstract paintings and narratives to foster reflective capacity in medical educators: a multinational faculty development workshop.

    PubMed

    Karkabi, Khaled; Wald, Hedy S; Cohen Castel, Orit

    2014-06-01

    Reflective capacity is integral to core healthcare professional practice competencies. Reflection plays a central role in teacher education as reflecting on teaching behaviours with critical analysis can potentially improve teaching practice. The humanities including narrative and the visual arts can serve as a valuable tool for fostering reflection. We conducted a multinational faculty development workshop aiming to enhance reflective capacity in medical educators by using a combination of abstract paintings and narratives. Twenty-three family physicians or physicians-in-training from 10 countries participated in the workshop. Qualitative assessment of the workshop showed that the combined use of art and narrative was well received and perceived as contributing to the reflective exercise. Participants generally felt that viewing abstract paintings had facilitated a valuable mood transformation and prepared them emotionally for the reflective writing. Our analysis found that the following themes emerged from participants' responses: (1) narratives from different countries are similar; (2) the use of art helped access feelings; (3) viewing abstract paintings facilitated next steps; (4) writing reflective narratives promoted examination of educational challenges, compassion for self and other, and building an action plan; and (5) sharing of narrative was helpful for fostering active listening and appreciating multiple perspectives. Future research might include comparing outcomes for a group participating in arts-narrative-based workshops with those of a control group using only reflective narrative or in combination with figurative art, and implementing a combination of qualitative and quantitative methods of assessment. PMID:24273319

  7. Numerical estimation of storage capacity in reflection-type holographic disk memory with three-dimensional speckle-shift multiplexing.

    PubMed

    Miura, Masato; Nitta, Kouichi; Matoba, Osamu

    2009-10-01

    Maximum storage capacity in a reflection-type holographic memory with three-dimensional speckle shift multiplexing is investigated numerically. An explicit expression of storage capacity is derived on the basis of interpage crosstalk noise. We fabricate a simulator to evaluate reflection-type holographic data storage by calculating wave propagation, recording a hologram, and reconstruction by scalar diffraction. We calculate the properties of the resultant diffraction efficiency, that is the noise, at the first null in the speckle-shift multiplexing. Numerical results indicate that the storage capacity is proportional to the numerical aperture to the fourth power and to the volume of the recording medium and is inversely proportional to the wavelength to the third power. Achievable storage capacity is discussed. PMID:19798408

  8. Capacity for Clinical Research on Herbal Medicines in Africa

    PubMed Central

    Siegfried, Nandi; Johnson, Quinton

    2012-01-01

    Abstract An electronic survey was used to assess the training needs of clinical and public health researchers who have been involved, and/or plan to become involved, in clinical trials of herbal medicines in Africa. Over 90 researchers were contacted through pre-existing networks, of whom 58 (64%) responded, from 35 institutions in 14 African countries. Over half (57%) had already been involved in a clinical trial of an herbal medicine, and gave information about a total of 23 trials that have already been completed. Of these, only five had been published, and only one had resulted in a licensed product. Fifty-four (54) of the researchers were planning to conduct a clinical trial of an herbal medicine in the future, and gave information about 54 possible trials. Respondents outlined the following most commonly encountered difficulties when conducting clinical trials: resource constraints (including lack of funding, equipment, staff, and infrastructure); social acceptance of the clinical trial (including difficulty recruiting enough patients, poor rapport with traditional healers, and willingness of biomedical staff to be involved); herbal medicine supply (including insufficient cultivation, production, and quality control); lack of trained staff; and logistical issues in conducting trials. The topics in which researchers were least confident were Intellectual Property Rights issues, statistical issues, and issues related to Good Clinical Practice guidelines. PMID:22784350

  9. Reflections on Clinical Learning in Novice Speech-Language Therapy Students

    ERIC Educational Resources Information Center

    Hill, Anne E.; Davidson, Bronwyn J.; Theodoros, Deborah G.

    2012-01-01

    Background: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice…

  10. Structure and Agency in Learning: A Critical Realist Theory of the Development of Capacity to Reflect on Academic Practice

    ERIC Educational Resources Information Center

    Kahn, Peter; Qualter, Anne; Young, Richard

    2012-01-01

    Theories of learning typically downplay the interplay between social structure and student agency. In this article, we adapt a causal hypothesis from realist social theory and draw on wider perspectives from critical realism to account for the development of capacity to engage in reflection on professional practice in academic roles. We thereby…

  11. [Pseudomonas aeruginosa colonisation in bronchiectatic patients and clinical reflections].

    PubMed

    Kömüs, Nuray; Tertemiz, Kemal Can; Akkoçlu, Atila; Gülay, Zeynep; Yilmaz, Erkan

    2006-01-01

    Bronchiectasis is characterized with irreversible dilatation according to destruction of epithelium, elastic and muscular layer. Most important cause of bronchiectasis is chronic bacterial infections. Pseudomonas aeruginosa colonisation is frequently seen in bronchiectatic patients. We aimed to find out P. aeruginosa colonisation frequency and clinical, radiological and spirometric reflections due to colonisation. We analysed 83 cases retrospectively. Mean age was 58.2 and 54.2% of them were female. Bronchiectasis were localised 19.3% in left lung, 19.3% right and 61.4% bilaterally. 29 (35.8%) normal, 28 (34.6%) obstructive, 7 (8.6%) restrictive, 17 (21%) mixed type disorders are detected in spirometric measures. Sputum culture performed in 50 cases. No microorganism colonisation determined in 30 (60%) cases, P. aeruginosa colonisation 16 (32%), Haemophilus influenzae 2 (4%), 1 (2%) Streptococcus pneumoniae and Proteus mirabilis 1 (2%) cases. P. aeruginosa colonisation determined more frequent in males (p<0.05). No significant correlation detected between colonisation and age or smoking habits (p>0.05). In cases with colonisation; clubbing and hemoptysis were significantly frequent (p<0.05). Only peribronchial thickening was significantly correlated with colonisation in radiological findings (p<0.05). In blood gase analysis PaO2, oxygen saturation were lower and PaCO2 higher in cases colonised with P. aeruginosa but it was not statisticaly significant (p>0.05). Hospitalization rate was higher in P. aeruginosa colonised cases (p>0.05). It is an important problem about mortality because of higher hemoptysis and hospitalisation requirement rate in P. aeruginosa colonised cases. PMID:17203422

  12. Multidimensional Collaboration: Reflections on Action Research in a Clinical Context

    ERIC Educational Resources Information Center

    Gregory, Sheila; Poland, Fiona; Spalding, Nicola J.; Sargen, Kevin; McCulloch, Jane; Vicary, Penny

    2011-01-01

    This paper reflects on the challenges and benefits of multidimensional collaboration in an action research study to evaluate and improve preoperative education for patients awaiting colorectal surgery. Three cycles of planning, acting, observing and reflecting were designed to evaluate practice and implement change in this interactive setting,…

  13. Enhancing Learning in Clinical Placements: Reflective Practice, Self-Assessment, Rubrics and Scaffolding

    ERIC Educational Resources Information Center

    Stupans, Ieva; March, Geoff; Owen, Susanne M.

    2013-01-01

    Professional preparatory health programmes generally involve clinical placements with a focus on integration of theory into real life practice. Reflective writing is often included in the assessment requirements for clinical placement courses. However enabling students to engage in deeper levels of reflective writing in action, on action and for…

  14. Predictive capacity of risk assessment scales and clinical judgment for pressure ulcers: a meta-analysis.

    PubMed

    García-Fernández, Francisco Pedro; Pancorbo-Hidalgo, Pedro L; Agreda, J Javier Soldevilla

    2014-01-01

    A systematic review with meta-analysis was completed to determine the capacity of risk assessment scales and nurses' clinical judgment to predict pressure ulcer (PU) development. Electronic databases were searched for prospective studies on the validity and predictive capacity of PUs risk assessment scales published between 1962 and 2010 in English, Spanish, Portuguese, Korean, German, and Greek. We excluded gray literature sources, integrative review articles, and retrospective or cross-sectional studies. The methodological quality of the studies was assessed according to the guidelines of the Critical Appraisal Skills Program. Predictive capacity was measured as relative risk (RR) with 95% confidence intervals. When 2 or more valid original studies were found, a meta-analysis was conducted using a random-effect model and sensitivity analysis. We identified 57 studies, including 31 that included a validation study. We also retrieved 4 studies that tested clinical judgment as a risk prediction factor. Meta-analysis produced the following pooled predictive capacity indicators: Braden (RR = 4.26); Norton (RR = 3.69); Waterlow (RR = 2.66); Cubbin-Jackson (RR = 8.63); EMINA (RR = 6.17); Pressure Sore Predictor Scale (RR = 21.4); and clinical judgment (RR = 1.89). Pooled analysis of 11 studies found adequate risk prediction capacity in various clinical settings; the Braden, Norton, EMINA (mEntal state, Mobility, Incontinence, Nutrition, Activity), Waterlow, and Cubbin-Jackson scales showed the highest predictive capacity. The clinical judgment of nurses was found to achieve inadequate predictive capacity when used alone, and should be used in combination with a validated scale. PMID:24280770

  15. Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease.

    PubMed

    de Müllenheim, P-Y; Chaudru, S; Mahé, G; Prioux, J; Le Faucheur, A

    2016-07-01

    The purpose of the present review was to provide, for the first time, a comprehensive analysis and synthesis of the available studies that highlighted the clinical interest of the ambulatory assessment of either physical activity (PA) or walking capacity in patients with lower extremity peripheral artery disease (PAD). We identified 96 related articles published up to March 2015 through a computer-assisted search of the MEDLINE, EMBASE, and Web of Science databases. Ambulatory-measured PA or related energy expenditure (EE) in PAD patients was performed in 87 of the 96 included studies. The main clinical interests of these measurements were (a) the assessment of PA/EE pattern; (b) the characterization of walking pattern; and (c) the control of training load during home-based walking programs. Ambulatory-measured walking capacity was performed in the remaining studies, using either Global Positioning System receivers or the Peripheral Arterial Disease Holter Control device. Highlighted clinical interests were (a) the assessment of community-based walking capacity; (b) the use of new outcomes to characterize walking capacity, besides the conventional absolute claudication distance; and (c) the association with the patient's self-perception of walking capacity. This review also provides for the clinicians step-by-step recommendations to specifically assess PA or walking capacity in PAD patients. PMID:26173488

  16. Reflections by clinical nurse specialists on changing ward practice.

    PubMed

    Thomas, Catherine; Ramcharan, Angie

    In September 2010, palliative care clinical nurse specialists at North Middlesex University Hospital Trust introduced competencies for all nurses in setting up and using syringe drivers. This was done after the trust identified a high level of clinical incidents involving syringe drivers. This article discusses how the competencies were implemented and assessed, explores the importance of understanding change management to achieve change, and how different leadership styles affect changes to practice. PMID:21957520

  17. Building clinical trial capacity to develop a new treatment for multidrug-resistant tuberculosis

    PubMed Central

    Tupasi, Thelma; Danilovits, Manfred; Cirule, Andra; Sanchez-Garavito, Epifanio; Xiao, Heping; Cabrera-Rivero, Jose L; Vargas-Vasquez, Dante E; Gao, Mengqiu; Awad, Mohamed; Gentry, Leesa M; Geiter, Lawrence J; Wells, Charles D

    2016-01-01

    Abstract Problem New drugs for infectious diseases often need to be evaluated in low-resource settings. While people working in such settings often provide high-quality care and perform operational research activities, they generally have less experience in conducting clinical trials designed for drug approval by stringent regulatory authorities. Approach We carried out a capacity-building programme during a multi-centre randomized controlled trial of delamanid, a new drug for the treatment of multidrug-resistant tuberculosis. The programme included: (i) site identification and needs assessment; (ii) achieving International Conference on Harmonization – Good Clinical Practice (ICH-GCP) standards; (iii) establishing trial management; and (iv) increasing knowledge of global and local regulatory issues. Local setting Trials were conducted at 17 sites in nine countries (China, Egypt, Estonia, Japan, Latvia, Peru, the Philippines, the Republic of Korea and the United States of America). Eight of the 10 sites in low-resource settings had no experience in conducting the requisite clinical trials. Relevant changes Extensive capacity-building was done in all 10 sites. The programme resulted in improved local capacity in key areas such as trial design, data safety and monitoring, trial conduct and laboratory services. Lessons learnt Clinical trials designed to generate data for regulatory approval require additional efforts beyond traditional research-capacity strengthening. Such capacity-building approaches provide an opportunity for product development partnerships to improve health systems beyond the direct conduct of the specific trial. PMID:26908964

  18. Clinical judgment development using structured classroom reflective practice: a qualitative study.

    PubMed

    Glynn, Donna M

    2012-03-01

    This qualitative study examined the incorporation of "reflection-on-action" in a structured reflective classroom format as defined by Tanner's Clinical Judgment Model on the development of perceived clinical judgment and clinical confidence in Bachelor of Science nursing students. The qualitative results described the students' perceptions of the benefit of the intervention on their development of clinical judgment and clinical confidence. This research was an important contribution to the debate regarding the benefit of structured reflection in a classroom setting. By using reflection in the classroom, nurse educators may influence the education-practice gap and incorporate new pedagogies to strengthen the educational preparedness of nursing students to provide high-quality, competent, compassionate care to patients and their families. PMID:22283156

  19. 21 CFR 862.2400 - Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use. 862.2400 Section 862.2400 Food and Drugs FOOD AND DRUG... CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2400 Densitometer/scanner...

  20. [Ethical questioning at the heart of clinical reflection].

    PubMed

    Kibler, Sébastien

    2015-11-01

    Ethical questioning within a team contributes to the personalisation of care. This approach has had a strong presence in the career of Sébastien Kibler, a nurse manager, and forms the basis for his day-to-day clinical thinking. PMID:26548389

  1. [Reflecting on a religious conversion event in a clinical setting].

    PubMed

    Binkowski, Gabriel; Baubet, Thierry

    2016-01-01

    What should be the clinical approach to the event represented by a religious conversion, adherence or attraction to extreme groups and ideas? It requires a conceptual analysis, an ethical and epistemological approach at the centre of social situations presenting a high level of ambiguity, tinged even with a certain sense of unreality, as is being experienced in France. PMID:26790594

  2. Determination of antioxidant capacity and phenolic content of chocolate by attenuated total reflectance-Fourier transformed-infrared spectroscopy.

    PubMed

    Hu, Yaxi; Pan, Zhi Jie; Liao, Wen; Li, Jiaqi; Gruget, Pierre; Kitts, David D; Lu, Xiaonan

    2016-07-01

    Antioxidant capacity and phenolic content of chocolate, containing different amounts of cacao (35-100%), were determined using attenuated total reflectance (ATR)-Fourier transformed-infrared (FT-IR) spectroscopy (4000-550cm(-1)). Antioxidant capacities were first characterized using DPPH (2,2-diphenyl-1-picrylhydrazyl) and ORAC (oxygen radical absorbance capacity) assays. Phenolic contents, including total phenol and procyanidins monomers, were quantified using the Folin-Ciocalteu assay and high performance liquid chromatography coupled with photodiode array detector (HPLC-DAD), respectively. Five partial least-squares regression (PLSR) models were constructed and cross-validated using FT-IR spectra from 18 types of chocolate and corresponding reference values determined using DPPH, ORAC, Folin-Ciocalteu, and HPLC assays. The models were validated using seven unknown samples of chocolate. PLSR models showed good prediction capability for DPPH [R(2)-P (prediction)=0.88, RMSEP (root mean squares error of prediction)=12.62μmol Trolox/g DFW], ORAC (R(2)-P=0.90, RMSEP=37.92), Folin-Ciocalteu (R(2)-P=0.88, RMSEP=5.08), and (+)-catechin (R(2)-P=0.86, RMSEP=0.10), but lacked accuracy in the prediction of (-)-epicatechin (R(2)-P=0.72, RMSEP=0.57). ATR-FT-IR spectroscopy can be used for rapid prediction of antioxidant capacity, total phenolic content, and (+)-catechin in chocolate. PMID:26920292

  3. Pearls of wisdom for clinical teaching: expert educators reflect.

    PubMed

    Lichtman, Ronnie; Varney Burst, Helen; Campau, Nancy; Carrington, Betty; Diegmann, Elaine K; Hsia, Lily; Thompson, Joyce E

    2003-01-01

    A group of expert educators, each with more than 20 years of experience in midwifery education, was asked to contribute a "pearl (or pearls) of wisdom" for clinical teaching. Despite minimal instructions regarding what type of wisdom was being solicited, remarkable similarities emerged from the educators' contributions. Themes included the need for self-evaluation to become a competent preceptor, the role-modeling function of the preceptor, the development of critical thinking in students, the need to appreciate students' varying learning styles and individual ways of functioning, and the use of positive reinforcement. Although these may seem like universally accepted concepts in clinical teaching, one contributor related stories she heard from students about "hazing" behaviors that have a negative impact on learning. This points to the need for ongoing education about being an educator, another theme echoed in several of the contributions. PMID:14660952

  4. Relation of the multilocus genetic composite reflecting high dopamine signaling capacity to future increases in BMI☆

    PubMed Central

    Yokum, Sonja; Marti, C. Nathan; Smolen, Andrew; Stice, Eric

    2014-01-01

    Because food intake exerts its rewarding effect by increasing dopamine (DA) signaling in reward circuitry, it theoretically follows that individuals with a greater number of genotypes putatively associated with high DA signaling capacity are at increased risk for overeating and subsequent weight gain. We tested the association between the multilocus genetic composite risk score, defined by the total number of genotypes putatively associated with greater DA signaling capacity (i.e. TaqIA A2 allele, DRD2-141C Ins/Del and Del/Del genotypes, DRD4-S allele, DAT1-S allele, and COMT Val/Val genotype), and future increases in Body Mass Index (BMI) in three prospective studies. Participants in Study 1 (N = 30; M age = 15.2; M baseline BMI = 26.9), Study 2 (N = 34; M age = 20.9; M baseline BMI = 28.2), and Study 3 (N = 162; M age = 15.3, M baseline BMI = 20.8) provided saliva samples from which epithelial cells were collected, permitting DNA extraction. The multilocus genetic composite risk score was associated with future increases in BMI in all three studies (Study 1, r = 0.37; Study 2, r = 0.22; Study 3, r = 0.14) and the overall sample (r = 0.19). DRD4-S was associated with increases in BMI in Study 1 (r = 0.42), Study 2 (r = 0.27), and in the overall sample (r = 0.17). DAT1-S was associated with increases in BMI in Study 3 (r = 0.17) and in the overall sample (r = 0.12). There were no associations between the other genotypes (TaqIA, COMT, and DRD2-141C) and change in BMI over 2-year follow-up. Data suggest that individuals with a genetic propensity for greater DA signaling capacity are at risk for future weight gain and that combining alleles that theoretically have a similar function may provide a more reliable method of modeling genetic risk associated with future weight gain than individual genotypes. PMID:25523644

  5. Cortical potentials in an auditory oddball task reflect individual differences in working memory capacity

    PubMed Central

    Yurgil, Kate A.; Golob, Edward J.

    2014-01-01

    This study determined whether auditory cortical responses associated with mechanisms of attention vary with individual differences in working memory capacity (WMC) and perceptual load. The operation span test defined subjects with low vs. high WMC, who then discriminated target/nontarget tones while EEG was recorded. Infrequent white noise distracters were presented at midline or ±90° locations, and perceptual load was manipulated by varying nontarget frequency. Amplitude of the N100 to distracters was negatively correlated with WMC. Relative to targets, only high WMC subjects showed attenuated N100 amplitudes to nontargets. In the higher WMC group, increased perceptual load was associated with decreased P3a amplitudes to distracters and longer-lasting negative slow wave to nontargets. Results show that auditory cortical processing is associated with multiple facets of attention control related to WMC and possibly higher-level cognition. PMID:24016201

  6. Generic Reflective Feedback: An Effective Approach to Developing Clinical Reasoning Skills

    ERIC Educational Resources Information Center

    Wojcikowski, K.; Brownie, S.

    2013-01-01

    Problem-based learning can be an effective tool to develop clinical reasoning skills. However, it traditionally takes place in tutorial groups, giving students little flexibility in how and when they learn. This pilot study compared the effectiveness of generic reflective feedback (GRF) with tutorial-based reflective feedback on the development of…

  7. Individual attentional selection capacities are reflected in interhemispheric connectivity of the parietal cortex.

    PubMed

    Vossel, Simone; Weidner, Ralph; Moos, Katharina; Fink, Gereon R

    2016-04-01

    Modelling psychophysical data using the Theory of Visual Attention (TVA) allows for a quantification of attentional sub-processes, such as the resolution of competition amongst multiple stimuli by top-down control signals for target selection (TVA-parameter α). This fMRI study investigated the neural correlates of α by comparing activity differences and changes of effective connectivity between conditions where a target was accompanied by a distractor or by a second target. Twenty-five participants performed a partial report task inside the MRI scanner. The left angular gyrus (ANG), medial frontal, and posterior cingulate cortex showed higher activity when a target was accompanied by a distractor as opposed to a second target. The reverse contrast yielded activation of a bilateral fronto-parietal network, the anterior insula, anterior cingulate cortex, and left inferior occipital gyrus. A psychophysiological interaction analysis revealed that the connectivity between left ANG and the left and right supramarginal gyrus (SMG), left anterior insula, and right putamen was enhanced in the target-distractor condition in participants with worse attentional top-down control. Dynamic causal modelling suggested that the connection from left ANG to right SMG during distractor presence was modulated by α. Our data show that interindividual differences in attentional processing are reflected in changes of effective connectivity without significant differences in activation strength of network nodes. PMID:26827815

  8. Supporting youth and community capacity through photovoice: Reflections on participatory research on maternal health in Wakiso district, Uganda.

    PubMed

    Musoke, David; Ndejjo, Rawlance; Ekirapa-Kiracho, Elizabeth; George, Asha S

    2016-01-01

    This paper reflects on the experiences of using photovoice to examine maternal health in Wakiso district, Uganda. The project involved 10 youth aged 18-29 years old, who were diverse in education, occupation, and marital status and identified by community leaders with researchers. By taking photos and sharing images and experiences in monthly meetings over five months, youth reported becoming more knowledgeable. They realised that they had common experiences but also reflected on and reinterpreted their circumstances. While they acquired self-confidence and enhanced their communication skills, they also initially faced community resistance regarding consent and lack of trust in their motives. Ethical practice in photovoice goes beyond institutional approval and individual consent. It includes extensively discussing the project with community members and building relationships with them. In certain instances, photos needed not to identify community members, or not be taken at all. Through these relationships and with improved capacity, youth engaged in individual instances of health education and advocacy, as well as spurred further local action through community dialogues. Researchers supporting photovoice must be open to learning alongside participants, flexible regarding study focus and processes, sustain interest and manage logistics, all while being reflective about the balance of power in such partnerships. PMID:27109246

  9. Developing a Capacity to Engage in Critical Reflection: Students' "Ways of Knowing" within an Undergraduate Business and Accounting Programme

    ERIC Educational Resources Information Center

    Lucas, Ursula; Tan, Phaik Leng

    2013-01-01

    The development of a capacity to engage in critical reflection is central to higher education. However, students vary in this capacity and its development requires students to move from an absolute towards a contextual way of knowing. Using 32 semi-structured interviews, this study identifies the ways of knowing of 17 business and accounting…

  10. Diffuse reflectance spectroscopy: a clinical study of tuberculin skin tests reading

    NASA Astrophysics Data System (ADS)

    Koenig, Anne; Grande, Sophie; Dahel, Karima; Planat-Chrétien, Anne; Poher, Vincent; Goujon, Catherine; Dinten, Jean-Marc

    2013-02-01

    Diffuse reflectance spectroscopy is a technique widely used to determine optical properties of tissues: scattering and absorption coefficients. In this study, we present the development of a low-cost optical instrument usable in a clinical environment based upon the spatially resolved diffuse reflectance spectroscopy approach. This instrument has been used in a clinical study to support the diagnosis of tuberculosis. The idea is to establish a new scanning method for an early detection of inflammation due to a reagent injection, before the onset of visual signs. Results comparing the instrumental and classical clinical readings are presented.

  11. Shorebirds' seasonal adjustments in thermogenic capacity are reflected by changes in body mass: how preprogrammed and instantaneous acclimation work together.

    PubMed

    Vézina, François; Dekinga, Anne; Piersma, Theunis

    2011-09-01

    Phenotypic flexibility in shorebirds has been studied mainly in the context of adjustments to migration and to quality of food; little is known on how birds adjust their phenotype to harsh winter conditions. We showed earlier that red knot (Calidris canutus islandica) can acclimate to cold by elevating body mass. This goes together with larger pectoral muscles, i.e., greater shivering machinery, and thus, better thermogenic capacity. Here, we present results of a yearlong experiment with indoor captive knots to determine whether this strategy is part of their natural seasonal phenotypic cycle. We maintained birds under three thermal regimes: constant cold (5 °C), constant thermoneutrality (25 °C) and natural seasonal variation between these extremes (9-22 °C). Each month we measured variables related to the birds' endurance to cold and physiological maintenance [body mass, thickness of pectoral muscles, summit metabolic rate (M(sum)), food intake, gizzard size, basal metabolic rate (BMR)]. Birds from all treatments expressed synchronized and comparable variation in body mass in spite of thermal treatments, with a 17-18% increase between the warmest and coldest months of the year; which appeared regulated by an endogenous driver. In addition, birds living in the cold exhibited a 10% higher average body mass than did those maintained at thermoneutrality. Thickness of the pectoral muscle tracked changes in body mass in all treatments and likely contributed to greater capacity for shivering in heavier birds. Consequently, M(sum) was 13% higher in cold-acclimated birds compared to those experiencing no thermoregulation costs. However, our data also suggest that part of maximal heat production comes from nonshivering processes. Birds facing cold conditions ate up to 25% more food than did birds under thermoneutral conditions, yet did not develop larger gizzards. Seasonal variation in BMR followed changes in body mass, probably reflecting changes in mass of

  12. Using focused reflection and articulation to promote clinical reasoning: an evidence-based teaching strategy.

    PubMed

    Murphy, Judy Irene

    2004-01-01

    This research explored the effects of instructing first-semester nursing students in the use of focused reflection and articulation to promote clinical reasoning. Student volunteers were randomly assigned to four clinical groups. Two groups that received instruction in the use of focused reflection and articulation scored significantly higher on the practice measure of clinical reasoning, accounting for 29 percent of the variance between groups. Once clinical reasoning scores were tabulated, the top six and bottom six scorers on clinical reasoning were interviewed to identify qualitative differences between students with different reasoning levels. Themes from the interviews revealed that those with high clinical reasoning reported a high frequency of use of focused reflection and articulation, engaged in abstract learning, and were more self-regulated in their learning than those who scored low on clinical reasoning. This study provides empirical evidence that using instructional methods that focus learners' attention on the concrete application of theory in the practicum setting helps enhance their reasoning skills. PMID:15508561

  13. Reflecting on Research: Self- Monitoring of Blood Glucose among Diabetes Patients Attending Government Health Clinics.

    PubMed

    Mastura, I

    2008-01-01

    This article described the author's reflection on conducting research in primary care. Certainly hand-on experience will give a better learning experience for a person to explore further in research and research training will help too. Conducting a collaborative research with other institutions also help in better research outcome. Research capacity building is important as most patients are seen in primary care. PMID:25606148

  14. Clinging, gripping, holding, containment: Reflections on a survival reflex and the development of a capacity to separate.

    PubMed

    Cavalli, Alessandra

    2014-09-01

    This paper attempts to describe how, in the very first months of extra-uterine life, personality structures are formed around notions of personal space, separateness, attachment and individuation. The contribution of a forgotten Hungarian analyst, Imre Hermann, who wrote about the 'clinging reflex', will be explored in relation to the origin of Bowlby's concept of attachment and Rey's theoretical understanding of personal space. Particular attention will be given to transitions, transitional experiences and the development of a sense of internal space. Vignettes from infant observations will be used to illustrate the theoretical frame of reference. Clinical material from the analysis of a child and an adult patient will be provided to postulate how a distorted perception of personal space and separateness in the first few months of life may affect the capacity to attach and to individuate. PMID:25155677

  15. Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care.

    PubMed

    Michaud, Pierre-André; Blum, Robert Wm; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina

    2015-10-01

    The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel. PMID:26281798

  16. Reflections of physiotherapy students in the United Arab Emirates during their clinical placements: A qualitative study

    PubMed Central

    Larin, Hélène; Wessel, Jean; Al-Shamlan, Amal

    2005-01-01

    Background Although Western models of education are being used to establish health professional programs in non-Western countries, little is known about how students in these countries perceive their learning experiences. The purpose of this qualitative study was to describe the reflections of physiotherapy students from a Middle East culture during their clinical placements and to compare them to reflections of physiotherapy students from a Western culture. Methods Subjects were six senior students (3 females, 3 males, mean age 22.6 years) and 15 junior, female students (mean age 20.1 years) in the baccalaureate physiotherapy program at a university in the United Arab Emirates (UAE). They wrote weekly entries in a journal while in their clinical placements. They described an event, their reaction to it, and how it might affect their future behavior. Two evaluators independently read and coded the content of all the journals, and then worked together to categorize the data and develop themes. A third evaluator, an UAE national, independently read the journals to validate the content analysis. A feedback session with students was used to further validate the data interpretation. The themes were compared to those derived from a similar study of Canadian physiotherapy students. Results The content of the students' reflections were grouped into 4 themes: professional behavior, awareness of learning, self-development and shift to a patient orientation, and identification and analysis of ethical issues. Although the events were different, students from the UAE considered many of the same issues reflected on by Canadian students. Conclusion Physiotherapy students from a Middle East culture consider many of the same issues as students from a Western culture when asked to reflect on their clinical experience. They reflect on their personal growth, on how they learn in a clinical setting, and on the ethical and professional behaviors of themselves and others. PMID:15661079

  17. Diffusing capacities and ventilation: perfusion ratios in patients with the clinical syndrome of alveolar capillary block

    PubMed Central

    Arndt, Hartmut; King, Thomas K. C.; Briscoe, William A.

    1970-01-01

    Studies were performed on 10 patients with the clinical syndrome of alveolar capillary block while each patient was breathing four different inspired oxygen mixtures. The data were interpreted using the principle of the Bohr integral isopleth with which alveolar oxygen tension in the differently ventilated parts of the lung can initially be treated as unknown. It is then possible to determine the distribution of ventilation, of perfusion, of diffusing capacity, of lung volume, and of alveolar and end capillary blood oxygen tension in the variously functioning parts of the lung. In two patients shunts were the major factor interfering with oxygen transfer. In four others inequalities in ventilation: perfusion ratios and in diffusing capacity in different parts of the lung were the factors interfering with oxygen transfer. In four more patients ventilation: perfusion ratios were the same throughout the lung, the only disturbance of oxygen transfer being in the total diffusing capacity or in its distribution between the different parts of the lung. PMID:5411791

  18. Developing a culture to facilitate research capacity building for clinical nurse consultants in generalist paediatric practice.

    PubMed

    Wilkes, Lesley; Cummings, Joanne; McKay, Nicola

    2013-01-01

    This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW), Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT) was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge. PMID:23956854

  19. Portfolio of Clinical Research in Adult Cardiovascular Disease as Reflected in ClinicalTrials.gov

    PubMed Central

    Alexander, Karen P.; Kong, David F.; Starr, Aijing Z.; Kramer, Judith; Chiswell, Karen; Tasneem, Asba; Califf, Robert M.

    2013-01-01

    Background Cardiovascular medicine is widely regarded as a vanguard for evidence‐based drug and technology development. Our goal was to describe the cardiovascular clinical research portfolio from ClinicalTrials.gov. Methods and Results We identified 40 970 clinical research studies registered between 2007 and 2010 in which patients received diagnostic, therapeutic, or other interventions per protocol. By annotating 18 491 descriptors from the National Library of Medicine's Medical Subject Heading thesaurus and 1220 free‐text terms to select those relevant to cardiovascular disease, we identified studies that related to the diagnosis, treatment, or prevention of diseases of the heart and peripheral arteries in adults (n=2325 [66%] included from review of 3503 potential studies). The study intervention involved a drug in 44.6%, a device or procedure in 39.3%, behavioral intervention in 8.1%, and biological or genetic interventions in 3.0% of the trials. More than half of the trials were postmarket approval (phase 4, 25.6%) or not part of drug development (no phase, 34.5%). Nearly half of all studies (46.3%) anticipated enrolling 100 patients or fewer. The majority of studies assessed biomarkers or surrogate outcomes, with just 31.8% reporting a clinical event as a primary outcome. Conclusions Cardiovascular studies registered on ClinicalTrials.gov span a range of study designs. Data have limited verification or standardization and require manual processes to describe and categorize studies. The preponderance of small and late‐phase studies raises questions regarding the strength of evidence likely to be generated by the current portfolio and the potential efficiency to be gained by more research consolidation. PMID:24072529

  20. Does Reflective Learning with Feedback Improve Dental Students' Self-Perceived Competence in Clinical Preparedness?

    PubMed

    Ihm, Jung-Joon; Seo, Deog-Gyu

    2016-02-01

    The value of dental students' self-assessment is often debated. The aim of this study was to explore whether reflective learning with feedback enabled dental students to more accurately assess their self-perceived levels of preparedness on dental competencies. Over 16 weeks, all third- and fourth-year students at a dental school in the Republic of Korea took part in clinical rotations that incorporated reflective learning and feedback. Following this educational intervention, they were asked to assess their perceptions of their clinical competence. The results showed that the students reported feeling most confident about performing periodontal treatment (mean 7.1 on a ten-point scale) and least confident about providing orthodontic care (mean 5.6). The fourth-year students reported feeling more confident on all the competencies than the third-year students. Their self-perceived competence in periodontal treatment and oral medicine significantly predicted the instructors' clinical evaluations. This study offered insights into determining if structured reflective learning with effective feedback helps to increase dental students' self-perceived level of clinical preparedness. PMID:26834135

  1. An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

    PubMed

    McLean, Gillian

    2015-12-01

    CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. PMID:26631520

  2. Clinical Correlation between Placido, Scheimpflug and LED Color Reflection Topographies in Imaging of a Scarred Cornea

    PubMed Central

    Kanellopoulos, Anastasios John; Asimellis, George

    2014-01-01

    This case report aims to evaluate safety, efficacy and feasibility of anterior surface imaging by a novel point-source reflection topographer, in comparison to four other corneal imaging modalities. A 17-year-old female patient, clinically diagnosed with chronic herpetic keratitis in her left eye was imaged by a novel multicolored-spot reflection topography system. We comparatively investigated elevation and curvature maps between the novel topographer and established Placido disk topography and Scheimpflug tomography systems. Pachymetry maps were compared between the Scheimpflug system and anterior-segment optical coherence tomography system. The Placido system failed to properly register the abnormal anterior surface due to incomplete mire registration, while the Scheimpflug topometry device imaged the anterior surface properly, but not the posterior (due to media opacity), and thus pachymetry was highly irregular and erroneous in this case. Imaging of corneas infected with herpes simplex virus keratitis has been rare; we have not identified any such documentation in the peer review literature in the last 10 years. This novel multicolored-spot reflection topography imaging may offer successful corneal imaging in cases where established clinical topography systems may fail to produce accurate reconstruction of the corneal shape. This is an important case demonstrating exceptional clinical feasibility in such rare cases offered by a newly introduced technology in ophthalmic imaging. PMID:25408671

  3. Clinical Correlation between Placido, Scheimpflug and LED Color Reflection Topographies in Imaging of a Scarred Cornea.

    PubMed

    Kanellopoulos, Anastasios John; Asimellis, George

    2014-09-01

    This case report aims to evaluate safety, efficacy and feasibility of anterior surface imaging by a novel point-source reflection topographer, in comparison to four other corneal imaging modalities. A 17-year-old female patient, clinically diagnosed with chronic herpetic keratitis in her left eye was imaged by a novel multicolored-spot reflection topography system. We comparatively investigated elevation and curvature maps between the novel topographer and established Placido disk topography and Scheimpflug tomography systems. Pachymetry maps were compared between the Scheimpflug system and anterior-segment optical coherence tomography system. The Placido system failed to properly register the abnormal anterior surface due to incomplete mire registration, while the Scheimpflug topometry device imaged the anterior surface properly, but not the posterior (due to media opacity), and thus pachymetry was highly irregular and erroneous in this case. Imaging of corneas infected with herpes simplex virus keratitis has been rare; we have not identified any such documentation in the peer review literature in the last 10 years. This novel multicolored-spot reflection topography imaging may offer successful corneal imaging in cases where established clinical topography systems may fail to produce accurate reconstruction of the corneal shape. This is an important case demonstrating exceptional clinical feasibility in such rare cases offered by a newly introduced technology in ophthalmic imaging. PMID:25408671

  4. Does reflective web-based discussion strengthen nursing students' learning experiences during clinical training?

    PubMed

    Mettiäinen, Sari; Vähämaa, Kristiina

    2013-09-01

    The aim of this research was to study how a web-based discussion forum can be used as a supervision tool during nursing students' clinical training. The study emphasises peer support and its importance for the students. The empirical research was carried out at a Finnish university of applied sciences. 25 nursing students took part in web-based discussion during their eight-week clinical training period. All in all, 395 comments were submitted. The material was analysed by using categorisation and a thematic analysis process. Finally, the results were reported using a modified Salmon's (2002) 5-stage model of Teaching and Learning On-line and Mezirow's (1981) levels of reflection. The students motivated each other by sharing their feelings and experiences. They noticed the value of peer support and started to learn from each other as well. By reflecting on their experiences, the students progressed in their learning process and at the same time advanced their reflective thinking process. This combination of theoretical knowledge and practice, based on the students' needs and interests, could lead to a deeper understanding which could also result in better clinical skills. This method offers the lecturers the possibility to support and follow the professional growth process in a new evidence-based manner. PMID:23116619

  5. Virtual Patients in Primary Care: Developing a Reusable Model That Fosters Reflective Practice and Clinical Reasoning

    PubMed Central

    Zary, Nabil; Björklund, Karin; Toth-Pal, Eva; Leanderson, Charlotte

    2014-01-01

    Background Primary care is an integral part of the medical curriculum at Karolinska Institutet, Sweden. It is present at every stage of the students’ education. Virtual patients (VPs) may support learning processes and be a valuable complement in teaching communication skills, patient-centeredness, clinical reasoning, and reflective thinking. Current literature on virtual patients lacks reports on how to design and use virtual patients with a primary care perspective. Objective The objective of this study was to create a model for a virtual patient in primary care that facilitates medical students’ reflective practice and clinical reasoning. The main research question was how to design a virtual patient model with embedded process skills suitable for primary care education. Methods The VP model was developed using the Open Tufts University Sciences Knowledgebase (OpenTUSK) virtual patient system as a prototyping tool. Both the VP model and the case created using the developed model were validated by a group of 10 experienced primary care physicians and then further improved by a work group of faculty involved in the medical program. The students’ opinions on the VP were investigated through focus group interviews with 14 students and the results analyzed using content analysis. Results The VP primary care model was based on a patient-centered model of consultation modified according to the Calgary-Cambridge Guides, and the learning outcomes of the study program in medicine were taken into account. The VP primary care model is based on Kolb’s learning theories and consists of several learning cycles. Each learning cycle includes a didactic inventory and then provides the student with a concrete experience (video, pictures, and other material) and preformulated feedback. The students’ learning process was visualized by requiring the students to expose their clinical reasoning and reflections in-action in every learning cycle. Content analysis of the focus

  6. Novel Paths to Relevance: How Clinical Ethics Committees Promote Ethical Reflection.

    PubMed

    Magelssen, Morten; Pedersen, Reidar; Førde, Reidun

    2016-09-01

    How may clinical ethics committees (CECs) inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, we argue that some novel working methods may be well suited to promote ethical reflection among clinicians, and that the CEC may be a suitable venue for discussing issues of organizational ethics. PMID:26248504

  7. Relationship building in Clinical Pastoral Education: a Confucian reflection from Asian chaplains.

    PubMed

    Kwon, Soo-Young; Le, Anthony Duc

    2004-01-01

    The authors reflect on the intentional model of relationship building in Clinical Pastoral Education (CPE) and its roots in the Western concept of the self as a rational, autonomous, and bounded agent. They compare the Western idea to the Confucian two-dimensional self orientation as relational as well as autonomous, and discuss possible difficulties that Asian students from Confucian background may encounter entering CPE. The chaplains explore implications and suggestions for how CPE supervisors and students may enter into dialogue in order to create mutual understanding and help Asian students translate CPE learning methods into meaningful cultural contexts. PMID:15478954

  8. Innovative acoustic reflection imaging techniques and application to clinical breast tomography

    NASA Astrophysics Data System (ADS)

    Schmidt, Steve P.

    Conventional ultrasound techniques use beam-formed, constant sound speed ray models for fast image reconstruction. However, these techniques are inadequate for the emerging new field of ultrasound tomography (UST). We present a new technique for reconstruction of reflection images from UST data. We have extended the planar Kirchhoff migration method used in geophysics, and combined it with sound speed and attenuation data obtained from the transmission signals to create reflection ultrasound images that are corrected for refractive and attenuative effects. The resulting techniques were applied to simulated numerical phantom data, physical phantom data and in-vivo breast data obtained with an experimental ring transducer prototype. Additionally, the ring transducer was customized to test compatibility with an existing ultrasound workstation. We were able to obtain independently recorded radio-frequency (RF) data for individual transmit-receive pair combinations for all 128 transducers. The signal data was then successfully reconstructed into reflection data using the Kirchhoff migration techniques. The results from the use of sound speed and attenuation corrections lead to significant improvements in image quality, particularly in dense tissues where the refractive and scattering effects are the greatest. The procedure was applied to a variety of breast densities and masses of different natures. The resulting reflection images successfully resolved boundaries and textures. The reflection characteristics of tomographic ultrasound maintain an indispensible position in the quantification of proper mass identification. The results of this project indicate the clinical significance of the invocation of properly compensated Kirchhoff based reconstruction method with the use of sound speed and attenuation parameters for the visualization and classification of masses and tissue.

  9. Building a Long Distance Training Program to Enhance Clinical Cancer Research Capacity in Puerto Rico

    PubMed Central

    Appleyard, Caroline B.; Antonia, Scott J.; Sullivan, Daniel M.; Santiago-Cardona, Pedro G.; Cáceres, William; Velez, Hector; Torres-Ruiz, Jose A.; Wright, Kenneth L.

    2015-01-01

    Barriers persist in the development and delivery of effective cancer therapies to under-represented minority populations. In Puerto Rico, cancer is the second leading cause of death, yet cancer research awareness and training opportunities remain somewhat limited on the island. These limitations hinder progress toward decreasing the cancer health disparities that exist within the Puerto Rican population. The predominantly Hispanic population of Puerto Rico is the focus of a partnership between the Ponce Health Sciences University-Medical School and Ponce Research Institute (PHSU) in Ponce, Puerto Rico and the H. Lee Moffitt Cancer Center in Tampa, Florida. The Partnership goals are to reduce these barriers through an integrated, multipronged approach of training and education alongside outreach and research components. This report describes the approaches, successes and challenges of enhancing clinical cancer research capacity on the island and the unique challenges of a partnership between two institutes physically separated by long distances. Once fully developed this model may be exportable to other Latin American countries where the need is even greater. PMID:25626061

  10. STRENGTHENING THE REFLECTIVE FUNCTIONING CAPACITIES OF PARENTS WHO HAVE A CHILD WITH A NEURODEVELOPMENTAL DISABILITY THROUGH A BRIEF, RELATIONSHIP-FOCUSED INTERVENTION.

    PubMed

    Sealy, Julie; Glovinsky, Ira P

    2016-01-01

    This randomized controlled trial examined the reflective functioning capacities of caregivers who have a child with a neurodevelopmental disorder between the ages of 2 years 0 months and 6 years 11 months. Children with a neurodevelopmental disorder receive a range of diagnoses, including sutism; however, they all exhibit social communication challenges that can derail social relationships. Forty parent-child dyads in Barbados were randomly assigned to either a developmental individual-difference, relationship-based/floortime(DIR/FT) group (n = 20), or a psychoeducational (wait-list) group (n = 20) with parental reflective functioning measured before and after a 12-week DIR/FT treatment intervention. Results revealed significant gains in parental reflective functioning in the treatment group, as compared to the psychoeducational (wait-list) group, after the 12-week relationship-focused intervention. PMID:26891621

  11. Individual differences in working memory capacity are reflected in different ERP and EEG patterns to task difficulty.

    PubMed

    Dong, Shanshan; Reder, Lynne M; Yao, Yuan; Liu, Yuqiu; Chen, Feiyan

    2015-08-01

    This study examined whether there are neural markers of individual differences in working memory (WM) capacity and whether these differences are only manifest when performing a demanding WM task or at all levels of difficulty. Each subject's WM capacity was estimated using a modified digit span task prior to participation in an N-back task that varied difficulty from 1- to 4-back. While performing the N-back task, subjects wore scalp electrodes that allowed measurement of both event-related potentials (ERP) and event-related synchronization and desynchronization (ERS/ERD). Those subjects classified as low WM were more affected by the higher cognitive demands (many more errors in the 4-back task and generally slower responses) than those classified as high WM. These behavioral differences between the two groups were also apparent in the neural markers. Specifically, low WM subjects, when compared with high WM subjects, produced smaller P300 amplitudes and theta ERS, as well as greater alpha ERD at the most difficult level. Importantly, the observed differences in electrophysiological responses between the two groups were also observed at the lowest difficulty level, not just when the task challenged WM capacity. In addition, P300 amplitudes and alpha ERD responses were found to correlate with individual WM capacities independent of the task difficulty. These results suggest that there are qualitative neural differences among individuals with different WM capacities when approaching cognitive operations. Individuals with high WM capacities may make more efficient use of neural resources to keep their attention focused on the task-relevant information when performing cognitive tasks. PMID:25976774

  12. Capacity Building in Southern Africa: Experiences and Reflections--Towards Joint Knowledge Production and Social Change in International Development Cooperation

    ERIC Educational Resources Information Center

    Zeelen, Jacques; van der Linden, Josje

    2009-01-01

    The intent of capacity building in international development cooperation is to enable people to control their own development. Important premises are ownership, choice and self-esteem. The authors analyse the dynamics of the enabling process in practice, based on their own experiences working for several years in universities in developing…

  13. A Model for Strengthening Collaborative Research Capacity: Illustrations from the Atlanta Clinical Translational Science Institute

    ERIC Educational Resources Information Center

    Rodgers, Kirsten C.; Akintobi, Tabia; Thompson, Winifred Wilkins; Evans, Donoria; Escoffery, Cam; Kegler, Michelle C.

    2014-01-01

    Introduction: Community-engaged research is effective in addressing health disparities but may present challenges for both academic institutions and community partners. Therefore, the need to build capacity for conducting collaborative research exists. The purpose of this study is to present a model for building research capacity in…

  14. Melanocytic nevi with special features: clinical-dermoscopic and reflectance confocal microscopic-findings.

    PubMed

    Larre Borges, A; Zalaudek, I; Longo, C; Dufrechou, L; Argenziano, G; Lallas, A; Piana, S; Moscarella, E

    2014-07-01

    Histopathology is considered the 'gold' standard for the diagnosis and classification of melanocytic nevi, but the widespread use of in vivo diagnostic technologies such as dermoscopy and reflectance confocal microscopy (RCM), has enriched profoundly the knowledge regarding the morphological variability in nevi. This is because most morphological observations made via these in vivo tools are closely correlated with features seen in histopathology. Dermoscopy has allowed for a more detailed classification of nevi. As such, dermoscopy identifies four main morphologic groups (i.e. globular, reticular, starburst and structureless blue nevi), one group of nevi located at special body sites (i.e. face, acral, nail) and one group of nevi with special features. This latter category consists of nevi of the former categories, which are typified by peculiar clinical-histopathological findings. They can be subdivided into 'melanoma simulators' including combined nevi, recurrent nevi and sclerosing nevus with pseudomelanomatous features, 'targetoid' nevi (i.e. halo, cockade, irritated targetoid haemosiderotic and eczematous nevus) and uncommon histopathological variants such as desmoplastic, white dysplastic or ballon cell nevus. While the dermoscopic and RCM patterns of the former categories have been studied in detail, little is currently known about the clinical morphology of the heterogeneous group of 'special' nevi. In this article, we describe the clinical, dermoscopic and RCM features of 'special' nevi and review the current literature on this group of melanocytic proliferations. PMID:24171788

  15. Non-invasive detection of periodontal disease using diffuse reflectance spectroscopy: a clinical study

    NASA Astrophysics Data System (ADS)

    Prasanth, Chandra Sekhar; Betsy, Joseph; Subhash, Narayanan; Jayanthi, Jayaraj L.; Prasanthila, Janam

    2012-03-01

    In clinical diagnostic procedures, gingival inflammation is considered as the initial stage of periodontal breakdown. This is often detected clinically by bleeding on probing as it is an objective measure of inflammation. Since conventional diagnostic procedures have several inherent drawbacks, development of novel non-invasive diagnostic techniques assumes significance. This clinical study was carried out in 15 healthy volunteers and 25 patients to demonstrate the applicability of diffuse reflectance (DR) spectroscopy for quantification and discrimination of various stages of inflammatory conditions in periodontal disease. The DR spectra of diseased lesions recorded using a point monitoring system consisting of a tungsten halogen lamp and a fiber-optic spectrometer showed oxygenated hemoglobin absorption dips at 545 and 575 nm. Mean DR spectra on normalization shows marked differences between healthy and different stages of gingival inflammation. Among the various DR intensity ratios investigated, involving oxy Hb absorption peaks, the R620/R575 ratio was found to be a good parameter of gingival inflammation. In order to screen the entire diseased area and its surroundings instantaneously, DR images were recorded with an EMCCD camera at 620 and 575 nm. We have observed that using the DR image intensity ratio R620/R575 mild inflammatory tissues could be discriminated from healthy with a sensitivity of 92% and specificity of 93%, and from moderate with a sensitivity of 83% and specificity of 96%. The sensitivity and specificity obtained between moderate and severe inflammation are 82% and 76% respectively.

  16. Reflective THz and MR imaging of burn wounds: a potential clinical validation of THz contrast mechanisms

    NASA Astrophysics Data System (ADS)

    Bajwa, Neha; Nowroozi, Bryan; Sung, Shijun; Garritano, James; Maccabi, Ashkan; Tewari, Priyamvada; Culjat, Martin; Singh, Rahul; Alger, Jeffry; Grundfest, Warren; Taylor, Zachary

    2012-10-01

    Terahertz (THz) imaging is an expanding area of research in the field of medical imaging due to its high sensitivity to changes in tissue water content. Previously reported in vivo rat studies demonstrate that spatially resolved hydration mapping with THz illumination can be used to rapidly and accurately detect fluid shifts following induction of burns and provide highly resolved spatial and temporal characterization of edematous tissue. THz imagery of partial and full thickness burn wounds acquired by our group correlate well with burn severity and suggest that hydration gradients are responsible for the observed contrast. This research aims to confirm the dominant contrast mechanism of THz burn imaging using a clinically accepted diagnostic method that relies on tissue water content for contrast generation to support the translation of this technology to clinical application. The hydration contrast sensing capabilities of magnetic resonance imaging (MRI), specifically T2 relaxation times and proton density values N(H), are well established and provide measures of mobile water content, lending MRI as a suitable method to validate hydration states of skin burns. This paper presents correlational studies performed with MR imaging of ex vivo porcine skin that confirm tissue hydration as the principal sensing mechanism in THz burn imaging. Insights from this preliminary research will be used to lay the groundwork for future, parallel MRI and THz imaging of in vivo rat models to further substantiate the clinical efficacy of reflective THz imaging in burn wound care.

  17. Experimental and clinical evaluation of a noninvasive reflectance pulse oximeter sensor.

    PubMed

    Takatani, S; Davies, C; Sakakibara, N; Zurick, A; Kraenzler, E; Golding, L R; Noon, G P; Nose, Y; DeBakey, M E

    1992-10-01

    The objective of this study was to evaluate a new reflectance pulse oximeter sensor. The prototype sensor consists of 8 light-emitting diode (LED) chips (4 at 665 nm and 4 at 820 nm) and a photodiode chip mounted on a single substrate. The 4 LED chips for each wavelength are spaced at 90-degree intervals around the substrate and at an equal radial distance from the photodiode chip. An optical barrier between the photodiode and LED chips prevents a direct coupling effect between them. Near-infrared LEDs (940 nm) in the sensor warm the tissue. The microthermocouple mounted on the sensor surface measures the temperature of the skin-sensor interface and maintains it at a present level by servoregulating the current in the 940-nm LEDs. An animal study and a clinical study were performed. In the animal study, 5 mongrel dogs (weight, 10-20 kg) were anesthetized, mechanically ventilated, and cannulated. In each animal, arterial oxygen saturation (SaO2) was measured continuously by a standard transmission oximeter probe placed on the dog's earlobe and a reflectance oximeter sensor placed on the dog's tongue. In the first phase of the experiment, signals from the reflectance sensor were recorded while the dog was immersed in ice water until its body temperature decreased to 30 degrees C. In the second phase, the animal's body temperature was normal, and the oxygen content of the ventilator was varied to alter the SaO2. In the clinical study, 18 critically ill patients were monitored perioperatively with the prototype reflectance sensor. The first phase of the study investigated the relationship between local skin temperature and the accuracy of oximeter readings with the reflectance sensor. Each measurement was taken at a high saturation level as a function of local skin temperature. The second phase of the study compared measurements of oxygen saturation by a reflectance oximeter (SpO2[r]) with those made by a co-oximeter (SaO2[IL]) and a standard transmission oximeter (Sp

  18. Light-induced autofluorescence and diffuse reflectance spectroscopy in clinical diagnosis of skin cancer

    NASA Astrophysics Data System (ADS)

    Borisova, E.; Pavlova, E.; Kundurjiev, T.; Troyanova, P.; Genova, Ts.; Avramov, L.

    2014-05-01

    We investigated more than 500 clinical cases to receive the spectral properties of basal cell (136 patients) and squamous cell carcinoma (28), malignant melanoma (41) and different cutaneous dysplastic and benign cutaneous lesions. Excitation at 365, 385 and 405 nm using LEDs sources is applied to obtain autofluorescence spectra, and broad-band illumination in the region of 400-900 nm is used to detect diffuse reflectance spectra of all pathologies investigated. USB4000 microspectrometer (Ocean Optics Inc, USA) is applied as a detector and fiber-optic probe is used for delivery of the light. In the case of in vivo tumor measurements spectral shape and intensity changes are observed that are specific for a given type of lesion. Autofluorescence origins of the signals coming from skin tissues are mainly due to proteins, such as collagen, elastin, keratin, their cross-links, co-enzimes - NADH and flavins and endogenous porphyrins. Spectral features significant into diffuse spectroscopy diagnosis are related to the effects of re-absorption of hemoglobin and its forms, as well as melanin and its concentration in different pathologies. We developed significant database and revealed specific features for a large class of cutaneous neoplasia, using about 30 different spectral peculiarities to differentiate cutaneous tumors. Sensitivity and specificity obtained exceed 90%, which make optical biopsy very useful tool for clinical practice. These results are obtained in the frames of clinical investigations for development of significant "spectral features" database for the most common cutaneous malignant, dysplastic and benign lesions. In the forthcoming plans, our group tries to optimize the existing experimental system for optical biopsy of skin, and to introduce it and the diagnostic algorithms developed into clinical practice, based on the high diagnostic accuracy achieved.

  19. Improving service delivery by evaluation of the referral pattern and capacity in a clinical genetics setting.

    PubMed

    McCann, Emma; Baines, Elizabeth A; Gray, Jonathon R; Procter, Annie M

    2009-08-15

    Quality improvement in specialist services such as clinical genetics is challenging largely due to the complexity of the service and the difficulty in obtaining accurate, reproducible, and measurable data. The objectives were to evaluate the pattern of referrals to the All Wales Medical Genetics Service (AWMGS) North Wales Genetics team based in three separate hospitals, define the capacity of the team and implement change to improve equity, timeliness and efficiency of care delivery to patients. The methodology required collating the monthly referral rates retrospectively for each center over a 2.5-year period and plotting on statistical process control charts. Process mapping of the referral process in each center was undertaken, differences documented and a common pathway implemented. "Did not attend" and "time to first appointment" rates were also measured in one center. PDSA methodology was used to implement "patient focused booking." The results show that the range for referral rates in any given month for each center was 3-33 referrals. The range for referral rate for the whole team was 18-64 per month. Since January 2004 the average number of monthly referrals to the North Wales service has increased by 50%. The potential range in monthly referrals varies between centers and the range of the variability has also increased also in two out of the three centers. Introduction of Patient Focused Booking reduced the "Failed to Attend" rate and 100% of patients were offered a choice of appointments. In addition 100% had a first face-to-face contact within 6 weeks if they chose. The measurement of improvement involved firstly introducing a series of continuous measures to provide a baseline for the process prior to the implementation of any changes and secondly to indicate the impact of the changes following implementation. The measures implemented included process (referrals numbers, percentage of patients offered a choice of appointments), outcome (percentage of

  20. Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience

    NASA Astrophysics Data System (ADS)

    Flores, Eileen S.; Cordova, Miguel; Kose, Kivanc; Phillips, William; Rossi, Anthony; Nehal, Kishwer; Rajadhyaksha, Milind

    2015-06-01

    Mohs surgery for the removal of nonmelanoma skin cancers (NMSCs) is performed in stages, while being guided by the examination for residual tumor with frozen pathology. However, preparation of frozen pathology at each stage is time consuming and labor intensive. Real-time intraoperative reflectance confocal microscopy (RCM), combined with video mosaicking, may enable rapid detection of residual tumor directly in the surgical wounds on patients. We report our initial experience on 25 patients, using aluminum chloride for nuclear contrast. Imaging was performed in quadrants in the wound to simulate the Mohs surgeon's examination of pathology. Images and videos of the epidermal and dermal margins were found to be of clinically acceptable quality. Bright nuclear morphology was identified at the epidermal margin and detectable in residual NMSC tumors. The presence of residual tumor and normal skin features could be detected in the peripheral and deep dermal margins. Intraoperative RCM imaging may enable detection of residual tumor directly on patients during Mohs surgery, and may serve as an adjunct for frozen pathology. Ultimately, for routine clinical utility, a stronger tumor-to-dermis contrast may be necessary, and also a smaller microscope with an automated approach for imaging in the entire wound in a rapid and controlled manner.

  1. Reproductive options for prospective parents in families with Huntington's disease: clinical, psychological and ethical reflections.

    PubMed

    de Die-Smulders, C E M; de Wert, G M W R; Liebaers, I; Tibben, A; Evers-Kiebooms, G

    2013-01-01

    BACKGROUND Huntington's disease (HD) is an autosomal dominant neurodegenerative late onset disorder. This review of reproductive options aims to increase reproductive confidence and to prevent suffering in relation to family planning around HD and possibly other late onset neurodegenerative disorders. METHODS Selected relevant literature and own views and experiences as clinical geneticists, psychologists and ethicists have been used. RESULTS Possible options, with emphasis on prenatal diagnosis (PD) and preimplantation genetic diagnosis (PGD) to prevent the transmission of HD to the next generation, are described and discussed. They are formally presented in a decision tree, taking into account the presence or absence of a fully penetrant allele (FPA), a reduced penetrant allele (RPA) or an intermediate allele (IA). A table compares invasive and non-invasive PD and PGD. From a psychological perspective, the complex process of counselling and decision-making regarding reproductive options is discussed. Special attention is paid to the decision to avoid the transmission of the mutation and to the confrontation and coping of a mutation-free child growing up with a parent developing disease symptoms. From an ethical point of view, reflections on both PD and PGD are brought forward taking into account the difference between FPA, RPA and IA, direct testing or exclusion testing and taking into account the welfare of the child in the context of medically assisted reproduction. CONCLUSION Recommendations and suggestions for good clinical practice in the reproductive care for HD families are formulated. PMID:23377865

  2. Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience

    PubMed Central

    Flores, Eileen S.; Cordova, Miguel; Kose, Kivanc; Phillips, William; Rossi, Anthony; Nehal, Kishwer; Rajadhyaksha, Milind

    2015-01-01

    Abstract. Mohs surgery for the removal of nonmelanoma skin cancers (NMSCs) is performed in stages, while being guided by the examination for residual tumor with frozen pathology. However, preparation of frozen pathology at each stage is time consuming and labor intensive. Real-time intraoperative reflectance confocal microscopy (RCM), combined with video mosaicking, may enable rapid detection of residual tumor directly in the surgical wounds on patients. We report our initial experience on 25 patients, using aluminum chloride for nuclear contrast. Imaging was performed in quadrants in the wound to simulate the Mohs surgeon’s examination of pathology. Images and videos of the epidermal and dermal margins were found to be of clinically acceptable quality. Bright nuclear morphology was identified at the epidermal margin and detectable in residual NMSC tumors. The presence of residual tumor and normal skin features could be detected in the peripheral and deep dermal margins. Intraoperative RCM imaging may enable detection of residual tumor directly on patients during Mohs surgery, and may serve as an adjunct for frozen pathology. Ultimately, for routine clinical utility, a stronger tumor-to-dermis contrast may be necessary, and also a smaller microscope with an automated approach for imaging in the entire wound in a rapid and controlled manner. PMID:25706821

  3. The Development of a Scale to Assess Practitioner Capacity to Engage in Clinical Education

    ERIC Educational Resources Information Center

    Abey, Sally; Lea, Susan; Callaghan, Lynne; Cotton, Debby; Shaw, Steve

    2015-01-01

    Clinical educators play an important role in the development of clinical skills during health care undergraduates' practice placements. The supportiveness of the learning environment and the attitude of the clinical educator towards student development are considered to be important factors that impact upon practice placement experience,…

  4. The clinical effectiveness of reflectance optical spectroscopy for the in vivo diagnosis of oral lesions.

    PubMed

    Messadi, Diana V; Younai, Fariba S; Liu, Hong-Hu; Guo, Gao; Wang, Cun-Yu

    2014-09-01

    Optical spectroscopy devices are being developed and tested for the screening and diagnosis of oral precancer and cancer lesions. This study reports a device that uses white light for detection of suspicious lesions and green-amber light at 545 nm that detect tissue vascularity on patients with several suspicious oral lesions. The clinical grading of vascularity was compared to the histological grading of the biopsied lesions using specific biomarkers. Such a device, in the hands of dentists and other health professionals, could greatly increase the number of oral cancerous lesions detected in early phase. The purpose of this study is to correlate the clinical grading of tissue vascularity in several oral suspicious lesions using the Identafi(®) system with the histological grading of the biopsied lesions using specific vascular markers. Twenty-one patients with various oral lesions were enrolled in the study. The lesions were visualized using Identafi(®) device with white light illumination, followed by visualization of tissue autofluorescence and tissue reflectance. Tissue biopsied was obtained from the all lesions and both histopathological and immunohistochemical studies using a vascular endothelial biomarker (CD34) were performed on these tissue samples. The clinical vascular grading using the green-amber light at 545 nm and the expression pattern and intensity of staining for CD34 in the different biopsies varied depending on lesions, grading ranged from 1 to 3. The increase in vascularity was observed in abnormal tissues when compared to normal mucosa, but this increase was not limited to carcinoma only as hyperkeratosis and other oral diseases, such as lichen planus, also showed increase in vascularity. Optical spectroscopy is a promising technology for the detection of oral mucosal abnormalities; however, further investigations with a larger population group is required to evaluate the usefulness of these devices in differentiating benign lesions from

  5. The clinical effectiveness of reflectance optical spectroscopy for the in vivo diagnosis of oral lesions

    PubMed Central

    Messadi, Diana V; Younai, Fariba S; Liu, Hong-Hu; Guo, Gao; Wang, Cun-Yu

    2014-01-01

    Optical spectroscopy devices are being developed and tested for the screening and diagnosis of oral precancer and cancer lesions. This study reports a device that uses white light for detection of suspicious lesions and green–amber light at 545 nm that detect tissue vascularity on patients with several suspicious oral lesions. The clinical grading of vascularity was compared to the histological grading of the biopsied lesions using specific biomarkers. Such a device, in the hands of dentists and other health professionals, could greatly increase the number of oral cancerous lesions detected in early phase. The purpose of this study is to correlate the clinical grading of tissue vascularity in several oral suspicious lesions using the Identafi® system with the histological grading of the biopsied lesions using specific vascular markers. Twenty-one patients with various oral lesions were enrolled in the study. The lesions were visualized using Identafi® device with white light illumination, followed by visualization of tissue autofluorescence and tissue reflectance. Tissue biopsied was obtained from the all lesions and both histopathological and immunohistochemical studies using a vascular endothelial biomarker (CD34) were performed on these tissue samples. The clinical vascular grading using the green–amber light at 545 nm and the expression pattern and intensity of staining for CD34 in the different biopsies varied depending on lesions, grading ranged from 1 to 3. The increase in vascularity was observed in abnormal tissues when compared to normal mucosa, but this increase was not limited to carcinoma only as hyperkeratosis and other oral diseases, such as lichen planus, also showed increase in vascularity. Optical spectroscopy is a promising technology for the detection of oral mucosal abnormalities; however, further investigations with a larger population group is required to evaluate the usefulness of these devices in differentiating benign lesions

  6. Evaluating the Use of Reflective Practice in a Nonprofessional, Undergraduate Clinical Communication Skills Course

    ERIC Educational Resources Information Center

    Beveridge, Tyler S.; Fruchter, Lauren L.; Sanmartin, Cleo V.; deLottinville, Carl B.

    2014-01-01

    Recent studies suggest that the quality of reflective practice being achieved in educational settings is inadequate. Our study aims to determine the level of reflection present in written student reflections in a nonprofessional undergraduate course. We also seek to explore student and instructor perspectives on the value of reflective practices.…

  7. The human capacity to reflect and decide: bioethics and the reconfiguration of the research subject in the British biomedical sciences.

    PubMed

    Reubi, David

    2012-06-01

    This article examines how a fundamental element of the British bioethical assemblage - the literature on informed consent published between 1980 and 2000, a period when bioethics became a powerful force in the UK--has influenced contemporary understandings of the research subject. Drawing on Foucault, the article argues that this corpus of texts has created a sphere of possibilities in which research subjects can imagine themselves as human beings who reflect and decide whether they want to participate in medical experimentation. In particular, it shows how the narratives found in these texts portray relationships between researchers and their human subjects as 'paternalistic', and calls for their replacement by new, more ethical relationships characterized by both 'dialogue' and 'respect' and articulated around subjects who can 'think and take decisions'. It also discusses the different strategies- using patient information sheets, a list of possible questions and invitations to take time to reflect--which the bioethical literature has developed in order to realise these new, ethical relationships. As the article suggests, these narratives and strategies provide researchers and research subjects with models and examples of how to interact with each other that are very different from the ones that prevailed before the emergence of bioethics. PMID:23035387

  8. Salivary pH and Buffering Capacity as Risk Markers for Early Childhood Caries: A Clinical Study

    PubMed Central

    Ganesan, S

    2015-01-01

    ABSTRACT Background: The diagnostic utility of saliva is currently being explored in various branches of dentistry, remarkably in the field of caries research. This study was aimed to determine if assessment of salivary pH and buffering capacity would serve as reliable tools in risk prediction of early childhood caries (ECC). Materials and methods: Paraffin-stimulated salivary samples were collected from 50 children with ECC (group I) and 50 caries free children (group II). Salivary pH and buffering capacity (by titration with 0.1 N hydrochloric acid) were assessed using a handheld digital pH meter in both groups. The data obtained were subjected to statistical analysis. Results: Statistically, no significant difference was observed between both the groups for all salivary parameters assessed, except for the buffering capacity level at 150 μl titration of 0.1 N hydrochloric acid (p = 0.73; significant at 1% level). Conclusion: Salivary pH and buffering capacity may not serve as reliable markers for risk prediction of ECC. How to cite this article: Jayaraj D, Ganesan S. Salivary pH and Buffering Capacity as Risk Markers for Early Childhood Caries: A Clinical Study. Int J Clin Pediatr Dent 2015;8(3):167-171. PMID:26628849

  9. Biased Recognition of Facial Affect in Patients with Major Depressive Disorder Reflects Clinical State

    PubMed Central

    Münkler, Paula; Rothkirch, Marcus; Dalati, Yasmin; Schmack, Katharina; Sterzer, Philipp

    2015-01-01

    Cognitive theories of depression posit that perception is negatively biased in depressive disorder. Previous studies have provided empirical evidence for this notion, but left open the question whether the negative perceptual bias reflects a stable trait or the current depressive state. Here we investigated the stability of negatively biased perception over time. Emotion perception was examined in patients with major depressive disorder (MDD) and healthy control participants in two experiments. In the first experiment subjective biases in the recognition of facial emotional expressions were assessed. Participants were presented with faces that were morphed between sad and neutral and happy expressions and had to decide whether the face was sad or happy. The second experiment assessed automatic emotion processing by measuring the potency of emotional faces to gain access to awareness using interocular suppression. A follow-up investigation using the same tests was performed three months later. In the emotion recognition task, patients with major depression showed a shift in the criterion for the differentiation between sad and happy faces: In comparison to healthy controls, patients with MDD required a greater intensity of the happy expression to recognize a face as happy. After three months, this negative perceptual bias was reduced in comparison to the control group. The reduction in negative perceptual bias correlated with the reduction of depressive symptoms. In contrast to previous work, we found no evidence for preferential access to awareness of sad vs. happy faces. Taken together, our results indicate that MDD-related perceptual biases in emotion recognition reflect the current clinical state rather than a stable depressive trait. PMID:26039710

  10. Biased recognition of facial affect in patients with major depressive disorder reflects clinical state.

    PubMed

    Münkler, Paula; Rothkirch, Marcus; Dalati, Yasmin; Schmack, Katharina; Sterzer, Philipp

    2015-01-01

    Cognitive theories of depression posit that perception is negatively biased in depressive disorder. Previous studies have provided empirical evidence for this notion, but left open the question whether the negative perceptual bias reflects a stable trait or the current depressive state. Here we investigated the stability of negatively biased perception over time. Emotion perception was examined in patients with major depressive disorder (MDD) and healthy control participants in two experiments. In the first experiment subjective biases in the recognition of facial emotional expressions were assessed. Participants were presented with faces that were morphed between sad and neutral and happy expressions and had to decide whether the face was sad or happy. The second experiment assessed automatic emotion processing by measuring the potency of emotional faces to gain access to awareness using interocular suppression. A follow-up investigation using the same tests was performed three months later. In the emotion recognition task, patients with major depression showed a shift in the criterion for the differentiation between sad and happy faces: In comparison to healthy controls, patients with MDD required a greater intensity of the happy expression to recognize a face as happy. After three months, this negative perceptual bias was reduced in comparison to the control group. The reduction in negative perceptual bias correlated with the reduction of depressive symptoms. In contrast to previous work, we found no evidence for preferential access to awareness of sad vs. happy faces. Taken together, our results indicate that MDD-related perceptual biases in emotion recognition reflect the current clinical state rather than a stable depressive trait. PMID:26039710

  11. Does the MUNIX Method Reflect Clinical Dysfunction in Amyotrophic Lateral Sclerosis

    PubMed Central

    Gawel, Malgorzata; Kuzma-Kozakiewicz, Magdalena

    2016-01-01

    Abstract The aim of our study was to assess the usefulness of the MUNIX method in reflecting the clinical dysfunction in patients with amyotrophic lateral sclerosis (ALS), as well as to assess an intra-rater reproducibility of MUNIX. The study group consisted of a total of 15 ALS patients. The mean age of symptoms onset was 55 years, and the mean disease duration was 10 months. The muscle strength and patients’ functional status were assessed according to the Medical Research Council (MRC) and by ALS functional rating scale revised (ALSFRS-R), respectively. The MUNIX was performed in 6 muscles: abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibial anterior (TA), extensor digitorum brevis (EDB), and abductor hallucis (AH), unilaterally, at a less affected side. Both muscle-specific and global MRC and MUNIX scores were calculated. In 11 patients, the study protocol was repeated at least twice every 3 months. An additional testing of the intra-rater reliability was performed at the first visit. There were no significant differences between MUNIX test and re-test values in the APB, ADM, BB, TA, EDB, and AH muscles (P >0.05). The highest variability of the test–retest values was found in the BB muscle (7.53%). Although there was a significant test–retest difference in the global MUNIX score (P = 0.02), the variability of the results was as low as 1.26%. The MUNIX value correlated with the muscle-specific MRC score in ABP, ADM, TA, EDB and AH (P <0.05), and the global MUNIX values correlated with global MRC scores (P <0.05). There was also a significant correlation between the global MUNIX score and the clinical dysfunction measured by the ALSFRS-R scale (P <0.05). The global MUNIX showed a higher monthly decline (4.3%) as compared with ALFRS-R (0.7%) and the MRC global score (0.5%). This study confirms that the MUNIX method is a sensitive, reliable, and accurate tool reflecting both motor dysfunction and disease

  12. The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum

    PubMed Central

    Bosnic-Anticevich, Sinthia; Schneider, Carl R.; Smith, Lorraine

    2016-01-01

    Objective. To determine the effectiveness of integrating reflective practice activities into a second-year undergraduate pharmacy curriculum and their impact on reflective thinking ability. Design. A cross-over design with repeated measures was employed. Newly developed reflective modules based on real hospital and community pharmacy cases were integrated into the second-year pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA), was introduced to enhance self- and peer reflection. Assessment. Student responses (n=214) to the adapted Kember et al1 Reflective Thinking Questionnaire (RTQ) were compared before and after reflective activities were undertaken. Significant improvement in three indicators of reflective thinking was shown after students engaged in reflective activities. Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective thinking capacity of students. Enhancing reflective thinking ability may help students make better informed decisions and clinical judgments, thus improving future practice. PMID:27293232

  13. The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum.

    PubMed

    Tsingos-Lucas, Cherie; Bosnic-Anticevich, Sinthia; Schneider, Carl R; Smith, Lorraine

    2016-05-25

    Objective. To determine the effectiveness of integrating reflective practice activities into a second-year undergraduate pharmacy curriculum and their impact on reflective thinking ability. Design. A cross-over design with repeated measures was employed. Newly developed reflective modules based on real hospital and community pharmacy cases were integrated into the second-year pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA), was introduced to enhance self- and peer reflection. Assessment. Student responses (n=214) to the adapted Kember et al(1) Reflective Thinking Questionnaire (RTQ) were compared before and after reflective activities were undertaken. Significant improvement in three indicators of reflective thinking was shown after students engaged in reflective activities. Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective thinking capacity of students. Enhancing reflective thinking ability may help students make better informed decisions and clinical judgments, thus improving future practice. PMID:27293232

  14. In vivo inflammation mapping of periodontal disease based on diffuse reflectance spectral imaging: a clinical study

    NASA Astrophysics Data System (ADS)

    Prasanth, Chandra Sekhar; Betsy, Joseph; Jayanthi, Jayaraj L.; Nisha, Unni G.; Prasantila, Janam; Subhash, Narayanan

    2013-02-01

    Since conventional techniques using periodontal probes have inherent drawbacks in the diagnosis of different grades of gingival inflammation, development of noninvasive screening devices becomes significant. Diffuse reflectance (DR) spectra recorded with white light illumination is utilized to detect periodontal inflammation from the oxygenated hemoglobin absorption ratio R620/R575. A multispectral imaging system is utilized to record narrow-band DR images at 575 and 620 nm from the anterior sextant of the gingivia of 15 healthy volunteers and 25 patients (N=40). An experienced periodontist assesses the level of gingival inflammation at each site through periodontal probing and assigns diagnosis as healthy, mild, moderate, or severe inflammation. The DR image ratio R620/R575 computed for each pixel (8-μm resolution) from the monochrome images is pseudo-color-mapped to identify gingival inflammation sites. The DR image ratio values at each site are compared with clinical diagnosis to estimate the specificity and sensitivity of the DR imaging technique in inflammation mapping. The high diagnostic accuracy is utilized to detect underlying inflammation in six patients with a previous history of periodontitis.

  15. The Pitfalls of Collegial Coaching: An Analysis of Collegial Coaching in Medical Education and Its Influence on Stimulating Reflection and Performance of Novice Clinical Teachers

    ERIC Educational Resources Information Center

    Truijen, Karin J. P.; van Woerkom, Marianne

    2008-01-01

    Purpose: Competent clinical teachers are essential for clinical teaching. According to the literature, coaching can contribute to improved levels of reflection and better performance of clinical teachers. By engaging in a dialogue about coachee's teaching behaviour, coaches can stimulate reflection of novice teachers. This study aims to gain…

  16. Broadening the "Ports of Entry" for Speech-Language Pathologists: A Relational and Reflective Model for Clinical Supervision

    ERIC Educational Resources Information Center

    Geller, Elaine; Foley, Gilbert M.

    2009-01-01

    Purpose: To offer a framework for clinical supervision in speech-language pathology that embeds a mental health perspective within the study of communication sciences and disorders. Method: Key mental health constructs are examined as to how they are applied in traditional versus relational and reflective supervision models. Comparisons between…

  17. A confirmatory factor analysis of the cognitive capacity screening examination in a clinical sample.

    PubMed

    Anderson, D A; Burton, D B; Parker, J D; Godding, P R

    2001-01-01

    Structured mental status examinations offer several advantages over unstructured mental status examinations; however, few have been subjected to advanced psychometric analysis. Confirmatory factor analysis empirically tests the predictive validity of individual test indices within an a priori methodological framework. With such analysis, one can test hypotheses about the structure of latent variability within a given data set. The purpose of this study was to perform a confirmatory factor analysis of the Cognitive Capacity Screening Examination, the most comprehensive of the brief structured mental status examinations. A confirmatory factor analysis of the Cognitive Capacity Screening Examination (CCSE) was performed by applying LISREL 7 to a sample of 924 male veterans, 409 patients from a chemical dependence treatment program, and 515 individuals from a psychology consultation service. Constructs were derived from previous exploratory analysis of the scale. The results of the confirmatory factor analysis and three indices of model fit support an 11 factor model more complex than that originally formulated for the CCSE. However, three of these factors (digit span with interference, complex mental mathematics, and verbal memory) were more sensitive to impairment than other factors, accounting for over 90% of the CCSE total score variance. Although the CCSE is a more complex test than originally envisioned by its designers, it may not be necessary to give all items on the test. Either a subset of the CCSE items (the CCSE-A) or a relatively brief, informal mental status exam may be adequate for many patients. PMID:11912677

  18. 21 CFR 862.2400 - Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., TLC, or radiochromatogram) for clinical use. 862.2400 Section 862.2400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2400 Densitometer/scanner...

  19. 21 CFR 862.2400 - Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., TLC, or radiochromatogram) for clinical use. 862.2400 Section 862.2400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2400 Densitometer/scanner...

  20. 21 CFR 862.2400 - Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., TLC, or radiochromatogram) for clinical use. 862.2400 Section 862.2400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2400 Densitometer/scanner...

  1. A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students

    PubMed Central

    Heinerichs, Scott; Vela, Luzita I.; Drouin, Joshua M.

    2013-01-01

    Context: Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning. Objective: To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students. Design: Randomized controlled clinical trial. Setting: Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme. Intervention(s): The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period. Main Outcome Measures: Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning. Results: Case presentations were longer (t18.806 = −5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale

  2. They Went, They Saw, They Learned: Medical Students' Reflections on Community Clinic Visits

    ERIC Educational Resources Information Center

    Beylefeld, Adriana A.

    2014-01-01

    Medicine has become a profession with increasing accountability to the needs of society. To meet this need, real-world, community-located experiences and reflection are frequently used to promote students' learning and personal growth. This article reports first-year medical students' reflective writing after visiting a primary…

  3. Teaching Reflective Practice in Practice Settings: Students' Perceptions of Their Clinical Educators

    ERIC Educational Resources Information Center

    Trede, Franziska; Smith, Megan

    2012-01-01

    Reflective practice in practice settings can enhance practice knowledge, self-assessment and lifelong learning, develop future practice capability and professional identity, and critically appraise practice traditions rather than reproduce them. The inherent power imbalance between student and educator runs the risk for the reflective practice…

  4. Teaching Softly in Hard Environments: Meanings of Small-Group Reflective Teaching to Clinical Faculty

    ERIC Educational Resources Information Center

    Whiting, Ellen; Wear, Delese; Aultman, Julie M.; Zupp, Laurie

    2012-01-01

    A vast literature exists on teaching reflection and reflective practice to trainees in small groups, yet with few exceptions the literature does not address the benefits of these interactions to faculty. Like multiculturalism or cultural competency, the literature assumes that faculty have themselves "achieved" these propensities and that trainees…

  5. Bone Marrow Mesenchymal Stromal Cells from Clinical Scale Culture: In Vitro Evaluation of Their Differentiation, Hematopoietic Support, and Immunosuppressive Capacities.

    PubMed

    Fajardo-Orduña, Guadalupe R; Mayani, Héctor; Castro-Manrreza, Marta E; Flores-Figueroa, Eugenia; Flores-Guzmán, Patricia; Arriaga-Pizano, Lourdes; Piña-Sánchez, Patricia; Hernández-Estévez, Erika; Castell-Rodríguez, Andrés E; Chávez-Rueda, Adriana K; Legorreta-Haquet, María V; Santiago-Osorio, Edelmiro; Montesinos, Juan J

    2016-09-01

    The differentiation capacity, hematopoietic support, and immunomodulatory properties of human bone marrow mesenchymal stromal cells (BM-MSCs) make them attractive therapeutic agents for a wide range of diseases. Clinical scale cultures (CSCs) have been used to expand BM-MSCs for their use in cell therapy protocols; however, little is known about the functionality of the expanded cells. The main goal of the present study was to evaluate the functional characteristics of BM-MSCs expanded from CSCs to determine the quality of the cells for cellular therapy protocols. To address this issue, we analyzed the morphology, immunophenotype, differentiation potential (adipogenic, osteogenic and chondrogenic), hematopoietic support, and immunosuppressive capacity of BM-MSCs from short scale cultures (SSCs) and CSCs in a comparative manner. After 12 days of culture in CSCs (HYPERFlask System), BM-MSCs reached cell numbers of 125.52 × 10(6) ± 25.6 × 10(6) MSCs, which corresponded to the number of cells required for transplantation (∼1.7 × 10(6) MSCs/kg for a 70-kg patient). After expansion, BM-MSCs expressed the characteristic markers CD73, CD90, and CD105; however, expansion decreased their differentiation capacity toward the adipogenic, osteogenic, and chondrogenic lineages and their ability to inhibit T-cell proliferation compared with SSCs-MSCs. Importantly, CSCs-MSCs maintained the ability to support the proliferation and expansion of hematopoietic progenitor cells and the capacity to express the molecules, cytokines, and extracellular matrix proteins involved in the regulation of hematopoiesis. Our study highlights the need to evaluate the functional properties of the expanded BM-MSCs for verification of their quality for cell therapy protocols. PMID:27462977

  6. First Clinical Experience with a High-Capacity Implantable Infusion Pump for Continuous Intravenous Chemotherapy

    SciTech Connect

    Damascelli, Bruno; Patelli, Gianluigi; Frigerio, Laura F.; Lanocita, Rodolfo; Di Tolla, Giuseppe; Marchiano, Alfonso; Spreafico, Carlo; Garbagnati, Francesco; Bonalumi, Maria G.; Monfardini, Lorenzo; Ticha, Vladimira; Prino, Aurelio

    1999-01-15

    Purpose: To evaluate the efficiency of a new high-capacity pump for systemic venous chemotherapy and to verify the quality of implantation by interventional radiology staff. Methods: A total of 47 infusion pumps with a 60-ml reservoir and variable flow rates (2, 6, 8, or 12 ml/24 hr) were implanted by radiologists in 46 patients with solid tumor metastases requiring treatment with a single, continuously infused cytostatic agent. The reservoir was refilled transcutaneously, usually once weekly. The flow accuracy of the pump was assessed from actual drug delivery recorded on 34 patients over a minimum observation period of 180 days. Results: No early complications occurred in any of the 47 implants in 46 patients. A total of 12 (25.53%) complications occurred between 3 and 24 months after implantation. Seven (14.90%) of these were due to the external design of the pump, while five (10.63%) were related to the central venous catheter. In the 34 patients available for pump evaluation (follow-up of at least 180 days), the system was used for a total of 14,191 days (range 180-911 days, mean 417.38 days), giving an overall complication rate of 0.84 per 1000 days of operation. The mean flow rate accuracy was 90.26%. Conclusion: The new implantable pump showed good flow rate accuracy and reliable operation. The pump-related complications were related to its external design and have now been corrected by appropriate modifications. From a radiologic and surgical viewpoint, the venous implantation procedure is identical to that of conventional vascular access devices and can be performed by radiologists familiar with these techniques. The current limitations lie in the high cost of the pump and, for certain drugs, the short time between refills.

  7. Emergency care capacity in Africa: A clinical and educational initiative in Tanzania

    PubMed Central

    Reynolds, Teri A; Mfinanga, Juma A; Sawe, Hendry R; Runyon, Michael S; Mwafongo, Victor

    2012-01-01

    Even though sub-Saharan Africa faces a disproportionate burden of acute injury and illness, few clinical facilities are configured to take an integrated approach to resuscitation and stabilization. Emergency care is a high-impact and cost-effective form of secondary prevention; disease surveillance at facilities delivering acute and emergency care is essential to guide primary prevention. Barriers to emergency care implementation in the region include limited documentation of the acute disease burden, a lack of consensus on regionally appropriate metrics to facilitate impact evaluation, and the lack of coordinated advocacy for acute disease prevention and emergency care. Despite these challenges, interest in creating dedicated acute care facilities and emergency training programs is rapidly expanding in Africa. We describe one such initiative at Muhimbili National Hospital in Dar es Salaam, with a focus on the development of the emergency medicine residency program. PMID:23254838

  8. Patient-powered research networks: building capacity for conducting patient-centered clinical outcomes research

    PubMed Central

    Daugherty, Sarah E; Wahba, Sarita; Fleurence, Rachael

    2014-01-01

    The Patient-Centered Outcomes Research Institute (PCORI) recently launched PCORnet to establish a single inter-operable multicenter data research network that will support observational research and randomized clinical trials. This paper provides an overview of the patient-powered research networks (PPRNs), networks of patient organizations focused on a particular health condition that are interested in sharing health information and engaging in research. PPRNs will build on their foundation of trust within the patient communities and draw on their expertise, working with participants to identify true patient-centered outcomes and direct a patient-centered research agenda. The PPRNs will overcome common challenges including enrolling a diverse and representative patient population; engaging patients in governance; designing the data infrastructure; sharing data securely while protecting privacy; prioritizing research questions; scaling small networks into a larger network; and identifying pathways to sustainability. PCORnet will be the first distributed research network to bring PCOR to national scale. PMID:24821741

  9. Patient-powered research networks: building capacity for conducting patient-centered clinical outcomes research.

    PubMed

    Daugherty, Sarah E; Wahba, Sarita; Fleurence, Rachael

    2014-01-01

    The Patient-Centered Outcomes Research Institute (PCORI) recently launched PCORnet to establish a single inter-operable multicenter data research network that will support observational research and randomized clinical trials. This paper provides an overview of the patient-powered research networks (PPRNs), networks of patient organizations focused on a particular health condition that are interested in sharing health information and engaging in research. PPRNs will build on their foundation of trust within the patient communities and draw on their expertise, working with participants to identify true patient-centered outcomes and direct a patient-centered research agenda. The PPRNs will overcome common challenges including enrolling a diverse and representative patient population; engaging patients in governance; designing the data infrastructure; sharing data securely while protecting privacy; prioritizing research questions; scaling small networks into a larger network; and identifying pathways to sustainability. PCORnet will be the first distributed research network to bring PCOR to national scale. PMID:24821741

  10. Fostering Dental Students' Academic Achievements and Reflection Skills Through Clinical Peer Assessment and Feedback.

    PubMed

    Tricio, Jorge A; Woolford, Mark J; Escudier, Michael P

    2016-08-01

    Peer assessment is increasingly being encouraged to enhance dental students' learning. The aim of this study was to evaluate the educational impact in terms of academic achievements and reflective thinking of a formative prospective peer assessment and feedback protocol. Volunteer final-year dental students at King's College London Dental Institute, UK, received training on peer assessment, peer feedback, and self-reflection. At the beginning (baseline) and end (resultant) of the 2012-13 academic year, 86 students (55% of the year group) completed a reflection questionnaire (RQ). Sixty-eight of those students used a modified Direct Observation of Procedural Skills (DOPS) as a framework for peer assessment and peer feedback during a complete academic year. End-of-year, high-stakes examination grades and RQ scores from the participants and nonparticipants were statistically compared. The participants completed 576 peer DOPS. Those 22 students who peer assessed each other ≥10 times exhibited highly statistically significant differences and powerful positive effect sizes in their high-stakes exam grades (p=0.0001, d=0.74) and critical reflection skills (p=0.005, d=1.41) when compared to those who did not assess one another. Furthermore, only the same 22 students showed a statistically significant increase and positive effect size in their critical reflection skills from baseline to resultant (p=0.003, d=1.04). The results of this study suggest that the protocol used has the potential to impact dental students' academic and reflection skills, provided it is practiced in ten or more peer encounters and ensuring peer feedback is provided followed by self-reflection. PMID:27480702

  11. The Vital Capacity Is Vital: Epidemiology and Clinical Significance of the Restrictive Spirometry Pattern.

    PubMed

    Godfrey, Mark S; Jankowich, Matthew D

    2016-01-01

    Epidemiologic research has revealed a substantial portion of the general population with abnormal spirometry results that are characterized by decreased FEV1 and FVC but a preserved FEV1/FVC ratio. This restrictive spirometry pattern (RSP) is inconsistently defined in the literature and not well addressed by current guidelines; there is an accumulating body of evidence, however, that RSP is prevalent to a similar degree as airflow obstruction. Genetic and other risk factors for RSP, such as inhalational injuries and early life exposures, continue to be actively described. Although it seems that RSP is closely associated with the metabolic syndrome, diabetes, and systemic inflammation, it is not a simple marker of obesity. RSP is associated with adverse cardiovascular outcomes, as well as mortality, and it may be an underappreciated cause of functional impairments and respiratory symptoms. Improvement in outcomes in this population will require that clinicians have an appreciation for the significance of this spirometry pattern; additional research into the clinical and radiologic phenotype of these subjects is also needed. This article provides an overview of the recent developments in our understanding of this prevalent and highly morbid spirometry pattern. PMID:26356330

  12. Peer Assisted Learning and Blogging: A Strategy to Promote Reflective Practice during Clinical Fieldwork

    ERIC Educational Resources Information Center

    Ladyshewsky, Richard K.; Gardner, Peter

    2008-01-01

    The use of peer assisted learning in clinical education is explored in this case study. Groups of undergraduate physiotherapy students were structured into communities of practice during the second half of their clinical fieldwork program. They collaborated online in an asynchronous manner, using information communications technology (blogs) and…

  13. Clinical Teacher Education: Reflections from an Urban Professional Development School Network. Readings in Educational Thought

    ERIC Educational Resources Information Center

    Bohan, Chara Haeussler, Ed.; Many, Joyce E., Ed.

    2011-01-01

    Clinical Teacher Education focuses on how to build a school-university partnership network for clinical teacher education in urban school systems serving culturally and linguistically diverse populations. The labor intensive nature of professional development school work has resulted in research institutions being slow to fully adopt a clinical…

  14. Measurements of functional residual capacity during intensive care treatment: the technical aspects and its possible clinical applications.

    PubMed

    Heinze, H; Eichler, W

    2009-10-01

    Direct measurement of lung volume, i.e. functional residual capacity (FRC) has been recommended for monitoring during mechanical ventilation. Mostly due to technical reasons, FRC measurements have not become a routine monitoring tool, but promising techniques have been presented. We performed a literature search of studies with the key words 'functional residual capacity' or 'end expiratory lung volume' and summarize the physiology and patho-physiology of FRC measurements in ventilated patients, describe the existing techniques for bedside measurement, and provide an overview of the clinical questions that can be addressed using an FRC assessment. The wash-in or wash-out of a tracer gas in a multiple breath maneuver seems to be best applicable at bedside, and promising techniques for nitrogen or oxygen wash-in/wash-out with reasonable accuracy and repeatability have been presented. Studies in ventilated patients demonstrate that FRC can easily be measured at bedside during various clinical settings, including positive end-expiratory pressure optimization, endotracheal suctioning, prone position, and the weaning from mechanical ventilation. Alveolar derecruitment can easily be monitored and improvements of FRC without changes of the ventilatory setting could indicate alveolar recruitment. FRC seems to be insensitive to over-inflation of already inflated alveoli. Growing evidence suggests that FRC measurements, in combination with other parameters such as arterial oxygenation and respiratory compliance, could provide important information on the pulmonary situation in critically ill patients. Further studies are needed to define the exact role of FRC in monitoring and perhaps guiding mechanical ventilation. PMID:19681779

  15. Theory before practice: implicit assumptions about clinical nursing education in Australia as revealed through a shared critical reflection.

    PubMed

    Grealish, Laurie; Smale, Lacey Anne

    2011-08-01

    The transfer of nursing education into the higher education sector occurred over a 10-year period in Australia (1985-1994). Australian nurse leaders settled on a single outcome measure to be applied for all nursing graduates in the form of national competency standards. While this move enabled diversity, the lack of consistency in curriculum design has subsequently led to increasing confusion for clinicians who support students' learning in clinical placements. Using a shared critical reflection method, the authors reviewed (1) the evaluation comments from nurses in one nursing unit of a hospital in one Australian jurisdiction and (2) an historical review of nursing literature at the time of the transfer of nursing education into the higher education sector. The reflection suggests that the aim of the transfer, to create critical thinking graduates, has been undermined by the implicit clinical education practices that have since emerged. In order to address the contemporary challenges for clinical staff working with students from multiple universities, as well as increased student numbers to address the nursing shortage, we recommend a new approach to curriculum design: a national clinical curriculum drawn from social, as well as cognitive, learning theory that at once informs clinicians of students' potential abilities and provides the scope to accommodate the increasingly difficult and critical learning requirements of tertiary-based nursing students. PMID:21955266

  16. Wave reflection quantification based on pressure waveforms alone--methods, comparison, and clinical covariates.

    PubMed

    Hametner, Bernhard; Wassertheurer, Siegfried; Kropf, Johannes; Mayer, Christopher; Holzinger, Andreas; Eber, Bernd; Weber, Thomas

    2013-03-01

    Within the last decade the quantification of pulse wave reflections mainly focused on measures of central aortic systolic pressure and its augmentation through reflections based on pulse wave analysis (PWA). A complementary approach is the wave separation analysis (WSA), which quantifies the total amount of arterial wave reflection considering both aortic pulse and flow waves. The aim of this work is the introduction and comparison of aortic blood flow models for WSA assessment. To evaluate the performance of the proposed modeling approaches (Windkessel, triangular and averaged flow), comparisons against Doppler measurements are made for 148 patients with preserved ejection fraction. Stepwise regression analysis between WSA and PWA parameters are performed to provide determinants of methodological differences. Against Doppler measurement mean difference and standard deviation of the amplitudes of the decomposed forward and backward pressure waves are comparable for Windkessel and averaged flow models. Stepwise regression analysis shows similar determinants between Doppler and Windkessel model only. The results indicate that the Windkessel method provides accurate estimates of wave reflection in subjects with preserved ejection fraction. The comparison with waveforms derived from Doppler ultrasound as well as recently proposed simple triangular and averaged flow waves showed that this approach may reduce variability and provide realistic results. PMID:23107159

  17. Helen Flanders Dunbar, John Dewey, and clinical pragmatism: reflections on method in psychosomatic medicine and bioethics.

    PubMed

    Hart, Curtis W

    2002-01-01

    This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in psychosomatic medicine and clinical pragmatism in bioethics, and illustrates the breadth of influence of the school of philosophical thought known as pragmatism with which Dewey's name and those of William James and Charles Sanders Pierce are most often identified. PMID:12385140

  18. 21 CFR 862.2400 - Densitometer/scanner (integrating, reflectance, TLC, or radiochromatogram) for clinical use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND... a photocell measurement of the light transmission through a given area of the medium or, in the...

  19. Clinical Thanatology and Psychotherapy: Some Reflections on Caring for the Dying Person.

    ERIC Educational Resources Information Center

    Feigenberg, Loma; Shneidman, Edwin S.

    1979-01-01

    Explores the relationship between psychotherapy and clinical thanatology relative to working with dying patients and their survivors. Eight special characteristics of thanatological exchanges are explained including comments on time, transference, aspirations, and empathy. Conversation, heirarchical exchange, psychotherapy, and thanatological…

  20. Some reflections on the unique time of Nachträglichkeit in theory and clinical practice.

    PubMed

    Marion, Paola

    2012-04-01

    Of the various forms that the matter of time assumes in analysis, Nachträglichkeit represents Freud's first intuition on the subject. The focus of this article is directed toward the specific temporal dimension that the concept of Nachträglichkeit expresses, and how that dimension, which overturns linear time, is expressed in clinical work. The concept of Nachträglichkeit is approached from a theoretical point of view, tracing back the role and development that this notion has had in psychoanalytic Freudian and post-Freudian thinking. The goal of this article is to demonstrate how Nachträglichkeit represents the unique temporal movement of the analytic session and the characteristic positioning of the mind of the analyst at work. Three clinical examples are presented. The analytic scene is formulated as occurring in two times, and through the working through that takes place, patients can recover the enigmatic 'remainder', which is consequently traumatic and which has compulsively accompanied them through the various times of their existence. Nachträglichkeit, as a non-linear temporality, introduces a unique dimension into the clinical work that influences listening to and interpretation of the material. The recognition of that (trauma, infantile sexuality, non-linear temporality) has consequences for the analyst's way of working in session and on the interpretation of clinical material, as I will try to show through my theoretical exposition and clinical examples. PMID:22471634

  1. Harnessing the hidden curriculum: a four-step approach to developing and reinforcing reflective competencies in medical clinical clerkship.

    PubMed

    Holmes, Cheryl L; Harris, Ilene B; Schwartz, Alan J; Regehr, Glenn

    2015-12-01

    Changing the culture of medicine through the education of medical students has been proposed as a solution to the intractable problems of our profession. Yet few have explored the issues associated with making students partners in this change. There is a powerful hidden curriculum that perpetuates not only desired attitudes and behaviors but also those that are less than desirable. So, how do we educate medical students to resist adopting unprofessional practices they see modeled by supervisors and mentors in the clinical environment? This paper explores these issues and, informed by the literature, we propose a specific set of reflective competencies for medical students as they transition from classroom curricula to clinical practice in a four-step approach: (1) Priming-students about hidden curriculum in their clinical environment and their motivations to conform or comply with external pressures; (2) Noticing-educating students to be aware of their motivations and actions in situations where they experience pressures to conform to practices that they may view as unprofessional; (3) Processing-guiding students to analyze their experiences in collaborative reflective exercises and finally; (4) Choosing-supporting students in selecting behaviors that validate and reinforce their aspirations to develop their best professional identity. PMID:25319835

  2. Electronic Medical Records (EMRs), Epidemiology, and Epistemology: Reflections on EMRs and Future Pediatric Clinical Research

    PubMed Central

    Wasserman, Richard C.

    2011-01-01

    Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to their use in scientific investigation. Particular issues include accuracy, completeness, comparability between settings, ease of extraction, and context of recording. Although these problems can be addressed through standard strategies for dealing with partially accurate and incomplete data, a longer term solution will involve work with pediatric clinicians to improve data quality. As research becomes one of the explicit purposes for which pediatricians collect EMR data, the pediatric clinician will play a central role in future pediatric clinical research. PMID:21622040

  3. Reflections on a do-it-yourself training program in clinical psychology.

    PubMed

    Shakow, D

    1976-01-01

    This paper is a somewhat modified version of the inaugural Rapaport--Klein Memorial Lecture at Austen Riggs Center presented June 21, 1974. The author describes the experiences, the series of "apprenticeships" and clinical exposures, which coalesced into his education, from teenage days in the New York Madison House settlement, through Harvard undergraduate and graduate work, to Worcester State Hospital as head of psychological services and research. In conclusion, the author discusses the effects of the kinds of training experiences he has described on the issues that arose in the formulation of formal standards of training in clinical psychology. PMID:801140

  4. An infant with pulmonary interstitial glycogenosis: clinical improvement is associated with improvement in the pulmonary diffusion capacity.

    PubMed

    Ehsan, Zarmina; Montgomery, Gregory S; Tiller, Christina; Kisling, Jeffrey; Chang, Daniel V; Tepper, Robert S

    2014-03-01

    Pulmonary interstitial glycogenosis (PIG) is an idiopathic interstitial lung disease of infants. The underlying pulmonary pathophysiology of PIG has not been well characterized. Herein we report a term-gestation infant who presented with persistent tachypnea and hypoxia. A chest CT scan demonstrated a diffuse ground glass appearance and lung biopsy demonstrated increased alveolar septae cellularity with glycogen-containing cells, consistent with a diagnosis of PIG. At 3 months of age, pulmonary function testing included: pre- and post-bronchodilator forced expiratory flows using the raised-volume technique and the ratio of pulmonary diffusing capacity for carbon monoxide to alveolar volume (DLCO /VA ). He was prescribed 5 days of oral prednisolone (2mg/kg/day) and pulmonary function testing (PFT) was repeated at 5, 13, and 20 months of age. Initial PFTs demonstrated reduced forced vital capacity (FVC: Z-score = -2.36) and an increased ratio of forced expiratory volume in 0.5 sec to FVC (FEV0.5/FVC: Z-score = 1.15) with no significant change following an inhaled bronchodilator. There was also a marked reduction in DLCO /VA (Z-score = -4.74) compared to age-matched controls. Follow-up demonstrated progressive clinical improvement as well as an increase in Z-FVC and normalization of DLCO /VA . Our in vivo physiological findings are consistent with previous reports that symptom resolution correlated with histological thinning of the alveolar septae upon repeat lung biopsy. The restrictive lung disease we observed is consistent with expected reduced compliance of an alveolar interstitial lung process like PIG, whereas the absence of a reduction in FEV0.5/FVC confirms the absence of obstructive airway disease. PMID:23401236

  5. Development of a movable diffuse reflectance spectroscopy system for clinical study of esophageal precancer

    NASA Astrophysics Data System (ADS)

    Hsiao, Yi-Hsien; Tien, Gen-Hao; Chuang, Min-Jie; Hsu, Fang-Wei; Hsieh, Hong-Po; Sung, Kung-Bin

    2015-07-01

    We constructed a movable imaging spectrograph-based system and a contact probe consisting of fibers with several source-to-detection separations (SDS) to measure spatially-resolved diffuse reflectance spectra from superficial tissue. The goal is to estimate optical properties of the mucosa in the oral cavity and investigate correlations between the estimated properties and precancerous changes in the mucosa. A previously developed GPU-based iterative curve-fitting inverse Monte Carlo model was used to extract optical properties from measured spectra. We validated the system with two-layer tissue phantoms, took in-vivo measurements on the buccal mucosa of three normal volunteers, and extracted optical parameters.

  6. Adapting Objective Structured Clinical Examinations to Assess Social Work Students' Performance and Reflections

    ERIC Educational Resources Information Center

    Bogo, Marion; Regehr, Cheryl; Logie, Carmen; Katz, Ellen; Mylopoulos, Maria; Regehr, Glenn

    2011-01-01

    The development of standardized, valid, and reliable methods for assessment of students' practice competence continues to be a challenge for social work educators. In this study, the Objective Structured Clinical Examination (OSCE), originally used in medicine to assess performance through simulated interviews, was adapted for social work to…

  7. Reflective Observation in the Clinical Education Setting: A Way to Promote Learning

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie M.; Bowman, Thomas G.; Benes, Sarah S.

    2015-01-01

    Context: Clinical experiences help athletic training students gain real-time learning experiences by engaging in patient care. Observational learning has been identified as important to athletic training student development, yet little is known about its effectiveness. Objective: To explore the athletic training students' perspectives on their…

  8. Drug administration in animal studies of cardiac arrest does not reflect human clinical experience

    PubMed Central

    Reynolds, Joshua C.; Rittenberger, Jon C.; Menegazzi, James J.

    2007-01-01

    Introduction To date, there is no evidence showing a benefit from any advanced cardiac life support (ACLS) medication in out-of-hospital cardiac arrest (OOHCA), despite animal data to the contrary. One explanation may be a difference in the time to first drug administration. Our previous work has shown the mean time to first drug administration in clinical trials is 19.4 minutes. We hypothesized that the average time to drug administration in large animal experiments occurs earlier than in OOHCA clinical trials. Methods We conducted a literature review between 1990 and 2006 in MEDLINE using the following MeSH headings: swine, dogs, resuscitation, heart arrest, EMS, EMT, ambulance, ventricular fibrillation, drug therapy, epinephrine, vasopressin, amiodarone, lidocaine, magnesium, and sodium bicarbonate. We reviewed the abstracts of 331 studies and 197 full manuscripts. Exclusion criteria included: non-peer reviewed, all without primary animal data, and traumatic models. From these, we identified 119 papers that contained unique information on time to medication administration. The data are reported as mean, ranges, and 95% confidence intervals. Mean time to first drug administration in animal laboratory studies and clinical trials was compared with a t-test. Regression analysis was performed to determine if time to drug predicted ROSC. Results Mean time to first drug administration in 2378 animals was 9.5 minutes (range 3.0–28.0; 95% CI around mean 2.78, 16.22). This is less than the time reported in clinical trials (19.4 min, p<0.001). Time to drug predicted ROSC (Odds Ratio 0.844; 95% CI 0.738, 0.966). Conclusion Shorter drug delivery time in animal models of cardiac arrest may be one reason for the failure of animal studies to translate successfully into the clinical arena. PMID:17360097

  9. Assessment of Capacity in an Aging Society

    ERIC Educational Resources Information Center

    Moye, Jennifer; Marson, Daniel C.; Edelstein, Barry

    2013-01-01

    Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights,…

  10. Cervical spinal cord injury: tailoring clinical trial endpoints to reflect meaningful functional improvements

    PubMed Central

    Bond, Lisa M.; McKerracher, Lisa

    2014-01-01

    Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extremities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in cervical subjects, raising the possibility of false positive outcomes in trials for cervical SCI. Endpoints focused on the recovery of hand and arm control (e.g., upper extremity motor score, motor level change) show the most potential for use as primary outcomes in upcoming trials of cervical SCI. As the field moves forward, the most reliable way to ensure meaningful clinical testing in cervical subjects may be the development of a composite primary endpoint that measures both neurological recovery and functional improvement. PMID:25317162

  11. Reflective Prompts to Guide Termination of the Psychiatric Clinical Student Nursing Experience.

    PubMed

    Hubbard, Grace B

    2016-04-01

    The average length of stay on psychiatric inpatient units has decreased in the past 40 years from 24.9 to 7.2 days. Inpatient psychiatric nurses are challenged to meet the standards and scope of practice despite the changing circumstances of their work environment. The amount of time student nurses spend with a given patient has been affected by changes in acute psychiatric inpatient care and decreased length of stay; however, opportunities exist for effective termination of the nurse-client relationship. Facilitation of students' awareness and understanding of the dynamics inherent in the termination process is an important teaching task for psychiatric nursing clinical instructors. In the current article, a clinically focused learning activity using structured prompts to guide and promote psychiatric nursing students' experiences with the process of termination is described and teaching strategies are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 54(4), 38-43.]. PMID:27042927

  12. Child Rights and Clinical Bioethics: Historical Reflections on Modern Medicine and Ethics.

    PubMed

    Brosco, Jeffrey P

    2016-01-01

    Why might pediatric bioethicists in the United States reject the U.N. Convention on the Rights of the Child (CRC) as a framework for resolving ethical issues? The essays in this issue present arguments and counterarguments regarding the usefulness of the CRC in various clinical and research cases. But underlying this debate are two historical factors that help explain the seeming paradox of pediatric bioethicists' arguing against child's rights. First, the profession of clinical bioethics emerged in the 1970s as one component of modern medicine's focus on improving health through the application of technologically sophisticated treatments. The everyday work of U.S. bioethicists thus usually involves emerging technologies or practices in clinical or laboratory settings; the articles of the CRC, in contrast, seem better suited to addressing broad policy issues that affect the social determinants of health. Second, U.S. child health policy veered away from a more communitarian approach in the early 20th century for reasons of demography that were reinforced by ideology and concerns about immigration. The divide between clinical medicine and public health in the United States, as well as the relatively meager social safety net, are not based on a failure to recognize the rights of children. Indeed, there is some historical evidence to suggest that "rights language" has hindered progress on child health and well-being in the United States. In today's political climate, efforts to ensure that governments pledge to treat children in accordance with their status as human beings (a child right's perspective) are less likely to improve child health than robust advocacy on behalf of children's unique needs, especially as novel models of health-care financing emerge. PMID:27157355

  13. A clinical education program for speech-language pathologists applying reflective practice, evidence-based practice and case-based learning.

    PubMed

    Meilijson, Sara; Katzenberger, Irit

    2014-01-01

    This paper presents a comprehensive clinical education program for speech-language pathology students while considering the learning process and gradual acquisition of knowledge and skills for becoming a practicing speech-language pathologist. It describes the clinical speech and language education program for speech-language pathology students at Hadassah Academic College Jerusalem (HAC) based on three facets of learning: reflective practice, evidence-based practice and case-based learning. Also described are the choice of the model of learning and its implementation. The clinical education program presented reflects the professional development of the faculty at HAC as well as recent trends in clinical education methods. PMID:25790922

  14. Perspectives in medical education: 6 reflections on the state of clinical training for residents in Japan.

    PubMed

    Rao, R Harsha

    2007-12-01

    The Muribushi Project in Okinawa, Japan, is breaking new ground for residency training in Japan by explicitly emphasizing clinical skills training and primary care. The core philosophy of the Project is defined by seven "concepts" that commit to (i) establishing cooperation between several hospitals to educate good clinicians; (ii) providing the best learning environment at multiple training sites; (iii) following global standards of practice; (iv) focusing on primary and emergency care of common diseases; (v) emphasizing faculty development through international exchange; (vi) providing residents with opportunities to obtain training abroad; and (vii) improving the quality of medical care through residents. Observations by the author during two week-long visits, one year apart, reveal that the Muribushi Project is fulfilling conceptual goals (iv), (v) and (vi) by emphasizing primary care and encouraging international exchange for faculty and students. The opportunity exists to fulfill goals (i) and (ii), but it is not being exploited because programs at member hospitals are not integrated, so that residents spend the duration of their residency at one location, and there is no formal system of rotations that would broaden their clinical experience. The Project is failing to meet a sixth goal of following global standards of care (goal #iii) and it is too early to say if it's pioneering approach to residency training is having an impact on healthcare in Japan (goal #vii). On balance, the Project's success in implementing elements of its core philosophy for residency training in the tradition-bound environment of Japan is particularly laudable. PMID:18185027

  15. Reflections on clinical applications of yoga in voice therapy with MTD.

    PubMed

    Moore, Carmelle

    2012-12-01

    This paper explores the application of modified yoga techniques, as an adjunct to voice therapy, by a speech pathologist who is also a yoga teacher. Yoga practices, with effects that may be short-term, are not considered a substitute for comprehensive and integrated somatic retraining systems (such as the Alexander Technique or Feldenkrais ATM). However, when yoga is conducted emphasizing kinaesthetic and proprioceptive awareness, the client may achieve an 'awareness state' that facilitates the learning of vocal remediation techniques (for example, by more easily 'tuning in' to the subtle sensations of supralaryngeal deconstriction). Core yoga elements and clinical applications are identified. The potential benefits and considerations when using yoga as an adjunct to the treatment of muscle tension dysphonia (MTD) are explored. PMID:23137146

  16. Portable handheld diffuse reflectance spectroscopy system for clinical evaluation of skin: a pilot study in psoriasis patients.

    PubMed

    Tzeng, Shih-Yu; Guo, Jean-Yan; Yang, Chao-Chun; Hsu, Chao-Kai; Huang, Hung Ji; Chou, Shih-Jie; Hwang, Chi-Hung; Tseng, Sheng-Hao

    2016-02-01

    Diffuse reflectance spectroscopy (DRS) has been utilized to study biological tissues for a variety of applications. However, many DRS systems are not designed for handheld use and/or relatively expensive which limit the extensive clinical use of this technique. In this paper, we report a handheld, low-cost DRS system consisting of a light source, optical switch, and a spectrometer, that can precisely quantify the optical properties of tissue samples in the clinical setting. The handheld DRS system was employed to determine the skin chromophore concentrations, absorption and scattering properties of 11 patients with psoriasis. The measurement results were compared to the clinical severity of psoriasis as evaluated by dermatologist using PASI (Psoriasis Area and Severity Index) scores. Our statistical analyses indicated that the handheld DRS system could be a useful non-invasive tool for objective evaluation of the severity of psoriasis. It is expected that the handheld system can be used for the objective evaluation and monitoring of various skin diseases such as keloid and psoriasis. PMID:26977366

  17. Portable handheld diffuse reflectance spectroscopy system for clinical evaluation of skin: a pilot study in psoriasis patients

    PubMed Central

    Tzeng, Shih-Yu; Guo, Jean-Yan; Yang, Chao-Chun; Hsu, Chao-Kai; Huang, Hung Ji; Chou, Shih-Jie; Hwang, Chi-Hung; Tseng, Sheng-Hao

    2016-01-01

    Diffuse reflectance spectroscopy (DRS) has been utilized to study biological tissues for a variety of applications. However, many DRS systems are not designed for handheld use and/or relatively expensive which limit the extensive clinical use of this technique. In this paper, we report a handheld, low-cost DRS system consisting of a light source, optical switch, and a spectrometer, that can precisely quantify the optical properties of tissue samples in the clinical setting. The handheld DRS system was employed to determine the skin chromophore concentrations, absorption and scattering properties of 11 patients with psoriasis. The measurement results were compared to the clinical severity of psoriasis as evaluated by dermatologist using PASI (Psoriasis Area and Severity Index) scores. Our statistical analyses indicated that the handheld DRS system could be a useful non-invasive tool for objective evaluation of the severity of psoriasis. It is expected that the handheld system can be used for the objective evaluation and monitoring of various skin diseases such as keloid and psoriasis. PMID:26977366

  18. Dancing in the Ditches: Reflecting on the Capacity of a University/School Partnership to Clarify the Role of a Teacher Educator

    ERIC Educational Resources Information Center

    Reynolds, Ruth; Ferguson-Patrick, Kate; McCormack, Ann

    2013-01-01

    This paper used the data collected from reflective diaries, semi-structured interviews and surveys to identify and examine common themes identified in the roles required and/or perceived for teacher educators by both teachers and teacher educators. Collaboration, discussion and critique enabled personal reflection as teacher educators worked as…

  19. Does the shift to higher capacities for isoprene emission at extreme temperatures in some oak species reflect acclimation to extreme drought and high temperature conditions?

    NASA Astrophysics Data System (ADS)

    Barta, C.; Gramann, J. H.; White, S. L.; Schade, G. W.

    2013-12-01

    decrease of 40% in the sensitive species. As opposed to 2011, the above average precipitation in the first months of 2012, allowed for recovery in both studied species. Photosynthesis rates were maintained at optimum levels throughout the summer of 2012, while standard isoprene emission rates completely recovered in the resistant Q.stellata. Photosynthesis and isoprene emission of the sensitive Q. nigra recovered only partially. Isoprene emission response to increasing temperatures in Q. stellata indicated a shift to higher capacities for isoprene emission at extreme temperatures, exceeding current model predictions during all three years, possibly reflecting an adaptation to the local climate. Additionally, in 2012 and 2013 we recorded a further shift of 3-5°C in the optimum temperature for isoprene emission in this species. We hypothesize, that these responses are due to the evolution of a more thermo-tolerant isoprene synthase enzyme in this species. For comparison, the sensitive species' emissions decreased above 40°C, as predicted by models.

  20. Effects of overnight captivity on antioxidant capacity and clinical chemistry of wild southern hairy-nosed wombats (Lasiorhinus latifrons).

    PubMed

    Debrincat, Steven; Taggart, David; Rich, Brian; Beveridge, Ian; Boardman, Wayne; Dibben, Ron

    2014-09-01

    An animal's antioxidant capacity is measured by its ability to quench reactive oxygen species (ROS). During everyday metabolism, antioxidants and ROS are in equilibrium with one another. In times of stress, an animal produces more ROS and therefore uses its antioxidant capacity more readily in order to maintain this equilibrium. When the production of ROS exceeds the antioxidant capacity, an animal will experience extensive oxidative stress, which can ultimately affect that animal's health. During experimental study of wild animals, it is often necessary to capture them for a short period of time. In order to obtain a measurement of the effects of short-term captivity on oxidative capacity in wild animals, a population of southern hairy-nosed wombats (Lasiorhinus latifrons) in Swan Reach, South Australia (34.57 degrees S, 139.60 degrees E), was studied. To assess the variation in antioxidant capacity, two assays, the ferric reducing ability of plasma and the trolox equivalent antioxidant capacity, were performed. A third assay, thiobarbituric acid reactive substances, was used to measure the effects of ROS. Measurements of the specific antioxidants uric acid, ascorbic acid, retinol, alpha-tocopherol, and superoxide dismutase were also performed. The biochemical parameters albumin, total protein, cholinesterase, creatinine, and urea were measured as indicators for health. Results showed a significant reduction in antioxidant capacity during the overnight period of captivity. PMID:25314812

  1. Relationship between Histological and Clinical Course of Psoriasis: A Pilot Investigation by Reflectance Confocal Microscopy during Goeckerman Treatment.

    PubMed

    Archid, Rami; Duerr, Hans Peter; Patzelt, Alexa; Philipp, Sandra; Röwert-Huber, Hans-Joachim; Ulrich, Martina; Meinke, Martina Claudia; Knorr, Fanny; Lademann, Jürgen

    2016-01-01

    Alterations of the skin microvasculature are known to play an important role in the development and maintenance of psoriatic skin lesions. In this study, we investigated lesional skin in 11 psoriatic patients during a modified Goeckerman treatment using reflectance confocal microscopy (RCM) to study the relationship between clinical clearance and histological normalization of psoriatic skin and the significance of histological abnormalities on the course of disease. The treatment regimen resulted in a significant reduction of the Psoriasis Area and Severity Index (PASI) as well as capillary and papillary diameters (p < 0.0001). The capillary and papillary diameters were still enlarged when compared to those in normal skin (p < 0.001). Capillary and papillary diameters correlated with each other prior to and after treatment (correlation coefficient = 0.63 and 0.64, p = 0.01 and 0.002, respectively) but not with the PASI. Capillary and papillary diameters after treatment and percentage reduction of the PASI during treatment seemed to be better predictors for the clinical course of relapse than the PASI after treatment. These findings make the subclinical changes of psoriatic skin vessels and dermal papillae a legitimate target for treatment. Further investigations of a large group of patients are needed to evaluate the potential of RCM findings as successor of the PASI in the monitoring of psoriasis. PMID:26841099

  2. Research Capacity-Building with New Technologies within New Communities of Practice: Reflections on the First Year of the Teacher Education Research Network

    ERIC Educational Resources Information Center

    Fowler, Zoe; Stanley, Grant; Murray, Jean; Jones, Marion; McNamara, Olwen

    2013-01-01

    This article focuses on a virtual research environment (VRE) and how it facilitated the networking of teacher educators participating in an Economic and Social Research Council-funded research capacity-building project. Using the theoretical lenses of situated learning and socio-cultural approaches to literacy, participants' ways of engaging…

  3. The Leishmaniasis East Africa Platform (LEAP): strengthening clinical trial capacity in resource-limited countries to deliver new treatments for visceral leishmaniasis

    PubMed Central

    Wasunna, Monique; Musa, Ahmed; Hailu, Asrat; Khalil, Eltahir A. G.; Olobo, Joseph; Juma, Rashid; Wells, Susan; Alvar, Jorge; Balasegaram, Manica

    2016-01-01

    Visceral leishmaniasis is a neglected tropical disease endemic in East Africa where improved patient-adapted treatments are needed. The Leishmaniasis East Africa Platform (LEAP) was created in 2003 to strengthen clinical research capacity, serve as a base for training, and evaluate and facilitate implementation of new treatments. Major infrastructure upgrades and personnel training have been carried out. A short course of Sodium Stibogluconate and Paramomycin (SSG&PM) was evaluated and is now first-line treatment in the region; alternative treatments have also been assessed. LEAP can serve as a successful model of collaboration between different partners and countries when conducting clinical research in endemic countries to international standards. PMID:27268714

  4. The Leishmaniasis East Africa Platform (LEAP): strengthening clinical trial capacity in resource-limited countries to deliver new treatments for visceral leishmaniasis.

    PubMed

    Wasunna, Monique; Musa, Ahmed; Hailu, Asrat; Khalil, Eltahir A G; Olobo, Joseph; Juma, Rashid; Wells, Susan; Alvar, Jorge; Balasegaram, Manica

    2016-06-01

    Visceral leishmaniasis is a neglected tropical disease endemic in East Africa where improved patient-adapted treatments are needed. The Leishmaniasis East Africa Platform (LEAP) was created in 2003 to strengthen clinical research capacity, serve as a base for training, and evaluate and facilitate implementation of new treatments. Major infrastructure upgrades and personnel training have been carried out. A short course of Sodium Stibogluconate and Paramomycin (SSG&PM) was evaluated and is now first-line treatment in the region; alternative treatments have also been assessed. LEAP can serve as a successful model of collaboration between different partners and countries when conducting clinical research in endemic countries to international standards. PMID:27268714

  5. Assessment of Capacity in an Aging Society

    PubMed Central

    Moye, Jennifer; Marson, Daniel C.; Edelstein, Barry

    2014-01-01

    Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights, deinstitutionalization, and disability rights movements. Because of these forces, capacity issues now permeate the fabric of everyday life, whether in the form of guardianship petitions, questions of capacity to consent to treatment, the ability to make a new will, or participation in human research. In seeking to resolve these issues, families, clinicians, and legal professionals increasingly turn to psychologists to assess a capacity and to provide empirically supported judgments that properly balance autonomy and protection for the individual. Psychologists have taken a leading role in the development of functional assessment instruments that measure important aspects of the capacity construct. In addition, psychology has been a major contributor to the scientific study of capacity. In collaboration with colleagues from medicine and law, psychologists have articulated crucial theoretical frameworks that integrate legal, clinical, and ethical dimensions of the capacity problem. This article focuses on the evolution of theory, law, science, and practice in the evaluation of capacity in older adults and its recent culmination in a series of interdisciplinary handbooks sponsored by the American Psychological Association and the American Bar Association. PMID:23586491

  6. Assessment of capacity in an aging society.

    PubMed

    Moye, Jennifer; Marson, Daniel C; Edelstein, Barry

    2013-04-01

    Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights, deinstitutionalization, and disability rights movements. Because of these forces, capacity issues now permeate the fabric of everyday life, whether in the form of guardianship petitions, questions of capacity to consent to treatment, the ability to make a new will, or participation in human research. In seeking to resolve these issues, families, clinicians, and legal professionals increasingly turn to psychologists to assess a capacity and to provide empirically supported judgments that properly balance autonomy and protection for the individual. Psychologists have taken a leading role in the development of functional assessment instruments that measure important aspects of the capacity construct. In addition, psychology has been a major contributor to the scientific study of capacity. In collaboration with colleagues from medicine and law, psychologists have articulated crucial theoretical frameworks that integrate legal, clinical, and ethical dimensions of the capacity problem. This article focuses on the evolution of theory, law, science, and practice in the evaluation of capacity in older adults and its recent culmination in a series of interdisciplinary handbooks sponsored by the American Psychological Association and the American Bar Association. PMID:23586491

  7. Context Impact of Clinical Scenario on Knowledge Transfer and Reasoning Capacity in a Medical Problem-Based Learning Curriculum

    ERIC Educational Resources Information Center

    Collard, A.; Brédart, S.; Bourguignon, J.-P.

    2016-01-01

    Since 2000, the faculty of Medicine at the University of Liège has integrated problem-based learning (PBL) seminars from year two to seven in its seven-year curriculum. The PBL approach has been developed to facilitate students' acquisition of reasoning capacity. This contextualized learning raises the question of the de- and re-contextualization…

  8. How Current Clinical Practice Guidelines for Low Back Pain Reflect Traditional Medicine in East Asian Countries: A Systematic Review of Clinical Practice Guidelines and Systematic Reviews

    PubMed Central

    Cho, Hyun-Woo; Hwang, Eui-Hyoung; Lim, Byungmook; Heo, Kwang-Ho; Liu, Jian-Ping; Tsutani, Kiichiro; Lee, Myeong Soo; Shin, Byung-Cheul

    2014-01-01

    Objectives The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM) interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs) and evidence from current systematic reviews and meta-analyses (SR-MAs) and to analyze the impact of this gap on present CPGs. Methods We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. Results Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54%) mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure). However, the CPGs did not recommend acupuncture (or acupressure). Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (sub)acute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (sub)acute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. Conclusions The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system. PMID:24505363

  9. Application of Attenuated Total Reflectance-Fourier Transformed Infrared (ATR-FTIR) Spectroscopy To Determine the Chlorogenic Acid Isomer Profile and Antioxidant Capacity of Coffee Beans.

    PubMed

    Liang, Ningjian; Lu, Xiaonan; Hu, Yaxi; Kitts, David D

    2016-01-27

    The chlorogenic acid isomer profile and antioxidant activity of both green and roasted coffee beans are reported herein using ATR-FTIR spectroscopy combined with chemometric analyses. High-performance liquid chromatography (HPLC) quantified different chlorogenic acid isomer contents for reference, whereas ORAC, ABTS, and DPPH were used to determine the antioxidant activity of the same coffee bean extracts. FTIR spectral data and reference data of 42 coffee bean samples were processed to build optimized PLSR models, and 18 samples were used for external validation of constructed PLSR models. In total, six PLSR models were constructed for six chlorogenic acid isomers to predict content, with three PLSR models constructed to forecast the free radical scavenging activities, obtained using different chemical assays. In conclusion, FTIR spectroscopy, coupled with PLSR, serves as a reliable, nondestructive, and rapid analytical method to quantify chlorogenic acids and to assess different free radical-scavenging capacities in coffee beans. PMID:26725502

  10. From Cases to Capacity? A Critical Reflection on the Role of ‘Ethical Dilemmas’ in the Development of Dual-Use Governance

    PubMed Central

    Edwards, Brett; Revill, James; Bezuidenhout, Louise

    2016-01-01

    The dual-use issue is often framed as a series of paralyzing ‘dilemmas’ facing the scientific community as well as institutions which support innovation. While this conceptualization of the dual-use issue can be useful in certain contexts (such as in awareness-raising and as part of educational activities directed at the scientific community) its usefulness is more limited when reflecting on the governance and politics of the dual-use issue. Within this paper, key shortcomings of the dilemma framing are outlined. It is argued that many of the issues raised in the most recent debates about ‘dual-use’ bird flu research remain unresolved. This includes questions about the trajectories of certain lines of research, as well as broader trends in the practice and governance of science. This leads to difficult questions about current approaches to the dual-use issue within the US, as well as internationally. PMID:23703451

  11. The Therapeutic Relationship in the Brief Treatment of Depression: Contributions to Clinical Improvement and Enhanced Adaptive Capacities

    ERIC Educational Resources Information Center

    Zuroff, David C.; Blatt, Sidney J.

    2006-01-01

    Using data from the National Institute of Mental Health Treatment for Depression Collaborative Research Program, the authors examined the impact on treatment outcome of the patient's perception of the quality of the therapeutic relationship and contribution to the therapeutic alliance. Shared variance with early clinical improvement was removed…

  12. Benefits of maltodextrin intake 2 hours before cholecystectomy by laparotomy in respiratory function and functional capacity: a prospective randomized clinical trial

    PubMed Central

    Zani, Fabiana Vieira Breijão; Aguilar-Nascimento, José Eduardo; Nascimento, Diana Borges Dock; da Silva, Ageo Mário Cândido; Caporossi, Fernanda Stephan; Caporossi, Cervantes

    2015-01-01

    ABSTRACT Objective: To evaluate the change in respiratory function and functional capacity according to the type of preoperative fasting. Methods: Randomized prospective clinical trial, with 92 female patients undergoing cholecystectomy by laparotomy with conventional or 2 hours shortened fasting. The variables measured were the peak expiratory flow, forced expiratory volume in the first second, forced vital capacity, dominant handgrip strength, and non-dominant handgrip strength. Evaluations were performed 2 hours before induction of anesthesia and 24 hours after the operation. Results: The two groups were similar in preoperative evaluations regarding demographic and clinical characteristics, as well as for all variables. However, postoperatively the group with shortened fasting had higher values than the group with conventional fasting for lung function tests peak expiratory flow (128.7±62.5 versus 115.7±59.9; p=0.040), forced expiratory volume in the first second (1.5±0.6 versus 1.2±0.5; p=0.040), forced vital capacity (2.3±1.1 versus 1.8±0.9; p=0.021), and for muscle function tests dominant handgrip strength (24.9±6.8 versus 18.4±7.7; p=0.001) and non-dominant handgrip strength (22.9±6.3 versus 17.0±7.8; p=0.0002). In the intragroup evaluation, there was a decrease in preoperative compared with postoperative values, except for dominant handgrip strength (25.2±6.7 versus 24.9±6.8; p=0.692), in the shortened fasting group. Conclusion: Abbreviation of preoperative fasting time with ingestion of maltodextrin solution is beneficial to pulmonary function and preserves dominant handgrip strength. PMID:26154547

  13. Reflecting Reflective Practice

    ERIC Educational Resources Information Center

    Galea, Simone

    2012-01-01

    This paper demystifies reflective practice on teaching by focusing on the idea of reflection itself and how it has been conceived by two philosophers, Plato and Irigaray. It argues that reflective practice has become a standardized method of defining the teacher in teacher education and teacher accreditation systems. It explores how practices of…

  14. Does living and working in a hot environment induce clinically relevant changes in immune function and voluntary force production capacity?

    PubMed

    Knez, Wade; Girard, Olivier; Racinais, Sebastien; Walsh, Andrew; Gaoua, Nadia; Grantham, Justin

    2014-01-01

    This study investigated the effect of living (summer vs. winter) and working (morning vs. afternoon) in a hot environment on markers of immune function and forearm strength. Thirty-one healthy male gas field employees were screened before (between 05:30 and 07:00) and after their working day (between 15:30 and 17:00) during both seasons. Body core temperature and physical activity were recorded throughout the working days. The hot condition (i.e. summer) led a higher (p≤0.05) average body core temperature (~37.2 vs. ~37.4 °C) but reduced physical activity (-14.8%) during the work-shift. Our data showed an increase (p≤0.05) in lymphocyte and monocyte counts in the summer. Additionally, work-shift resulted in significant (p≤0.001) changes in leukocytes, lymphocytes and monocytes independently of the environment. Handgrip (p=0.069) and pinch (p=0.077) forces tended to be reduced from pre-to post-work, while only force produced during handgrip manoeuvres was significantly reduced (p≤0.05) during the hot compared to the temperate season. No interactions were observed between the environment and work-shift for any marker of immune function or forearm strength. In summary, working and living in hot conditions impact on markers of immune function and work capacity; however by self-regulating energy expenditure, immune markers remained in a healthy reference range. PMID:24583514

  15. Evaluating the capacity of theories of justice to serve as a justice framework for international clinical research.

    PubMed

    Pratt, Bridget; Zion, Deborah; Loff, Bebe

    2012-01-01

    This article investigates whether or not theories of justice from political philosophy, first, support the position that health research should contribute to justice in global health, and second, provide guidance about what is owed by international clinical research (ICR) actors to parties in low- and middle-income countries. Four theories-John Rawls's theory of justice, the rights-based cosmopolitan theories of Thomas Pogge and Henry Shue, and Jennifer Ruger's health capability paradigm-are evaluated. The article shows that three of the four theories require the conduct of health research for justice in global health. The theories help identify the ends of justice to which ICR is to contribute, but they cannot tell us how to organize ICR to promote these ends. Aside from Ruger's health capability paradigm, the theories also lack an allocative principle for assigning specific duties to specific actors. This creates difficulties for establishing obligations for certain types of ICR actors. PMID:23072678

  16. The Practicum Script Concordance Test: An Online Continuing Professional Development Format to Foster Reflection on Clinical Practice

    ERIC Educational Resources Information Center

    Hornos, Eduardo H.; Pleguezuelos, Eduardo M.; Brailovsky, Carlos A.; Harillo, Leandro D.; Dory, Valerie; Charlin, Bernard

    2013-01-01

    Introduction: Judgment in the face of uncertainty is an important dimension of expertise and clinical competence. However, it is challenging to conceive continuing professional development (CPD) initiatives aimed at helping physicians enhance their clinical judgment skills in ill-defined situations. We present an online script concordance-based…

  17. Effects of an Exercise Programme on Functional Capacity, Body Composition and Risk of Falls in Patients with Cirrhosis: A Randomized Clinical Trial

    PubMed Central

    Román, Eva; García-Galcerán, Cristina; Torrades, Teresa; Herrera, Silvia; Marín, Ana; Doñate, Maite; Alvarado-Tapias, Edilmar; Malouf, Jorge; Nácher, Laura; Serra-Grima, Ricard; Guarner, Carlos; Soriano, German

    2016-01-01

    Patients with cirrhosis often have functional limitations, decreased muscle mass, and a high risk of falls. These variables could improve with exercise. The aim was to study the effects of moderate exercise on functional capacity, body composition and risk of falls in patients with cirrhosis. Twenty-three cirrhotic patients were randomized to an exercise programme (n = 14) or to a relaxation programme (n = 9). Both programmes consisted of a one-hour session 3 days a week for 12 weeks. At the beginning and end of the study, we measured functional capacity using the cardiopulmonary exercise test, evaluated body composition using anthropometry and dual energy X-ray absorptiometry, and estimated risk of falls using the Timed Up&Go test. In the exercise group, cardiopulmonary exercise test showed an increase in total effort time (p<0.001) and ventilatory anaerobic threshold time (p = 0.009). Upper thigh circumference increased and mid-arm and mid-thigh skinfold thickness decreased. Dual energy X-ray absorptiometry showed a decrease in fat body mass (-0.94 kg, 95%CI -0.48 to -1.41, p = 0.003) and an increase in lean body mass (1.05 kg, 95%CI 0.27 to 1.82, p = 0.01), lean appendicular mass (0.38 kg, 95%CI 0.06 to 0.69, p = 0.03) and lean leg mass (0.34 kg, 95%CI 0.10 to 0.57, p = 0.02). The Timed Up&Go test decreased at the end of the study compared to baseline (p = 0.02). No changes were observed in the relaxation group. We conclude that a moderate exercise programme in patients with cirrhosis improves functional capacity, increases muscle mass, and decreases body fat and the Timed Up&Go time. Trial Registration: ClinicalTrials.gov NCT01447537 PMID:27011355

  18. Research capacity-building program for clinicians and staff at a community-based HIV clinic in Uganda: A pre/post evaluation.

    PubMed

    Njie-Carr, Veronica; Kalengé, Sheila; Kelley, Jack; Wilson, Amy; Muliira, Joshua Kanaabi; Nabirye, Rose Chalo; Glass, Nancy; Bollinger, Robert; Alamo-Talisuna, Stella; Chang, Larry William

    2012-01-01

    Developing capacity for HIV research and clinical practice is critically needed in resource-limited countries. The purpose of this study was to evaluate a research capacity-building program for community-based participants in the preparation and conduct of mobile phone-based technology interventions. A descriptive, cross-sectional design was used. Participants completed self-report surveys at three time points. Thirty-three participated in the situational analysis, and all (100%) felt that the research training was needed. For the interim evaluation, more than 96.8% (n = 30) reported increased knowledge and confidence and attributed this to the training. Fourteen participants completed the final evaluation. Dedicated time away from work was an important factor to facilitate recruitment and data collection, followed by financial incentives to commute to data collection sites. Expertise through supervision and mentorship for participants and sustained funding for research projects are critical to the innovation needed to improve HIV prevention and care outcomes. PMID:22265671

  19. Effects of conventional versus multimodal vestibular rehabilitation on functional capacity and balance control in older people with chronic dizziness from vestibular disorders: design of a randomized clinical trial

    PubMed Central

    2012-01-01

    Background There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal) on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders. Methods/design A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity) and the Dynamic Gait Index (body balance). Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68) will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions). The outcomes of both protocols will be compared according to the intention-to-treat analysis. Discussion Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders. Trial registration ACTRN12610000018011 PMID:23276084

  20. Host Immune Transcriptional Profiles Reflect the Variability in Clinical Disease Manifestations in Patients with Staphylococcus aureus Infections

    PubMed Central

    Banchereau, Romain; Jordan-Villegas, Alejandro; Ardura, Monica; Mejias, Asuncion; Baldwin, Nicole; Xu, Hui; Saye, Elizabeth; Rossello-Urgell, Jose; Nguyen, Phuong; Blankenship, Derek; Creech, Clarence B.; Pascual, Virginia; Banchereau, Jacques; Chaussabel, Damien; Ramilo, Octavio

    2012-01-01

    Staphylococcus aureus infections are associated with diverse clinical manifestations leading to significant morbidity and mortality. To define the role of the host response in the clinical manifestations of the disease, we characterized whole blood transcriptional profiles of children hospitalized with community-acquired S. aureus infection and phenotyped the bacterial strains isolated. The overall transcriptional response to S. aureus infection was characterized by over-expression of innate immunity and hematopoiesis related genes and under-expression of genes related to adaptive immunity. We assessed individual profiles using modular fingerprints combined with the molecular distance to health (MDTH), a numerical score of transcriptional perturbation as compared to healthy controls. We observed significant heterogeneity in the host signatures and MDTH, as they were influenced by the type of clinical presentation, the extent of bacterial dissemination, and time of blood sampling in the course of the infection, but not by the bacterial isolate. System analysis approaches provide a new understanding of disease pathogenesis and the relation/interaction between host response and clinical disease manifestations. PMID:22496797

  1. Expanding the "Ports of Entry" for Speech-Language Pathologists: A Relational and Reflective Model for Clinical Practice

    ERIC Educational Resources Information Center

    Geller, Elaine; Foley, Gilbert M.

    2009-01-01

    Purpose: To outline an expanded framework for clinical practice in speech-language pathology. This framework broadens the focus on discipline-specific knowledge and infuses mental health constructs within the study of communication sciences and disorders, with the objective of expanding the potential "ports or points of entry" (D. Stern, 1995) for…

  2. Academicians and Neurologic Physical Therapy Residents Partner to Expand Clinical Reflection Using the SOLO Taxonomy: A Novel Approach.

    PubMed

    Pinto Zipp, Genevieve; Maher, Catherine; Donnelly, Erin; Fritz, Brian; Snowdon, Lauren

    2016-01-01

    Creating curriculums that develop physical therapy (PT) students into evidenced-based, critically reflective, entry-level practitioners is one of the primary goals for PT programs. Academic faculty partnering with neurologic residency programs to design learning environments that capitalize upon the strengths of both can create insightful educational experiences for students during their didactic training. These partnerships support the development of critical thinking skills and provide mentorship for residents transitioning from their role as a clinician to that of an educator. Using the SOLO (structure of observed learning outcomes) taxonomy as a framework for developing learning experiences, Seton Hall University neurologic academic faculty and program directors from the Kessler Institute for Rehabilitation Residency in Neurologic Physical Therapy have built a partnership that seeks to develop critical reflection skills in both the neurologic resident and entry-level PT students. While integration of residents into entry-level PT curriculum may not be novel, we believe that utilizing the SOLO model within this partnership is unique. This paper describes the partnership and learning experiences rooted in the SOLO taxonomy theoretical framework and discusses perceived benefits of this learning experience across professional health science programs. PMID:27262476

  3. Infrapatellar Fat Pad-Derived Stem Cells Maintain Their Chondrogenic Capacity in Disease and Can be Used to Engineer Cartilaginous Grafts of Clinically Relevant Dimensions

    PubMed Central

    Liu, Yurong; Buckley, Conor Timothy; Almeida, Henrique V.; Mulhall, Kevin J.

    2014-01-01

    A therapy for regenerating large cartilaginous lesions within the articular surface of osteoarthritic joints remains elusive. While tissue engineering strategies such as matrix-assisted autologous chondrocyte implantation can be used in the repair of focal cartilage defects, extending such approaches to the treatment of osteoarthritis will require a number of scientific and technical challenges to be overcome. These include the identification of an abundant source of chondroprogenitor cells that maintain their chondrogenic capacity in disease, as well as the development of novel approaches to engineer scalable cartilaginous grafts that could be used to resurface large areas of damaged joints. In this study, it is first demonstrated that infrapatellar fat pad-derived stem cells (FPSCs) isolated from osteoarthritic (OA) donors possess a comparable chondrogenic capacity to FPSCs isolated from patients undergoing ligament reconstruction. In a further validation of their functionality, we also demonstrate that FPSCs from OA donors respond to the application of physiological levels of cyclic hydrostatic pressure by increasing aggrecan gene expression and the production of sulfated glycosaminoglycans. We next explored whether cartilaginous grafts could be engineered with diseased human FPSCs using a self-assembly or scaffold-free approach. After examining a range of culture conditions, it was found that continuous supplementation with both transforming growth factor-β3 (TGF-β3) and bone morphogenic protein-6 (BMP-6) promoted the development of tissues rich in proteoglycans and type II collagen. The final phase of the study sought to scale-up this approach to engineer cartilaginous grafts of clinically relevant dimensions (≥2 cm in diameter) by assembling FPSCs onto electrospun PLLA fiber membranes. Over 6 weeks in culture, it was possible to generate robust, flexible cartilage-like grafts of scale, opening up the possibility that tissues engineered using FPSCs

  4. Infrapatellar fat pad-derived stem cells maintain their chondrogenic capacity in disease and can be used to engineer cartilaginous grafts of clinically relevant dimensions.

    PubMed

    Liu, Yurong; Buckley, Conor Timothy; Almeida, Henrique V; Mulhall, Kevin J; Kelly, Daniel John

    2014-11-01

    A therapy for regenerating large cartilaginous lesions within the articular surface of osteoarthritic joints remains elusive. While tissue engineering strategies such as matrix-assisted autologous chondrocyte implantation can be used in the repair of focal cartilage defects, extending such approaches to the treatment of osteoarthritis will require a number of scientific and technical challenges to be overcome. These include the identification of an abundant source of chondroprogenitor cells that maintain their chondrogenic capacity in disease, as well as the development of novel approaches to engineer scalable cartilaginous grafts that could be used to resurface large areas of damaged joints. In this study, it is first demonstrated that infrapatellar fat pad-derived stem cells (FPSCs) isolated from osteoarthritic (OA) donors possess a comparable chondrogenic capacity to FPSCs isolated from patients undergoing ligament reconstruction. In a further validation of their functionality, we also demonstrate that FPSCs from OA donors respond to the application of physiological levels of cyclic hydrostatic pressure by increasing aggrecan gene expression and the production of sulfated glycosaminoglycans. We next explored whether cartilaginous grafts could be engineered with diseased human FPSCs using a self-assembly or scaffold-free approach. After examining a range of culture conditions, it was found that continuous supplementation with both transforming growth factor-β3 (TGF-β3) and bone morphogenic protein-6 (BMP-6) promoted the development of tissues rich in proteoglycans and type II collagen. The final phase of the study sought to scale-up this approach to engineer cartilaginous grafts of clinically relevant dimensions (≥2 cm in diameter) by assembling FPSCs onto electrospun PLLA fiber membranes. Over 6 weeks in culture, it was possible to generate robust, flexible cartilage-like grafts of scale, opening up the possibility that tissues engineered using FPSCs

  5. Tumor DNA in cerebral spinal fluid reflects clinical course in a patient with melanoma leptomeningeal brain metastases.

    PubMed

    Li, Yingmei; Pan, Wenying; Connolly, Ian D; Reddy, Sunil; Nagpal, Seema; Quake, Stephen; Gephart, Melanie Hayden

    2016-05-01

    Cerebral spinal fluid (CSF) from brain tumor patients contains tumor cellular and cell-free DNA (cfDNA), which provides a less-invasive and routinely accessible method to obtain tumor genomic information. In this report, we used droplet digital PCR to test mutant tumor DNA in CSF of a patient to monitor the treatment response of metastatic melanoma leptomeningeal disease (LMD). The primary melanoma was known to have a BRAF (V600E) mutation, and the patient was treated with whole brain radiotherapy and BRAF inhibitors. We collected 9 CSF samples over 6 months. The mutant cfDNA fraction gradually decreased from 53 % (time of diagnosis) to 0 (time of symptom alleviation) over the first 6 time points. Three months after clinical improvement, the patient returned with severe symptoms and the mutant cfDNA was again detected in CSF at high levels. The mutant DNA fraction corresponded well with the patient's clinical response. We used whole exome sequencing to examine the mutation profiles of the LMD tumor DNA in CSF before therapeutic response and after disease relapse, and discovered a canonical cancer mutation PTEN (R130*) at both time points. The cellular and cfDNA revealed similar mutation profiles, suggesting cfDNA is representative of LMD cells. This study demonstrates the potential of using cellular or cfDNA in CSF to monitor treatment response for LMD. PMID:26961773

  6. Globalisation as we enter the 21st century: reflections and directions for nursing education, science, research and clinical practice.

    PubMed

    Davidson, Patricia M; Meleis, Afaf; Daly, John; Douglas, Marilyn Marty

    2003-10-01

    The events of September 11th, 2001 in the United States and the Bali bombings of October 2002 are chastening examples of the entangled web of the religious, political, health, cultural and economic forces we experience living in a global community. To view these forces as independent, singular, linearly deterministic entities of globalisation is irrational and illogical. Understanding the concept of globalisation has significant implications not only for world health and international politics, but also the health of individuals. Depending on an individual's political stance and world-view, globalisation may be perceived as an emancipatory force, having the potential to bridge the chasm between rich and poor or, in stark contrast, the very essence of the divide. It is important that nurses appreciate that globalisation does not pertain solely to the realms of economic theory and world politics, but also that it impacts on our daily nursing practice and the welfare of our patients. Globalisation and the closer interactions of human activity that result, have implications for international governance, policy and theory development as well as nursing education, research and clinical practice. Nurses, individually and collectively, have the political power and social consciousness to influence the forces of globalisation to improve health for all. This paper defines and discusses globalisation in today's world and its implications for contemporary nursing education, science, research and clinical practice. PMID:14649522

  7. Reflective Teaching

    ERIC Educational Resources Information Center

    Farrell, Thomas S. C.

    2013-01-01

    Thomas Farrell's "Reflective Teaching" outlines four principles that take teachers from just doing reflection to making it a way of being. Using the four principles, Reflective Practice Is Evidence Based, Reflective Practice Involves Dialogue, Reflective Practice Links Beliefs and Practices, and Reflective Practice Is a Way of Life,…

  8. Students' reflections on the relationships between safe learning environments, learning challenge and positive experiences of learning in a simulated GP clinic.

    PubMed

    Young, J E; Williamson, M I; Egan, T G

    2016-03-01

    Learning environments are a significant determinant of student behaviour, achievement and satisfaction. In this article we use students' reflective essays to identify key features of the learning environment that contributed to positive and transformative learning experiences. We explore the relationships between these features, the students' sense of safety in the learning environment (LE), the resulting learning challenge with which they could cope and their positive reports of the experience itself. Our students worked in a unique simulation of General Practice, the Safe and Effective Clinical Outcomes clinic, where they consistently reported positive experiences of learning. We analysed 77 essays from 2011 and 2012 using an immersion/crystallisation framework. Half of the students referred to the safety of the learning environment spontaneously. Students described deep learning experiences in their simulated consultations. Students valued features of the LE which contributed to a psychologically safe environment. Together with the provision of constructive support and immediate, individualised feedback this feeling of safety assisted students to find their own way through clinical dilemmas. These factors combine to make students feel relaxed and able to take on challenges that otherwise would have been overwhelming. Errors became learning opportunities and students could practice purposefully. We draw on literature from medical education, educational psychology and sociology to interpret our findings. Our results demonstrate relationships between safe learning environments, learning challenge and powerful learning experiences, justifying close attention to the construction of learning environments to promote student learning, confidence and motivation. PMID:25952645

  9. Reflections One Year into the 22 Center NIH-funded WRIST Study. A Primer on Conducting a Multicenter Clinical Trial

    PubMed Central

    2013-01-01

    The Wrist and Radius Surgery Trial (WRIST) study group is a collaboration of 22 hand surgery centers in the US, Canada, and Singapore to showcase the interest and capability of hand surgeons to conduct a multicenter clinical trial. The WRIST study group was formed in response to the seminal systematic review by Margaliot et al. and the Cochrane report that indicated marked deficiency in the quality of evidence in the distal radius fracture literature. Since the initial description of this fracture by Colles in 1814, over 2,000 studies have been published on this subject, yet high level studies based on the principles of evidence-based medicine are lacking. As we continue to embrace evidence-based medicine to raise the quality of research, the lessons learned during the organization and conduct of WRIST can serve as a template for others contemplating similar efforts. This paper will trace the course of WRIST by sharing the triumphs, and more importantly the struggles, faced in the first year of this study. PMID:23608306

  10. How accurately does the VIVO Harvester reflect actual Clinical and Translational Sciences Award–affiliated faculty member publications?*

    PubMed Central

    Eldredge, Jonathan D.; Kroth, Philip J.; Murray-Krezan, Cristina; Hantak, Chad M.; Weagel, Edward F.; Hannigan, Gale G.

    2015-01-01

    Objective: The research tested the accuracy of the VIVO Harvester software in identifying publications authored by faculty members affiliated with a National Institutes of Health Clinical and Translational Sciences Award (CTSA) site. Methods: Health sciences librarians created “gold standard” lists of references for the years 2001 to 2011 from PubMed for twenty-five randomly selected investigators from one CTSA site. These gold standard lists were compared to the same twenty-five investigators' reference lists produced by VIVO Harvester. The authors subjected the discrepancies between the lists to sensitivity and specificity analyses. Results: The VIVO Harvester correctly identified only about 65% of the total eligible PubMed references for the years 2001–2011 for the CTSA-affiliated investigators. The identified references produced by VIVO Harvester were precise yet incomplete. The sensitivity rate was 0.65, and the specificity rate was 1.00. Conclusion: While the references produced by VIVO Harvester could be confirmed in PubMed, the VIVO Harvester retrieved only two-thirds of the required references from PubMed. National Institutes of Health CTSA sites will need to supplement VIVO Harvester–produced references with the expert searching skills of health sciences librarians. Implications: Health sciences librarians with searching skills need to alert their CTSA sites about these deficiencies and offer their skills to advance their sites' missions. PMID:25552940

  11. Working with chronic and relentless self-hatred, self-harm and existential shame: a clinical study and reflections.

    PubMed

    Austin, Sue

    2016-02-01

    This paper is the first of a two-part series which explores some of the theoretical and experiential reference points that have emerged in my work with people whose relationship to their body and/or sense of self is dominated by self-hatred and (what Hultberg describes as) existential shame. The first paper focuses on self-hatred and the second paper focuses on shame. This first paper is structured around vignettes taken from a 14-year analysis with a woman who was bulimic, self-harmed and repeatedly described herself as 'feeling like a piece of shit'. It draws together elements of Jung's concepts of the complex and symbol, and Laplanche's enigmatic signifier to focus on experiences of 'inner otherness' around which we are unconsciously organized. It also brings Jung's understanding that emotion is the chief source of consciousness into conversation with Laplanche's approach to the transference which is that by being aware that they do not 'know', the analyst provides a 'hollow' in which the patient's analytic process can evolve. These combinations of ideas are linked speculatively to emerging understandings of the neuroscience of perception and throughout the paper clinical material is used to illustrate these discussions. PMID:26785411

  12. From research to clinical practice: considerations in moving research into people's hands. Personal reflections that may be useful to others.

    PubMed

    Rosenbaum, Peter

    2005-01-01

    It may take many years for published clinical research findings to be found, understood, adopted and applied in practice. In recognition of this delay, many jurisdictions and agencies are now promoting a stronger link between research and its dissemination in useable forms that will enable practitioners to access, understand and use new ideas. The purpose of this paper, first presented as a keynote address at the 15th Annual Meeting of the European Academy of Childhood Disability in Oslo in October 2003, is to share experiences of the author and his colleagues at a childhood disability system-linked research centre in Ontario, Canada. The lessons learned include the value of striving to describe one's findings in plain language; writing study reports for parents and children who are involved in research studies; using multiple methods to disseminate one's work; and making explicit the potential importance and applicability of the findings to readers of the work. Engaging end users at many stages of the development and field testing of one's work will enhance buy-in and lend added credibility to the work, as well as influencing content and process as the research unfolds. The result is likely to be greater recognition of 'familiar' aspects of the research and the adoption of relevant findings. PMID:16087550

  13. Antioxidant capacity of calendula officinalis flowers extract and prevention of radiation induced oropharyngeal mucositis in patients with head and neck cancers: a randomized controlled clinical study

    PubMed Central

    2013-01-01

    This study was designed to determine the effect of Calendula officinalis flowers extract mouthwash as oral gel on radiation-induced oropharyngeal mucositis (OM) in patients with head-and-neck cancer. Forty patients with neck and head cancers under radiotherapy or concurrent chemoradiotherapy protocols were randomly assigned to receive either 2% calendula extract mouthwash or placebo (20 patients in each group). Patients were treated with telecobalt radiotherapy at conventional fractionation (200 cGy/fraction, five fractions weekly, 30–35 fractions within 4–7 weeks). The oropharyngeal mucositis was evaluated by two clinical investigators (a radiation oncologist and a dentist), using the oral mucositis assessment scale (OMAS). Trying to find out the possible mechanism of action of the treatment, total antioxidant, polyphenol and flavonoid contents, and quercetin concentration of the mouth wash were measured. Calendula mouthwash significantly decreased the intensity of OM compared to placebo at week 2 (score: 5.5 vs. 6.8, p = 0.019), week 3 (score: 8.25 vs. 10.95, p < 0.0001) and week 6 (score: 11.4 vs. 13.35, p = 0.031). Total antioxidant, polyphenol and flavonoid contents and quercetin concentration of the 2% extract were 2353.4 ± 56.5 μM, 313.40 ± 6.52 mg/g, 76.66 ± 23.24 mg/g, and 19.41 ± 4.34 mg/l, respectively. Calendula extract gel could be effective on decreasing the intensity of radiotherapy- induced OM during the treatment and antioxidant capacity may be partly responsible for the effect. PMID:23497687

  14. Antioxidant capacity of calendula officinalis flowers extract and prevention of radiation induced oropharyngeal mucositis in patients with head and neck cancers: a randomized controlled clinical study.

    PubMed

    Babaee, Neda; Moslemi, Dariush; Khalilpour, Mohammad; Vejdani, Fatemeh; Moghadamnia, Yasaman; Bijani, Ali; Baradaran, Mahmoud; Kazemi, Mohammad Taghi; Khalilpour, Asieh; Pouramir, Mahdi; Moghadamnia, Ali Akbar

    2013-01-01

    This study was designed to determine the effect of Calendula officinalis flowers extract mouthwash as oral gel on radiation-induced oropharyngeal mucositis (OM) in patients with head-and-neck cancer. Forty patients with neck and head cancers under radiotherapy or concurrent chemoradiotherapy protocols were randomly assigned to receive either 2% calendula extract mouthwash or placebo (20 patients in each group). Patients were treated with telecobalt radiotherapy at conventional fractionation (200 cGy/fraction, five fractions weekly, 30-35 fractions within 4-7 weeks). The oropharyngeal mucositis was evaluated by two clinical investigators (a radiation oncologist and a dentist), using the oral mucositis assessment scale (OMAS). Trying to find out the possible mechanism of action of the treatment, total antioxidant, polyphenol and flavonoid contents, and quercetin concentration of the mouth wash were measured. Calendula mouthwash significantly decreased the intensity of OM compared to placebo at week 2 (score: 5.5 vs. 6.8, p = 0.019), week 3 (score: 8.25 vs. 10.95, p < 0.0001) and week 6 (score: 11.4 vs. 13.35, p = 0.031). Total antioxidant, polyphenol and flavonoid contents and quercetin concentration of the 2% extract were 2353.4 ± 56.5 μM, 313.40 ± 6.52 mg/g, 76.66 ± 23.24 mg/g, and 19.41 ± 4.34 mg/l, respectively. Calendula extract gel could be effective on decreasing the intensity of radiotherapy- induced OM during the treatment and antioxidant capacity may be partly responsible for the effect. PMID:23497687

  15. Effect of continued treatment with pirfenidone following clinically meaningful declines in forced vital capacity: analysis of data from three phase 3 trials in patients with idiopathic pulmonary fibrosis

    PubMed Central

    Nathan, Steven D; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; du Bois, Roland M; Fagan, Elizabeth A; Fishman, Robert S; Glaspole, Ian; Glassberg, Marilyn K; King, Talmadge E; Lancaster, Lisa; Lederer, David J; Lin, Zhengning; Pereira, Carlos A; Swigris, Jeffrey J; Valeyre, Dominique; Noble, Paul W; Wells, Athol U

    2016-01-01

    Background The assessment of treatment response in idiopathic pulmonary fibrosis (IPF) is complicated by the variable clinical course. We examined the variability in the rate of disease progression and evaluated the effect of continued treatment with pirfenidone in patients who experienced meaningful progression during treatment. Methods The source population included patients enrolled in the ASCEND and CAPACITY trials (N=1247). Pearson's correlation coefficients were used to characterise the relationship between changes in FVC during consecutive 6-month intervals in the placebo population. Outcomes following a ≥10% decline in FVC were evaluated by comparing the proportion of patients in the pirfenidone and placebo groups who experienced a ≥10% decline in FVC or death during the subsequent 6 months. Results A weak negative correlation was observed between FVC changes during consecutive intervals in the placebo population (coefficient, −0.146, p<0.001), indicating substantial variability. Thirty-four (5.5%) and 68 (10.9%) patients in the pirfenidone and placebo groups, respectively, experienced a ≥10% decline in FVC by month 6. During the subsequent 6 months, fewer patients in the pirfenidone group compared with placebo experienced a ≥10% decline in FVC or death (5.9% vs 27.9%; relative difference, 78.9%). There was one (2.9%) death in the pirfenidone group and 14 (20.6%) deaths in the placebo group (relative difference, 85.7%). Conclusions Longitudinal FVC data from patients with IPF showed substantial intrasubject variability, underscoring the inability to reliably assess therapeutic response using serial FVC trends. In patients who progressed during treatment, continued treatment with pirfenidone resulted in a lower risk of subsequent FVC decline or death. Trial registration numbers NCT01366209, NCT00287729, NCT00287716. PMID:26968970

  16. The combined predictive capacity of rat models of algogen-induced and neuropathic hypersensitivity to clinically used analgesics varies with nociceptive endpoint and consideration of locomotor function.

    PubMed

    Munro, Gordon; Storm, Ann; Hansen, Merete K; Dyhr, Helene; Marcher, Lotte; Erichsen, Helle K; Sheykhzade, Majid

    2012-05-01

    Different neurobiological mechanism(s) might contribute to evoked and non-evoked pains and to limited translational drug discovery efforts. Other variables including the pain model and sensory testing method used, dose/route/preadministration time of compound(s), lack of adverse effect profiling and level of observer experience might also contribute. With these points in mind, we tested three mechanistically distinct analgesics in rat models of algogen-induced and neuropathic pain. In chronic constriction injury (CCI) rats evoked hindpaw mechanical hypersensitivity and spontaneous weight bearing deficits developed quickly and persisted for at least 3 weeks post-injury. In contrast, evoked cold hypersensitivity, or movement-associated behavioural deficits (rotarod, beam-walking) were less manifested or dissipated rapidly post-injury. Mechanical hypersensitivity was dose-dependently reversed by morphine (3-10 mg/kg, s.c.) and gabapentin (50-200 mg/kg, i.p.). Weight bearing deficits and cold hypersensitivity were reversed only by high doses of each drug. Surprisingly, duloxetine (10-60 mg/kg, s.c.) was largely ineffective in neuropathic rats although it partially reduced formalin-induced spontaneous nocifensive behaviours; especially during interphase, a period associated with activation of descending monoaminergic inhibition. Morphine and gabapentin markedly attenuated second phase formalin- and in addition capsaicin-induced nocifensive behaviours; indicative of effects on central sensitization and nociceptor hyperexcitability mechanisms. Only gabapentin consistently attenuated nociceptive behaviours at a dose that did not impair exploratory locomotor behaviour in naïve rats. Accordingly, this comparative analysis indicates that the pharmacological sensitivity of evoked and non-evoked pain indices does not necessarily correlate within models, perhaps reflecting differing underlying mechanisms. Conversely, the pharmacological specificity of non-evoked pain indices to

  17. Reflection Coefficients.

    ERIC Educational Resources Information Center

    Greenslade, Thomas B., Jr.

    1994-01-01

    Discusses and provides an example of reflectivity approximation to determine whether reflection will occur. Provides a method to show thin-film interference on a projection screen. Also applies the reflectivity concepts to electromagnetic wave systems. (MVL)

  18. The Reflective Learning Continuum: Reflecting on Reflection

    ERIC Educational Resources Information Center

    Peltier, James W.; Hay, Amanda; Drago, William

    2005-01-01

    The importance of reflection to marketing educators is increasingly recognized. However, there is a lack of empirical research that considers reflection within the context of both the marketing and general business education literature. This article describes the use of an instrument that can be used to measure four identified levels of a…

  19. Withdrawal and withholding of medical treatment for patients lacking capacity who are in a critical condition--reflections on the judgment of the Supreme Court in Aintree University Hospitals NHS Foundation Trust v James.

    PubMed

    Wise, Ian

    2014-12-01

    Consideration of recent judgment of the Supreme Court in leading case concerning the withdrawal and withholding of medical treatment for a patient lacking capacity who was in a critical condition. PMID:25349194

  20. Reflections From the Intersection of Health Professions Education and Clinical Practice: The State of the Science of Interprofessional Education and Collaborative Practice.

    PubMed

    Lutfiyya, M Nawal; Brandt, Barbara F; Cerra, Frank

    2016-06-01

    This informed reflection, from the intersection of health professions education and clinical practice, takes stock of the state of the field of interprofessional education (IPE) and collaborative practice (CP) (together IPECP) by answering the following three questions: (1) As a field of study, where is IPECP? (2) As a research enterprise, what are the current analytical gaps? (3) Scientifically, what needs to be done going forward? While IPE and CP, as well as IPECP, have been areas of scholarly inquiry for nearly 50 years, they have collectively and individually had a limited sphere of influence. Analytical gaps identified include little research dealing with big picture health-related outcomes; mixed results on the effectiveness of health care teams; increasing recognition that additional IPECP competencies might be needed; a gap between the identification and application of educational best practices; and the need for sound, reliable, and validated tools for measuring IPECP. The authors outline the work of the National Center for Interprofessional Practice and Education at the University of Minnesota, which is focused on filling the identified analytical gaps by way of strategic actions organized around three domains-(1) developing an IPECP research agenda, (2) nurturing IPECP intervention research grounded in comparative effectiveness research study designs and the assumptions of critical realism, and (3) the creation of a sound informatics platform. The authors argue that filling these gaps is important because if the effectiveness of IPE on CP and of CP on health outcomes is ever to be ascertained, generalizable findings are paramount. PMID:26959223

  1. Clinical Measures Are Feasible and Sensitive to Assess Balance and Gait Capacities in Older Persons with Mild to Moderate Intellectual Disabilities

    ERIC Educational Resources Information Center

    Enkelaar, Lotte; Smulders, Ellen; Lantman-de Valk, Henny van Schrojenstein; Weerdesteyn, Vivian; Geurts, Alexander C. H.

    2013-01-01

    Mobility limitations are common in persons with Intellectual Disabilities (ID). Differences in balance and gait capacities between persons with ID and controls have mainly been demonstrated by instrumented assessments (e.g. posturography and gait analysis), which require sophisticated and expensive equipment such as force plates or a 3D motion…

  2. Magnitude and Complexity of Rectal Mucosa HIV-1-Specific CD8+ T-Cell Responses during Chronic Infection Reflect Clinical Status

    PubMed Central

    Critchfield, J. William; Young, Delandy H.; Hayes, Timothy L.; Braun, Jerome V.; Garcia, Juan C.; Pollard, Richard B.; Shacklett, Barbara L.

    2008-01-01

    Background The intestinal mucosa displays robust virus replication and pronounced CD4+ T-cell loss during acute human immunodeficiency virus type 1 (HIV-1) infection. The ability of HIV-specific CD8+ T-cells to modulate disease course has prompted intensive study, yet the significance of virus-specific CD8+ T-cells in mucosal sites remains unclear. Methods and Findings We evaluated five distinct effector functions of HIVgag-specific CD8+ T-cells in rectal mucosa and blood, individually and in combination, in relationship to clinical status and antiretroviral therapy (ART). In subjects not on ART, the percentage of rectal Gag-specific CD8+ T-cells capable of 3, 4 or 5 simultaneous effector functions was significantly related to blood CD4 count and inversely related to plasma viral load (PVL) (p<0.05). Polyfunctional rectal CD8+ T-cells expressed higher levels of MIP-1β and CD107a on a per cell basis than mono- or bifunctional cells. The production of TNFα, IFN-γ, and CD107a by Gag-specific rectal CD8+ T-cells each correlated inversely (p<0.05) with PVL, and MIP-1β expression revealed a similar trend. CD107a and IFN-γ production were positively related to blood CD4 count (p<0.05), with MIP-1β showing a similar trend. IL-2 production by rectal CD8+ T-cells was highly variable and generally low, and showed no relationship to viral load or blood CD4 count. Conclusions The polyfunctionality of rectal Gag-specific CD8+ T-cells appears to be related to blood CD4 count and inversely related to PVL. The extent to which these associations reflect causality remains to be determined; nevertheless, our data suggest a potentially important role for mucosal T-cells in limiting virus replication during chronic infection. PMID:18974782

  3. Bioethics for clinicians: 3. Capacity.

    PubMed Central

    Etchells, E; Sharpe, G; Elliott, C; Singer, P A

    1996-01-01

    In the context of patient consent, "capacity" refers to the patient's ability to understand information relevant to a treatment decision and to appreciate the reasonably foreseeable consequences of a decision or lack of decision. A person may be "capable" with respect to one decision but not with respect to another. Clinicians can usually identify patients who are clearly capable or incapable, but in some cases a clinical capacity assessment is required. Such assessment may consist of cognitive status testing, general impressions of capacity or specific capacity assessment. Specific capacity assessment, in which the clinician evaluates the patient's ability to understand pertinent information and appreciate its implications, is probably the optimal method. When conducting a specific capacity assessment, the clinician must ensure that the disclosure of information is effective and must evaluate the patient's reason for his or her decision. If the assessment suggests that the patient is incapable, further assessment is generally recommended. PMID:8823211

  4. The Value of Reflective: Functioning within an Academic Therapeutic Nursery.

    PubMed

    LaLonde, Mary M; Dreier, Mona; Aaronson, Gayle; O'Brien, John

    2015-01-01

    The self begins as a social self and is dependent on the other and the self-other relationship. Furthermore, shortly after birth, the intersubjective self is nurtured and sustained by the reciprocal interactions with the significant other. Recent research suggests that the significant other's reciprocity depends on his or her capacity for mentalization, and this reflective functioning capacity influences not only the child's developing sense of I, other, and we, but also his or her developing attachment pattern. Several studies have demonstrated that parental reflective functioning can be improved with intervention, and enhancing parental reflective functioning can lead to a more secure attachment pattern and better outcomes for the child and parent. Therefore, intervention with toddlers and their families requires us to consider this dynamic two-person psychology. In this paper, we describe an academic parent-child nursery program aimed at enhancing parental reflective functioning. A clinical example from the collaborative treatment of a mother and her two-year-old will demonstrate how reflective functioning can be enhanced in the parent-child dyad and lead to a more secure parent-child relationship. We will also discuss the value of reflective functioning to the interdisciplinary team and how we dealt with countertransference issues that arose during the treatment. PMID:27337824

  5. Cholecalciferol supplementation improves suppressive capacity of regulatory T-cells in young patients with new-onset type 1 diabetes mellitus - A randomized clinical trial.

    PubMed

    Treiber, Gerlies; Prietl, Barbara; Fröhlich-Reiterer, Elke; Lechner, Evelyne; Ribitsch, Anja; Fritsch, Maria; Rami-Merhar, Birgit; Steigleder-Schweiger, Claudia; Graninger, Winfried; Borkenstein, Martin; Pieber, Thomas R

    2015-12-01

    It is unknown if cholecalciferol is able to modify defects in regulatory T cells (Tregs) in type 1 diabetes (T1D). In this randomized, double-blind, placebo controlled trial 30 young patients with new-onset T1D were assigned to cholecalciferol (70IU/kgbodyweight/day) or placebo for 12months. Tregs were determined by FACS-analysis and functional tests were assessed with ex vivo suppression co-cultures at months 0, 3, 6 and 12. Suppressive capacity of Tregs increased (p<0.001) with cholecalciferol from baseline (-1.59±25.6%) to 3 (30.5±39.4%), 6 (44.6±23.8%) and 12months (37.2±25.0%) and change of suppression capacity from baseline to 12months was significantly higher (p<0.05) with cholecalciferol (22.2±47.2%) than placebo (-16.6±21.1%). Serum calcium and parathormone stayed within normal range. This is the first study, which showed that cholecalciferol improved suppressor function of Tregs in patients with T1D and vitamin D could serve as one possible agent in the development of immunomodulatory combination therapies for T1D. PMID:26277548

  6. Reflected Glory

    ERIC Educational Resources Information Center

    Forster, Colin

    2006-01-01

    The scientific model of how people see things is far removed from children's real-world experience. They know that light is needed in order to see an object, but may not know that light is reflected off the object and some of that light enters the eyes. In this article, the author explores children's understanding of reflection and how to develop…

  7. Building Research Capacity of Medical Students and Health Professionals in Rural Communities: Leveraging a Rural Clinical School's Resources to Conduct Research Skills Workshops

    ERIC Educational Resources Information Center

    Lasserre, Kaye E.; Moffatt, Jennifer J.

    2013-01-01

    The paper reports on a project where the objective was for the Rural Clinical School, The University of Queensland, Australia, to design an acceptable model of research skills workshops for medical students and rural health professionals. Eight, interactive research skills workshops focused on skill development were conducted in rural Queensland,…

  8. Evaluation of short-term use of nocturnal nasal continuous positive airway pressure for a clinical profile and exercise capacity in adult patients with obstructive sleep apnea-hypopnea syndrome

    PubMed Central

    Goel, Amrit K; Talwar, Deepak; Jain, Sushil K

    2015-01-01

    Background and Aim: The obstructive sleep apnea–hypopnea syndrome (OSAHS) is a common chronic respiratory disease, characterized by repetitive complete or partial collapse of the upper airway during sleep. The clinical spectrum extends between stoppage of breathing, snoring, daytime somnolence, and fatigue, to serious cardiovascular disease, stroke, metabolic syndrome, increased morbidity, and mortality. We aim to evaluate the short-term use of nasal continuous positive airway pressure (nCPAP) therapy for the clinical profile and exercise capacity of patients with OSAHS. Patient Selection: Twenty patients diagnosed with moderate-to-severe OSAHS were enrolled in the study (study group — 15; clinically and PSG-matched control group — 5). Materials and Methods: Each patient was clinically evaluated for sleep-related symptoms, and also assessed with spirometry, the six-minute walk test (6MWT), and a symptom-limited incremental cardiopulmonary exercise test (CPET). The study group patients were administered nCPAP therapy for eight hours each night for four weeks, while the control group patients were just observed. They were re-assessed after four weeks and the data were statistically analyzed between the two groups. Results: The study group patients showed a significant (P- < 0.05) improvement in the OSAHS symptoms—the Epworth sleepiness score, six-minute walk distance; duration of exercise, power output, peak oxygen uptake, anaerobic threshold, diastolic blood pressure, dyspnea, and fatigue—in comparison with the control group patients. The improvement in exercise capacity following nCPAP therapy was attributed to the relief of disabling the OSAHS symptoms and improved cardiovascular, ventilator, and musculoskeletal functions. Conclusion: All OSAHS patients must be treated with nCPAP. PMID:25983407

  9. Reflection and Learning: Characteristics, Obstacles, and Implications

    ERIC Educational Resources Information Center

    Denton, David

    2011-01-01

    Reflection represents an important form of human thought; from ancient to modern times, the human capacity for reflective thinking has held the imagination of various philosophers and educational theorists. Despite this interest, researchers define reflection in different ways. One of the purposes of this article is to explore the activity of…

  10. Multicultural Training Applied in Clinical Practice: Reflections from a Euro-American Female Counselor-in-Training Working with Mexican Immigrants

    ERIC Educational Resources Information Center

    Paynter, Clara K.; Estrada, Diane

    2009-01-01

    The clinical experience of a Euro-American female counselor-in-training providing bilingual family therapy services to Mexican immigrants is described. Cultural themes encountered when applying academic discourse to clinical work are raised in the context of case studies in which the student therapist works from a postmodern client-as-expert…

  11. Students' Reflections on the Relationships between Safe Learning Environments, Learning Challenge and Positive Experiences of Learning in a Simulated GP Clinic

    ERIC Educational Resources Information Center

    Young, J. E.; Williamson, M. I.; Egan, T. G.

    2016-01-01

    Learning environments are a significant determinant of student behaviour, achievement and satisfaction. In this article we use students' reflective essays to identify key features of the learning environment that contributed to positive and transformative learning experiences. We explore the relationships between these features, the students'…

  12. [Functional capacity evaluation in a clinical and ambulatory setting: new challenges of accelerometry to assessment balance and muscle power in aging population].

    PubMed

    Izquierdo, M; Martínez-Ramírez, A; Larrión, J L; Irujo-Espinosa, M; Gómez, M

    2008-01-01

    If we consider a population of free-living individuals, who are 65 years old and even older, a substantial proportion (in the range of 6% to 25%) suffers from many of the elements of the syndrome of frailty. Although the syndrome is complex and still lacks a standard definition, there is a growing consensus about its signs and symptoms. Patients who are afflicted with frailty typically exhibit losses of muscle strength, fatigue easily, are physically inactive, with an increased risk (and fear) of falling, have undergone a recent, unintentional loss of weight, experience impaired cognition and depression, all of which is frequently complicated by a variety of coexistent illnesses. In this context, functional tests to predict disability and frailty are needed. Accelerometry offers a practical and low cost method of objectively monitoring human movements, and has particular applicability to the monitoring of disability in an aging population. Accelerometers have been used to monitor a range of different movements, including gait, sit to stand transfers and postural sway. This review focuses on methodological concepts in the evaluation of skeletal muscle function and monitoring systems (accelerometers and gyroscopes) in each of these areas. An integrated approach is described in which a combination of accelorometry and gyroscopy can be used to monitor a range of different parameters (muscle power, gait and balance) in an aging population in a clinical or out-patient setting. PMID:18953364

  13. Reflective Learning

    ERIC Educational Resources Information Center

    Morales, Stephen

    2011-01-01

    In this article, the author presents his study of parent participation at an international school in Spain offering the British curriculum. He used quantitative methods and administered questionnaires to gather data that reflected the views of a large proportion of the school's parent community. He administered semi-structured interviews to gain a…

  14. Capacity Building of MAGDAS

    NASA Astrophysics Data System (ADS)

    Yumoto, K.

    2011-12-01

    Under the framework of the MAGDAS Project of SERC (at Kyushu University), this report will cover the three phases of "Capacity Building": (1) Development of instrument capacity, (2) Development of data analysis capacity, and (3) Development of science capacity. Capacity Building is one of the major goals of IHY and ISWI, as specified by the organizers of IHY and ISWI.

  15. Safety profile, efficacy, and biodistribution of a bicistronic high-capacity adenovirus vector encoding a combined immunostimulation and cytotoxic gene therapy as a prelude to a phase I clinical trial for glioblastoma

    SciTech Connect

    Puntel, Mariana; Ghulam, Muhammad A.K.M.; Farrokhi, Catherine; VanderVeen, Nathan; Paran, Christopher; Appelhans, Ashley; Kroeger, Kurt M.; Salem, Alireza; Lacayo, Liliana; Pechnick, Robert N.; Kelson, Kyle R.; Kaur, Sukhpreet; Kennedy, Sean; Palmer, Donna; Ng, Philip; and others

    2013-05-01

    Adenoviral vectors (Ads) are promising gene delivery vehicles due to their high transduction efficiency; however, their clinical usefulness has been hampered by their immunogenicity and the presence of anti-Ad immunity in humans. We reported the efficacy of a gene therapy approach for glioma consisting of intratumoral injection of Ads encoding conditionally cytotoxic herpes simplex type 1 thymidine kinase (Ad-TK) and the immunostimulatory cytokine fms-like tyrosine kinase ligand 3 (Ad-Flt3L). Herein, we report the biodistribution, efficacy, and neurological and systemic effects of a bicistronic high-capacity Ad, i.e., HC-Ad-TK/TetOn-Flt3L. HC-Ads elicit sustained transgene expression, even in the presence of anti-Ad immunity, and can encode large therapeutic cassettes, including regulatory elements to enable turning gene expression “on” or “off” according to clinical need. The inclusion of two therapeutic transgenes within a single vector enables a reduction of the total vector load without adversely impacting efficacy. Because clinically the vectors will be delivered into the surgical cavity, normal regions of the brain parenchyma are likely to be transduced. Thus, we assessed any potential toxicities elicited by escalating doses of HC-Ad-TK/TetOn-Flt3L (1 × 10{sup 8}, 1 × 10{sup 9}, or 1 × 10{sup 10} viral particles [vp]) delivered into the rat brain parenchyma. We assessed neuropathology, biodistribution, transgene expression, systemic toxicity, and behavioral impact at acute and chronic time points. The results indicate that doses up to 1 × 10{sup 9} vp of HC-Ad-TK/TetOn-Flt3L can be safely delivered into the normal rat brain and underpin further developments for its implementation in a phase I clinical trial for glioma. - Highlights: ► High capacity Ad vectors elicit sustained therapeutic gene expression in the brain. ► HC-Ad-TK/TetOn-Flt3L encodes two therapeutic genes and a transcriptional switch. ► We performed a dose escalation study at

  16. Standardized clinical pathways may potentially help to reduce the opacity of medical treatment in China - reflections on the murder of a doctor in Wenling, Zhejiang.

    PubMed

    Mei, L; Xu, L Z

    2013-10-01

    A doctor was murdered at Wenling First People's Hospital in Zhejiang, China on October 25, 2013. During the incident, a patient assaulted three doctors, resulting in the death of one of the doctors. This incident has led to a heated discussion about the unhealthy doctor-patient relationship in China. There are complex reasons for the strained doctor-patient relationship in China, but one aspect that helped lead to this situation is the opacity of medical treatment. Research has shown that implementation of clinical pathways reduces the variability of clinical practice and improves outcomes. Standardized clinical pathways can provide a standard for evaluation of the rationality of treatment and also suggest a recommended treatment, potentially reducing the opacity of medical treatment in China. However, the standardized clinical pathways that are currently in use in China still need to be improved. The implementation of clinical pathways needs to be increased, those pathways need to be formulated in detail, a supervisory body needs to be established, and the public needs to be better informed. These aspects should be studied further. PMID:24270386

  17. What limits working memory capacity?

    PubMed

    Oberauer, Klaus; Farrell, Simon; Jarrold, Christopher; Lewandowsky, Stephan

    2016-07-01

    We review the evidence for the 3 principal theoretical contenders that vie to explain why and how working memory (WM) capacity is limited. We examine the possibility that capacity limitations arise from temporal decay; we examine whether they might reflect a limitation in cognitive resources; and we ask whether capacity might be limited because of mutual interference of representations in WM. We evaluate each hypothesis against a common set of findings reflecting the capacity limit: The set-size effect and its modulation by domain-specificity and heterogeneity of the memory set; the effects of unfilled retention intervals and of distractor processing in the retention interval; and the pattern of correlates of WM tests. We conclude that-at least for verbal memoranda-a decay explanation is untenable. A resource-based view remains tenable but has difficulty accommodating several findings. The interference approach has its own set of difficulties but accounts best for the set of findings, and therefore, appears to present the most promising approach for future development. (PsycINFO Database Record PMID:26950009

  18. Event-related brain potentials reflect increased concentration ability after mindfulness-based cognitive therapy for depression: a randomized clinical trial.

    PubMed

    Bostanov, Vladimir; Keune, Philipp M; Kotchoubey, Boris; Hautzinger, Martin

    2012-10-30

    Mindfulness-based cognitive therapy (MBCT) effectively prevents relapse/recurrence in major depression. The ability to deploy and maintain attention on a particular focus is considered as a prerequisite for 'mindful', 'metacognitive' awareness, and hence crucial for therapy success. Accordingly, sustained concentration is the skill most extensively taught in MBCT. The goal of the present study was to test whether this ability increases after MBCT, as assumed. The late component of the contingent negative variation (CNV), an event-related brain potential (ERP), known to reflect the allocation of attentional resources, was used as the measure of concentration ability. In the main phase of the study, 91 recurrently depressed patients in remission were randomly assigned to eight-week treatment by either MBCT or waiting (WAIT for delayed MBCT). The CNV response to an auditory test stimulus was measured pre- and post-treatment in a 'mindfulness task', in which patients were instructed to focus on their breath, as taught in MBCT. The late CNV (LCNV) was increased only after MBCT (and not after WAIT). This result reflects patients' improved ability to shift their attention toward current moment experience and away from potentially depressogenic thinking or rumination during mild dysphoric states-a known risk factor for depressive relapse/recurrence. PMID:22771173

  19. Haitian reflections.

    PubMed

    Docrat, Fathima

    2010-08-01

    Natural disasters and acts of terrorism demonstrate a similar critical need for national preparedness. As one of a team of volunteers with a local South African NGO who recently went on a medical mission, I would like to share glimpses of our experience and reflect on the mistakes - and also to state the obvious: that we do not learn from our mistakes. A simple literature search has shown that the same mistakes happen repeatedly. 'Humanitarian disasters occur with frightening regularity, yet international responses remain fragmented, with organizations and responders being forced to "reinvent the wheel" with every new event'. This is the result of an obvious lack of preparedness. PMID:20822625

  20. Reflective Packaging

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The aluminized polymer film used in spacecraft as a radiation barrier to protect both astronauts and delicate instruments has led to a number of spinoff applications. Among them are aluminized shipping bags, food cart covers and medical bags. Radiant Technologies purchases component materials and assembles a barrier made of layers of aluminized foil. The packaging reflects outside heat away from the product inside the container. The company is developing new aluminized lines, express mailers, large shipping bags, gel packs and insulated panels for the building industry.

  1. LMO2 expression reflects the different stages of blast maturation and genetic features in B-cell acute lymphoblastic leukemia and predicts clinical outcome

    PubMed Central

    Malumbres, Raquel; Fresquet, Vicente; Roman-Gomez, Jose; Bobadilla, Miriam; Robles, Eloy F.; Altobelli, Giovanna G.; Calasanz, M.ª José; Smeland, Erlend B.; Aznar, Maria Angela; Agirre, Xabier; Martin-Palanco, Vanesa; Prosper, Felipe; Lossos, Izidore S.; Martinez-Climent, Jose A.

    2011-01-01

    Background LMO2 is highly expressed at the most immature stages of lymphopoiesis. In T-lymphocytes, aberrant LMO2 expression beyond those stages leads to T-cell acute lymphoblastic leukemia, while in B cells LMO2 is also expressed in germinal center lymphocytes and diffuse large B-cell lymphomas, where it predicts better clinical outcome. The implication of LMO2 in B-cell acute lymphoblastic leukemia must still be explored. Design and Methods We measured LMO2 expression by real time RT-PCR in 247 acute lymphoblastic leukemia patient samples with cytogenetic data (144 of them also with survival and immunophenotypical data) and in normal hematopoietic and lymphoid cells. Results B-cell acute lymphoblastic leukemia cases expressed variable levels of LMO2 depending on immunophenotypical and cytogenetic features. Thus, the most immature subtype, pro-B cells, displayed three-fold higher LMO2 expression than pre-B cells, common-CD10+ or mature subtypes. Additionally, cases with TEL-AML1 or MLL rearrangements exhibited two-fold higher LMO2 expression compared to cases with BCR-ABL rearrangements or hyperdyploid karyotype. Clinically, high LMO2 expression correlated with better overall survival in adult patients (5-year survival rate 64.8% (42.5%–87.1%) vs. 25.8% (10.9%–40.7%), P= 0.001) and constituted a favorable independent prognostic factor in B-ALL with normal karyotype: 5-year survival rate 80.3% (66.4%–94.2%) vs. 63.0% (46.1%–79.9%) (P= 0.043). Conclusions Our data indicate that LMO2 expression depends on the molecular features and the differentiation stage of B-cell acute lymphoblastic leukemia cells. Furthermore, assessment of LMO2 expression in adult patients with a normal karyotype, a group which lacks molecular prognostic factors, could be of clinical relevance. PMID:21459790

  2. Pathways to Reflection: Exploring the Reflective Analytical Practices of Novice Teachers

    ERIC Educational Resources Information Center

    Hayden, H. Emily

    2010-01-01

    This mixed methods study explores reflective analytical practices of novice teachers who taught in a University Reading Clinic just prior to student teaching. Novices' reflective practices are compared to reflective practices of experienced teachers in a pilot study in the same setting. A theoretical model of novices' reflective analytical…

  3. Reflected Glory

    NASA Astrophysics Data System (ADS)

    2011-02-01

    The nebula Messier 78 takes centre stage in this image taken with the Wide Field Imager on the MPG/ESO 2.2-metre telescope at the La Silla Observatory in Chile, while the stars powering the bright display take a backseat. The brilliant starlight ricochets off dust particles in the nebula, illuminating it with scattered blue light. Igor Chekalin was the overall winner of ESO's Hidden Treasures 2010 astrophotography competition with his image of this stunning object. Messier 78 is a fine example of a reflection nebula. The ultraviolet radiation from the stars that illuminate it is not intense enough to ionise the gas to make it glow - its dust particles simply reflect the starlight that falls on them. Despite this, Messier 78 can easily be observed with a small telescope, being one of the brightest reflection nebulae in the sky. It lies about 1350 light-years away in the constellation of Orion (The Hunter) and can be found northeast of the easternmost star of Orion's belt. This new image of Messier 78 from the MPG/ESO 2.2-metre telescope at the La Silla Observatory is based on data selected by Igor Chekalin in his winning entry to the Hidden Treasures competition [1]. The pale blue tint seen in the nebula in this picture is an accurate representation of its dominant colour. Blue hues are commonly seen in reflection nebulae because of the way the starlight is scattered by the tiny dust particles that they contain: the shorter wavelength of blue light is scattered more efficiently than the longer wavelength red light. This image contains many other striking features apart from the glowing nebula. A thick band of obscuring dust stretches across the image from the upper left to the lower right, blocking the light from background stars. In the bottom right corner, many curious pink structures are also visible, which are created by jets of material being ejected from stars that have recently formed and are still buried deep in dust clouds. Two bright stars, HD 38563A and

  4. Reflected Glory

    NASA Astrophysics Data System (ADS)

    2011-02-01

    The nebula Messier 78 takes centre stage in this image taken with the Wide Field Imager on the MPG/ESO 2.2-metre telescope at the La Silla Observatory in Chile, while the stars powering the bright display take a backseat. The brilliant starlight ricochets off dust particles in the nebula, illuminating it with scattered blue light. Igor Chekalin was the overall winner of ESO's Hidden Treasures 2010 astrophotography competition with his image of this stunning object. Messier 78 is a fine example of a reflection nebula. The ultraviolet radiation from the stars that illuminate it is not intense enough to ionise the gas to make it glow - its dust particles simply reflect the starlight that falls on them. Despite this, Messier 78 can easily be observed with a small telescope, being one of the brightest reflection nebulae in the sky. It lies about 1350 light-years away in the constellation of Orion (The Hunter) and can be found northeast of the easternmost star of Orion's belt. This new image of Messier 78 from the MPG/ESO 2.2-metre telescope at the La Silla Observatory is based on data selected by Igor Chekalin in his winning entry to the Hidden Treasures competition [1]. The pale blue tint seen in the nebula in this picture is an accurate representation of its dominant colour. Blue hues are commonly seen in reflection nebulae because of the way the starlight is scattered by the tiny dust particles that they contain: the shorter wavelength of blue light is scattered more efficiently than the longer wavelength red light. This image contains many other striking features apart from the glowing nebula. A thick band of obscuring dust stretches across the image from the upper left to the lower right, blocking the light from background stars. In the bottom right corner, many curious pink structures are also visible, which are created by jets of material being ejected from stars that have recently formed and are still buried deep in dust clouds. Two bright stars, HD 38563A and

  5. [The clinical practice and related reflections of staged step-up approach in the treatment of patients with severe acute pancreatitis].

    PubMed

    Sun, Bei; Ji, Liang

    2015-09-01

    Both new insights in the pathophysiology of severe acute pancreatitis (SAP) and upspringing related evidence-based supports prompt the staged step-up approach, which stress emphasis on minimal invasiveness and damage control, to be accepted and advocated by the majority of guidelines. For documented or suspected patients with infected pancreatic necrosis, an imaging-guided percutaneous catheter drainage or an endoscopic transluminal drainage should be initially performed followed by, if necessary, a minimal access retroperitoneal necrosectomy, or a video-assisted retroperitoneal debridement, or an endoscopic transluminal necrosectomy, or an even an open access necrosectomy. The outstanding performance of staged step-up approach in patients with SAP has been justified from both a clinical and a health economic point of view, meanwhile, there are some issues remained to be further elucidated and optimized. PMID:26654144

  6. The role of the public in developing interventions: a reflection and critique of a cancer clinical trials unit’s model

    PubMed Central

    Fitzgibbon, Jim; Baillie, Jessica; Simon, Natalie; Nelson, Annmarie

    2014-01-01

    The importance of involving lay representatives in research is well-recognized but is not consistently meaningfully practiced or reported. Although the positive outcomes of lay representative involvement can include more relevant research questions and outcomes, challenges are also apparent, including tokenistic involvement by research teams. A Cancer Research UK-funded and National Cancer Research Institute-registered cancer clinical trials unit in the United Kingdom established a program of work to promote genuine and consistent involvement of lay representatives (or “research partners”) as part of the research team. Furthermore, a volunteer was employed to recruit and coordinate the research partners in partnership with a national agency for public involvement in health and social care research in Wales. This article reports on the development of this project and how it will be formally evaluated. Recommendations for involving lay representatives are also posed. PMID:25395838

  7. Teaching Critical Reflection to Graduate Students

    ERIC Educational Resources Information Center

    Watson, Gavan Peter Longley; Kenny, Natasha

    2014-01-01

    Critical reflection is a highly valued and widely applied learning approach in higher education. There are many benefits associated with engaging in critical reflection, and it is often integrated into the design of graduate level courses on university teaching as a life-long learning strategy to help ensure that learners build their capacity as…

  8. Reflective Communication: Cultivating Mindsight through Nurturing Relationships

    ERIC Educational Resources Information Center

    Siegel, Daniel J.; Shahmoon-Shanok, Rebecca

    2010-01-01

    This article integrates ideas about mindsight, developed by Daniel Siegel, with those of reflective supervision in the zero-to-three field. The authors explore how the flow of energy and information in the context of nurturing relationships through reflective supervision supports the capacity to develop mindsight. Mindsight is the ability to have…

  9. Inflammatory Marker sTREM-1 Reflects the Clinical Stage and Respiratory Tract Obstruction in Allergic Asthma Bronchiale Patients and Correlates with Number of Neutrophils

    PubMed Central

    Bucova, Maria; Suchankova, Magda; Dzurilla, Martin; Vrlik, Mojmir; Novosadova, Helena; Tedlova, Eva; Urban, Stefan; Hornakova, Edita; Seligova, Marianna; Durmanova, Vladimira; Penz, Peter; Javor, Juraj; Paulovicova, Ema

    2012-01-01

    The knowledge that asthma is an inflammatory disorder has prompted us to investigate the plasma levels of a new inflammatory marker sTREM-1 that is released from the surfaces of activated neutrophils and monocytes. The plasma levels of sTREM-1 were analysed by a sandwich ELISA test in the cohort of 76 patients with allergic asthma bronchiale and 39 healthy controls. Our results revealed more than 3.5 times higher levels of sTREM-1 in AB patients (92.3 pg/mL ± 125.6) compared with healthy subjects (25.7 pg/mL ± 9.2; P = 0.0001). Higher levels of sTREM-1 were found also in patients with exacerbated AB (170.5 pg/mL ± 78.2) compared with nonexacerbated AB patients (59.1 ± 78.2; P < 0.0001), patients with respiratory tract obstruction (176.4 pg/mL ± 177.8), than those without obstruction (51.99 pg/mL ± 64.0; P < 0.0001) and patients with anti-IgE therapy (P < 0.0001). Levels of sTREM-1 correlated with number of leucocytes (P = 0.002), and absolute number of neutrophils (P = 0.001). Elevated plasma levels of sTREM-1 reflect the severity, state of exacerbation, presence of respiratory tract obstruction in AB patients and together with increased number of neutrophils point to the role of neutrophils in inflammation accompanying AB. PMID:22829716

  10. Reflections 1 year into the 21-Center National Institutes of Health--funded WRIST study: a primer on conducting a multicenter clinical trial.

    PubMed

    2013-06-01

    The Wrist and Radius Injury Surgery Trial (WRIST) study group is a collaboration of 21 hand surgery centers in the United States, Canada, and Singapore, to showcase the interest and capability of hand surgeons to conduct a multicenter clinical trial. The WRIST study group was formed in response to the seminal systematic review by Margaliot et al and the Cochrane report that indicated marked deficiency in the quality of evidence in the distal radius fracture literature. Since the initial description of this fracture by Colles in 1814, over 2,000 studies have been published on this subject; yet, high-level studies based on the principles of evidence-based medicine are lacking. As we continue to embrace evidence-based medicine to raise the quality of research, the lessons learned during the organization and conduct of WRIST can serve as a template for others contemplating similar efforts. This article traces the course of WRIST by sharing the triumphs and, more important, the struggles faced in the first year of this study. PMID:23608306

  11. Working with chronic and relentless self-hatred, self-harm, and existential shame: a clinical study and reflections (Paper 2 of 2).

    PubMed

    Austin, Sue

    2016-09-01

    This second of two papers focuses on the shame which emerged in the first 14 years of analysis of a woman who was bulimic, self-harmed, and repeatedly described herself as 'feeling like a piece of shit'. To explore this intense and pervasive shame I draw on Jung's and Laplanche's emphasis on experiences of unresolvable, non-pathological 'foreignness' or 'otherness' at the heart of the psyche. Images, metaphors, elements of clinical experience, and working hypotheses from a number of analytic traditions are used to flesh out this exploration. These include Kilborne's use of Pirandello's image of shame as like a 'hole in the paper sky' which, I suggest, points to a crack in subjectivity, and reveals our belief in the efficacy of the self to be illusory. Hultberg's observations on shame as having an existential mode (function) are also explored, as is the nature of analytic truth. Using these ideas I describe my patient's process of finding some small but freeing space in relation to her shame and self-hatred. Through enduring and learning from her shame in analysis she realized that it was part of a desperate unconscious attempt to draw close to her troubled father and so to 'love him better'. PMID:27530165

  12. Building Leadership Capacity

    ERIC Educational Resources Information Center

    Flanary, Dick

    2009-01-01

    The NASSP "Breaking Ranks" framework lays out multiple strategies for building capacity within a school, beginning with the leaders. To change an organization and increase its capacity to produce greater results, the people within the organization must change and increase their capacity. School change begins with changes in the principal, the…

  13. From Whining to Wondering: Reflective Journaling with Preservice Educators

    ERIC Educational Resources Information Center

    Applebaum, Lauren

    2014-01-01

    Reflective journaling is frequently employed to help preservice educators make sense of fieldwork experiences. Analyzing the weekly journals of eight preservice educators, I offer conceptual language to describe how journal writing provides a window into students' capacity for reflection. This capacity is described in terms of three continua:…

  14. A Reflective Look at Reflecting Teams

    ERIC Educational Resources Information Center

    Pender, Rebecca L.; Stinchfield, Tracy

    2012-01-01

    This article reviewed existing literature and research on the reflecting team process. There is a dearth of empirical research that explores the reflecting team process and the outcome of counseling that uses reflecting teams. Implications of using reflecting teams for counselors, counselor educators, and clients will be discussed. A call for…

  15. Reflected Ceiling Plan/Reflected Deck Plan 2009; Reflected Ceiling Plan/Reflected Deck ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Reflected Ceiling Plan/Reflected Deck Plan 2009; Reflected Ceiling Plan/Reflected Deck Plan 2010 - Gilpin's Falls Covered Bridge, Spanning North East Creek at Former (Bypassed) Section of North East Road (SR 272), North East, Cecil County, MD

  16. Impaired self-reflection in psychiatric disorders among adults: a proposal for the existence of a network of semi independent functions.

    PubMed

    Dimaggio, Giancarlo; Vanheule, Stijn; Lysaker, Paul H; Carcione, Antonino; Nicolò, Giuseppe

    2009-09-01

    Self-reflection plays a key role in healthy human adaptation. Self-reflection might involve different capacities which may be impaired to different degrees relatively independently of one another. Variation in abilities for different forms of self-reflection are commonly seen as key aspects of many adult mental disorders. Yet little has been written about whether there are different kinds of deficits in self-reflection found in mental illness, how those deficits should be distinguished from one another and how to characterize the extent to which they are interrelated. We review clinical and experimental literature and suggest four different forms of deficits in self-reflection: (a) sense of ownership of one's own thoughts and actions, (b) emotional awareness, (c) distinction between fantasy and reality and (d) the integration of a range of different views of oneself and others. We propose how these different impairments in self-reflection are linked with one another. PMID:19615919

  17. On Gaussian feedback capacity

    NASA Technical Reports Server (NTRS)

    Dembo, Amir

    1989-01-01

    Pinsker and Ebert (1970) proved that in channels with additive Gaussian noise, feedback at most doubles the capacity. Cover and Pombra (1989) proved that feedback at most adds half a bit per transmission. Following their approach, the author proves that in the limit as signal power approaches either zero (very low SNR) or infinity (very high SNR), feedback does not increase the finite block-length capacity (which for nonstationary Gaussian channels replaces the standard notion of capacity that may not exist). Tighter upper bounds on the capacity are obtained in the process. Specializing these results to stationary channels, the author recovers some of the bounds recently obtained by Ozarow.

  18. International Clinical Trial Day and clinical trials in Ethiopia and Africa.

    PubMed

    Fekadu, Abebaw; Teferra, Solomon; Hailu, Asrat; Gebre-Mariam, Tsige; Addissie, Adamu; Deressa, Wakgari; Yimer, Getnet; Reja, Ahmed

    2014-01-01

    Low income countries like Ethiopia are underrepresented in clinical research. As a major public commitment to clinical research, Ethiopia celebrated the International Clinical Trial Day (ICTD) for the first time on 20 May 2014 under the auspices of Addis Ababa University. The motto for the day was 'Clinical Trials for Excellence in Patient Care'. The celebration offered an opportunity to inform academic staff, researchers, students and the leadership about clinical trials being conducted and to discuss the future of clinical trials in the country. Although clear challenges to the conduct of trials abound, clinical trials registered from Ethiopia in trial registration databases is increasing. Cross-country collaborations, international funding support, motivation of academic staff to conduct clinical trials and the commitment and engagement of the leadership in research are all improving. The overall impact of clinical trials is also encouraging. For example, some of the trials conducted in Ethiopia have informed treatment guidelines. However, administrative capacity, research infrastructure as well as financial support remain weak. There is a need for enhanced university-industry linkage and translation of research findings into locally relevant evidence. Ethiopia, as well as the whole of Africa, has an unparalleled opportunity to lead the way in clinical trials, given its prospect of development and the need to have locally relevant evidence for its growing population. In this commentary we reflect on the celebration of ICTD, the status and opportunities for conducting clinical trials and the way forward for facilitating clinical trials in Ethiopia and Africa. PMID:25526797

  19. Heat Capacity Analysis Report

    SciTech Connect

    A. Findikakis

    2004-11-01

    The purpose of this report is to provide heat capacity values for the host and surrounding rock layers for the waste repository at Yucca Mountain. The heat capacity representations provided by this analysis are used in unsaturated zone (UZ) flow, transport, and coupled processes numerical modeling activities, and in thermal analyses as part of the design of the repository to support the license application. Among the reports that use the heat capacity values estimated in this report are the ''Multiscale Thermohydrologic Model'' report, the ''Drift Degradation Analysis'' report, the ''Ventilation Model and Analysis Report, the Igneous Intrusion Impacts on Waste Packages and Waste Forms'' report, the ''Dike/Drift Interactions report, the Drift-Scale Coupled Processes (DST and TH Seepage) Models'' report, and the ''In-Drift Natural Convection and Condensation'' report. The specific objective of this study is to determine the rock-grain and rock-mass heat capacities for the geologic stratigraphy identified in the ''Mineralogic Model (MM3.0) Report'' (BSC 2004 [DIRS 170031], Table 1-1). This report provides estimates of the heat capacity for all stratigraphic layers except the Paleozoic, for which the mineralogic abundance data required to estimate the heat capacity are not available. The temperature range of interest in this analysis is 25 C to 325 C. This interval is broken into three separate temperature sub-intervals: 25 C to 95 C, 95 C to 114 C, and 114 C to 325 C, which correspond to the preboiling, trans-boiling, and postboiling regimes. Heat capacity is defined as the amount of energy required to raise the temperature of a unit mass of material by one degree (Nimick and Connolly 1991 [DIRS 100690], p. 5). The rock-grain heat capacity is defined as the heat capacity of the rock solids (minerals), and does not include the effect of water that exists in the rock pores. By comparison, the rock-mass heat capacity considers the heat capacity of both solids and pore

  20. Stigma of Mental Illness-1: Clinical reflections

    PubMed Central

    Shrivastava, Amresh; Johnston, Megan; Bureau, Yves

    2012-01-01

    Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, therapeutic revolutions in psychiatry have not yet been able to reduce stigma. Stigma is a risk factor leading to negative mental health outcomes. It is responsible for treatment seeking delays and reduces the likelihood that a mentally ill patient will receive adequate care. It is evident that delay due to stigma can have devastating consequences. This review will discuss the causes and consequences of stigma related to mental illness. PMID:22654383

  1. Father regression. Clinical narratives and theoretical reflections.

    PubMed

    Stein, Ruth

    2006-08-01

    The author deals with love-hate enthrallment and submission to a primitive paternal object. This is a father-son relationship that extends through increasing degrees of 'primitiveness' or extremeness, and is illustrated through three different constellations that constitute a continuum. One pole of the continuum encompasses certain male patients who show a loving, de-individuated connection to a father experienced as trustworthy, soft, and in need of protection. Further along the continuum is the case of a transsexual patient whose analysis revealed an intense 'God-transference', a bondage to an idealized, feared, and ostensibly protective father-God introject. A great part of this patient's analysis consisted in a fierce struggle to liberate himself from this figure. The other end of the continuum is occupied by religious terrorists, who exemplify the most radical thralldom to a persecutory, godly object, a regressive submission that banishes woman and enthrones a cruel superego, and that ends in destruction and self-destruction. Psychoanalytic thinking has traditionally dealt with the oedipal father and recently with the nurturing father, but there is a gap in thinking about the phallic, archaic father, and his relations with his son(s). The author aims at filling this gap, at the same time as she also raises the very question of 'What is a father?' linking it with literary and religious themes. PMID:16877249

  2. Variable capacity gasification burner

    SciTech Connect

    Saxon, D.I.

    1985-03-05

    A variable capacity burner that may be used in gasification processes, the burner being adjustable when operating in its intended operating environment to operate at two different flow capacities, with the adjustable parts being dynamically sealed within a statically sealed structural arrangement to prevent dangerous blow-outs of the reactants to the atmosphere.

  3. Liquid heat capacity lasers

    DOEpatents

    Comaskey, Brian J.; Scheibner, Karl F.; Ault, Earl R.

    2007-05-01

    The heat capacity laser concept is extended to systems in which the heat capacity lasing media is a liquid. The laser active liquid is circulated from a reservoir (where the bulk of the media and hence waste heat resides) through a channel so configured for both optical pumping of the media for gain and for light amplification from the resulting gain.

  4. Problems of Excess Capacity

    NASA Technical Reports Server (NTRS)

    Douglas, G.

    1972-01-01

    The problems of excess capacity in the airline industry are discussed with focus on the following topics: load factors; fair rate of return on investment; service-quality rivalry among airlines; pricing (fare) policies; aircraft production; and the impacts of excess capacity on operating costs. Also included is a discussion of the interrelationships among these topics.

  5. Reflective Practice in Dance: A Review of the Literature

    ERIC Educational Resources Information Center

    Tembrioti, Lara; Tsangaridou, Niki

    2014-01-01

    The importance of reflective practice is frequently noted in the literature; indeed, reflective capacity is regarded as an essential characteristic for professional competence. The ability to think about why and what one does is critical to intelligent practice, practice that is reflective rather than routine. In recent years, higher education…

  6. Who needs capacity?

    PubMed

    Buchanan, Alec

    2015-01-01

    The UK Law Commission's Discussion Paper, Criminal Liability: Insanity and Automatism, recommends introducing the concept of capacity to the insanity defence. The concept of capacity has an established role in those parts of the law that concern the validity of the decisions that people make, for instance in composing a will or entering into a contract. Making mental capacity a criterion for criminal responsibility in a mentally disordered defendant, however, is potentially problematic. First, the term capacity already has several different meanings in the literature on the jurisprudence of mental abnormality. Second, using the concept of capacity in the way that the Law Commission proposes poses difficulties that relate to the provision of testimony by expert witnesses. PMID:25939285

  7. Nanofluid heat capacities

    NASA Astrophysics Data System (ADS)

    Starace, Anne K.; Gomez, Judith C.; Wang, Jun; Pradhan, Sulolit; Glatzmaier, Greg C.

    2011-12-01

    Significant increases in the heat capacity of heat transfer fluids are needed not only to reduce the costs of liquid heating and cooling processes, but also to bring clean energy producing technologies like concentrating solar power (CSP) to price parity with conventional energy generation. It has been postulated that nanofluids could have higher heat capacities than conventional fluids. In this work, nano- and micron-sized particles were added to five base fluids (poly-α olefin, mineral oil, ethylene glycol, a mixture of water and ethylene glycol, and calcium nitrate tetrahydrate), and the resulting heat capacities were measured and compared with those of the neat base fluids and the weighted average of the heat capacities of the components. The particles used were inert metals and metal oxides that did not undergo any phase transitions over the temperature range studied. In the nanofluids studied here, we found no increase in heat capacity upon the addition of the particles larger than the experimental error.

  8. Challenging Narcissus, or Reflecting on Reflecting.

    ERIC Educational Resources Information Center

    Achilles, C. M.

    The concept of reflective practice and teaching people to be reflective practitioners is examined. The document begins with a look at professional knowledge according to three prominent professionals in the educational administration field: Schon, Schein, and Achilles. "Reflective" strategies that could be incorporated into courses and seminars,…

  9. Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 2--the evaluation.

    PubMed

    Dawber, Chris

    2013-06-01

    This paper outlines an evaluation of reflective practice groups (RPG) involving nurses and midwives from three clinical nursing specialties at Redcliffe and Caboolture Hospitals, Queensland, Australia. The groups were facilitated by the consultation liaison psychiatry nurse and author using a process-focused, whole-of-group approach to explore clinical narrative in a supportive group setting. This was a preliminary evaluation utilizing a recently-developed tool, the Clinical Supervision Evaluation Questionnaire, along with externally-facilitated focus groups. Nurses and midwives responded favourably to RPG, reporting a positive impact on clinical practice, self-awareness, and resilience. The majority of participants considered RPG had positive implications for team functioning. The focus groups identified the importance of facilitation style and the need to address aspects of workplace culture to enable group development and enhance the capacity for reflection. Evaluation of the data indicates this style of RPG can improve reflective thinking, promote team cohesion, and provide support for nurses and midwives working in clinical settings. Following on from this study, a second phase of research has commenced, providing more detailed, longitudinal evaluation across a larger, more diverse group of nurses. PMID:23020828

  10. Emotion and Value in the Evaluation of Medical Decision-Making Capacity: A Narrative Review of Arguments.

    PubMed

    Hermann, Helena; Trachsel, Manuel; Elger, Bernice S; Biller-Andorno, Nikola

    2016-01-01

    Ever since the traditional criteria for medical decision-making capacity (understanding, appreciation, reasoning, evidencing a choice) were formulated, they have been criticized for not taking sufficient account of emotions or values that seem, according to the critics and in line with clinical experiences, essential to decision-making capacity. The aim of this paper is to provide a nuanced and structured overview of the arguments provided in the literature emphasizing the importance of these factors and arguing for their inclusion in competence evaluations. Moreover, a broader reflection on the findings of the literature is provided. Specific difficulties of formulating and measuring emotional and valuational factors are discussed inviting reflection on the possibility of handling relevant factors in a more flexible, case-specific, and context-specific way rather than adhering to a rigid set of operationalized criteria. PMID:27303329

  11. Emotion and Value in the Evaluation of Medical Decision-Making Capacity: A Narrative Review of Arguments

    PubMed Central

    Hermann, Helena; Trachsel, Manuel; Elger, Bernice S.; Biller-Andorno, Nikola

    2016-01-01

    Ever since the traditional criteria for medical decision-making capacity (understanding, appreciation, reasoning, evidencing a choice) were formulated, they have been criticized for not taking sufficient account of emotions or values that seem, according to the critics and in line with clinical experiences, essential to decision-making capacity. The aim of this paper is to provide a nuanced and structured overview of the arguments provided in the literature emphasizing the importance of these factors and arguing for their inclusion in competence evaluations. Moreover, a broader reflection on the findings of the literature is provided. Specific difficulties of formulating and measuring emotional and valuational factors are discussed inviting reflection on the possibility of handling relevant factors in a more flexible, case-specific, and context-specific way rather than adhering to a rigid set of operationalized criteria. PMID:27303329

  12. Capacity Development for Education Systems in Fragile Contexts. Working Paper

    ERIC Educational Resources Information Center

    Davies, Lynn

    2009-01-01

    This paper examines fragility, capacity development and education and the links between these by analysing relevant research and policy literature. It proposes ways forward for action and reflection at national, regional and international levels. An important element of capacity development in education systems is the establishment of education…

  13. Orientations to Reflective Practice.

    ERIC Educational Resources Information Center

    Wellington, Bud; Austin, Patricia

    1996-01-01

    Delineates five orientations to reflective practice: immediate, technical, deliberative, dialectic, and transpersonal, each reflecting different social science bases and beliefs and values about education. Views them as interactive, interdependent, noncompeting, aspects of reflective practice. (SK)

  14. Emergent Biosynthetic Capacity in Simple Microbial Communities

    PubMed Central

    Chiu, Hsuan-Chao; Levy, Roie; Borenstein, Elhanan

    2014-01-01

    Microbes have an astonishing capacity to transform their environments. Yet, the metabolic capacity of a single species is limited and the vast majority of microorganisms form complex communities and join forces to exhibit capabilities far exceeding those achieved by any single species. Such enhanced metabolic capacities represent a promising route to many medical, environmental, and industrial applications and call for the development of a predictive, systems-level understanding of synergistic microbial capacity. Here we present a comprehensive computational framework, integrating high-quality metabolic models of multiple species, temporal dynamics, and flux variability analysis, to study the metabolic capacity and dynamics of simple two-species microbial ecosystems. We specifically focus on detecting emergent biosynthetic capacity – instances in which a community growing on some medium produces and secretes metabolites that are not secreted by any member species when growing in isolation on that same medium. Using this framework to model a large collection of two-species communities on multiple media, we demonstrate that emergent biosynthetic capacity is highly prevalent. We identify commonly observed emergent metabolites and metabolic reprogramming patterns, characterizing typical mechanisms of emergent capacity. We further find that emergent secretion tends to occur in two waves, the first as soon as the two organisms are introduced, and the second when the medium is depleted and nutrients become limited. Finally, aiming to identify global community determinants of emergent capacity, we find a marked association between the level of emergent biosynthetic capacity and the functional/phylogenetic distance between community members. Specifically, we demonstrate a “Goldilocks” principle, where high levels of emergent capacity are observed when the species comprising the community are functionally neither too close, nor too distant. Taken together, our results

  15. The heat capacity mapping mission

    NASA Technical Reports Server (NTRS)

    Short, N. M.

    1981-01-01

    The first in a series of low cost Atmospheric Explorer Satellites, the Heat Capacity Mapping Mission (HCMM) was designed to evaluate the utility of thermal inertial and other thermal and reflectance data for: (1) discriminating bedrock and unconsolidated regolith types; (2) mapping soil moisture; (3) measuring plant canopy temperatures; (4) examining thermal circulation in large bodies of water; and (5) monitoring urban heat islands. Final reports from the HCMM investigator's program are beginning to define the utility of day/the night thermal data. Under favorable circumstances, some major rock types can be identified, soil moisture in extensive agricultural and alluvial terrains can be detected and at least semiqualitatively assessed; and circulation of currents in large bodies of water can be followed by noting thermal patterns.

  16. Refinery Capacity Report

    EIA Publications

    2016-01-01

    Data series include fuel, electricity, and steam purchased for consumption at the refinery; refinery receipts of crude oil by method of transportation; and current and projected atmospheric crude oil distillation, downstream charge, and production capacities. Respondents are operators of all operating and idle petroleum refineries (including new refineries under construction) and refineries shut down during the previous year, located in the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, and other U.S. possessions. The Refinery Capacity Report does not contain working and shell storage capacity data. This data is now being collected twice a year as of March 31 and September 30 on the Form EIA-810, "Monthly Refinery Report", and is now released as a separate report Working and Net Available Shell Storage Capacity.

  17. Knudsen heat capacity

    SciTech Connect

    Babac, Gulru; Reese, Jason M.

    2014-05-15

    We present a “Knudsen heat capacity” as a more appropriate and useful fluid property in micro/nanoscale gas systems than the constant pressure heat capacity. At these scales, different fluid processes come to the fore that are not normally observed at the macroscale. For thermodynamic analyses that include these Knudsen processes, using the Knudsen heat capacity can be more effective and physical. We calculate this heat capacity theoretically for non-ideal monatomic and diatomic gases, in particular, helium, nitrogen, and hydrogen. The quantum modification for para and ortho hydrogen is also considered. We numerically model the Knudsen heat capacity using molecular dynamics simulations for the considered gases, and compare these results with the theoretical ones.

  18. Refinery Capacity Report

    EIA Publications

    2015-01-01

    Data series include fuel, electricity, and steam purchased for consumption at the refinery; refinery receipts of crude oil by method of transportation; and current and projected atmospheric crude oil distillation, downstream charge, and production capacities. Respondents are operators of all operating and idle petroleum refineries (including new refineries under construction) and refineries shut down during the previous year, located in the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, and other U.S. possessions. The Refinery Capacity Report does not contain working and shell storage capacity data. This data is now being collected twice a year as of March 31 and September 30 on the Form EIA-810, "Monthly Refinery Report", and is now released as a separate report Working and Net Available Shell Storage Capacity.

  19. Forward capacity market CONEfusion

    SciTech Connect

    Wilson, James F.

    2010-11-15

    In ISO New England and PJM it was assumed that sponsors of new capacity projects would offer them into the newly established forward centralized capacity markets at prices based on their levelized net cost of new entry, or ''Net CONE.'' But the FCCMs have not operated in the way their proponents had expected. To clear up the CONEfusion, FCCM designs should be reconsidered to adapt them to the changing circumstances and to be grounded in realistic expectations of market conduct. (author)

  20. Panama Canal capacity analysis

    SciTech Connect

    Bronzini, M.S.

    1995-04-27

    Predicting the transit capacities of the various Panama Canal alternatives required analyzing data on present Canal operations, adapting and extending an existing computer simulation model, performing simulation runs for each of the alternatives, and using the simulation model outputs to develop capacity estimates. These activities are summarized in this paper. A more complete account may be found in the project final report (TAMS 1993). Some of the material in this paper also appeared in a previously published paper (Rosselli, Bronzini, and Weekly 1994).

  1. Photovoltaics effective capacity: Interim final report 2

    SciTech Connect

    Perez, R.; Seals, R.

    1997-11-01

    The authors provide solid evidence, based on more than 8 million data points, that regional photovoltaic (PV) effective capacity is largely unrelated to the region`s solar resource. They confirm, however, that effective capacity is strongly related to load-shape characteristics. The load-shape effective-capacity relationship appears to be valid for end-use loads as small as 100 kW, except possibly in the case of electrically heated buildings. This relationship was used as a tool to produce a US map of PV`s effective capacity. The regions of highest effective capacities include (1) the central US from the northern Great Plains to the metropolitan areas of Chicago and Detroit, down to the lower Mississippi Valley, (2) California and western Arizona, and (3) the northeast metropolitan corridor. The features of this map are considerably different from the traditional solar resource maps. They tend to reflect the socio-economic and climatic factors that indirectly drive PV`s effective capacity: e.g., commercial air-conditioning, little use of electric heat, and strong summer heat waves. The map provides a new and significant insight to a comprehensive valuation of the PV resource. The authors assembled preliminary evidence showing that end-use load type may be related to PV`s effective capacity. Highest effective capacities were found for (nonelectrically heated) office buildings, followed by hospitals. Lowest capacities were found for airports and residences. Many more data points are needed, however, to ascertain and characterize these preliminary findings.

  2. Benefits of Reflective Practice

    ERIC Educational Resources Information Center

    Wagner, Kathi

    2006-01-01

    In this article, the author discusses what she was able to learn from an exercise in self-reflection regarding her teaching. She also discusses the advantages of reflection for administrators: First, a reflective practice is data-driven, making it a more valid way to evaluate administrators' knowledge and skills. Second, a reflective practice…

  3. Telescope With Reflecting Baffle

    NASA Technical Reports Server (NTRS)

    Linlor, W. I.

    1985-01-01

    Telescope baffle made from combination of reflecting surfaces. In contrast with previous ellipsoidal reflecting baffles, new baffle reflects skew rays more effectively and easier to construct. For infrared telescopes, reflecting baffles better than absorbing baffles because heat load reduced, and not necessary to contend with insufficiency of infrared absorption exhibited by black coatings.

  4. Scintillator reflective layer coextrusion

    SciTech Connect

    Yun, Jae-Chul; Para, Adam

    2001-01-01

    A polymeric scintillator has a reflective layer adhered to the exterior surface thereof. The reflective layer comprises a reflective pigment and an adhesive binder. The adhesive binder includes polymeric material from which the scintillator is formed. A method of forming the polymeric scintillator having a reflective layer adhered to the exterior surface thereof is also provided. The method includes the steps of (a) extruding an inner core member from a first amount of polymeric scintillator material, and (b) coextruding an outer reflective layer on the exterior surface of the inner core member. The outer reflective layer comprises a reflective pigment and a second amount of the polymeric scintillator material.

  5. Uncertainty in adaptive capacity

    NASA Astrophysics Data System (ADS)

    Adger, W. Neil; Vincent, Katharine

    2005-03-01

    The capacity to adapt is a critical element of the process of adaptation: it is the vector of resources that represent the asset base from which adaptation actions can be made. Adaptive capacity can in theory be identified and measured at various scales, from the individual to the nation. The assessment of uncertainty within such measures comes from the contested knowledge domain and theories surrounding the nature of the determinants of adaptive capacity and the human action of adaptation. While generic adaptive capacity at the national level, for example, is often postulated as being dependent on health, governance and political rights, and literacy, and economic well-being, the determinants of these variables at national levels are not widely understood. We outline the nature of this uncertainty for the major elements of adaptive capacity and illustrate these issues with the example of a social vulnerability index for countries in Africa. To cite this article: W.N. Adger, K. Vincent, C. R. Geoscience 337 (2005).

  6. Reflectivity, Reflexivity and Situated Reflective Practice

    ERIC Educational Resources Information Center

    Malthouse, Richard; Roffey-Barentsen, Jodi; Watts, Mike

    2014-01-01

    This paper describes an aspect of reflective practice referred to as situated reflective practice. The overarching theory is derived from social theories of structuration and reflexivity. In particular, from Giddens' theory of structuration, which sees social life as an interplay of agency and structure. Discussion of the research reported…

  7. Reflective journaling: developing an online journal for distance education.

    PubMed

    Kessler, Penny D; Lund, Carole H

    2004-01-01

    Reflective journal writing can be a useful heuristic tool to foster critical thinking skills and develop reflective clinical practice in nursing. When combined with a distance education delivery format, the online journal helps to leverage the strengths of reflective learning with educational technology as well as provide a seamless record of learning outcomes across the curriculum. The authors discuss the incorporation of an online reflective journal into a distance education clinical course and provide guidelines for educators considering a similar approach. PMID:14726795

  8. AGU leadership reflects back, looks forward

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie; Buhrman, Joan

    2011-09-01

    AGU president Mike McPhaden, president-elect Carol Finn, and executive director Chris McEntee have served in their current capacities for approximately a year. In this interview, held 18 August after the AGU Council meeting, they reflect back on the year and discuss prospects for the future.

  9. Capacity Maximizing Constellations

    NASA Technical Reports Server (NTRS)

    Barsoum, Maged; Jones, Christopher

    2010-01-01

    Some non-traditional signal constellations have been proposed for transmission of data over the Additive White Gaussian Noise (AWGN) channel using such channel-capacity-approaching codes as low-density parity-check (LDPC) or turbo codes. Computational simulations have shown performance gains of more than 1 dB over traditional constellations. These gains could be translated to bandwidth- efficient communications, variously, over longer distances, using less power, or using smaller antennas. The proposed constellations have been used in a bit-interleaved coded modulation system employing state-ofthe-art LDPC codes. In computational simulations, these constellations were shown to afford performance gains over traditional constellations as predicted by the gap between the parallel decoding capacity of the constellations and the Gaussian capacity

  10. Geothermal Plant Capacity Factors

    SciTech Connect

    Greg Mines; Jay Nathwani; Christopher Richard; Hillary Hanson; Rachel Wood

    2015-01-01

    The capacity factors recently provided by the Energy Information Administration (EIA) indicated this plant performance metric had declined for geothermal power plants since 2008. Though capacity factor is a term commonly used by geothermal stakeholders to express the ability of a plant to produce power, it is a term frequently misunderstood and in some instances incorrectly used. In this paper we discuss how this capacity factor is defined and utilized by the EIA, including discussion on the information that the EIA requests from operations in their 923 and 860 forms that are submitted both monthly and annually by geothermal operators. A discussion is also provided regarding the entities utilizing the information in the EIA reports, and how those entities can misinterpret the data being supplied by the operators. The intent of the paper is to inform the facility operators as the importance of the accuracy of the data that they provide, and the implications of not providing the correct information.

  11. Dual capacity reciprocating compressor

    DOEpatents

    Wolfe, R.W.

    1984-10-30

    A multi-cylinder compressor particularly useful in connection with northern climate heat pumps and in which different capacities are available in accordance with reversing motor rotation is provided with an eccentric cam on a crank pin under a fraction of the connecting rods, and arranged for rotation upon the crank pin between opposite positions 180[degree] apart so that with cam rotation on the crank pin such that the crank throw is at its normal maximum value all pistons pump at full capacity, and with rotation of the crank shaft in the opposite direction the cam moves to a circumferential position on the crank pin such that the overall crank throw is zero. Pistons whose connecting rods ride on a crank pin without a cam pump their normal rate with either crank rotational direction. Thus a small clearance volume is provided for any piston that moves when in either capacity mode of operation. 6 figs.

  12. Dual capacity reciprocating compressor

    DOEpatents

    Wolfe, Robert W.

    1984-01-01

    A multi-cylinder compressor 10 particularly useful in connection with northern climate heat pumps and in which different capacities are available in accordance with reversing motor 16 rotation is provided with an eccentric cam 38 on a crank pin 34 under a fraction of the connecting rods, and arranged for rotation upon the crank pin between opposite positions 180.degree. apart so that with cam rotation on the crank pin such that the crank throw is at its normal maximum value all pistons pump at full capacity, and with rotation of the crank shaft in the opposite direction the cam moves to a circumferential position on the crank pin such that the overall crank throw is zero. Pistons 24 whose connecting rods 30 ride on a crank pin 36 without a cam pump their normal rate with either crank rotational direction. Thus a small clearance volume is provided for any piston that moves when in either capacity mode of operation.

  13. Implementing reflection: insights from pre-registration mental health students.

    PubMed

    Donovan, Moira O

    2007-08-01

    Reflection and reflective practice continues to be contentious issues in nursing. The focus of this article is the use of reflection by pre-registration mental health students. The broad aim of this preliminary study was to discover student mental health nurses' perceptions of reflection as a learning strategy during clinical placement. Using a constructivist grounded theory methodology [Charmaz, K., 2000. Grounded theory: Objectivist and Constructivist Methods. In: Denzin, N., Lincoln, Y. (Eds.), Handbook of Qualitative Research, second ed. Sage, Thousand Oaks, California], five students were interviewed individually in their clinical placements. Data analysis revealed three major categories: understanding the process of reflection, using reflection in clinical practice, and needing support and guidance. Findings indicated that students were primarily using reflection-on-action, but to varying extents. Overall, students felt that reflection facilitated their learning. Factors were discovered that both helped and hindered students' use of reflection. These included level of preparation to reflect, a limited culture of reflection and the level of support from preceptors, clinical staff, clinical placement co-ordinators, and lecturers. In conclusion, it appears that a collaborative approach between students, Health Service Providers and institutes of nursing is vital for the successful development and implementation of reflective learning strategies in clinical placement. Suggestions are made as to how a collaborative approach may be developed to enhance this process. PMID:17081658

  14. Understanding reflective practice.

    PubMed

    Nicol, Jacqueline Sian; Dosser, Isabel

    2016-05-01

    The Nursing and Midwifery Council (NMC) requires that nurses and midwives use feedback as an opportunity for reflection and learning, to improve practice. The NMC revalidation process stipulates that practitioners provide examples of how they have achieved this. To reflect in a meaningful way, it is important to understand what is meant by reflection, the skills required, and how reflection can be undertaken successfully. Traditionally, reflection occurs after an event encountered in practice. The authors challenge this perception, suggesting that reflection should be undertaken before, during and after an event. This article provides practical guidance to help practitioners use reflective models to write reflective accounts. It also outlines how the reflective process can be used as a valuable learning tool in preparation for revalidation. PMID:27154119

  15. Releasing capacity in sexual health through modernization.

    PubMed

    Griffiths, V; Ahmed-Jushuf, I

    2007-05-01

    Increasing rates of sexually transmitted infections (STIs), coupled with a lack of investment, have placed mounting pressure on sexual health services. To address these growing demands and meet new Government targets for access, the British Association for Sexual Health and HIV (BASHH) and other UK bodies are keen to promote modernization and innovation within the service. The 'Six Sigma' study group was formed in 2003 to investigate whether capacity within genitourinary (GU) medicine clinics could be enhanced by further reducing the follow-up to new-case patient visit ratio. A process improvement methodology, Six Sigma, was employed to achieve these aims. The clinics within the Six Sigma group demonstrated a significant reduction in the follow-up to new-case ratio, so releasing a considerable amount of additional capacity. Importantly, this group developed the tools for other GU medicine clinics to achieve similar results and benefit from their considerable expertise. PMID:17524187

  16. Flood Bypass Capacity Optimization

    NASA Astrophysics Data System (ADS)

    Siclari, A.; Hui, R.; Lund, J. R.

    2015-12-01

    Large river flows can damage adjacent flood-prone areas, by exceeding river channel and levee capacities. Particularly large floods are difficult to contain in leveed river banks alone. Flood bypasses often can efficiently reduce flood risks, where excess river flow is diverted over a weir to bypasses, that incur much less damage and cost. Additional benefits of bypasses include ecosystem protection, agriculture, groundwater recharge and recreation. Constructing or expanding an existing bypass costs in land purchase easements, and levee setbacks. Accounting for such benefits and costs, this study develops a simple mathematical model for optimizing flood bypass capacity using benefit-cost and risk analysis. Application to the Yolo Bypass, an existing bypass along the Sacramento River in California, estimates optimal capacity that economically reduces flood damage and increases various benefits, especially for agriculture. Land availability is likely to limit bypass expansion. Compensation for landowners could relax such limitations. Other economic values could affect the optimal results, which are shown by sensitivity analysis on major parameters. By including land geography into the model, location of promising capacity expansions can be identified.

  17. The Moral Capacity Profile

    ERIC Educational Resources Information Center

    Wilks, Duffy; Ratheal, Juli D'Ann

    2011-01-01

    Effective counseling practice continues to be inevitably linked to underlying theories of behavioral causality. In this article, the authors present the Moral Capacity Profile of an individual from the perspective of the Amoral, Moral, Quasi-Moral/Quasi-Immoral, and Immoral Model of Behavior, a model that uniquely expands counseling's theoretical…

  18. Reflections in art

    PubMed Central

    CAVANAGH, PATRICK; CHAO, JESSICA; WANG, DINA

    2009-01-01

    When artists depict a mirror in a painting, it necessarily lacks the most obvious property of a mirror: as we move around the painting of the mirror, the reflections we see in it do not change. And yet representations of mirrors and other reflecting surfaces can be quite convincing in paintings. Here, we will examine the rules of reflection, the many ways that painters can break those rules without losing the impression of reflection and the rules that cannot be broken. The rules that govern the perception of reflection are a small subset of the physical rules of reflection. PMID:18534102

  19. Neutron reflecting supermirror structure

    DOEpatents

    Wood, James L.

    1992-01-01

    An improved neutron reflecting supermirror structure comprising a plurality of stacked sets of bilayers of neutron reflecting materials. The improved neutron reflecting supermirror structure is adapted to provide extremely good performance at high incidence angles, i.e. up to four time the critical angle of standard neutron mirror structures. The reflection of neutrons striking the supermirror structure at a high critical angle provides enhanced neutron throughput, and hence more efficient and economical use of neutron sources.

  20. Neutron reflecting supermirror structure

    DOEpatents

    Wood, J.L.

    1992-12-01

    An improved neutron reflecting supermirror structure comprising a plurality of stacked sets of bilayers of neutron reflecting materials. The improved neutron reflecting supermirror structure is adapted to provide extremely good performance at high incidence angles, i.e. up to four time the critical angle of standard neutron mirror structures. The reflection of neutrons striking the supermirror structure at a high critical angle provides enhanced neutron throughput, and hence more efficient and economical use of neutron sources. 2 figs.

  1. Spectral reflectance of human skin in vivo.

    PubMed

    Andersen, P H; Bjerring, P

    1990-02-01

    A newly developed skin reflectance spectrophotometer was evaluated for measurements of both melanin pigmentation and erythema. Physiological changes in blood flow and blood content in normal humans were induced by compression with an arm cuff during recording of skin reflectance spectra. Reflectance spectra of UV-induced erythema were also recorded and compared with laser-Doppler flow measurements. Spectral reflectance measurements were found to be highly sensitive in determining minimal erythema, which was not clinically detectable. The measurements of erythema using reflectance spectroscopy and UV irradiation were very highly correlated (r = 0.996). It was possible to calculate the in vivo absorbance of oxygenized haemoglobin. The melanin pigmentation following UV irradiation was quantified by reflectance spectroscopy and correlates highly with the dose of UV irradiation (r = 0.995). Furthermore, regional variations in skin melanin and haemoglobin were analysed for fair Caucasian skin. PMID:2196543

  2. Developing reflective writing as effective pedagogy.

    PubMed

    Kennison, Monica

    2012-01-01

    While reflective writing about practice experiences is frequently used in nursing curricula to foster critical thinking, faculty members may be unaware of how to help students reflect, what kinds of feedback are helpful, and how to deal with students' concerns. This article describes faculty best practices in mentoring the student to effectively think critically through structured reflective writing. Models of structured reflection, Baker's four-step model and John's revision of Carper's patterns of knowing, are discussed as effective guides at graduate and undergraduate levels. The article addresses potentially problematic issues with the implementation and evaluation of reflective writing assignments in clinical courses. With foresight and planning, reflective writing may be an empowering strategy for facilitating students' thinking skills. PMID:23061188

  3. Reflective Learning in Practice.

    ERIC Educational Resources Information Center

    Brockbank, Anne, Ed.; McGill, Ian, Ed.; Beech, Nic, Ed.

    This book contains 22 papers on reflective learning in practice. The following papers are included: "Our Purpose" (Ann Brockbank, Ian McGill, Nic Beech); "The Nature and Context of Learning" (Ann Brockbank, Ian McGill, Nic Beech); "Reflective Learning and Organizations" (Ann Brockbank, Ian McGill, Nic Beech); "Reflective Learning in Practice" (Ann…

  4. Liberating Moral Reflection

    ERIC Educational Resources Information Center

    Horell, Harold D.

    2013-01-01

    The author argues that if we are to foster life-giving and liberating moral reflection, we must first liberate moral reflection from distortions; specifically, from the distorting effects of moral insensitivity, destructive moral relativism, and confusions resulting from a failure to understand the dynamics of moral reflection. The author proposes…

  5. Teaching Critical Reflection

    ERIC Educational Resources Information Center

    Smith, Elizabeth

    2011-01-01

    Despite long-standing commitment to the notion of critical reflection across the healthcare professions it is unusual for critical theory and practice to be taught as explicit subjects in healthcare higher education. There is evidence to show that reflective techniques such as critical portfolios and reflective diaries can help students to…

  6. Seismic capacity of switchgear

    SciTech Connect

    Bandyopadhyay, K.; Hofmayer, C.; Kassir, M.; Pepper, S.

    1989-01-01

    As part of a component fragility program sponsored by the USNRC, BNL has collected existing information on the seismic capacity of switchgear assemblies from major manufacturers. Existing seismic test data for both low and medium voltage switchgear assemblies have been evaluated and the generic results are presented in this paper. The failure modes are identified and the corresponding generic lower bound capacity levels are established. The test response spectra have been used as a measure of the test vibration input. The results indicate that relays chatter at a very low input level at the base of the switchgear cabinet. This change of state of devices including relays have been observed. Breaker tripping occurs at a higher vibration level. Although the structural failure of internal elements have been noticed, the overall switchgear cabinet structure withstands a high vibration level. 5 refs., 2 figs., 2 tabs.

  7. Enhancing capacity management.

    PubMed

    Rees, Susan; Houlahan, Beth; Lavrenz, Dennise

    2014-03-01

    It is essential for organizations to be able to accept patients requiring care. Capacity planning and management are necessary to ensure an organization has an accepting physician/service, an available bed, and staff to care for the patient and family. This organization implemented strategies including communication plans, staffing guidelines, morning rounds, proactive planning, and an escalation process to reverse the trend of not being able to accept all patients. PMID:24531280

  8. Heat Capacity Mapping Mission

    NASA Technical Reports Server (NTRS)

    Nilsson, C. S.; Andrews, J. C.; Scully-Power, P.; Ball, S.; Speechley, G.; Latham, A. R. (Principal Investigator)

    1980-01-01

    The Tasman Front was delineated by airborne expendable bathythermograph survey; and an Heat Capacity Mapping Mission (HCMM) IR image on the same day shows the same principal features as determined from ground-truth. It is clear that digital enhancement of HCMM images is necessary to map ocean surface temperatures and when done, the Tasman Front and other oceanographic features can be mapped by this method, even through considerable scattered cloud cover.

  9. CSTI High Capacity Power

    NASA Technical Reports Server (NTRS)

    Winter, Jerry M.

    1989-01-01

    The SP-100 program was established in 1983 by DOD, DOE, and NASA as a joint program to develop the technology necessary for space nuclear power systems for military and civil application. During FY-86 and 87, the NASA SP-100 Advanced Technology Program was devised to maintain the momentum of promising technology advancement efforts started during Phase 1 of SP-100 and to strengthen, in key areas, the chances for successful development and growth capability of space nuclear reactor power systems for future space applications. In FY-88, the Advanced Technology Program was incorporated into NASA's new Civil Space Technology Initiative (CSTI). The CSTI Program was established to provide the foundation for technology development in automation and robotics, information, propulsion, and power. The CSTI High Capacity Power Program builds on the technology efforts of the SP-100 program, incorporates the previous NASA SP-100 Advanced Technology project, and provides a bridge to NASA Project Pathfinder. The elements of CSTI High Capacity Power development include Conversion Systems, Thermal Management, Power Management, System Diagnostics, and Environmental Interactions. Technology advancement in all areas, including materials, is required to assure the high reliability and 7 to 10 year lifetime demanded for future space nuclear power systems. The overall program will develop and demonstrate the technology base required to provide a wide range of modular power systems as well as allowing mission independence from solar and orbital attitude requirements. Several recent advancements in CSTI High Capacity power development will be discussed.

  10. CSTI high capacity power

    SciTech Connect

    Winter, J.M.

    1994-09-01

    The SP-100 program was established in 1983 by DOD, DOE, and NASA as a joint program to develop the technology necessary for space nuclear power systems for military and civil application. During FY86 and 87, the NASA SP-100 Advanced Technology Program was devised to maintain the momentum of promising technology advancement efforts started during Phase I of SP-100 and to strengthen, in key areas, the chances for successful development and growth capability of space nuclear reactor power systems for future space applications. In FY88, the Advanced Technology Program was incorporated into NASA`s new Civil Space Technology Initiative (CSTI). The CSTI Program was established to provide the foundation for technology development in automation and robotics, information, propulsion, and power. The CSTI High Capacity Power Program builds on the technology efforts of the SP-100 program, incorporates the previous NASA SP-100 Advanced Technology project, and provides a bridge to NASA Project Pathfinder. The elements of CSTI High Capacity Power development include Conversion Systems, Thermal Management, Power Management, System Diagnostics, and Environmental Interactions. Technology advancement in all areas, including materials, is required to assure the high reliability and 7 to 10 year lifetime demanded for future space nuclear power systems. The overall program will develop and demonstrate the technology base required to provide a wide range of modular power systems as well as allowing mission independence from solar and orbital attitude requirements. Several recent advancements in CSTI High Capacity power development will be discussed.

  11. Revalidation and reflective practice.

    PubMed

    Finch, Alison

    2016-04-01

    From April 2016 nurses must meet the requirements of the new Nursing and Midwifery Council (NMC) revalidation process to maintain their registration. It is their responsibility to ensure they meet all revalidation requirements, but organisations and nurse leaders can support them to do so. Reflection is an important part of revalidation, and nurses are required to submit written reflective accounts and engage in reflective discussion. This article discusses how revalidation encourages a more conscious and active form of reflection. It also describes how leaders can help nurses to reflect on practice to identify improvements and become more familiar with the NMC Code. PMID:27032284

  12. Scaffolding Collaborative Reflective Writing in a VET Curriculum

    ERIC Educational Resources Information Center

    Boldrini, Elena; Cattaneo, Alberto

    2014-01-01

    Learning journal writing is an effective tool to foster the development of reflective capacity in the context of Vocational Education and Training (VET) if conceived as a collection of descriptions and reflections on real professional experiences. Reporting professional situations in a learning journal outside the workplace in turn fosters the…

  13. Parenting and Adolescent Adjustment: The Role of Parental Reflective Function

    ERIC Educational Resources Information Center

    Benbassat, Naomi; Priel, Beatriz

    2012-01-01

    Reflective function (RF) is the capacity to reflect on one's own mental experiences and those of others. This study examined the relationship between parental RF and adolescent adjustment. One hundred and five adolescents, aged 14-18, and their mothers and fathers were interviewed and completed questionnaires during home visits. We measured…

  14. Cognitive Spare Capacity as an Index of Listening Effort.

    PubMed

    Rudner, Mary

    2016-01-01

    Everyday listening may be experienced as effortful, especially by individuals with hearing loss. This may be due to internal factors, such as cognitive load, and external factors, such as noise. Even when speech is audible, internal and external factors may combine to reduce cognitive spare capacity, or the ability to engage in cognitive processing of spoken information. A better understanding of cognitive spare capacity and how it can be optimally allocated may guide new approaches to rehabilitation and ultimately improve outcomes. This article presents results of three tests of cognitive spare capacity:1. Sentence-final Word Identification and Recall (SWIR) test2. Cognitive Spare Capacity Test (CSCT)3. Auditory Inference Span Test (AIST)Results show that noise reduces cognitive spare capacity even when speech intelligibility is retained. In addition, SWIR results show that hearing aid signal processing can increase cognitive spare capacity, and CSCT and AIST results show that increasing load reduces cognitive spare capacity. Correlational evidence suggests that while the effect of noise on cognitive spare capacity is related to working memory capacity, the effect of load is related to executive function. Future studies should continue to investigate how hearing aid signal processing can mitigate the effect of load on cognitive spare capacity, and whether such effects can be enhanced by developing executive skills through training. The mechanisms modulating cognitive spare capacity should be investigated by studying their neural correlates, and tests of cognitive spare capacity should be developed for clinical use in conjunction with developing new approaches to rehabilitation. PMID:27355773

  15. Reflectance imaging by fiber bundle endoscope: Vertical reconstruction by multipositional illumination

    NASA Astrophysics Data System (ADS)

    Ando, Yoriko; Koida, Kowa; Sawahata, Hirohito; Sakurai, Takashi; Natsume, Mitsuo; Kawano, Takeshi; Numano, Rika

    2016-02-01

    Fiber bundles for imaging internal organs with minimum physical damage have been increasingly developed for both basic life sciences and clinical applications. Reflectance imaging is possible using fiber bundles for detecting the intrinsic optical contrast of blood vessels and tissue structure. The placement of an illumination source adjacent to imaging optics causes scattered light from deeper tissue layers to illuminate superficial tissues and results in a reflectance image. However, it does not have focal capacity and lacks depth resolution. In this study, we performed spatial analysis for the vertical reconstruction of in vivo tissues using a multipositional illumination scheme. The observed image corresponded to the "shadow" of a target object. When we manipulated the location of illumination, the shadow moved horizontally depending on the depth of the target. We used this horizontal displacement as a cue and successfully performed the vertical reconstruction of mouse brain blood vessels.

  16. Surge capacity for healthcare systems: a conceptual framework.

    PubMed

    Kaji, Amy; Koenig, Kristi L; Bey, Tareg

    2006-11-01

    This report reflects the proceedings of a breakout session, "Surge Capacity: Defining Concepts," at the 2006 Academic Emergency Medicine Consensus Conference, "Science of Surge Capacity." Although there are several general descriptions of surge capacity in the literature, there is no universally accepted standard definition specifying the various components. Thus, the objectives of this breakout session were to better delineate the components of surge capacity and to outline the key considerations when planning for surge capacity. Participants were from diverse backgrounds and included academic and community emergency physicians, economists, hospital administrators, and experts in mathematical modeling. Three essential components of surge capacity were identified: staff, stuff, and structure. The focus on enhancing surge capacity during a catastrophic event will be to increase patient-care capacity, rather than on increasing things, such as beds and medical supplies. Although there are similarities between daily surge and disaster surge, during a disaster, the goal shifts from the day-to-day operational focus on optimizing outcomes for the individual patient to optimizing those for a population. Other key considerations in defining surge capacity include psychosocial behavioral issues, convergent volunteerism, the need for special expertise and supplies, development of a standard of care appropriate for a specific situation, and standardization of a universal metric for surge capacity. PMID:16968688

  17. Surface retention capacity calculation

    NASA Astrophysics Data System (ADS)

    David, Vaclav; Dostal, Tomas

    2010-05-01

    Flood wave transformation in the floodplain is the phenomenon which is researched within interdisciplinary project NIVA - Water Retention in Floodplains and Possibilities of Retention Capacity Increase. The project focuses on broad range of floodplain ecosystem services and mitigation of flooding is one of them. Despite main influence on flood wave transformation is due to flow retardation, retention in surface depressions within floodplain has been analyzed to get better overview of whole transformation process. Detail digital relief model (DRM) has been used for given purposes to be able to analyze terrain depressions volumes. The model was developed with use of stereophotogrammetric evaluation of airborne images with high resolution of 10 cm. It was essential for purposes of presented analysis not to apply pit removal routines which are often used for generation of DRM for hydrological modelling purposes. First, the methodology of analysis was prepared and tested on artificial surface. This surface was created using random raster generation, filtration and resampling with final resolution of 1000 x 1000 units and height of maximum 10 units above datum. The methodology itself is based on analysis of areas inundated by water at different elevation levels. Volume is than calculated for each depression using extraction of terrain elevations under corresponding water level. The method was then applied on the area of Lužnice River floodplain section to assess retention capacity of real floodplain. The floodplain had to be cut into sections perpendicular to main river orientation for analyses as the method was tested for square shaped area without any significant inclination. Results obtained by mentioned analysis are presented in this paper. Acknowledgement Presented research was accomplished within national project NIVA - Water Retention in Floodplains and Possibilities of Retention Capacity Increase, nr. QH82078. The project is funded by Ministry of Agriculture of

  18. Honesty in Critically Reflective Essays: An Analysis of Student Practice

    ERIC Educational Resources Information Center

    Maloney, Stephen; Tai, Joanna Hong-Meng; Lo, Kristin; Molloy, Elizabeth; Ilic, Dragan

    2013-01-01

    In health professional education, reflective practice is seen as a potential means for self-improvement from everyday clinical encounters. This study aims to examine the level of student honesty in critical reflection, and barriers and facilitators for students engaging in honest reflection. Third year physiotherapy students, completing summative…

  19. Acoustic Change Complex: Clinical Implications.

    PubMed

    Kim, Jae-Ryong

    2015-12-01

    The acoustic change complex (ACC) is a cortical auditory evoked potential elicited in response to a change in an ongoing sound. The characteristics and potential clinical implications of the ACC are reviewed in this article. The P1-N1-P2 recorded from the auditory cortex following presentation of an acoustic stimulus is believed to reflect the neural encoding of a sound signal, but this provides no information regarding sound discrimination. However, the neural processing underlying behavioral discrimination capacity can be measured by modifying the traditional methodology for recording the P1-N1-P2. When obtained in response to an acoustic change within an ongoing sound, the resulting waveform is referred to as the ACC. When elicited, the ACC indicates that the brain has detected changes within a sound and the patient has the neural capacity to discriminate the sounds. In fact, results of several studies have shown that the ACC amplitude increases with increasing magnitude of acoustic changes in intensity, spectrum, and gap duration. In addition, the ACC can be reliably recorded with good test-retest reliability not only from listeners with normal hearing but also from individuals with hearing loss, hearing aids, and cochlear implants. The ACC can be obtained even in the absence of attention, and requires relatively few stimulus presentations to record a response with a good signal-to-noise ratio. Most importantly, the ACC shows reasonable agreement with behavioral measures. Therefore, these findings suggest that the ACC might represent a promising tool for the objective clinical evaluation of auditory discrimination and/or speech perception capacity. PMID:26771009

  20. Acoustic Change Complex: Clinical Implications

    PubMed Central

    2015-01-01

    The acoustic change complex (ACC) is a cortical auditory evoked potential elicited in response to a change in an ongoing sound. The characteristics and potential clinical implications of the ACC are reviewed in this article. The P1-N1-P2 recorded from the auditory cortex following presentation of an acoustic stimulus is believed to reflect the neural encoding of a sound signal, but this provides no information regarding sound discrimination. However, the neural processing underlying behavioral discrimination capacity can be measured by modifying the traditional methodology for recording the P1-N1-P2. When obtained in response to an acoustic change within an ongoing sound, the resulting waveform is referred to as the ACC. When elicited, the ACC indicates that the brain has detected changes within a sound and the patient has the neural capacity to discriminate the sounds. In fact, results of several studies have shown that the ACC amplitude increases with increasing magnitude of acoustic changes in intensity, spectrum, and gap duration. In addition, the ACC can be reliably recorded with good test-retest reliability not only from listeners with normal hearing but also from individuals with hearing loss, hearing aids, and cochlear implants. The ACC can be obtained even in the absence of attention, and requires relatively few stimulus presentations to record a response with a good signal-to-noise ratio. Most importantly, the ACC shows reasonable agreement with behavioral measures. Therefore, these findings suggest that the ACC might represent a promising tool for the objective clinical evaluation of auditory discrimination and/or speech perception capacity. PMID:26771009

  1. Early hominin auditory capacities.

    PubMed

    Quam, Rolf; Martínez, Ignacio; Rosa, Manuel; Bonmatí, Alejandro; Lorenzo, Carlos; de Ruiter, Darryl J; Moggi-Cecchi, Jacopo; Conde Valverde, Mercedes; Jarabo, Pilar; Menter, Colin G; Thackeray, J Francis; Arsuaga, Juan Luis

    2015-09-01

    Studies of sensory capacities in past life forms have offered new insights into their adaptations and lifeways. Audition is particularly amenable to study in fossils because it is strongly related to physical properties that can be approached through their skeletal structures. We have studied the anatomy of the outer and middle ear in the early hominin taxa Australopithecus africanus and Paranthropus robustus and estimated their auditory capacities. Compared with chimpanzees, the early hominin taxa are derived toward modern humans in their slightly shorter and wider external auditory canal, smaller tympanic membrane, and lower malleus/incus lever ratio, but they remain primitive in the small size of their stapes footplate. Compared with chimpanzees, both early hominin taxa show a heightened sensitivity to frequencies between 1.5 and 3.5 kHz and an occupied band of maximum sensitivity that is shifted toward slightly higher frequencies. The results have implications for sensory ecology and communication, and suggest that the early hominin auditory pattern may have facilitated an increased emphasis on short-range vocal communication in open habitats. PMID:26601261

  2. Albermarle boosts MASC capacity

    SciTech Connect

    D`Amico, E.

    1996-07-17

    Albemarle plans to triple capacity for methylaluminum sesquichloride (MASC) at its Houston complex. The move is in response to growing demand for aluminum alkyl catalyst systems, says Greg Lambeth, product manager/organometallics North America. MASC is the key raw material for trimethylaluminum (TMA), a Ziegler-Natta cocatalyst, and for methylaluminoxane (MAO), a cocatalyst for metallocene polyolefin catalysts. {open_quotes}This is a very competitive area because of the growing importance of metallocenes in polyolefin production,{close_quotes} Lambeth says. Several companies-including Exxon Chemical, Dow Chemical, and Hoechst - have invested in metallocene catalysts this year. Others have announced plans either to convert technology from conventional Ziegler-Natta catalyst systems or to build new facilities for metallocene catalyst production. Albemarle, the largest producer of TMA and other aluminum alkyls, completed a debottlenecking project in Houston earlier this year that increased its capacity 50%. The company also expects to complete a TMA expansion project at its Orangeburg, SC facility soon.

  3. Early hominin auditory capacities

    PubMed Central

    Quam, Rolf; Martínez, Ignacio; Rosa, Manuel; Bonmatí, Alejandro; Lorenzo, Carlos; de Ruiter, Darryl J.; Moggi-Cecchi, Jacopo; Conde Valverde, Mercedes; Jarabo, Pilar; Menter, Colin G.; Thackeray, J. Francis; Arsuaga, Juan Luis

    2015-01-01

    Studies of sensory capacities in past life forms have offered new insights into their adaptations and lifeways. Audition is particularly amenable to study in fossils because it is strongly related to physical properties that can be approached through their skeletal structures. We have studied the anatomy of the outer and middle ear in the early hominin taxa Australopithecus africanus and Paranthropus robustus and estimated their auditory capacities. Compared with chimpanzees, the early hominin taxa are derived toward modern humans in their slightly shorter and wider external auditory canal, smaller tympanic membrane, and lower malleus/incus lever ratio, but they remain primitive in the small size of their stapes footplate. Compared with chimpanzees, both early hominin taxa show a heightened sensitivity to frequencies between 1.5 and 3.5 kHz and an occupied band of maximum sensitivity that is shifted toward slightly higher frequencies. The results have implications for sensory ecology and communication, and suggest that the early hominin auditory pattern may have facilitated an increased emphasis on short-range vocal communication in open habitats. PMID:26601261

  4. Reflective diffraction grating

    DOEpatents

    Lamartine, Bruce C.

    2003-06-24

    Reflective diffraction grating. A focused ion beam (FIB) micromilling apparatus is used to store color images in a durable medium by milling away portions of the surface of the medium to produce a reflective diffraction grating with blazed pits. The images are retrieved by exposing the surface of the grating to polychromatic light from a particular incident bearing and observing the light reflected by the surface from specified reception bearing.

  5. Tandem resonator reflectance modulator

    DOEpatents

    Fritz, Ian J.; Wendt, Joel R.

    1994-01-01

    A wide band optical modulator is grown on a substrate as tandem Fabry-Perot resonators including three mirrors spaced by two cavities. The absorption of one cavity is changed relative to the absorption of the other cavity by an applied electric field, to cause a change in total reflected light, as light reflecting from the outer mirrors is in phase and light reflecting from the inner mirror is out of phase with light from the outer mirrors.

  6. Tandem resonator reflectance modulator

    DOEpatents

    Fritz, I.J.; Wendt, J.R.

    1994-09-06

    A wide band optical modulator is grown on a substrate as tandem Fabry-Perot resonators including three mirrors spaced by two cavities. The absorption of one cavity is changed relative to the absorption of the other cavity by an applied electric field, to cause a change in total reflected light, as light reflecting from the outer mirrors is in phase and light reflecting from the inner mirror is out of phase with light from the outer mirrors. 8 figs.

  7. Neutron reflecting supermirror structure

    DOEpatents

    Wood, James L.

    1992-01-01

    An improved neutron reflecting supermirror structure comprising a plurality of stacked sets of bilayers of neutron reflecting materials. The improved neutron reflecting supermirror structure is adapted to provide extremely good performance at high incidence angles, i.e. up to four time the critical angle of standard neutron mirror structures. The reflection of neutrons striking the supermirror structure at a high critical angle provides enhanced neutron throughput, and hence more efficient and economical use of neutron sources. One layer of each set of bilayers consist of titanium, and the second layer of each set of bilayers consist of an alloy of nickel with carbon interstitially present in the nickel alloy.

  8. Reflections on strategic nurse leadership.

    PubMed

    White, Jean

    2012-10-01

    This paper sets out some personal reflections by the Chief Nursing Officer for Wales on the challenges facing nurses and midwives as they undertake strategic leadership roles in NHS organisations. The paper looks at the national approach taken in Wales where behavioural competencies for executive nurse directors have been implemented. It considers the implications of the breadth of responsibilities executive nurse directors have and the importance of developing and supporting middle grade nurse managers and clinical directors. It concludes by looking at who is responsible for care within an organisation. PMID:23050616

  9. Supervised practice: a midwife's reflective journey.

    PubMed

    Davidson, Sue; Raynor, Maureen

    2012-09-01

    The Nursing and Midwifery Council (NMC) (2007) defines supervised practice as a structured and formal programme, devised to provide a midwife whose practice falls short of the required professional standards, with learning opportunities to enrich his/her clinical experience and improve practice. The primary aim is to ensure that the period of development agreed by the Local Supervising Authority Midwifery Officer (LSAMO) in supporting the midwife to improve their knowledge and skills, is subject to scrutiny through assessment, evaluation and reflection. The importance of reflective learning in midwifery practice is well recognised. This article provides the reflective account of a midwife's personal experience of supervised practice. PMID:23082405

  10. The making of expert clinicians: reflective practice.

    PubMed

    Maestre, J M; Szyld, D; Del Moral, I; Ortiz, G; Rudolph, J W

    2014-05-01

    Debriefing is a rigorous reflection process which helps trainees recognize and resolve clinical and behavioral dilemmas raised by a clinical case. This approach emphasizes eliciting trainees'assumptions about the situation and their reasons for performing as they did (mental models). It analyses their impact on actions, to understand if it is necessary to maintain them or construct new ones that may lead to better performance in the future. It blends evidence and theory from education research, the social and cognitive sciences, and experience drawn from conducting and teaching debriefing to clinicians worldwide, on how to improve professional effectiveness through "reflective practice". PMID:24439667

  11. "If That's What I Need, It Could Be What Someone Else Needs." Exploring the Role of Attachment and Reflective Function in Counselling Psychologists' Accounts of How They Use Personal Therapy in Clinical Practice: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Rizq, Rosemary; Target, Mary

    2010-01-01

    Empirical evidence supporting the inclusion of mandatory training therapy for therapists is sparse. We present results from a mixed methods study designed to interrogate how counselling psychologists' attachment status and levels of reflective function (RF) intersect with how they experience, recall and describe using personal therapy in clinical…

  12. Renewable liquid reflection grating

    DOEpatents

    Ryutov, Dmitri D.; Toor, Arthur

    2003-10-07

    A renewable liquid reflection grating. Electrodes are operatively connected to a conducting liquid in an arrangement that produces a reflection grating and driven by a current with a resonance frequency. In another embodiment, the electrodes create the grating by a resonant electrostatic force acting on a dielectric liquid.

  13. Critically Reflective Leadership

    ERIC Educational Resources Information Center

    Cunningham, Christine L.

    2012-01-01

    Critical Reflective Practice (CRP) has a proven reputation as a method for teacher-researchers in K-12 classrooms, but there have been few published examples of this method being used to document school leaders' work-based practice. This paper outlines adaptations made by the author from an original CRP method to a Critically Reflective Leadership…

  14. Transparencies and Reflections.

    ERIC Educational Resources Information Center

    Hubbard, Guy

    1999-01-01

    Discusses the use of perspective, or showing things as the human eye sees them, when creating reflections and transparencies in works of art. Provides examples of artwork using transparency, reflection, and refraction by M. C. Escher, Richard Estes, and Janet Fish to give students an opportunity to learn about these three art techniques. (CMK)

  15. Earth's Reflection: Albedo

    ERIC Educational Resources Information Center

    Gillette, Brandon; Hamilton, Cheri

    2011-01-01

    When viewing objects of different colors, you might notice that some appear brighter than others. This is because light is reflected differently from various surfaces, depending on their physical properties. The word "albedo" is used to describe how reflective a surface is. The Earth-atmosphere has a combined albedo of about 30%, a number that is…

  16. Engaging in Retrospective Reflection

    ERIC Educational Resources Information Center

    Brevig, Laurey

    2006-01-01

    Reflection is a powerful means to involve readers actively in gaining new insights about texts and themselves as readers. This article relates the story of three fifth-grade girls engaged in metacognitive inquiry within a classroom book club group. The use of exploratory talk and reflection illustrate how the girls constructed meaning and deepened…

  17. Reflecting Random Flights

    NASA Astrophysics Data System (ADS)

    De Gregorio, Alessandro; Orsingher, Enzo

    2015-09-01

    We consider random flights in reflecting on the surface of a sphere with center at the origin and with radius R, where reflection is performed by means of circular inversion. Random flights studied in this paper are motions where the orientation of the deviations are uniformly distributed on the unit-radius sphere . We obtain the explicit probability distributions of the position of the moving particle when the number of changes of direction is fixed and equal to . We show that these distributions involve functions which are solutions of the Euler-Poisson-Darboux equation. The unconditional probability distributions of the reflecting random flights are obtained by suitably randomizing n by means of a fractional-type Poisson process. Random flights reflecting on hyperplanes according to the optical reflection form are considered and the related distributional properties derived.

  18. A prospective comparison of alginate-hydrogel with standard medical therapy to determine impact on functional capacity and clinical outcomes in patients with advanced heart failure (AUGMENT-HF trial)

    PubMed Central

    Anker, Stefan D.; Coats, Andrew J.S.; Cristian, Gabriel; Dragomir, Dinu; Pusineri, Enrico; Piredda, Massimo; Bettari, Luca; Dowling, Robert; Volterrani, Maurizio; Kirwan, Bridget-Anne; Filippatos, Gerasimos; Mas, Jean-Louis; Danchin, Nicolas; Solomon, Scott D.; Lee, Randall J.; Ahmann, Frank; Hinson, Andy; Sabbah, Hani N.; Mann, Douglas L.

    2015-01-01

    Aims AUGMENT-HF was an international, multi-centre, prospective, randomized, controlled trial to evaluate the benefits and safety of a novel method of left ventricular (LV) modification with alginate-hydrogel. Methods Alginate-hydrogel is an inert permanent implant that is directly injected into LV heart muscle and serves as a prosthetic scaffold to modify the shape and size of the dilated LV. Patients with advanced chronic heart failure (HF) were randomized (1 : 1) to alginate-hydrogel (n = 40) in combination with standard medical therapy or standard medical therapy alone (Control, n = 38). The primary endpoint of AUGMENT-HF was the change in peak VO2 from baseline to 6 months. Secondary endpoints included changes in 6-min walk test (6MWT) distance and New York Heart Association (NYHA) functional class, as well as assessments of procedural safety. Results Enrolled patients were 63 ± 10 years old, 74% in NYHA functional class III, had a LV ejection fraction of 26 ± 5% and a mean peak VO2 of 12.2 ± 1.8 mL/kg/min. Thirty-five patients were successfully treated with alginate-hydrogel injections through a limited left thoracotomy approach without device-related complications; the 30-day surgical mortality was 8.6% (3 deaths). Alginate-hydrogel treatment was associated with improved peak VO2 at 6 months—treatment effect vs. Control: +1.24 mL/kg/min (95% confidence interval 0.26–2.23, P = 0.014). Also 6MWT distance and NYHA functional class improved in alginate-hydrogel-treated patients vs. Control (both P < 0.001). Conclusion Alginate-hydrogel in addition to standard medical therapy for patients with advanced chronic HF was more effective than standard medical therapy alone for improving exercise capacity and symptoms. The results of AUGMENT-HF provide proof of concept for a pivotal trial. Trial Registration Number NCT01311791. PMID:26082085

  19. Reflecting on Čerenkov reflections

    NASA Astrophysics Data System (ADS)

    Fargion, D.; Gaug, M.; Oliva, P.

    2008-05-01

    MAGIC, as well as HESS and VERITAS, is a Čerenkov Telescope unveiling γ-ray sources above 60 GeV at vertical within noisy (hadronic) airshowering sky. These telescopes while facing the horizons may reveal rarest blazing UHECR as well as far fluorescence tails of downward PeV-EeV hadronic airshowers. Few of these inclined airshowers blazing on axis are spread by the geomagnetic field into twin spots. These twin flashes and their morphology may tag the UHECR origination site. There is a rich window of such reflecting Čerenkov lights visible by Telescopes on top of Mountains as MAGIC (and partially VERITAS): the reflections from the nearby ground (possibly enhanced by rain or snow, ice white cover), from the Sea and from the cloudy sky; in particular, these cloudy sheets may lay above or below the observer. MAGIC looking downward to the clouds or the snow, may well reveal blazing Moliere disks diffusing Čerenkov spots (few events per night). Because of geomagnetic forces and splitting of the inclined air-shower, one should reveal for the first time (at tens PeV or above) Čerenkov airshowers whose flashes are skimming the MAGIC nearby Sea and opened into twin spots. Their morphology may tag the UHECR origination, its consequent cross-section and composition. Magic telescopes looking upward into cloudy sky may observe very rare up-going UHE Tau, originated by UHE PeVs neutrinos skimming earth, air-showering into sky, reflecting into clouds. In particular Glashow resonant antineutrinos electron hitting into Earth electrons may lead to gauged boson W-, whose decay (inside the Earth) may produce a τ + bar nuτ [3], which later escape and decay in air is producing Čerenkov lights; these flashes may blaze into the clouds above MAGIC as upward dot spots. The Magic energy threshold for such UHE Neutrinos showers rises to PeV values. EeV UHE tau neutrinos by guaranteed GZK UHECR secondaries [6, 16], via the muon-tau flavor mixing, may skim the Earth, produce UHE tau

  20. North American fertilizer capacity data

    SciTech Connect

    Not Available

    1991-01-01

    This listing of producers and their fertilizer production capacities was compiled in January 1991 with the cooperation of the US and Canadian fertilizer industry. Capacity is only an indicator of supply. Nameplate capacity differs from planned production levels or actual production because plants often operate above or below design capacity. Unless reported otherwise, plant capacities are based on 340 days per year of operation. No adjustment is made for partial year operation. Numerical data for the production of ammonia, ammonium nitrate, nitrogen solutions, urea, phosphate rock, phosphoric acid and ammonium phosphates is included.

  1. Reflecting on 80 years of excellence

    PubMed Central

    Savla, Ushma

    2004-01-01

    A small group of members of the American Society for Clinical Investigation began chatting in 1916 about the possibility of launching a new biomedical research journal. By October 1924, they managed to make the idea a reality with the publication of the first issue of the Journal of Clinical Investigation. Our 80th birthday seems an appropriate time to reflect on the history of biomedical science as it has been played out on our pages. PMID:15489943

  2. Reflection, dialogue, and the possibilities of space.

    PubMed

    Kumagai, Arno K; Naidu, Thirusha

    2015-03-01

    To educate physicians who are capable of delivering ethical, socially responsible, patient-centered care, there have been calls for identifying curricular space for reflection on the human and societal dimensions of medicine. These appeals, however, beg the question: What does it mean to devote space in an otherwise busy curriculum for these types of reflection? This Perspective is an attempt to understand the nature of this educational space in terms of its purpose, uses, dynamics, and limitations, and the underlying components that allow reflection and transformation to occur. Reflections on psychosocial themes often take the form of dialogues, which differ from the discussions commonly encountered in clinical settings because they require the engagement of the participants' whole selves--life experiences, backgrounds, personal values, beliefs, and perspectives--in the exchanges. Dialogues allow for the inclusion of affective and experiential dimensions in addition to intellectual/cognitive domains in learning, and for an emphasis on discovering new perspectives, insights, and questions instead of limiting participants solely to an instrumental search for solutions. Although these reflections may vary greatly in their form and settings, the reflective space requires three qualities: safety and confidentiality, an intentional designation of a time apart from the distractions of daily life for reflection and dialogue, and an awareness of the transitional nature--the liminality--of a critically important period of professional identity development. In this open space of reflection and dialogue, one's identity as a humanistic physician takes form. PMID:25426737

  3. Weak shock reflection

    NASA Astrophysics Data System (ADS)

    Hunter, John K.; Brio, Moysey

    2000-05-01

    We present numerical solutions of a two-dimensional inviscid Burgers equation which provides an asymptotic description of the Mach reflection of weak shocks. In our numerical solutions, the incident, reflected, and Mach shocks meet at a triple point, and there is a supersonic patch behind the triple point, as proposed by Guderley for steady weak-shock reflection. A theoretical analysis indicates that there is an expansion fan at the triple point, in addition to the three shocks. The supersonic patch is extremely small, and this work is the first time it has been resolved.

  4. GNSS Ocean Reflected Signals

    NASA Astrophysics Data System (ADS)

    Hoeg, P.

    2012-12-01

    Ocean reflected signals from the GNSS satellites (received at low-Earth orbiting satellites, airplanes and fixed mountain locations) describe the ocean surface mean height, waves, roughness, spectral reflectivity and emissivity. The estimated accuracy of the average surface height is of the order of 10 cm for smooth conditions. Thus global observations could be an important new contribution to long-term variations of the ocean mean height as well as the monitoring of ocean mesoscale eddies, which result in sea-height changes much larger than the accuracy of the GNSS technique for reflected signals. The ocean reflected signals can be divided into two set of measurements, 1) high elevation measurements (equal to low incidence angles) and 2) low elevation grazing angle measurements. For the first type the ocean reflection cross-section has a limited extent. The reflected signal is coherent with smaller errors due to ocean waves, sampling rate and the internal processing method of the receiver. For low elevations, the signal reveals the incoherent scatter process at the reflection zone. To quantify the potential of the GNSS signals for determining spectral reflectivity at low elevations, we present ocean reflection GPS measurements from the Haleakala Summit on Maui, Hawaii, revealing the spectral characteristics of both the direct satellite signal and the ocean reflected signal for low elevation angles. The characteristics of the reflected signal depend on the scattering properties of the sea surface and the footprint of the reflection zone. While the footprint size and shape in turn depends on the signal incidence angle, the ocean mean tilt, and the relative velocities of transmitter and receiver to the reflection point. Thus the scattering properties of the sea surface are related to the sea surface roughness. We present the spectral properties of the signals as received by a high precision GPS instrument, simultaneously in both phase-locked mode and open-loop raw

  5. Capacity Building for School Gardening: A Swedish Case Study

    ERIC Educational Resources Information Center

    Akerblom, Petter

    2005-01-01

    This article reflects on experiences from Swedish research on school gardening and greening school grounds. A process-orientated case study in two Swedish cities is discussed, based on future workshops as a platform for situated capacity building in interaction between stakeholders in the in-school context and stakeholders from outside the local…

  6. High capacity oil burner

    SciTech Connect

    Pedrosa, O.A. Jr.; Couto, N.C.; Fanqueiro, R.C.C.

    1983-11-01

    The present invention relates to a high capacity oil burner comprising a cylindrical atomizer completely surrounded by a protective cylindrical housing having a diameter from 2 to 3 times greater than the diameter of said atomizer; liquid fuels being injected under pressure into said atomizer and accumulating within said atomizer in a chamber for the accumulation of liquid fuels, and compressed air being injected into a chamber for the accumulation of air; cylindrical holes communicating said chamber for the accumulation of liquid fuels with the outside and cylindrical holes communicating said chamber for the accumulation of air with said cylindrical holes communicating the chamber for the accumulation of liquids with the outside so that the injection of compressed air into said liquid fuel discharge holes atomizes said fuel which is expelled to the outside through the end portions of said discharge holes which are circumferentially positioned to be burnt by a pilot flame; said protecting cylindrical housing having at its ends perforated circular rings into which water is injected under pressure to form a protecting fan-like water curtain at the rear end of the housing and a fan-like water curtain at the flame to reduce the formation of soot; the burning efficiency of said burner being superior to 30 barrels of liquid fuel per day/kg of the apparatus.

  7. First mideast capacity planned

    SciTech Connect

    Fattah, H.

    1996-11-06

    Kuwait catalyst Co.`s (KCC) plans to build a hydrodesulfurization (HDS) catalysts plant in Kuwait will mark the startup of the first refining catalysts production in the Persian Gulf region. KCC, owned by a conglomerate of Kuwait companies and governmental agencies, has licensed catalyst manufacturing technology from Japan Energy in a deal estimated at more than 7 billion ($62 million). Plant design will be based on technology from Orient Catalyst, Japan Energy`s catalysts division. Construction is expected to begin in January 1997 for production startup by January 1998. A source close to the deal says the new plant will eventually reach a capacity of 5,000 m.t./year of HDS catalysts to supply most of Kuwait`s estimated 3,500-m.t./year demand, driven primarily by Kuwait National Petroleum refineries. KCC also expects to supply demand from other catalyst consumers in the region. Alumina supply will be acquired on the open market. KCC will take all production from the plant and will be responsible for marketing.

  8. Advanced work capacity testing.

    PubMed

    Bretz, Károly J; Dános, László; Smudla, Szilvia; Pálosi, Adrienn

    2015-01-01

    The aim of this study is to describe an accurate work capacity testing which can be used in the industry, as well as in rehabilitation process. The first part of this paper is dealing with the NIOSH lifting equation, which is a tool used by occupational health and safety professionals. The second part of this paper summarizes the features and applications of the "ErgoScope" work simulator. Static and dynamic strength of upper and lower limbs, as well as whole body efforts can be measured. The equipment makes it possible to evaluate pushing, pulling, lifting and carrying activities comprising reaching, bending and stooping movements. In the third part of this paper we demonstrate handgrip force data recorded using the "ErgoScope" work simulator comparing with handgrip force data published in the literature. "ErgoScope" work simulator is capable to measure handgrip and pinch forces, suitable to evaluate fine motor skills, hand and finger dexterity, as well as reaction times. PMID:26294589

  9. Development and Validation of a Self-Report Measure of Mentalizing: The Reflective Functioning Questionnaire

    PubMed Central

    Fonagy, Peter; Luyten, Patrick; Moulton-Perkins, Alesia; Lee, Ya-Wen; Warren, Fiona; Howard, Susan; Ghinai, Rosanna; Fearon, Pasco; Lowyck, Benedicte

    2016-01-01

    Reflective functioning or mentalizing is the capacity to interpret both the self and others in terms of internal mental states such as feelings, wishes, goals, desires, and attitudes. This paper is part of a series of papers outlining the development and psychometric features of a new self-report measure, the Reflective Functioning Questionnaire (RFQ), designed to provide an easy to administer self-report measure of mentalizing. We describe the development and initial validation of the RFQ in three studies. Study 1 focuses on the development of the RFQ, its factor structure and construct validity in a sample of patients with Borderline Personality Disorder (BPD) and Eating Disorder (ED) (n = 108) and normal controls (n = 295). Study 2 aims to replicate these findings in a fresh sample of 129 patients with personality disorder and 281 normal controls. Study 3 addresses the relationship between the RFQ, parental reflective functioning and infant attachment status as assessed with the Strange Situation Procedure (SSP) in a sample of 136 community mothers and their infants. In both Study 1 and 2, confirmatory factor analyses yielded two factors assessing Certainty (RFQ_C) and Uncertainty (RFQ_U) about the mental states of self and others. These two factors were relatively distinct, invariant across clinical and non-clinical samples, had satisfactory internal consistency and test–retest stability, and were largely unrelated to demographic features. The scales discriminated between patients and controls, and were significantly and in theoretically predicted ways correlated with measures of empathy, mindfulness and perspective-taking, and with both self-reported and clinician-reported measures of borderline personality features and other indices of maladaptive personality functioning. Furthermore, the RFQ scales were associated with levels of parental reflective functioning, which in turn predicted infant attachment status in the SSP. Overall, this study lends

  10. [Ecotourism carrying capacity of Hangzhou Xixi National Wetland Park in China].

    PubMed

    Li, Rui; Rong, Liang

    2007-10-01

    In this paper, an integrated estimation on the ecotourism carrying capacity of Hangzhou Xixi National Wetland Park in China was made from the aspects of ecological carrying capacity, spatial carrying capacity, facility carrying capacity, management carrying capacity, and psychological carrying capacity. The results indicated that the tourism carrying capacity of the Park was 4 145 - 6 450 persons per day. The rational distance between man and bird was first adopted to determine the ecotourism carrying capacity of wetland, which provided an effective solution both to fully ensure bird safety and to appropriately develop wetland tourism. The estimation of psychological carrying capacity based on tourist satisfaction degree reflected more objectively the extent the tourist demands satisfied at the planning, construction and management of tour places. Such an integrated estimation method based on the distance between man and bird and the tourist satisfaction degree could be of practical and instructive significances in the planning and management of wetland parks. PMID:18163314

  11. Reflections on Miniature Golf.

    ERIC Educational Resources Information Center

    Powell, Nancy Norem; And Others

    1994-01-01

    Describes a transformational geometry project in which groups of students explore symmetry, reflections, translations, rotations, and dilations to design and create one hole of miniature golf large enough to play on. Includes unit plan for transformational geometry. (MKR)

  12. Seasonal soybean crop reflectance

    NASA Technical Reports Server (NTRS)

    Lemaster, E. W. (Principal Investigator); Chance, J. E.

    1983-01-01

    Data are presented from field measurements of 1980 including 5 acquisitions of handheld radiometer reflectance measurements, 7 complete sets of parameters for implementing the Suits mode, and other biophysical parameters to characterize the soybean canopy. LANDSAT calculations on the simulated Brazilian soybean reflectance are included along with data collected during the summer and fall on 1981 on soybean single leaf optical parameters for three irrigation treatments. Tests of the Suits vegetative canopy reflectance model for the full hemisphere of observer directions as well as the nadir direction show moderate agreement for the visible channels of the MSS and poor agreement in the near infrared channel. Temporal changes in the spectral characteristics of the single leaves were seen to occur as a function of maturity which demonstrates that the absorptance of a soybean single leaf is more a function of thetransmittancee characteristics than the seasonally consistent single leaf reflectance.

  13. Andreev reflection in graphene

    NASA Astrophysics Data System (ADS)

    Beenakker, Carlo

    2007-03-01

    Relativity and superconductivity have no common ground in ordinary matter, because the velocity of electrons is only a small fraction of the velocity of light. The unusual band structure of a single layer of carbon atoms (graphene) contains negatively and positively charged particles that move as relativistic electrons and positrons. The electron-like particles in the conduction band can be converted into positron-like particles in the valence band when they are reflected by a superconductor. (The missing charge of 2e enters the superconductor as a Cooper pair.) This interband reflection process can be distinguished from the usual intraband Andreev reflection, because the reflection angle has the opposite sign. A new phenomenology of graphene--superconductor junctions is predicted, including an anomalous scaling of the supercurrent with the length of the junction and the existence of charge-neutral modes propagating along the interface.

  14. Reflectance of aqueous solutions

    NASA Technical Reports Server (NTRS)

    Querry, M. R.

    1972-01-01

    The optical properties and optical constants of water and aqueous solutions were studied to develop an accurate tabulation of graphical representations of the optical constants through a broad spectrum. Manuscripts of articles are presented concerning extinction coefficients, relative specular reflectance, and temperature effect on the water spectrum. Graphs of absolute reflectance, phase shifts, index of refraction, and extinction coefficients for water, heavy water and aqueous solutions are included.

  15. Selectively reflective transparent sheets

    NASA Astrophysics Data System (ADS)

    Waché, Rémi; Florescu, Marian; Sweeney, Stephen J.; Clowes, Steven K.

    2015-08-01

    We investigate the possibility to selectively reflect certain wavelengths while maintaining the optical properties on other spectral ranges. This is of particular interest for transparent materials, which for specific applications may require high reflectivity at pre-determined frequencies. Although there exist currently techniques such as coatings to produce selective reflection, this work focuses on new approaches for mass production of polyethylene sheets which incorporate either additives or surface patterning for selective reflection between 8 to 13 μ m. Typical additives used to produce a greenhouse effect in plastics include particles such as clays, silica or hydroxide materials. However, the absorption of thermal radiation is less efficient than the decrease of emissivity as it can be compared with the inclusion of Lambertian materials. Photonic band gap engineering by the periodic structuring of metamaterials is known in nature for producing the vivid bright colors in certain organisms via strong wavelength-selective reflection. Research to artificially engineer such structures has mainly focused on wavelengths in the visible and near infrared. However few studies to date have been carried out to investigate the properties of metastructures in the mid infrared range even though the patterning of microstructure is easier to achieve. We present preliminary results on the diffuse reflectivity using FDTD simulations and analyze the technical feasibility of these approaches.

  16. Visuospatial Working Memory Capacity Predicts Physiological Arousal in a Narrative Task.

    PubMed

    Smithson, Lisa; Nicoladis, Elena

    2016-06-01

    Physiological arousal that occurs during narrative production is thought to reflect emotional processing and cognitive effort (Bar-Haim et al. in Dev Psychobiol 44:238-249, 2004). The purpose of this study was to determine whether individual differences in visuospatial working memory and/or verbal working memory capacity predict physiological arousal in a narrative task. Visuospatial working memory was a significant predictor of skin conductance level (SCL); verbal working memory was not. When visuospatial working memory interference was imposed, visuospatial working memory was no longer a significant predictor of SCL. Visuospatial interference also resulted in a significant reduction in SCL. Furthermore, listener ratings of narrative quality were contingent upon the visuospatial working memory resources of the narrator. Potential implications for educators and clinical practitioners are discussed. PMID:26718206

  17. Defining Reflection: Another Look at John Dewey and Reflective Thinking.

    ERIC Educational Resources Information Center

    Rodgers, Carol

    2002-01-01

    Examines four criteria that characterize John Dewey's view of reflective thought: reflection as a meaning-making process; reflection as a systematic, rigorous, disciplined way of thinking with its roots in scientific inquiry; reflection needs to happen in community, in interaction with others; and reflection requires attitudes that value the…

  18. Analytical elimination of substrate backside reflections from reflectance measurements.

    PubMed

    Wilbrandt, Steffen; Stenzel, Olaf

    2016-09-01

    An analytical approach to eliminate substrate backside reflections from measured reflectance of an unknown optical coating has been deducted. Thereby, measured transmittance, reflectance, and backside reflectance of the coating and transmittance and reflectance of the uncoated substrate at the desired angle of incidence and polarization state are required as input data. In the underlying theory, layer and substrate materials may be absorbing. PMID:27607274

  19. CHP Installed Capacity Optimizer Software

    Energy Science and Technology Software Center (ESTSC)

    2004-11-30

    The CHP Installed Capacity Optimizer is a Microsoft Excel spreadsheet application that determines the most economic amount of capacity of distributed generation and thermal utilization equipment (e.g., absorption chillers) to install for any user-defined set of load and cost data. Installing the optimum amount of capacity is critical to the life-cycle economic viability of a distributed generation/cooling heat and power (CHP) application. Using advanced optimization algorithms, the software accesses the loads, utility tariffs, equipment costs,more » etc., and provides to the user the most economic amount of system capacity to install.« less

  20. CHP Installed Capacity Optimizer Software

    SciTech Connect

    2004-11-30

    The CHP Installed Capacity Optimizer is a Microsoft Excel spreadsheet application that determines the most economic amount of capacity of distributed generation and thermal utilization equipment (e.g., absorption chillers) to install for any user-defined set of load and cost data. Installing the optimum amount of capacity is critical to the life-cycle economic viability of a distributed generation/cooling heat and power (CHP) application. Using advanced optimization algorithms, the software accesses the loads, utility tariffs, equipment costs, etc., and provides to the user the most economic amount of system capacity to install.

  1. Adaptive capacity and its assessment

    SciTech Connect

    Engle, Nathan L.

    2011-04-20

    This paper reviews the concept of adaptive capacity and various approaches to assessing it, particularly with respect to climate variability and change. I find that adaptive capacity is a relatively under-researched topic within the sustainability science and global change communities, particularly since it is uniquely positioned to improve linkages between vulnerability and resilience research. I identify opportunities for advancing the measurement and characterization of adaptive capacity by combining insights from both vulnerability and resilience frameworks, and I suggest several assessment approaches for possible future development that draw from both frameworks and focus on analyzing the governance, institutions, and management that have helped foster adaptive capacity in light of recent climatic events.

  2. The Capacity to Build Organizational Capacity in Schools

    ERIC Educational Resources Information Center

    King, M. Bruce; Bouchard, Kate

    2011-01-01

    Purpose: Reformers, policymakers, and researchers have given considerable attention to organizational capacity in schools, especially in those schools that perpetuate or exacerbate achievement gaps among diverse student groups and reproduce social inequalities. There is an emerging consensus about key dimensions of school capacity and how they can…

  3. An International Experience for Social Work Students: Self-Reflection through Poetry and Journal Writing Exercises

    ERIC Educational Resources Information Center

    Furman, Rich; Coyne, Ann; Negi, Nalini Junko

    2008-01-01

    This descriptive article explores the uses of poetry and journaling exercises as means of helping students develop their self-reflective capacities within the context of international social work. First, self-reflection and its importance to social work practice and education is discussed. Second, the importance of self-reflection in international…

  4. The Discourse and Reflections of Teacher Candidates during an Early Field Experience

    ERIC Educational Resources Information Center

    Henning, John E.; Dani, Danielle E.; Weade, Ginger

    2012-01-01

    The purpose of this study was to determine the capacity of teacher candidates to facilitate and reflect on classroom discourse in the context of an early field experience. The classroom discourse and reflections of 10 teacher candidates were examined through interviews, audio and video recordings, and written reflections. The findings indicated…

  5. A Framework for Teacher Reflectivity.

    ERIC Educational Resources Information Center

    Stanley, Claire

    1998-01-01

    Proposes a framework for teacher reflection based on a longitudinal study of the development of six experienced second-language teachers who attempted to implement reflection and reflective action into their teaching practice. The resulting framework included several phases in the development of reflective teaching: engaging with reflection,…

  6. Measuring Decision-Making Capacity in Cognitively Impaired Individuals

    PubMed Central

    Karlawish, Jason

    2009-01-01

    Cognitive and functional losses are only part of the spectrum of disability experienced by persons with Alzheimer’s disease and related dementias. They also experience losses in the ability to make decisions, known as decision-making capacity. Researchers have made substantial progress in developing a model of capacity assessment that rests upon the concept of the 4 decision-making abilities: understanding, appreciation, choice and reasoning. Empirical research has increased our understanding of the effects of late-life cognitive impairment on a person’s ability to make decisions. This review examines studies of the capacity to consent to treatment, research and the management of everyday functional abilities. The results illustrate the clinical phenotype of the patient who retains the capacity to consent. They also suggest that measures of capacity can improve how researchers measure the benefits of cognitive enhancements and stage dementia. PMID:18097164

  7. Fluoride coatings for vacuum ultraviolet reflection filters.

    PubMed

    Guo, Chun; Kong, Mingdong; Lin, Dawei; Li, Bincheng

    2015-12-10

    LaF3/MgF2 reflection filters with a high spectral-discrimination capacity of the atomic-oxygen lines at 130.4 and 135.6 nm, which were employed in vacuum ultraviolet imagers, were prepared by molybdenum-boat thermal evaporation. The optical properties of reflection filters were characterized by a high-precision vacuum ultraviolet spectrophotometer. The vulnerability of the filter's microstructures to environmental contamination and the recovery of the optical properties of the stored filter samples with ultraviolet ozone cleaning were experimentally demonstrated. For reflection filters with the optimized nonquarter-wave multilayer structures, the reflectance ratios R135.6 nm/R130.4 nm of 92.7 and 20.6 were achieved for 7° and 45° angles of incidence, respectively. On the contrary, R135.6 nm/R130.4 nm ratio of 12.4 was obtained for a reflection filter with a standard π-stack multilayer structure with H/L=1/4 at 7° AOI. PMID:26836877

  8. Building Organizational Capacity through Trust

    ERIC Educational Resources Information Center

    Cosner, Shelby

    2009-01-01

    This article explores the cultivation of collegial trust as a central feature of the capacity-building work of 11 high school principals, nominated for their expertise with capacity building. This qualitative study examined interview data and school documents collected over 18 months. Principals regarded trust as critical and were motivated to…

  9. Measuring Capacities for Community Resilience

    ERIC Educational Resources Information Center

    Sherrieb, Kathleen; Norris, Fran H.; Galea, Sandro

    2010-01-01

    The purpose of this study was to measure the sets of adaptive capacities for Economic Development and Social Capital in the Norris et al. (2008) community resilience model with publicly accessible population indicators. Our approach involved five steps. First, we conducted a literature review on measurements of the capacities. Second, we created…

  10. Enrollment Capacity and Technology Study

    ERIC Educational Resources Information Center

    Washington Higher Education Coordinating Board, 2008

    2008-01-01

    The 2007-09 Appropriations Act provided funding to the Higher Education Coordinating Board (HECB) to study the state's capital facility and technology capacity. Specifically, "...state appropriation is provided solely to implement a capital facility and technology capacity study which will compare the 10-year enrollment projections with the…

  11. Biology Reflective Assessment Curriculum

    NASA Astrophysics Data System (ADS)

    Bayley, Cheryl Ann

    Often students and educators view assessments as an obligation and finality for a unit. In the current climate of high-stakes testing and accountability, the balance of time, resources and emphasis on students' scores related to assessment have been slanted considerably toward the summative side. This tension between assessment for accountability and assessment to inform teaching strains instruction and educators' ability to use that information to design learning opportunities that help students develop deeper conceptual understanding. A substantive body of research indicates that formative and reflective assessment can significantly improve student learning. Biology Reflective Assessment Curriculum (BRAC) examines support provided for high school science students through assessment practices. This investigation incorporates the usage of reflective assessments as a guiding practice for differentiated instruction and student choice. Reflective assessment is a metacognitive strategy that promotes self-monitoring and evaluation. The goals of the curriculum are to promote self-efficacy and conceptual understanding in students learning biology through developing their metacognitive awareness. BRAC was implemented in a high school biology classroom. Data from assessments, metacognitive surveys, self-efficacy surveys, reflective journals, student work, a culminating task and field notes were used to evaluate the effectiveness of the curriculum. The results suggest that students who develop their metacognitive skills developed a deeper conceptual understanding and improved feelings of self-efficacy when they were engaged in a reflective assessment unit embedded with student choice. BRAC is a tool for teachers to use assessments to assist students in becoming metacognitive and to guide student choice in learning opportunities.

  12. Heat capacity, configurational heat capacity and fragility of hydrous magmas

    NASA Astrophysics Data System (ADS)

    Di Genova, D.; Romano, C.; Giordano, D.; Alletti, M.

    2014-10-01

    The glassy and liquid heat capacities of four series of dry and hydrous natural glasses and magma as a function of temperature and water content (up to 19.9 mol%) were investigated using differential scanning calorimetry (DSC). The analyzed compositions are basalt, latite, trachyte and pantellerite. The results of this study indicate that the measured heat capacity of glasses (Cpg) is a linear function of composition and is well reproduced by the empirical model of Richet (1987). For the investigated glasses, the partial molar heat capacity of water can be considered as independent of composition, in agreement with Bouhifd et al. (2006). For hydrous liquids, the heat capacity (Cpliq) decreases nonlinearly with increasing water content. Previously published models, combined with the partial molar heat capacity of water from the literature, are not able to reproduce our experimental data in a satisfactory way. We estimated the partial molar heat capacity of water (CpH2O) in hydrous magma over a broad compositional range. The proposed value is 41 ± 3 J mol-1 K-1. Water strongly affects the configurational heat capacity at the glass transition temperature [Cpconf (Tg)]. An increases of Cpconf (Tg) with water content was measured for the polymerized liquids (trachyte and pantellerite), while the opposite behavior was observed for the most depolymerized liquids (basalt and latite). Structural and rheological implications of this behavior are discussed in light of the presented results.

  13. Design for reflection.

    PubMed

    Bagnara, Sebastiano; Pozzi, Simone

    2012-01-01

    Since a few years, a number of academic papers have been proposing to shift from user-centered design to human-centered (or person) design. In this contribution, we discuss as the common tread underlying these works the idea that design should also address the reflective part of our human experience, and not only aim to maximize the experiential aspects. Our review is complemented with examples derived from the internet world and from ICT consumer products. The main research areas we see as promising for the approach of "design for reflection" are: design for pauses, design for detachment, design for serendipity. PMID:22316867

  14. Mystic Reflection Groups

    NASA Astrophysics Data System (ADS)

    Bazlov, Yuri; Berenstein, Arkady

    2014-04-01

    This paper aims to systematically study mystic reflection groups that emerged independently in the paper [Selecta Math. (N.S.) 14 (2009), 325-372] by the authors and in the paper [Algebr. Represent. Theory 13 (2010), 127-158] by Kirkman, Kuzmanovich and Zhang. A detailed analysis of this class of groups reveals that they are in a nontrivial correspondence with the complex reflection groups G(m,p,n). We also prove that the group algebras of corresponding groups are isomorphic and classify all such groups up to isomorphism.

  15. North American fertilizer capacity data

    SciTech Connect

    Not Available

    1993-02-01

    This listing of fertilizer producers and their production capacities was compiled in February 1993 with the cooperation of the US and Canadian fertilizer industry. TVA does not guarantee the completeness or accuracy of the information. Capacity is only an indicator of supply. Nameplate capacity differs from planned production levels or actual production because plants often operate above or below design capacity. Unless reported otherwise, plant capacities are based on 340 days per year of operation. No adjustment is made for partial year operation. Information is given on the following types of fertilizers: ammonia, ammonium nitrate, nitrogen solutions, urea, ammonium sulfate, phosphate rock, wet-process phosphoric acid, ammonium phosphates, concentrated superphosphates, potash, nitric acid, superphosphoric acid, upgraded phosphoric acids, normal superphosphate, elemental phosphorus, potassium sulfate, and sulfate of potash/magnesia.

  16. Heat capacity of molten halides.

    PubMed

    Redkin, Alexander A; Zaikov, Yurii P; Korzun, Iraida V; Reznitskikh, Olga G; Yaroslavtseva, Tatiana V; Kumkov, Sergey I

    2015-01-15

    The heat capacities of molten salts are very important for their practical use. Experimental investigation of this property is challenging because of the high temperatures involved and the corrosive nature of these materials. It is preferable to combine experimental investigations with empirical relationships, which allows for the evaluation of the heat capacity of molten salt mixtures. The isobaric molar heat capacities of all molten alkali and alkaline-earth halides were found to be constant for each group of salts. The value depends on the number of atoms in the salt, and the molar heat capacity per atom is constant for all molten halide salts with the exception of the lithium halides. The molar heat capacities of molten halides do not change when the anions are changed. PMID:25530462

  17. Photoplethysmogram reflection index and aging

    NASA Astrophysics Data System (ADS)

    Qawqzeh, Yousef K.; Reaz, M. B. I.; Maskon, O.; Chellappan, Kalaivani; Ali, M. A. M.

    2011-10-01

    This study conducted to investigate and study the effect of aging on Photoplethysmogram (PPG) signal and the effects of aging on the calculations of reflection index (RI). The results showed that PPG is highly affected by aging which noteworthy to be observed by the variations of PPG contour. Since we advance in age, PPG becomes more rounded which in turn make PPG inflection point and dicrotic notch less pronounced. As a conclusion, RI may provide a window to small and medium arteries compliance and it can be a measure of small and medium arteries stiffness. When small and medium arteries start stiffening, early detection of atherosclerosis in sub-clinical settings can be investigated and detected.

  18. A time to step in: legal mechanisms for protecting those with declining capacity.

    PubMed

    Arias, Jalayne J

    2013-01-01

    Current estimates approximate that the population over sixty-five years of age will increase from 40 million in 2010 to 72.1 million by 2030. As society ages, the number of elderly with cognitive deficits that impair decision-making abilities will also increase. This will place additional burdens on families and probate courts seeking to balance individual autonomy with necessary protections. A legal determination of incompetency is a prerequisite to a judicial order appointing a guardianship or other protective mechanism. The current legal-medical model for competency determinations fails to reflect the complexities of declining capacity in an aging population. A global structure for competency determinations leaves a critical gap between competent and incompetent. The gap between competence and incompetence not only raises concerns about how to classify those that fall between the two, but also highlights the lack of legal protections for those within the gap. A revised model is needed to provide protections to individuals who do not yet meet the threshold for incompetence but require additional protections for their personal or financial welfare. This Article provides an unprecedented examination of the legal model for determining competence through a comparison of the medical model for evaluating capacity. While a number of legal scholars have examined the appointment and oversight of guardians, fewer articles have critically examined the process by which individuals are declared incompetent. This Article presents a comprehensive overview of competency and clinical capacity determination procedures, legal mechanisms available to protect individuals with declining capacity, and policy recommendations for improving legal protections in light of inefficiencies related to legal competency determinations. PMID:23678789

  19. THE ELECTRICAL CAPACITY OF VALONIA : DIRECT CURRENT MEASUREMENTS.

    PubMed

    Blinks, L R; Skow, R K

    1940-11-20

    Impaled cells of Valonia were balanced in a Wheatstone bridge against a simple series-parallel circuit of two resistances and a capacity, the transient charge and discharge curves at make and break of direct current being recorded with a string galvanometer. With the resistances properly balanced, a series of characteristic deflections resulted when the balancing capacity was varied. With many cells, no complete capacity balance was ever attained over the entire transient time course; but instead either a monophasic or diphasic residual deflection always remained. This behavior is comparable to that of a polarizing electrode in D.C., although not so clearly marked; and it is concluded that Valonia usually has an appreciable polarization component, probably in parallel with a static capacity. However, some cells can be balanced almost completely against a mica condenser of proper value, which indicates that they display a nearly pure static capacity under some conditions. This static state could be produced experimentally by exposure to weak acids (acetic, carbonic, etc.) and by metabolic agents probably inducing internal acidity (low oxygen tension, long exposure to cold, narcotics, etc.). Conversely, penetrating weak bases, such as ammonia, abolished the static capacity, or even any regular polarization. Light acts something like ammonia, after an initial "acid gush" anomaly. Most of these agents likewise affect the P.D. and its response to external ionic alterations, and it seems likely that the change in capacity type reflects altered ionic permeabilities and relative mobilities. PMID:19873211

  20. Modeling Coevolution between Language and Memory Capacity during Language Origin.

    PubMed

    Gong, Tao; Shuai, Lan

    2015-01-01

    Memory is essential to many cognitive tasks including language. Apart from empirical studies of memory effects on language acquisition and use, there lack sufficient evolutionary explorations on whether a high level of memory capacity is prerequisite for language and whether language origin could influence memory capacity. In line with evolutionary theories that natural selection refined language-related cognitive abilities, we advocated a coevolution scenario between language and memory capacity, which incorporated the genetic transmission of individual memory capacity, cultural transmission of idiolects, and natural and cultural selections on individual reproduction and language teaching. To illustrate the coevolution dynamics, we adopted a multi-agent computational model simulating the emergence of lexical items and simple syntax through iterated communications. Simulations showed that: along with the origin of a communal language, an initially-low memory capacity for acquired linguistic knowledge was boosted; and such coherent increase in linguistic understandability and memory capacities reflected a language-memory coevolution; and such coevolution stopped till memory capacities became sufficient for language communications. Statistical analyses revealed that the coevolution was realized mainly by natural selection based on individual communicative success in cultural transmissions. This work elaborated the biology-culture parallelism of language evolution, demonstrated the driving force of culturally-constituted factors for natural selection of individual cognitive abilities, and suggested that the degree difference in language-related cognitive abilities between humans and nonhuman animals could result from a coevolution with language. PMID:26544876

  1. Modeling Coevolution between Language and Memory Capacity during Language Origin

    PubMed Central

    Gong, Tao; Shuai, Lan

    2015-01-01

    Memory is essential to many cognitive tasks including language. Apart from empirical studies of memory effects on language acquisition and use, there lack sufficient evolutionary explorations on whether a high level of memory capacity is prerequisite for language and whether language origin could influence memory capacity. In line with evolutionary theories that natural selection refined language-related cognitive abilities, we advocated a coevolution scenario between language and memory capacity, which incorporated the genetic transmission of individual memory capacity, cultural transmission of idiolects, and natural and cultural selections on individual reproduction and language teaching. To illustrate the coevolution dynamics, we adopted a multi-agent computational model simulating the emergence of lexical items and simple syntax through iterated communications. Simulations showed that: along with the origin of a communal language, an initially-low memory capacity for acquired linguistic knowledge was boosted; and such coherent increase in linguistic understandability and memory capacities reflected a language-memory coevolution; and such coevolution stopped till memory capacities became sufficient for language communications. Statistical analyses revealed that the coevolution was realized mainly by natural selection based on individual communicative success in cultural transmissions. This work elaborated the biology-culture parallelism of language evolution, demonstrated the driving force of culturally-constituted factors for natural selection of individual cognitive abilities, and suggested that the degree difference in language-related cognitive abilities between humans and nonhuman animals could result from a coevolution with language. PMID:26544876

  2. Meanings and Reflective Teaching.

    ERIC Educational Resources Information Center

    Stone, Lynda

    Meaning constructs are aspects of a person's cultural worldview. They are those aspects that philosophers often write about as a means by which to make sense of the world. Teachers carry their worldviews and meaning constructs into the classrooms with them. Similarly to teachers, reflective teaching proponents hold meaning constructs that are…

  3. Lights, Camera, Reflection!

    ERIC Educational Resources Information Center

    Mourlam, Daniel

    2013-01-01

    There are many ways to critique teaching, but few are more effective than video. Personal reflection through the use of video allows one to see what really happens in the classrooms--good and bad--and provides a visual path forward for improvement, whether it be in one's teaching, work with a particular student, or learning environment. This…

  4. Reflecting on Data

    ERIC Educational Resources Information Center

    Kraus, Rudolf V.

    2014-01-01

    This article describes a two-day optics laboratory activity that investigates the scientific phenomenon of reflection, which students are generally familiar with but usually have not studied in depth. This investigation can be used on its own or as part of a larger unit on optics. This lesson encourages students to think critically and…

  5. Renew, Reflect, and Refresh

    ERIC Educational Resources Information Center

    Texley, Juliana

    2005-01-01

    Is that the sound of the last bus leaving the schoolyard? Or the staff's collective sigh of relief? School's out. Now it's time to nurture the lifelong learner deep inside with a summer reading list that will allow teachers to renew, reflect, and refresh. The National Science Education Standards reminds us, "Becoming an effective science teacher…

  6. Reflections on Expectations

    ERIC Educational Resources Information Center

    Santini, Joseph

    2014-01-01

    This article describes a teachers reflections on the matter of student expectations. Santini begins with a common understanding of the "Pygmalion effect" from research projects conducted in earlier years that intimated "people's expectations could influence other people in the world around them." In the world of deaf…

  7. Reflections on "La Esperanza"

    ERIC Educational Resources Information Center

    Cortez, Anita

    2007-01-01

    The author was recently asked to reflect on her "educational journey." As far as she can remember she has been hungry to learn. A friend once described her as having "hambres atrasadas," which he described as a kind of "hunger nipping at her heels." It goes back, of course, to her parents: Her father's and her early journeys scavenging the Wyoming…

  8. Reflecting through Peshkin's I's

    ERIC Educational Resources Information Center

    Savage, Jonathan

    2007-01-01

    Reflection is an appropriate way of accounting for professional practice and is a standard way in which one can "become better acquainted with one's own story". Defining "subjectivity" as "the quality of an investigator that affects the results of observational investigation", Peshkin highlights the requirement for any observer of, or participant…

  9. Interactive Reflective Logs

    ERIC Educational Resources Information Center

    Deaton, Cynthia Minchew; Deaton, Benjamin E.; Leland, Katina

    2010-01-01

    The authors created an interactive reflective log (IRL) to provide teachers with an opportunity to use a journal approach to record, evaluate, and communicate student understanding of science concepts. Unlike a traditional journal, the IRL incorporates prompts to encourage students to discuss their understanding of science content and science…

  10. Reflections on 1972

    ERIC Educational Resources Information Center

    Gutierrez, Ramon A.

    2007-01-01

    In this article, the author reflects on the events that took place in the year 1972. The author was a junior at the University of New Mexico back then, refusing to eat or buy grapes and lettuce, picketing grocers who did not carry United Farm Workers of America produce. He and his buddies cast their votes against granting Richard Nixon a second…

  11. Reflection by Porro Prisms

    NASA Astrophysics Data System (ADS)

    Greenslade, Thomas B.

    2010-04-01

    Students all know that reflection from a plane mirror produces an image that is reversed right to left and so cannot be read by anyone but Leonardo da Vinci, who kept his notes in mirror writing. A useful counter-example is the Porro prism, which produces an image that is not reversed.

  12. Ionosphere-reflected propagation

    NASA Technical Reports Server (NTRS)

    Reddy, B. M.

    1979-01-01

    The predictability of those ionospheric parameters relevant to ionosphere-reflected communications is considered along with their optimum utilization. Several excellent original articles and review papers which have been published from time to time dealing with the long term and short term forecasting of ionospheric parameters, radio systems, and modelling needs for ionospheric communications, are covered.

  13. Reflective Database Access Control

    ERIC Educational Resources Information Center

    Olson, Lars E.

    2009-01-01

    "Reflective Database Access Control" (RDBAC) is a model in which a database privilege is expressed as a database query itself, rather than as a static privilege contained in an access control list. RDBAC aids the management of database access controls by improving the expressiveness of policies. However, such policies introduce new interactions…

  14. The ''Complex Reality'' of Research Capacity Development in Mathematics Education in Southern African Development Community Countries

    ERIC Educational Resources Information Center

    Julie, Cyril; Mikalsen, Oyvind; Persens, Jan

    2005-01-01

    This paper explores how an aid-funded Ph.D.-programme in mathematics education instituted in some Southern African Development Community countries measures up to issues related to research capacity development projects. The research capacity development programme is described and reflected against mutual benefit, relevance, sustainability and…

  15. Building Capacity for Developing Statistical Literacy in a Developing Country: Lessons Learned from an Intervention

    ERIC Educational Resources Information Center

    North, Delia; Gal, Iddo; Zewotir, Temesgen

    2014-01-01

    This paper aims to contribute to the emerging literature on capacity-building in statistics education by examining issues pertaining to the readiness of teachers in a developing country to teach basic statistical topics. The paper reflects on challenges and barriers to building statistics capacity at grass-roots level in a developing country,…

  16. Terminal Behavioral Objectives for Teaching Clinical Toxicology to Clinical Pharmacists

    ERIC Educational Resources Information Center

    Veltri, Joseph C.; And Others

    1976-01-01

    As a first step in the development of a competency-based clinical toxicology clerkship, a set of terminal behavioral objectives were developed that reflect the anticipated role that clinical pharmacists should play as part of the clinical toxicology team. The evaluation approaches used at the University of Utah are presented. (LBH)

  17. Measuring Practicum Student Teachers' Reflectivity: The Reflective Pedagogical Thinking Scale

    ERIC Educational Resources Information Center

    Seng, Toh Wah

    2004-01-01

    The purpose of the original study was to investigate practicum student teachers' reflectivity. This paper describes the use of a revised version of the Reflective Pedagogical Thinking Scale (Sparks-Langer, et al., 1990) to measure reflectivity. The original scale was used by the developers to assess reflectivity through a structured interview. The…

  18. Psychiatric Issues in Palliative Care: Assessing Mental Capacity

    PubMed Central

    Udo, Itoro; Mohammed, Zeid; Gash, Amanda

    2013-01-01

    Issues surrounding capacity to consent to or refuse treatment are increasingly receiving clinical and legal attention. Through the use of 3 case vignettes that involve different aspects of mental health care in palliative care settings, mental capacity issues are discussed. The vignettes tackle capacity in a patient with newly developed mental illness consequent to physical illness, capacity in a patient with mental illness but without delirium and capacity in a patient with known impairment of the mind. These discussions give credence to best practice position where physicians act in the best interests of their patients at all times. It is important to emphasize that capacity decisions have to be made on a case by case basis, within the remit of legal protection. This is a fundamental requirement of the Mental Capacity Act 2005, England & Wales (MCA). The later is used as the legal basis for these discussions. The psychiatric liaison service is a useful resource to provide consultation, advice and or joint assessment to clinicians encountering complex dilemmas involving decision-making capacity. PMID:25278761

  19. The predictive capacity of personal genome sequencing.

    PubMed

    Roberts, Nicholas J; Vogelstein, Joshua T; Parmigiani, Giovanni; Kinzler, Kenneth W; Vogelstein, Bert; Velculescu, Victor E

    2012-05-01

    New DNA sequencing methods will soon make it possible to identify all germline variants in any individual at a reasonable cost. However, the ability of whole-genome sequencing to predict predisposition to common diseases in the general population is unknown. To estimate this predictive capacity, we use the concept of a "genometype." A specific genometype represents the genomes in the population conferring a specific level of genetic risk for a specified disease. Using this concept, we estimated the maximum capacity of whole-genome sequencing to identify individuals at clinically significant risk for 24 different diseases. Our estimates were derived from the analysis of large numbers of monozygotic twin pairs; twins of a pair share the same genometype and therefore identical genetic risk factors. Our analyses indicate that (i) for 23 of the 24 diseases, most of the individuals will receive negative test results; (ii) these negative test results will, in general, not be very informative, because the risk of developing 19 of the 24 diseases in those who test negative will still be, at minimum, 50 to 80% of that in the general population; and (iii) on the positive side, in the best-case scenario, more than 90% of tested individuals might be alerted to a clinically significant predisposition to at least one disease. These results have important implications for the valuation of genetic testing by industry, health insurance companies, public policy-makers, and consumers. PMID:22472521

  20. To build capacity, build confidence

    NASA Astrophysics Data System (ADS)

    Hewitson, Bruce

    2015-07-01

    The history of attempts to spread scientific know-how beyond western centres of excellence is littered with failures. Capacity building needs long-term commitment, a critical mass of trainees, and a supportive home environment.

  1. Neuropsychological assessment of mental capacity.

    PubMed

    Sullivan, Karen

    2004-09-01

    The assessment of mental capacity to assist legal determinations of competency is potentially a growth area for neuropsychology, although to date neuropsychologists have published relatively little in this area. In this paper a systematic review of methods used to assess capacity is presented, including coverage of specialized tests and interviews used for this purpose. A neuropsychological model for conducting capacity assessments is proposed. This model involves comprehensive assessment of a wide range of cognitive abilities as well as assessment of specific skills and knowledge related to the type of capacity being assessed. The purpose of proposing this model is to stimulate further discussion and debate about the contribution neuropsychologists might make in this area. PMID:15673234

  2. Reflective Walkthroughs: The Impact of the Reflective Walkthrough Protocol on Teacher Instructional Practices and Student Proficiency Trends in an Urban Public School

    ERIC Educational Resources Information Center

    Brooks-Long, Wanda

    2012-01-01

    The purpose of this study was to determine if the implementation of a walkthrough protocol combined with reflective practice had the capacity to influence the sample school's objectives of building staff capacity, strengthening instructional delivery in classrooms, and improving student learning. This study's primary focus is to examine the…

  3. Normal-reflection image

    SciTech Connect

    Huang, L.; Fehler, Michael C.

    2003-01-01

    Common-angle wave-equation migration using the double-square-root is generally less accurate than the common-shot migration because the wavefield continuation equation for thc former involves additional approximations compared to that for the latter. We present a common-angle wave-equation migration that has the same accuracy as common-shot wave-equation migration. An image obtained from common-angle migration is a four- to five-dimensional output volume for 3D cases. We propose a normal-reflection imaging condition for common-angle migration to produce a 3D output volume for 3D migration. The image is closely related to the normal-reflection coefficients at interfaces. This imaging condition will allow amplitude-preserving migration to generate an image with clear physical meaning.

  4. Depth from water reflection.

    PubMed

    Linjie Yang; Jianzhuang Liu; Xiaoou Tang

    2015-04-01

    The scene in a water reflection image often exhibits bilateral symmetry. In this paper, we design a framework to reconstruct the depth from a single water reflection image. This problem can be regarded as a special case of two-view stereo vision. It is challenging to obtain correspondences from the real scene and the mirror scene due to their large appearance difference. We first propose an appearance adaptation method to transform the appearance of the mirror scene so that it is much closer to the real scene. We then present a stereo matching algorithm to obtain the disparity map of the real scene. Compared with other depth-from-symmetry work that deals with man-made objects, our algorithm can recover the depth maps of a variety of scenes, where both natural and man-made objects may exist. PMID:25643408

  5. Capacity Markets and Market Stability

    SciTech Connect

    Stauffer, Hoff

    2006-04-15

    The good news is that market stability can be achieved through a combination of longer-term contracts, auctions for far enough in the future to permit new entry, a capacity management system, and a demand curve. The bad news is that if and when stable capacity markets are designed, the markets may seem to be relatively close to where we started - with integrated resource planning. Market ideologues will find this anathema. (author)

  6. Reflective optical imaging system

    DOEpatents

    Shafer, David R.

    2000-01-01

    An optical system compatible with short wavelength (extreme ultraviolet) radiation comprising four reflective elements for projecting a mask image onto a substrate. The four optical elements are characterized in order from object to image as convex, concave, convex and concave mirrors. The optical system is particularly suited for step and scan lithography methods. The invention increases the slit dimensions associated with ringfield scanning optics, improves wafer throughput and allows higher semiconductor device density.

  7. My Reflective Practice as Research.

    ERIC Educational Resources Information Center

    Pereira, Marcia A.

    1999-01-01

    Using Schon's concepts and definition of reflective practice, this article elaborates a model used to analyze the author's own processes of "reflection-in-action" and "reflection-on-action" in teaching first-year architectural students. Emphasizes the importance of the concept of "role-frame" in informing the whole reflective process. (EV)

  8. Reflection Revisited: The Class Collage

    ERIC Educational Resources Information Center

    Sommers, Jeff

    2011-01-01

    Through the regular use of what Donald Schon has termed reflection-in-action and reflection-on-action, students can learn to improve their "reflection-in-presentation," in Kathleen Blake Yancey's term. Students are often asked to do this type of reflection-in-presentation as a capstone to first-year or basic writing courses. However, a number of…

  9. Maximizing the optical network capacity

    PubMed Central

    Bayvel, Polina; Maher, Robert; Liga, Gabriele; Shevchenko, Nikita A.; Lavery, Domaniç; Killey, Robert I.

    2016-01-01

    Most of the digital data transmitted are carried by optical fibres, forming the great part of the national and international communication infrastructure. The information-carrying capacity of these networks has increased vastly over the past decades through the introduction of wavelength division multiplexing, advanced modulation formats, digital signal processing and improved optical fibre and amplifier technology. These developments sparked the communication revolution and the growth of the Internet, and have created an illusion of infinite capacity being available. But as the volume of data continues to increase, is there a limit to the capacity of an optical fibre communication channel? The optical fibre channel is nonlinear, and the intensity-dependent Kerr nonlinearity limit has been suggested as a fundamental limit to optical fibre capacity. Current research is focused on whether this is the case, and on linear and nonlinear techniques, both optical and electronic, to understand, unlock and maximize the capacity of optical communications in the nonlinear regime. This paper describes some of them and discusses future prospects for success in the quest for capacity. PMID:26809572

  10. Maximizing the optical network capacity.

    PubMed

    Bayvel, Polina; Maher, Robert; Xu, Tianhua; Liga, Gabriele; Shevchenko, Nikita A; Lavery, Domaniç; Alvarado, Alex; Killey, Robert I

    2016-03-01

    Most of the digital data transmitted are carried by optical fibres, forming the great part of the national and international communication infrastructure. The information-carrying capacity of these networks has increased vastly over the past decades through the introduction of wavelength division multiplexing, advanced modulation formats, digital signal processing and improved optical fibre and amplifier technology. These developments sparked the communication revolution and the growth of the Internet, and have created an illusion of infinite capacity being available. But as the volume of data continues to increase, is there a limit to the capacity of an optical fibre communication channel? The optical fibre channel is nonlinear, and the intensity-dependent Kerr nonlinearity limit has been suggested as a fundamental limit to optical fibre capacity. Current research is focused on whether this is the case, and on linear and nonlinear techniques, both optical and electronic, to understand, unlock and maximize the capacity of optical communications in the nonlinear regime. This paper describes some of them and discusses future prospects for success in the quest for capacity. PMID:26809572

  11. Neuropsychologist Experts and Civil Capacity Evaluations: Representative Cases.

    PubMed

    Kaufmann, Paul M

    2016-09-01

    Clinical neuropsychologists accept more forensic referrals now and spend more time in forensic consulting than ever before. Recent surveys show weekly hours devoted to forensic consulting increased 97% in the past decade. During the same time period, the number of board certified neuropsychologists more than doubled. Under recently published Specialty Guidelines for Forensic Psychology, clinical neuropsychologists practice forensic psychology when applying scientific, technical, or specialized knowledge of neuropsychology to the law to assist in addressing legal, contractual, or administrative matters. Among those increasingly varied forensic referrals, clinical neuropsychologists are conducting more civil competency and capacity evaluations. Representative cases from three jurisdictions demonstrate how neuropsychologists provide expertize in matters involving testamentary capacity, contractual capacity, business judgments, and job capacity. Case presentations illustrate some of the strengths and weaknesses of neuropsychological evaluation of civil capacities. The article concludes with a "battle of experts" case involving five neuropsychologists with opposing opinions recently heard in a Federal Appellate court. Implications for neuropschology training and forensic competencies are considered. In offering quality services to the legal profession, neuropsychologists support the truth-seeking function of the judiciary, promote justice, protect the profession, and serve public policy. PMID:27538441

  12. Teaching Reflection Seismic Processing

    NASA Astrophysics Data System (ADS)

    Forel, D.; Benz, T.; Pennington, W. D.

    2004-12-01

    Without pictures, it is difficult to give students a feeling for wave propagation, transmission, and reflection. Even with pictures, wave propagation is still static to many. However, when students use and modify scripts that generate wavefronts and rays through a geologic model that they have modified themselves, we find that students gain a real feeling for wave propagation. To facilitate teaching 2-D seismic reflection data processing (from acquisition through migration) to our undergraduate and graduate Reflection Seismology students, we use Seismic Un*x (SU) software. SU is maintained and distributed by Colorado School of Mines, and it is freely available (at www.cwp.mines.edu/cwpcodes). Our approach includes use of synthetic and real seismic data, processing scripts, and detailed explanation of the scripts. Our real data were provided by Gregory F. Moore of the University of Hawaii. This approach can be used by any school at virtually no expense for either software or data, and can provide students with a sound introduction to techniques used in processing of reflection seismic data. The same software can be used for other purposes, such as research, with no additional expense. Students who have completed a course using SU are well equipped to begin using it for research, as well. Scripts for each processing step are supplied and explained to the students. Our detailed description of the scripts means students do not have to know anything about SU to start. Experience with the Unix operating system is preferable but not necessary -- our notes include Computer Hints to help the beginner work with the Unix operating system. We include several examples of synthetic model building, acquiring shot gathers through synthetic models, sorting shot gathers to CMP gathers, gain, 1-D frequency filtering, f-k filtering, deconvolution, semblance displays and velocity analysis, flattening data (NMO), stacking the CMPs, and migration. We use two real (marine) data sets. One

  13. A fluorescence method for estimation of toxemia: binding capacity of lipoproteins and albumin in plasma.

    PubMed

    Altamentova, S M; Shaklai, N; Arav, R; Miller, Y I

    1998-03-23

    The hazard of toxemia, a condition resulting from the spread of toxins by the bloodstream, is regulated by plasma proteins capable of binding with free toxins. As toxin binding results in a reduction of available binding sites, measuring the proteins' binding capacity can be used to estimate toxemia severity. Suggested by this approach, a novel fluorescence method was developed to determine lipoprotein and albumin binding capacities in whole plasma. The method entails two steps: specific binding of N(n-carboxy)phenylimide-4-dimethyl-aminonaphthalic acid with albumin followed by addition of 12-(9-anthroyloxy)stearic acid which, under these conditions, binds mostly with lipoprotein. Reduced fluorescence intensity of the probes in plasma of patients compared to that of healthy donors reflected saturation of binding sites by toxins, thereby estimating toxemia severity. Poor correlation was found between the lipoprotein and albumin binding abilities, suggesting their independent diagnostic values. The simplicity and rapidity of this method are advantageous for its clinical application. PMID:9565329

  14. Know yourself and you shall know the other... to a certain extent: multiple paths of influence of self-reflection on mindreading.

    PubMed

    Dimaggio, Giancarlo; Lysaker, Paul H; Carcione, Antonino; Nicolò, Giuseppe; Semerari, Antonio

    2008-09-01

    Social and neurocognitive research suggests that thinking about one's own thinking and thinking about the thinking of others-termed 'mindreading', 'metacognition', 'social cognition' or 'mentalizing' are not identical activities. The ability though to think about thinking in the first person is nevertheless related to the ability to think about other's thoughts in the third person. Unclear is how these phenomena influence one another. In this review, we explore how self-reflection and autobiographical memory influence the capacity to think about the thoughts and emotions of others. We review studies suggesting that the more individuals are able to reflect on and retrieve episodes from their life narratives, the more they are likely to grasp others' thoughts and emotions. We discuss evidence supporting this possibility including studies of the neurocognitive bases of empathy and self-awareness and how different aspects of self-reflection may impact on mindreading. We also draw from clinical reports how improved self-reflection may result in a more nuanced mindreading, namely persons suffering from schizophrenia and narcissistic personality disorder. We finally discuss the implications for research and practice and consider whether there are conditions in which the reverse is true, where self-reflection might impair mindreading or in which mindreading may facilitate self-reflection. PMID:18394921

  15. Seismic reflection imaging, accounting for primary and multiple reflections

    NASA Astrophysics Data System (ADS)

    Wapenaar, Kees; van der Neut, Joost; Thorbecke, Jan; Broggini, Filippo; Slob, Evert; Snieder, Roel

    2015-04-01

    Imaging of seismic reflection data is usually based on the assumption that the seismic response consists of primary reflections only. Multiple reflections, i.e. waves that have reflected more than once, are treated as primaries and are imaged at wrong positions. There are two classes of multiple reflections, which we will call surface-related multiples and internal multiples. Surface-related multiples are those multiples that contain at least one reflection at the earth's surface, whereas internal multiples consist of waves that have reflected only at subsurface interfaces. Surface-related multiples are the strongest, but also relatively easy to deal with because the reflecting boundary (the earth's surface) is known. Internal multiples constitute a much more difficult problem for seismic imaging, because the positions and properties of the reflecting interfaces are not known. We are developing reflection imaging methodology which deals with internal multiples. Starting with the Marchenko equation for 1D inverse scattering problems, we derived 3D Marchenko-type equations, which relate reflection data at the surface to Green's functions between virtual sources anywhere in the subsurface and receivers at the surface. Based on these equations, we derived an iterative scheme by which these Green's functions can be retrieved from the reflection data at the surface. This iterative scheme requires an estimate of the direct wave of the Green's functions in a background medium. Note that this is precisely the same information that is also required by standard reflection imaging schemes. However, unlike in standard imaging, our iterative Marchenko scheme retrieves the multiple reflections of the Green's functions from the reflection data at the surface. For this, no knowledge of the positions and properties of the reflecting interfaces is required. Once the full Green's functions are retrieved, reflection imaging can be carried out by which the primaries and multiples are

  16. Individual differences in working memory capacity and workload capacity

    PubMed Central

    Yu, Ju-Chi; Chang, Ting-Yun; Yang, Cheng-Ta

    2014-01-01

    We investigated the relationship between working memory capacity (WMC) and workload capacity (WLC). Each participant performed an operation span (OSPAN) task to measure his/her WMC and three redundant-target detection tasks to measure his/her WLC. WLC was computed non-parametrically (Experiments 1 and 2) and parametrically (Experiment 2). Both levels of analyses showed that participants high in WMC had larger WLC than those low in WMC only when redundant information came from visual and auditory modalities, suggesting that high-WMC participants had superior processing capacity in dealing with redundant visual and auditory information. This difference was eliminated when multiple processes required processing for only a single working memory subsystem in a color-shape detection task and a double-dot detection task. These results highlighted the role of executive control in integrating and binding information from the two working memory subsystems for perceptual decision making. PMID:25566143

  17. A Pause for Reflection: Incorporating Reflection into Surgical Training

    PubMed Central

    McGlinn, Evan P.; Chung, Kevin C.

    2014-01-01

    Reflection is an important learning technique for surgeons during their training and is a valuable tool for life-long learning and maintenance of certification to assure competency. Reflection helps individuals to evaluate their performance in the interest of improving their ability to deal with similar experiences in the future. Additionally, reflection can be helpful for established surgeons to continue to improve upon their performance and hone their craft. This article outlines the theoretical role of reflection in the learning process. We will discuss methods for incorporating reflection into training programs, and review the evidence for implementing reflection in surgical training. PMID:25003410

  18. Characterisation of Balance Capacity in Prader-Willi Patients

    ERIC Educational Resources Information Center

    Capodaglio, Paolo; Menegoni, Francesco; Vismara, Luca; Cimolin, Veronica; Grugni, Graziano; Galli, Manuela

    2011-01-01

    Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome (PWS). This explorative study aims to characterise balance capacity in PWS as compared to non-genetically obese patients (O) and to a group of normal-weight individuals (CG). We enrolled 14 PWS patients: 8 females and 6 males (BMI = 41.3 [plus or minus] 7.3…

  19. Biological variability of transferrin saturation and unsaturated iron binding capacity

    PubMed Central

    Adams, PC; Reboussin, DM; Press, RD; Barton, JC; Acton, RT; Moses, GC; Leiendecker-Foster, C; McLaren, GD; Dawkins, FW; Gordeuk, VR; Lovato, L; Eckfeldt, JH

    2007-01-01

    Background Transferrin saturation is widely considered the preferred screening test for hemochromatosis. Unsaturated iron binding capacity has similar performance at lower cost. However, the within-person biological variability of both these tests may limit their ability at commonly used cut points to detect HFE C282Y homozygous patients. Methods The Hemochromatosis and Iron Overload Screening (HEIRS) Study screened 101,168 primary care participants for iron overload using tansferrin saturation, unsaturated iron binding capacity, ferritin and HFE C282Y and H63D genotyping. Transferrin saturation and unsaturated iron binding capacity were performed at initial screening and again when selected participants and controls returned for a clinical examination several months later. A missed case was defined as a C282Y homozygote who had transferrin saturation below cut point (45 % women, 50 % men) or unsaturated iron binding capacity above cut point (150 μmol/L women, 125 μmol/L men) at either the initial screening or clinical examination, or both, regardless of serum ferritin. Results There were 209 C282Y previously undiagnosed homozygotes with transferrin saturation and unsaturated iron binding capacity testing done at initial screening and clinical examination. Sixty-eight C282Y homozygotes (33%) would have been missed at these transferrin saturation cut points (19 men, 49 women, median SF 170 μg/L, first and third quartiles 50 and 474 μg/L), and 58 homozygotes (28 %) would have been missed at the unsaturated iron binding capacity cut points (20 men, 38 women, median SF 168 μg/L, quartiles 38 and 454 μg/L). There was no advantage to using fasting samples. Conclusions The within-person biological variability of transferrin saturation and unsaturated iron binding capacity limit their usefulness as an initial screening test for expressing C282Y homozygotes. PMID:17976429

  20. Capacity sharing of water reservoirs

    NASA Astrophysics Data System (ADS)

    Dudley, Norman J.; Musgrave, Warren F.

    1988-05-01

    The concept of a water use property right is developed which does not apply to water volumes as such but to a share of the capacity (not contents) of river storage reservoirs and their inflows. The shareholders can withdraw water from their share over time in accordance with their preferences for stability of water deliveries. The reservoir authority does not manage reservoir releases but keeps record of individual shareholder's withdrawals and net inflows to monitor the quantity of water in each shareholder's capacity share. A surplus of total reservoir contents over the sum of the contents of the individual shareholder's capacity shares will accrue over time. Two different criteria for its periodic distribution among shareholders are compared. A previous paper Dudley (this issue(b)) noted a loss of short-run economic efficiency as reservoir and farm management decision making become separated. This is largely overcome by capacity sharing which allows each user to integrate the management of their portion of the reservoir and their farming operations. The nonattenuated nature of the capacity sharing water rights also promotes long-run economic efficiency.

  1. Reflections on Rodent Implantation.

    PubMed

    Cha, Jeeyeon M; Dey, Sudhansu K

    2015-01-01

    Embryo implantation is a complex process involving endocrine, paracrine, autocrine, and juxtacrine modulators that span cell-cell and cell-matrix interactions. The quality of implantation is predictive for pregnancy success. Earlier observational studies formed the basis for genetic and molecular approaches that ensued with emerging technological advances. However, the precise sequence and details of the molecular interactions involved have yet to be defined. This review reflects briefly on aspects of our current understanding of rodent implantation as a tribute to Roger Short's lifelong contributions to the field of reproductive physiology. PMID:26450495

  2. Force reflection with compliance control

    NASA Technical Reports Server (NTRS)

    Kim, Won S. (Inventor)

    1993-01-01

    Two types of systems for force-reflecting control, which enables high force-reflection gain, are presented: position-error-based force reflection and low-pass-filtered force reflection. Both of the systems are combined with shared compliance control. In the position-error-based class, the position error between the commanded and the actual position of a compliantly controlled robot is used to provide force reflection. In the low-pass-filtered force reflection class, the low-pass-filtered output of the compliance control is used to provide force reflection. The increase in force reflection gain can be more than 10-fold as compared to a conventional high-bandwidth pure force reflection system, when high compliance values are used for the compliance control.

  3. Reflected Deck Plan, Reflected Roof Plan, Deck Plan Bridgeport ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Reflected Deck Plan, Reflected Roof Plan, Deck Plan - Bridgeport Covered Bridge, Spanning South Fork of Yuba River at bypassed section of Pleasant Valley Road (originally Virginia Turnpike) in South Yuba River State Park , Bridgeport, Nevada County, CA

  4. On risk and decisional capacity.

    PubMed

    Checkland, D

    2001-02-01

    Limits to paternalism are, in the liberal democracies, partially defined by the concepts of decision-making capacity/incapacity (mental competence/incompetence). The paper is a response to Ian Wilks's (1997) recent attempt to defend the idea that the standards for decisional capacity ought to vary with the degree of risk incurred by certain choices. Wilks's defense is based on a direct appeal to the logical features of examples and analogies, thus attempting to by-pass earlier criticisms (e.g., Culver & Gert, 1990) of risk-based standards. Wilks's argument is found wanting on the grounds that he misconstrues the logic of such capacity, especially in accounting for conceptual and pragmatic ties with issues of decisional authority. A diagnosis is offered as to the source of Wilks's error (the assumption that mental competence is a species of wider genus of "competence"), and an alternative way of accounting for risk within the predominant contemporary legal framework is sketched. PMID:11262640

  5. Quantitative Hyperspectral Reflectance Imaging

    PubMed Central

    Klein, Marvin E.; Aalderink, Bernard J.; Padoan, Roberto; de Bruin, Gerrit; Steemers, Ted A.G.

    2008-01-01

    Hyperspectral imaging is a non-destructive optical analysis technique that can for instance be used to obtain information from cultural heritage objects unavailable with conventional colour or multi-spectral photography. This technique can be used to distinguish and recognize materials, to enhance the visibility of faint or obscured features, to detect signs of degradation and study the effect of environmental conditions on the object. We describe the basic concept, working principles, construction and performance of a laboratory instrument specifically developed for the analysis of historical documents. The instrument measures calibrated spectral reflectance images at 70 wavelengths ranging from 365 to 1100 nm (near-ultraviolet, visible and near-infrared). By using a wavelength tunable narrow-bandwidth light-source, the light energy used to illuminate the measured object is minimal, so that any light-induced degradation can be excluded. Basic analysis of the hyperspectral data includes a qualitative comparison of the spectral images and the extraction of quantitative data such as mean spectral reflectance curves and statistical information from user-defined regions-of-interest. More sophisticated mathematical feature extraction and classification techniques can be used to map areas on the document, where different types of ink had been applied or where one ink shows various degrees of degradation. The developed quantitative hyperspectral imager is currently in use by the Nationaal Archief (National Archives of The Netherlands) to study degradation effects of artificial samples and original documents, exposed in their permanent exhibition area or stored in their deposit rooms.

  6. Ionospherically reflected proton whistlers

    NASA Astrophysics Data System (ADS)

    Vavilov, D. I.; Shklyar, D. R.

    2014-12-01

    We present experimental observations and detailed investigation of the variety of proton whistlers that includes transequatorial and ionospherically reflected proton whistlers. The latter have previously been indicated from numerical modeling of spectrograms. The study is based on six-component ELF wave data from the Detection of Electro-Magnetic Emissions Transmitted from Earthquake Regions (DEMETER) satellite which permits to obtain not only spectrograms displaying the power spectral density but also such wave properties as the polarization, wave normal angle, wave refractive index, and normalized parallel component of the Poynting vector. The explanation of various types of proton whistlers is based on the properties of ion cyclotron wave propagation in a multicomponent magnetoplasma, with special consideration of the effect of ion hybrid resonance reflection. Analysis of experimental data is supplemented by numerical modeling of spectrograms that reproduces the main features of experimental ones. As a self-contained result, we provide conclusive experimental evidences that the region illuminated by a lightning stroke in the Earth-ionosphere waveguide may spread over a distance of 4000 km in both hemispheres.

  7. Buffer Capacity: An Undergraduate Laboratory Experiment.

    ERIC Educational Resources Information Center

    Russo, Steven O.; Hanania, George I. H.

    1987-01-01

    Describes a quantitative experiment designed to demonstrate buffer action and the measurement of buffer capacity. Discusses how to make acetate buffers, determine their buffer capacity, plot the capacity/pH curve, and interpret the data obtained. (TW)

  8. Spray dryer capacity stretched 50%

    SciTech Connect

    Paraskevas, J.

    1983-01-01

    This article describes plant equipment modifications which has resulted in a 50% increase in spray drying capacity. The installation of a new atomizer and screening system in NL Chemicals' Newberry Springs plant which produces natural clays for use as rheological additives in industrial coatings, cosmetics and other products, resulted in a 50% increase in spray drying capacity. Energy consumption per pound of product was reduced by 7%, and product quality improved. This was achieved in less than three months at an investment of less than 10% of what an additional spray dryer would have cost.

  9. Reflecting on Reflective Practice: (Re)Visiting Dewey and Schon

    ERIC Educational Resources Information Center

    Farrell, Thomas S. C.

    2012-01-01

    Since the author began work in reflective practice, at first informally in the late 1970s and then more formally in the mid-1980s, he has always looked at reflective practice as a compass of sorts to guide teachers when they may be seeking direction as to what they are doing in their classrooms. The metaphor of reflection as a compass enables…

  10. Reflection: Journals and Reflective Questions: A Strategy for Professional Learning

    ERIC Educational Resources Information Center

    Clarke, Maggie

    2004-01-01

    Reflective journals have been used widely in teacher education programs to promote reflective thinking (Freidus, 1998; Carter & Francis, 2000; Yost, Senter & Forlenzo-Bailey, 2000). Smyth (1992) advocated that posing a series of questions to be answered in written journals could enhance reflective thinking. It was for this reason that…

  11. Reflection and Non-Reflection of Particle Wavepackets

    ERIC Educational Resources Information Center

    Cox, Timothy; Lekner, John

    2008-01-01

    Exact closed-form solutions of the time-dependent Schrodinger equation are obtained, describing the propagation of wavepackets in the neighbourhood of a potential. Examples given include zero reflection, total reflection and partial reflection of the wavepacket, for the sech[superscript 2]x/a, 1/x[superscript 2] and delta(x) potentials,…

  12. Reinventing practice and education partnerships for capacity expansion.

    PubMed

    Allen, Patricia; Schumann, Renae; Collins, Cathleen; Selz, Nina

    2007-04-01

    Two alternative models offering solutions to the nursing shortage in Texas enhance communication between schools of nursing and acute care service agencies to strengthen the partnership between education and practice. These initiatives use the valuable asset of onsite nurses in practice to clinically instruct nursing students, thus replenishing the number of clinical instructors and freeing clinical space to overcome the obstacles in increasing capacity. Forming practice-education partnerships and integrating technology support, including using simulations and online courseware to train qualified nurses, reinvent the combining resources to address a common need. Moving into the last year of grant funding, both projects show initial promise in meeting project goals of increasing capacity in nursing education. PMID:17474487

  13. Renewable liquid reflecting zone plate

    DOEpatents

    Toor, Arthur; Ryutov, Dmitri D.

    2003-12-09

    A renewable liquid reflecting zone plate. Electrodes are operatively connected to a dielectric liquid in a circular or other arrangement to produce a reflecting zone plate. A system for renewing the liquid uses a penetrable substrate.

  14. Reflections on conformal spectra

    NASA Astrophysics Data System (ADS)

    Kim, Hyungrok; Kravchuk, Petr; Ooguri, Hirosi

    2016-04-01

    We use modular invariance and crossing symmetry of conformal field theory to reveal approximate reflection symmetries in the spectral decompositions of the partition function in two dimensions in the limit of large central charge and of the four-point function in any dimension in the limit of large scaling dimensions Δ0 of external operators. We use these symmetries to motivate universal upper bounds on the spectrum and the operator product expansion coefficients, which we then derive by independent techniques. Some of the bounds for four-point functions are valid for finite Δ0 as well as for large Δ0. We discuss a similar symmetry in a large spacetime dimension limit. Finally, we comment on the analogue of the Cardy formula and sparse light spectrum condition for the four-point function.

  15. JFET reflection oscillator

    NASA Technical Reports Server (NTRS)

    Kleinberg, L. L. (Inventor)

    1985-01-01

    A high frequency oscillator circuit is provided using a low cost junction type field effect transistor (T sub 1) with a tuned circuit connected to its gate. The frequency of operation is determined by the tuned circuit and the capacitance reflected from the source to the gate. The transistor is matched to the frequency of operation so that this frequency falls within the roll-off portion of the transistor's transconductance verses frequency curve, preferably somewhat above the 3 db point in frequency. Phase shift necessary to sustain oscillation occurs due to the operation of the transistor in the roll-off portion of the curve and the addition of a phase shifting network (R sub 1, C sub 1) at the source.

  16. Digital infrared fundus reflectance.

    PubMed

    Packer, S; Schneider, K; Lin, H Z; Feldman, M

    1980-06-01

    An infrared sensor was inserted at the film plane of a fundus camera. The signal was visualized on an oscilloscope. In this manner we measured infrared reflectance from the surface of the fundus. The purpose was to characterize choroidal malignant melanomas more reliably than is done with infrared color translation photography. Control lesions were choroidal nevi, metastatic tumors, and disciform macular degenerations. Correlations were made with radioactive phosphorus (32P) uptake, fluorescein angiography, and histopathologic findings. Several cases are presented, one in which this new method of infrared detection was the first diagnostic test to detect the spread of a choroidal melanoma. The simplicity of this technique and its increased accuracy justify the needed further refinements. PMID:7413142

  17. North American fertilizer capacity data

    SciTech Connect

    Not Available

    1991-12-01

    This listing of producers and their fertilizer production capacities was compiled in October 1991 with the cooperation of the US and Canadian fertilizer industry. Fertilizers production is reported or forecasted for the years 1987 through 1997. The fertilizers reported on are: ammonia, ammonium nitrate, nitrogen solutions, urea, phosphate rock, wet-process phosphoric acid, ammonium phosphates, concentrated superphosphates, and potash.

  18. North American fertilizer capacity data

    SciTech Connect

    Not Available

    1991-12-01

    This listing of producers and their fertilizer production capacities was compiled in October 1991 with the cooperation of the US and Canadian fertilizer industries. Yearly production and forecasts are given for 1987 through 1997. Fertilizers reported on include: ammonium sulfate, nitric acid, wet-process superphosphoric acid, normal superphosphate, elemental phosphorus, potassium sulfate, and sulfate of potash/magnesia.

  19. AccessSTEM: Building Capacity

    ERIC Educational Resources Information Center

    DO-IT, 2009

    2009-01-01

    A series of activities were undertaken to understand the underrepresentation of people with disabilities in science, technology, engineering, and mathematics (STEM) careers and increase their participation in these fields. "AccessSTEM" collaborated with key stakeholders to conduct a "Capacity-Building Institute" ("CBI") in April 2009; share…

  20. Capacity Issue Looms for Vouchers

    ERIC Educational Resources Information Center

    Zehr, Mary Ann

    2011-01-01

    State-level momentum in support of vouchers and tax credits that help students go to private schools highlights what has been a largely theoretical issue: private school capacity to support voucher-financed enrollment. Academics say the national supply of seats in secular and religious private schools is sufficient to meet short-term demand from…

  1. Quantum channel capacities: Multiparty communication

    NASA Astrophysics Data System (ADS)

    Demianowicz, Maciej; Horodecki, Paweł

    2006-10-01

    We analyze different aspects of multiparty communication over quantum memoryless channels and generalize some of the key results known from bipartite channels to the multiparty scenario. In particular, we introduce multiparty versions of subspace and entanglement transmission fidelities. We also provide alternative, local, versions of fidelities and show their equivalence to the global ones in context of capacity regions defined. An equivalence of two different capacity notions with respect to two types of fidelities is proven. In analogy to the bipartite case it is shown, via sufficiency of isometric encoding theorem, that additional classical forward side channel does not increase capacity region of any quantum channel with k senders and m receivers which represents a compact unit of general quantum networks theory. The result proves that recently provided capacity region of a multiple access channel [M. Horodecki , Nature 436, 673 (2005); J. Yard , e-print quant-ph/0501045], is optimal also in a scenario of an additional support of forward classical communication.

  2. Working memory capacity in Generalized Social Phobia

    PubMed Central

    Amir, Nader; Bomyea, Jessica

    2011-01-01

    Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with Generalized Social Phobia (GSP). Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with Generalized Social Phobia and non-anxious controls using an Operation Span task using threat relevant and neutral stimuli. Results revealed that non-anxious individuals demonstrated better WMC than individuals with GSP for neutral words, but not for social threat words. Individuals with GSP demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with GSP may have relatively enhanced working memory performance for salient, socially-relevant information. This enhanced working memory capacity for threat relevant information may be the result of practice with this information in GSP. PMID:21381805

  3. Working memory capacity in generalized social phobia.

    PubMed

    Amir, Nader; Bomyea, Jessica

    2011-05-01

    Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with generalized social phobia. Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with generalized social phobia and nonanxious controls using an operation span task with threat-relevant and neutral stimuli. Results revealed that nonanxious individuals demonstrated better WMC than individuals with generalized social phobia for neutral words but not for social threat words. Individuals with generalized social phobia demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with generalized social phobia may have relatively enhanced working memory performance for salient, socially relevant information. This enhanced working memory capacity for threat-relevant information may be the result of practice with this information in generalized social phobia. PMID:21381805

  4. Anomalous reflections from the ionosphere

    NASA Astrophysics Data System (ADS)

    Givishvili, G. V.; Leshchenko, L. N.

    2013-09-01

    The existence of anomalous ionospheric reflections was shown on the basis of vertical soundings at the Moskow station. They are observed at heights of 100-200 km. These anomalous reflections are not related to the main Ne( h) ionospheric profile. Morphological characteristics of such reflections are presented: the daily, seasonal, and cyclic dependences of their appearance.

  5. Reflections From a Fresnel Lens

    ERIC Educational Resources Information Center

    Keeports, David

    2005-01-01

    Reflection of light by a convex Fresnel lens gives rise to two distinct images. A highly convex inverted real reflective image forms on the object side of the lens, while an upright virtual reflective image forms on the opposite side of the lens. I describe here a set of laser experiments performed upon a Fresnel lens. These experiments provide…

  6. Structures for Facilitating Student Reflection

    ERIC Educational Resources Information Center

    Grossman, Robert

    2009-01-01

    The goal of this article is to describe a continuum of levels of reflection. It briefly focuses on Deanna Kuhn's research into the development of scientific thinking and Robert Kegan's Object-Subject Theory of Development applied to the problems of inspiring students to be able to reflect. Assignments for improving students' ability to reflect are…

  7. Identifying hidden capacity through modernization of genitourinary medicine services.

    PubMed

    Ahmed-Jushuf, I; Griffiths, V

    2007-05-01

    Rates of sexually transmitted infections have continued to rise in recent years throughout the UK. Poor access to genitourinary medicine clinics has been highlighted as a major factor contributing to this increase. Despite a lack of investment in sexual health services, capacity for new patients has almost doubled over the past decade. However, a significant amount of unreleased capacity is still available within the service. This 'Six Sigma' study group was formed in 2003 to explore whether capacity could be enhanced by further reducing the ratio of follow-up to new-case patient visits. Following implementation of recommended changes, the mean follow-up to new-case ratio reduced from 0.82 (range 0.29-1.69) to 0.62 (range: 0.19-1.40). Crucially, this increase in capacity was achieved without adversely affecting quality of care. The Six Sigma group have developed the tools to release capacity in a controlled and validated way and are keen to help other clinics achieve similar results. PMID:17524186

  8. University cardiology clinic.

    PubMed

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  9. Reflections on RSNA 1981

    SciTech Connect

    Zeitler, E.; Abrams, H.L.; Sos, T.A.; Harrington, D.P.

    1982-01-01

    The annual meeting of RSNA has provided the following points. Computed tomography and ultrasound have become well established in routine medical care. Digital technology is becoming increasingly important in many fields of medicine like in radiology (digital substraction angiography), physiologic and clinical information system. Nuclear magnetic resonance (NMR) recently recognised as a more important diagnostic tool may become the technique of choice for the early diagnosis of multiple sclerosis and high pressure hydroencephalus. It is also usefull for the diagnosis of cardiac and vascular diseases.

  10. Bidirectional reflectance of zinc oxide

    NASA Technical Reports Server (NTRS)

    Scott, R.

    1973-01-01

    This investigation was undertaken to determine original and useful information about the bidirection reflectance of zinc oxide. The bidirectional reflectance will be studied for the spectra between .25-2.5 microns and the hemisphere above the specimen. The following factors will be considered: (1) surface conditions; (2) specimen preparation; (3) specimen substrate, (4) polarization; (5) depolarization; (6) wavelength; and (7) angles of incident and reflection. The bidirectional reflectance will be checked by experimentally determined angular hemispherical measurements or hemispherical measurements will be used to obtain absolute bidirectional reflectance.

  11. The effects of sleep loss on capacity and effort

    PubMed Central

    Engle-Friedman, Mindy

    2014-01-01

    Sleep loss appears to affect the capacity for performance and access to energetic resources. This paper reviews research examining the physical substrates referred to as resource capacity, the role of sleep in protecting that capacity and the reaction of the system as it attempts to respond with effort to overcome the limitations on capacity caused by sleep loss. Effort is the extent to which an organism will exert itself beyond basic levels of functioning or attempt alternative strategies to maintain performance. The purpose of this review is to bring together research across sleep disciplines to clarify the substrates that constitute and influence capacity for performance, consider how the loss of sleep influences access to those resources, examine cortical, physiological, perceptual, behavioral and subjective effort responses and consider how these responses reflect a system reacting to changes in the resource environment. When sleep deprived, the ability to perform tasks that require additional energy is impaired and the ability of the system to overcome the deficiencies caused by sleep loss is limited. Taking on tasks that require effort including school work, meal preparation, pulling off the road to nap when driving drowsy appear to be more challenging during sleep loss. Sleep loss impacts the effort-related choices we make and those choices may influence our health and safety. PMID:26483932

  12. The effects of sleep loss on capacity and effort.

    PubMed

    Engle-Friedman, Mindy

    2014-12-01

    Sleep loss appears to affect the capacity for performance and access to energetic resources. This paper reviews research examining the physical substrates referred to as resource capacity, the role of sleep in protecting that capacity and the reaction of the system as it attempts to respond with effort to overcome the limitations on capacity caused by sleep loss. Effort is the extent to which an organism will exert itself beyond basic levels of functioning or attempt alternative strategies to maintain performance. The purpose of this review is to bring together research across sleep disciplines to clarify the substrates that constitute and influence capacity for performance, consider how the loss of sleep influences access to those resources, examine cortical, physiological, perceptual, behavioral and subjective effort responses and consider how these responses reflect a system reacting to changes in the resource environment. When sleep deprived, the ability to perform tasks that require additional energy is impaired and the ability of the system to overcome the deficiencies caused by sleep loss is limited. Taking on tasks that require effort including school work, meal preparation, pulling off the road to nap when driving drowsy appear to be more challenging during sleep loss. Sleep loss impacts the effort-related choices we make and those choices may influence our health and safety. PMID:26483932

  13. Teachers' Reflective Practice in Lesson Study: A Tool for Improving Instructional Practice

    ERIC Educational Resources Information Center

    Gutierez, Sally Baricaua

    2015-01-01

    In teacher education, a collection of research has established the importance of reflection in professional development. Lesson study, a popular professional development in Japan, incorporates reflection in one of its stages to enhance teachers' capacity to look into their enacted practices to improve their research lessons. However, there appear…

  14. Teachers Talking about Teaching and School: Collaboration and Reflective Practice via Critical Friends Groups

    ERIC Educational Resources Information Center

    Kuh, Lisa P.

    2016-01-01

    Reflective practice has potentially positive effects on an organization's capacity to focus on student learning and teaching practices. In an effort to comply with policy and provide teachers with opportunities to reflect on their practice, districts, schools, and teachers have turned to various models that feature collaborative experiences. One…

  15. Cushing's ulcer: Further reflections

    PubMed Central

    Kemp, William J.; Bashir, Asif; Dababneh, Haitham; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Brain tumors, traumatic head injury, and other intracranial processes including infections, can cause increased intracranial pressure and lead to overstimulation of the vagus nerve. As a result, increased secretion of gastric acid may occur which leads to gastro-duodenal ulcer formation known as Cushing's ulcer. Methods: A review of original records of Dr. Harvey Cushing's patients suffering from gastro-duodenal ulcers was performed followed by a discussion of the available literature. We also reviewed the clinical records of the patients never reported by Cushing to gain his perspective in describing this phenomenon. Dr. Cushing was intrigued to investigate gastro-duodenal ulcers as he lost patients to acute gastrointestinal perforations following successful brain tumor operations. It is indeed ironic that Harvey Cushing developed a gastro-duodenal ulcer in his later years with failing health. Results: Clinically shown by Cushing's Yale Registry, a tumor or lesion can disrupt this circuitry, leading to gastroduodenal ulceration. Cushing said that it was “reasonable to believe that the perforations following posterior fossa cerebellar operations were produced in like fashion by an irritative disturbance either of fiber tracts or vagal centers in the brain stem.” Conclusion: Harvey Cushing's pioneering work depicted in his Yale registry serves as a milestone for continuing research that can further discern this pathway. PMID:25972936

  16. The Art of Reflection: Turning the Strange into the Familiar.

    PubMed

    Weingarten, Kaethe

    2016-06-01

    There are a great many useful articles on the dynamics and pragmatics of reflecting teams but few articles address what constitutes a good or inept reflection and why. I provide a conceptual model for thinking about what a good reflection does, distinguishing it from a nice reflection. With some further refinements in place, I then illustrate how reflections can be part of any relationship, not just clinical ones. We have opportunities to make them and to recognize when others make them to us. By using examples from my personal life-as a grandmother, daughter, radio listener, cancer survivor, and client-I attempt to ease the personal/professional binary, a project of mine for the last 35 years. In the second part of the article, I address how writing can serve reflection. Although best offered at the moment one is called for, it is never too late for a reflection. Writing allows people to offer reflections after the fact to those who have shared their stories. Sometimes, it is to ourselves we offer those reflections, when the reflector has long since dropped the thread of obligation or interest. I provide an example of working with iconic imagery to unpack meaning so that reflection can eventually take place, allowing integration to proceed, facilitating the strange becoming the familiar. PMID:26118842

  17. [Parenting capacity of mothers with schizophrenia].

    PubMed

    Arvaniti, A; Spyropoulou, A; Zervas, I

    2012-01-01

    Recent studies indicate that the pregnancy rates of mothers with schizophrenia do not differ significantly from those of the general population. Mothers' severe mental illness, combined with poor social support and comorbidity, may significantly affect her parenting capacity. However, the poor quality of parenting by psychotic mothers should not be taken for granted, in advance. Some of them may become excellent parents while other may abuse their children and finally lose custody because of this. The parenting capacity is significantly influenced by the existing insight of patient-parent's disease. Assessing the parenting capacity comprises the measurement of insight and of the risk of child abuse as well. Factors associated with increased risk for child abuse are: (a) active psychiatric symptomatology, (b) history of violent behavior in the past, (c) maternal history of abuse during childhood, (d) dangerous domestic environment, (e) stressful events and poor social support to the mother and (f) unrealistic parental expectations. These factors should be assessed both clinically and by using the appropriate psychometric tools. Tools which have been widely used for this purpose are: (a) "Schedule for Assessment of Insight-SAI", (b) "Childhood Trauma Interview", (c) "Home Observation for the Measurement of the Environment Inventory-HOME" and "Home Screening Questionnaire -HSQ", (d) "Parental Stress Inventory-PSI", "Swedish Parenthood Stress Questionnaire-SPSQ", "Arizona Social Support Inventory" (e) "Parent Opinion Questionnaire-POQ". Interventions to ensure a more adequate parenting capacity should be focused on family planning: mothers with severe mental illness have poor knowledge about reproductive and contraception issues. Their pregnancies are mostly not planned. It is important for the family planning to be tailored according to the specific needs of schizophrenic mothers and to take into account the following issues: (a) the severity and the duration

  18. Remarks on entanglement assisted classical capacity

    NASA Astrophysics Data System (ADS)

    Fan, Heng

    2003-06-01

    The property of the optimal signal ensembles of entanglement assisted channel capacity is studied. A relationship between entanglement assisted channel capacity and one-shot capacity of unassisted channel is obtained. The data processing inequalities, convexity and additivity of the entanglement assisted channel capacity are reformulated by simple methods.

  19. Passive field reflectance measurements

    NASA Astrophysics Data System (ADS)

    Weber, Christian; Schinca, Daniel C.; Tocho, Jorge O.; Videla, Fabian

    2008-10-01

    The results of reflectance measurements performed with a three-band passive radiometer with independent channels for solar irradiance reference are presented. Comparative operation between the traditional method that uses downward-looking field and reference white panel measurements and the new approach involving duplicated downward- and upward-looking spectral channels (each latter one with its own diffuser) is analyzed. The results indicate that the latter method performs in very good agreement with the standard method and is more suitable for passive sensors under rapidly changing atmospheric conditions (such as clouds, dust, mist, smog and other scatterers), since a more reliable synchronous recording of reference and incident light is achieved. Besides, having separate channels for the reference and the signal allows a better balancing of gains in the amplifiers for each spectral channel. We show the results obtained in the determination of the normalized difference vegetation index (NDVI) corresponding to the period 2004-2007 field experiments concerning weed detection in soybean stubbles and fertilizer level assessment in wheat. The method may be used to refine sensor-based nitrogen fertilizer rate recommendations and to determine suitable zones for herbicide applications.

  20. Venus Highland Anomalous Reflectivity

    NASA Astrophysics Data System (ADS)

    Simpson, Richard A.; Tyler, G. L.; Häusler, B.; Mattei, R.; Patzold, M.

    2009-09-01

    Maxwell Montes was one of several unusually bright areas identified from early Venus radar backscatter observations. Pioneer Venus' orbiting radar associated low emissivity with the bright areas and established a correlation between reflectivity and altitude. Magellan, using an oblique bistatic geometry, showed that the bright surface dielectric constant was not only large but also imaginary -- i.e., the material was conducting, at least near Cleopatra Patera (Pettengill et al., Science, 272, 1996). Venus Express (VEX) repeated Magellan's bistatic observations over Maxwell, using the more conventional circular polarization carried by most spacecraft. Although VEX signal-to-noise ratio was lower than Magellan's, echoes were sufficiently strong to verify the Magellan conclusions near Cleopatra (see J. Geophys. Res., 114, E00B41, doi:10.1029/2008JE003156). Only about 40% of the surface at Cleopatra scatters specularly, opening the Fresnel (specular) interpretation model to question. Elsewhere in Maxwell, the specular percentage may be even lower. Nonetheless, the echo polarization is reversed throughout Maxwell, a result that is consistent with large dielectric constants and difficult to explain without resorting qualitatively (if not quantitatively) to specular models. VEX was scheduled to explore other high altitude regions when its S-Band (13-cm wavelength) radio system failed in late 2006, so further probing of high altitude targets awaits arrival of a new spacecraft.

  1. Reflective Fourier ptychography

    NASA Astrophysics Data System (ADS)

    Pacheco, Shaun; Zheng, Guoan; Liang, Rongguang

    2016-02-01

    The Fourier ptychography technique in reflection mode has great potential applications in tissue imaging and optical inspection, but the current configuration either has a limitation on cut-off frequency or is not practical. By placing the imaging aperture stop outside the illumination path, the illumination numerical aperture (NA) can be greater than the imaging NA of the objective lens. Thus, the cut-off frequency achieved in the proposed optical system is greater than twice the objective's NA divided by the wavelength (2NAobj/λ), which is the diffraction limit for the cut-off frequency in an incoherent epi-illumination configuration. We experimentally demonstrated that the synthesized NA is increased by a factor of 4.5 using the proposed optical concept. The key advantage of the proposed system is that it can achieve high-resolution imaging over a large field of view with a simple objective. It will have a great potential for applications in endoscopy, biomedical imaging, surface metrology, and industrial inspection.

  2. Reflective Fourier ptychography.

    PubMed

    Pacheco, Shaun; Zheng, Guoan; Liang, Rongguang

    2016-02-01

    The Fourier ptychography technique in reflection mode has great potential applications in tissue imaging and optical inspection, but the current configuration either has a limitation on cut-off frequency or is not practical. By placing the imaging aperture stop outside the illumination path, the illumination numerical aperture (NA) can be greater than the imaging NA of the objective lens. Thus, the cut-off frequency achieved in the proposed optical system is greater than twice the objective's NA divided by the wavelength (2NAobj/λ ), which is the diffraction limit for the cut-off frequency in an incoherent epi-illumination configuration. We experimentally demonstrated that the synthesized NA is increased by a factor of 4.5 using the proposed optical concept. The key advantage of the proposed system is that it can achieve high-resolution imaging over a large field of view with a simple objective. It will have a great potential for applications in endoscopy, biomedical imaging, surface metrology, and industrial inspection. PMID:26891601

  3. Peer consultation reflection exercise.

    PubMed Central

    Brown, J. B.; Hogg, W.; Delva, D.; Nanchoff-Glatt, M.; Moore, L.

    1999-01-01

    OBJECTIVE: To explore participants' overall perception of the value of the Peer Consultation Reflection Exercise (PCRE); of barriers and facilitators to participation and learning during a PCRE; and of the transferability of the experience to participants' own settings. DESIGN: This study used the qualitative techniques of key informant interviews and a focus group. SETTING: Focus group and key informant interviews at the 1996 Annual Meeting of the College of Family Physicians of Canada's Section of Teachers. PARTICIPANTS: Family medicine teachers attending a PCRE. METHOD: Five key informant interviews and one focus group composed of five participants were conducted to explore participants' experience of participating and learning during a PCRE. MAIN FINDINGS: Participants viewed the PCRE as a valuable opportunity to interact and learn from colleagues a were especially impressed with the opportunity to listen. Confidentiality and the important role of the facilitator were identified as key components. The greatest perceived barrier was the formal structure of the PCRE. CONCLUSIONS: The PCRE is an innovative strategy for personal and professional development. It could be used in other settings. PMID:10386215

  4. High capacity carbon dioxide sorbent

    SciTech Connect

    Dietz, Steven Dean; Alptekin, Gokhan; Jayaraman, Ambalavanan

    2015-09-01

    The present invention provides a sorbent for the removal of carbon dioxide from gas streams, comprising: a CO.sub.2 capacity of at least 9 weight percent when measured at 22.degree. C. and 1 atmosphere; an H.sub.2O capacity of at most 15 weight percent when measured at 25.degree. C. and 1 atmosphere; and an isosteric heat of adsorption of from 5 to 8.5 kilocalories per mole of CO.sub.2. The invention also provides a carbon sorbent in a powder, a granular or a pellet form for the removal of carbon dioxide from gas streams, comprising: a carbon content of at least 90 weight percent; a nitrogen content of at least 1 weight percent; an oxygen content of at most 3 weight percent; a BET surface area from 50 to 2600 m.sup.2/g; and a DFT micropore volume from 0.04 to 0.8 cc/g.

  5. High capacity immobilized amine sorbents

    DOEpatents

    Gray, McMahan L.; Champagne, Kenneth J.; Soong, Yee; Filburn, Thomas

    2007-10-30

    A method is provided for making low-cost CO.sub.2 sorbents that can be used in large-scale gas-solid processes. The improved method entails treating an amine to increase the number of secondary amine groups and impregnating the amine in a porous solid support. The method increases the CO.sub.2 capture capacity and decreases the cost of utilizing an amine-enriched solid sorbent in CO.sub.2 capture systems.

  6. Communication Capacity of Quantum Computation

    NASA Astrophysics Data System (ADS)

    Bose, S.; Rallan, L.; Vedral, V.

    2000-12-01

    By considering quantum computation as a communication process, we relate its efficiency to its classical communication capacity. This formalism allows us to derive lower bounds on the complexity of search algorithms in the most general context. It enables us to link the mixedness of a quantum computer to its efficiency and also allows us to derive the critical level of mixedness beyond which there is no quantum advantage in computation.

  7. Information capacity of specific interactions.

    PubMed

    Huntley, Miriam H; Murugan, Arvind; Brenner, Michael P

    2016-05-24

    Specific interactions are a hallmark feature of self-assembly and signal-processing systems in both synthetic and biological settings. Specificity between components may arise from a wide variety of physical and chemical mechanisms in diverse contexts, from DNA hybridization to shape-sensitive depletion interactions. Despite this diversity, all systems that rely on interaction specificity operate under the constraint that increasing the number of distinct components inevitably increases off-target binding. Here we introduce "capacity," the maximal information encodable using specific interactions, to compare specificity across diverse experimental systems and to compute how specificity changes with physical parameters. Using this framework, we find that "shape" coding of interactions has higher capacity than chemical ("color") coding because the strength of off-target binding is strongly sublinear in binding-site size for shapes while being linear for colors. We also find that different specificity mechanisms, such as shape and color, can be combined in a synergistic manner, giving a capacity greater than the sum of the parts. PMID:27155013

  8. Heat capacity of coal chars

    SciTech Connect

    Wang, W.Y.

    1982-01-01

    The selected starting materials were, a North Dakota lignite, an Illinois No. 6 bituminous and a Virginia coking coal. The carbon content of these coals ranged from 59 to 75 wt% (mineral matter included). Half of each of the received coal sample was demineralized using a standard procedure. Chars were prepared from the received and demineralized pulverized coals by pyrolysis. Heating rate of 5/sup 0/C/minute was employed for the pyrolysis under dry nitrogen gas atmosphere. The pyrolysis temperatures were 700, 900 and 1100/sup 0/C for periods of 0.1, 1 and 24. The char samples were characterized by chemical composition analysis, x-ray diffraction and porosimetry. Heat capacity data were collected over 75 to 300/sup 0/K temperature range using an adiabatic calorimeter. The heat capacity of these samples increases, with increasing temperature and moisture content, and its behavior and order of magnitude are similar to that of carbon when compared on a moisture free basis. Due to the uncertainties of the chemical forms of the mineral matter and the water phase below room temperature, all the heat capacity data are analyzed on a dry mineral matter free basis.

  9. Health reform requires policy capacity

    PubMed Central

    Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D.; Helms, David

    2015-01-01

    Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

  10. Health reform requires policy capacity.

    PubMed

    Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D; Helms, David

    2015-05-01

    Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

  11. Measurements and modeling of ear-canal reflectance and cochlear reflectance

    NASA Astrophysics Data System (ADS)

    Neely, Stephen T.; Rasetshwane, Daniel M.

    2015-12-01

    Cochlear reflectance (CR), the cochlear contribution to ear-canal reflectance (ECR), has theoretical advantages for cochlear modeling. Comparisons between measurements and models may lead to improved clinical interpretation of cochlear status and provide a basis for making improvements to the models. Simulation of ECR was performed using a combination of (1) an ear-canal model, (2) a middle-ear model and (3) a one-dimensional cochlear model. Simulated CR was the ECR difference between active and passive conditions of the model. The model simulation results were compared with measurements of both ECR and CR in both the time-domain and frequency-domains. Disparities between measurements and model provide a basis for improvements in the model. Substantial agreement between measurements and model suggest that CR is consistent with linear coherent reflection due to random impedance perturbations along the cochlear partition.

  12. The Influence of Age, Health Literacy, and Affluence on Adolescents' Capacity to Consent to Research.

    PubMed

    Nelson, Lance R; Stupiansky, Nathan W; Ott, Mary A

    2016-04-01

    While adults are assumed to have the capacity to consent to medical research, and young children to have no capacity, adolescents' capacity to consent is not well described. Adapting the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), we describe adolescents' capacity to consent to medical research and factors influencing that capacity. Our pilot study included a community-based sample of 30 adolescents, 14 to 21 years of age, who completed the MacCAT-CR after undergoing a simulated informed consent process. We found that adolescents' capacity to consent to research was associated with age, health literacy, and family affluence. These findings suggest that investigators and institutional review boards should be aware that factors other than age may influence capacity to consent, and, for modifiable factors, such as health literacy, consent processes for medical research with adolescents can be modified. PMID:27009303

  13. Destructiveness, atrocities and healing: epistemological and clinical reflections.

    PubMed

    Papadopoulos, R K

    1998-10-01

    In this paper, destructiveness is approached as a multi-dimensional phenomenon where the mental health perspective addresses only one of these dimensions. An attempt is made to locate this phenomenon in the context of epistemological and societal considerations. Critical of mono-dimensional explanations based on causal-reductive epistemology, the paper instead proposes the idea of an 'ecology of destructiveness', according to which mental health professionals cannot possibly continue to assume the role of detached observers. The ordinariness and archetypal fascination of destructiveness are discussed as preventing the psychologizing and pathologizing of it. In addition, it is suggested that 'destructiveness may be a tragic facet of the human condition', without this implying any justification of it. Based on my work with a group of Bosnian ex-camp prisoners, some basic principles of how one can work with survivors of atrocities are derived and discussed. A central feature of this work is the attempt to create an appropriate therapeutic context within which a 'therapeutic presence' and 'therapeutic witnessing' can be developed. Finally, the relevance of Jungian insights to this kind of work is reviewed and the emergence of new types of defences of the self is identified. PMID:9821401

  14. Evaluating Clinical Teaching in Medicine.

    ERIC Educational Resources Information Center

    Irby, David; Rakestraw, Philip

    1981-01-01

    Medical students have been rating clinical teaching in an obstetrics and gynecology clerkship at the University of Washington using an assessment form designed to reflect six factors of clinical teaching effectiveness. High interrater reliability and the utility of the data for faculty development and advancement are discussed. (Author/JMD)

  15. Teaching Reflective Social Work Practice in Health Care: Promoting Best Practices

    ERIC Educational Resources Information Center

    McCoyd, Judith L. M.; Kerson, Toba S.

    2013-01-01

    Reflection on case material is traditionally believed to promote better clinical practice; recent neurobiological understandings explain why reflection consolidates learning and allows professional heuristics to develop. Here, we describe a practice in context (PIC) framework that requires reflection on the contextual and decisional aspects of a…

  16. Peripheral reductive capacity is associated with cognitive performance and survival in Alzheimer's disease

    PubMed Central

    Minghetti, Luisa; Greco, Anita; Puopolo, Maria; Combrinck, Marc; Warden, Donald; Smith, A David

    2006-01-01

    Background Oxidative stress is believed to be an early event and a key factor in Alzheimer's disease (AD) pathogenesis and progression. In spite of an intensive search for surrogate markers to monitor changes related to oxidative stress in the brain, there is as yet no consensus about which markers to use in clinical studies. The measurement of peripheral anti-oxidants is an alternative way of evaluating the involvement of oxidative stress in the course of the disease. Given the complexity of peripheral anti-oxidant defence, variations in the levels of individual anti-oxidant species may not fully reflect the overall capacity to fight oxidant conditions. We therefore chose to evaluate the total reductive capacity (herein defined as anti-oxidant capacity, AOC) in serum from control subjects and AD patients in order to study the association between peripheral anti-oxidant defence, cognitive impairment and patient survival. Methods We measured the levels of AOC in serum samples from 26 cognitively normal controls and 25 AD patients (12 post-mortem confirmed) who completed the Cambridge Cognitive Assessment. Cognitive decline was assessed in a subgroup of 19 patients who underwent a second cognitive assessment 2 years after the initial visit. Results Serum AOC levels were lower in AD patients than in controls and were correlated with their cognitive test scores, although AOC levels were unrelated to cognitive decline assessed two years later. On the other hand, AOC levels were predictive of the length of patients' survival, with higher levels giving longer survival. Conclusion This study indicates that peripheral anti-oxidant defences are depleted in AD patients. The results suggest that serum AOC is a good index of the general health status and prognosis of patients but does not necessarily reflect the extent to which vulnerable neuronal populations are protected from oxidant processes. Further studies are required to establish whether peripheral AOC measurements may

  17. Assessing Organizational Capacity for Achieving Meaningful Use of Electronic Health Records

    PubMed Central

    Shea, Christopher M.; Malone, Robb; Weinberger, Morris; Reiter, Kristin L.; Thornhill, Jonathan; Lord, Jennifer; Nguyen, Nicholas G.; Weiner, Bryan J.

    2013-01-01

    Background Health care institutions are scrambling to manage the complex organizational change required for achieving meaningful use (MU) of electronic health records (EHR). Assessing baseline organizational capacity for the change can be a useful step toward effective planning and resource allocation. Purpose This article describes an adaptable method and tool for assessing organizational capacity for achieving MU of EHR. Data on organizational capacity (people, processes, and technology resources) and barriers are presented from outpatient clinics within one integrated health care delivery system; thus, the focus is on MU requirements for eligible professionals, not eligible hospitals. Methods We conducted 109 interviews with representatives from 46 outpatient clinics. Findings Most clinics had core elements of the people domain of capacity in place. However, the process domain was problematic for many clinics, specifically, capturing problem lists as structured data and having standard processes for maintaining the problem list in the EHR. Also, nearly half of all clinics did not have methods for tracking compliance with their existing processes. Finally, most clinics maintained clinical information in multiple systems, not just the EHR. The most common perceived barriers to MU for eligible professionals included EHR functionality, changes to workflows, increased workload, and resistance to change. Practice Implications Organizational capacity assessments provide a broad institutional perspective and an in-depth clinic-level perspective useful for making resource decisions and tailoring strategies to support the MU change effort for eligible professionals. PMID:23380882

  18. THE PRENATAL PARENTAL REFLECTIVE FUNCTIONING QUESTIONNAIRE: EXPLORING FACTOR STRUCTURE AND CONSTRUCT VALIDITY OF A NEW MEASURE IN THE FINN BRAIN BIRTH COHORT PILOT STUDY.

    PubMed

    Pajulo, Marjukka; Tolvanen, Mimmi; Karlsson, Linnea; Halme-Chowdhury, Elina; Öst, Camilla; Luyten, Patrick; Mayes, Linda; Karlsson, Hasse

    2015-01-01

    Parental reflective functioning (PRF) is the capacity to focus on experience and feelings in oneself and in the child. Individual differences in PRF reportedly affect child attachment and socioemotional development. In this study, we report work on developing a questionnaire to assess PRF during pregnancy (Prenatal Parental Reflective Functioning Questionnaire; P-PRFQ). The factor structure of the 33-item version of the P-PRFQ was explored using pilot study data from the Finn Brain Birth Cohort Study (n = 124 mothers, n = 82 fathers). Construct validity was assessed against the Pregnancy Interview (PI; A. Slade, L. Grunebaum, L. Huganir, & M. Reeves, 1987, 2002, 2011) in a subsample of 29 mothers from the same pilot sample. Exploratory and confirmatory factor analysis resulted in a 14-item P-PRFQ, with three factors which seem to capture relevant aspects of prenatal parental mentalization-F1: "Opacity of mental states," F2: "Reflecting on the fetus-child," and F3: "The dynamic nature of the mental states." Functioning of the factor structure was further tested in the large cohort with 600 mothers and 600 fathers. Correlations with the PI result were high, both regarding total and factor scores of the P-PRFQ. Cost-effective tools to assess key areas of early parenting are needed for both research and clinical purposes. The 14-item P-PRFQ seems to be an applicable and promising new tool for assessing very early parental mentalizing capacity. PMID:26096692

  19. Troubling Muddy Waters: Problematizing Reflective Practice in Global Medical Education.

    PubMed

    Naidu, Thirusha; Kumagai, Arno K

    2016-03-01

    The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself. PMID:26630601

  20. The French Version of the Reflective Functioning Questionnaire: Validity Data for Adolescents and Adults and Its Association with Non-Suicidal Self-Injury

    PubMed Central

    Badoud, Deborah; Luyten, Patrick; Fonseca-Pedrero, Eduardo; Eliez, Stephan; Fonagy, Peter; Debbané, Martin

    2015-01-01

    Introduction The capacity to understand one’s own actions and those of others in terms of cognitive and affective mental states (i.e., reflective functioning or mentalizing) is thought to play a critical role in both typical and atypical development. To date, however, no self-report tool is available for assessing reflective functioning ability in French-speaking samples. The first aim of this study is to investigate the reliability and validity of the reflective functioning questionnaire (RFQ) in French-speaking adolescents and adults. Secondly, we investigate whether low levels of reflective functioning were associated with non-suicidal self-injury. Methods 130 adolescents (66 females, Mage = 15.72, SDage = 1.74) and 253 adults (168 females, Mage = 23.10, SDage = 2.56) completed a French translation of the RFQ and a battery of self-reported questionnaires to assess a set of clinical (alexithymia; borderline traits; internalizing and externalizing symptoms) and psychological (empathy; mindfulness) variables. Results The current results showed configural invariance of the original two-factor structure of the RFQ across French-speaking adolescents and adults and satisfactory reliability and construct validity of the two subscales. Furthermore, we observed that recent episodes of non-suicidal self-injury were associated with lower levels of reflective functioning in the adult, but not in the adolescent, sample. Discussion The present research has methodological and clinical implications in that it provides the first evidence that the RFQ can be used to reliably assess reflective functioning in French-speaking population. The study further shows that impaired ability to consider mental states that lie behind behaviors might play a role in non-suicidal self-injury, at least in adults. PMID:26714319

  1. Planar Reflection of Detonations Waves

    NASA Astrophysics Data System (ADS)

    Damazo, Jason; Shepherd, Joseph

    2012-11-01

    An experimental study examining normally reflected gaseous detonation waves is undertaken so that the physics of reflected detonations may be understood. Focused schlieren visualization is used to describe the boundary layer development behind the incident detonation wave and the nature of the reflected shock wave. Reflected shock wave bifurcation-which has received extensive study as it pertains to shock tube performance-is predicted by classical bifurcation theory, but is not observed in the present study for undiluted hydrogen-oxygen and ethylene-oxygen detonation waves. Pressure and thermocouple gauges are installed in the floor of the detonation tube so as to examine both the wall pressure and heat flux. From the pressure results, we observe an inconsistency between the measured reflected shock speed and the measured reflected shock strength with one dimensional flow predictions confirming earlier experiments performed in our laboratory. This research is sponsored by the DHS through the University of Rhode Island, Center of Excellence for Explosives Detection.

  2. Baffle system employing reflective surfaces

    NASA Astrophysics Data System (ADS)

    Linlor, W. I.

    1983-12-01

    Reflective baffles are proposed to reject off-axis light entering a telescope. Toroidal surfaces and adjacent cones are positioned so that off-axis rays make multiple reflections between these two surfaces. Meridional rays are reflected approximately parallel to the entering direction. Skew rays are reflected obliquely, but leave the telescope aperture. The range of incident angles for which these reflections are obtained is approximately 45 deg. A system is described that is designed specifically for the Space Shuttle Infrared Telescope Facility (SIRTF). Because of its reflective properties, the proposed baffle system rejects about 90 deg of the heat load from the SIRTF sunshade that would be absorbed in systems of conventional black baffles.

  3. Variable area light reflecting assembly

    DOEpatents

    Howard, T.C.

    1986-12-23

    Device is described for tracking daylight and projecting it into a building. The device tracks the sun and automatically adjusts both the orientation and area of the reflecting surface. The device may be mounted in either a wall or roof of a building. Additionally, multiple devices may be employed in a light shaft in a building, providing daylight to several different floors. The preferred embodiment employs a thin reflective film as the reflecting device. One edge of the reflective film is fixed, and the opposite end is attached to a spring-loaded take-up roller. As the sun moves across the sky, the take-up roller automatically adjusts the angle and surface area of the film. Additionally, louvers may be mounted at the light entrance to the device to reflect incoming daylight in an angle perpendicular to the device to provide maximum reflective capability when daylight enters the device at non-perpendicular angles. 9 figs.

  4. Variable area light reflecting assembly

    DOEpatents

    Howard, Thomas C.

    1986-01-01

    Device for tracking daylight and projecting it into a building. The device tracks the sun and automatically adjusts both the orientation and area of the reflecting surface. The device may be mounted in either a wall or roof of a building. Additionally, multiple devices may be employed in a light shaft in a building, providing daylight to several different floors. The preferred embodiment employs a thin reflective film as the reflecting device. One edge of the reflective film is fixed, and the opposite end is attached to a spring-loaded take-up roller. As the sun moves across the sky, the take-up roller automatically adjusts the angle and surface area of the film. Additionally, louvers may be mounted at the light entrance to the device to reflect incoming daylight in an angle perpendicular to the device to provide maximum reflective capability when daylight enters the device at non-perpendicular angles.

  5. Balancing operating theatre and bed capacity in a cardiothoracic centre.

    PubMed

    Bowers, John

    2013-09-01

    Cardiothoracic surgery requires many expensive resources. This paper examines the balance between operating theatres and beds in a specialist facility providing elective heart and lung surgery. Without both operating theatre time and an Intensive Care bed a patient's surgery has to be postponed. While admissions can be managed, there are significant stochastic features, notably the cancellation of theatre procedures and patients' length of stay on the Intensive Care Unit. A simulation was developed, with clinical and management staff, to explore the interdependencies of resource availabilities and the daily demand. The model was used to examine options for expanding the capacity of the whole facility. Ideally the bed and theatre capacity should be well balanced but unmatched increases in either resource can still be beneficial. The study provides an example of a capacity planning problem in which there is uncertainty in the demand for two symbiotic resources. PMID:23400879

  6. Building operational research capacity in the Pacific

    PubMed Central

    Viney, K.; Brostrom, R.; Gounder, S.; Khogali, M.; Kishore, K.; Kool, B.; Kumar, A. M. V.; Manzi, M.; Marais, B.; Marks, G.; Linh, N. N.; Ram, S.; Reid, S.; Roseveare, C.; Tayler-Smith, K.; Van den Bergh, R.; Harries, A. D.

    2014-01-01

    Operational research (OR) in public health aims to investigate strategies, interventions, tools or knowledge that can enhance the quality, coverage, effectiveness or performance of health systems. Attention has recently been drawn to the lack of OR capacity in public health programmes throughout the Pacific Islands, despite considerable investment in implementation. This lack of ongoing and critical reflection may prevent health programme staff from understanding why programme objectives are not being fully achieved, and hinder long-term gains in public health. The International Union Against Tuberculosis and Lung Disease (The Union) has been collaborating with Pacific agencies to conduct OR courses based on the training model developed by The Union and Médecins Sans Frontières Brussels-Luxembourg in 2009. The first of these commenced in 2011 in collaboration with the Fiji National University, the Fiji Ministry of Health, the World Health Organization and other partners. The Union and the Secretariat of the Pacific Community organised a second course for participants from other Pacific Island countries and territories in 2012, and an additional course for Fijian participants commenced in 2013. Twelve participants enrolled in each of the three courses. Of the two courses completed by end 2013, 18 of 24 participants completed their OR and submitted papers by the course deadline, and 17 papers have been published to date. This article describes the context, process and outputs of the Pacific courses, as well as innovations, adaptations and challenges. PMID:26477282

  7. Journal Writing as a Teaching Technique to Promote Reflection

    PubMed Central

    Walker, Stacy E

    2006-01-01

    Objective: To introduce the process of journal writing to promote reflection and discuss the techniques and strategies to implement journal writing in an athletic training education curriculum. Background: Journal writing can facilitate reflection and allow students to express feelings regarding their educational experiences. The format of this writing can vary depending on the students' needs and the instructor's goals. Description: Aspects of journal writing assignments are discussed, including different points to take into account before assigning the journals. Lastly, various factors to contemplate are presented when providing feedback to the students regarding their written entries. Clinical Advantages: Journal writing assignments can benefit students by enhancing reflection, facilitating critical thought, expressing feelings, and writing focused arguments. Journal writing can be adapted into a student's clinical course to assist with bridging the gap between classroom and clinical knowledge. In addition, journals can assist athletic training students with exploring different options for handling daily experiences. PMID:16791310

  8. Reflectional transformation for structural stiffness

    SciTech Connect

    Vashi, K.M.

    1990-01-01

    This paper presents a structural reflection-related transformation for structural stiffness. The stiffness transformation addresses reflection of a structure about any of the three coordinate planes and renders the desired stiffness matrix using a stiffness matrix for the same structure before reflection. This transformation is elegant and simple, provides an efficient and technically rigorous approach to derive the required stiffness matrix without structural remodeling, and can be readily programmed to quickly perform the required matrix manipulations. 2 figs.

  9. Atlas of soil reflectance properties

    NASA Technical Reports Server (NTRS)

    Stoner, E. R.; Baumgardner, M. F.; Biehl, L. L.; Robinson, B. F.

    1979-01-01

    A compendium of soil spectral reflectance curves together with soil test results and site information is presented in an abbreviated manner listing those soil properties most important in influencing soil reflectance. Results are presented for 251 soils from 39 states and Brazil. A narrative key describes relationships between soil parameters and reflectance curves. All soils are classified according to the U.S. soil taxonomy and soil series name for ease of identification.

  10. Diffuse reflectance spectroscopy of liver tissue

    NASA Astrophysics Data System (ADS)

    Reistad, Nina; Nilsson, Jan; Vilhelmsson Timmermand, Oskar; Sturesson, Christian; Andersson-Engels, Stefan

    2015-06-01

    Diffuse reflectance spectroscopy (DRS) with a fiber-optic contact probe is a cost-effective, rapid, and non-invasive optical method used to extract diagnosis information of tissue. By combining commercially available VIS- and NIR-spectrometers with various fiber-optic contact-probes, we have access to the full wavelength range from around 400 to 1600 nm. Using this flexible and portable spectroscopy system, we have acquired ex-vivo DRS-spectra from murine, porcine, and human liver tissue. For extracting the tissue optical properties from the measured spectra, we have employed and compared predictions from two models for light propagation in tissue, diffusion theory model (DT) and Monte Carlo simulations (MC). The focus in this work is on the capacity of this DRS-technique in discriminating metastatic tumor tissue from normal liver tissue as well as in assessing and characterizing damage to non-malignant liver tissue induced by preoperative chemotherapy for colorectal liver metastases.

  11. Reflections on basic science.

    PubMed

    Piatigorsky, Joram

    2010-01-01

    After almost 50 years in science, I believe that there is an acceptable, often advantageous chasm between open-ended basic research-free exploration without a practical destination and in which the original ideas may fade into new concepts-and translational research or clinical research. My basic research on crystalline (proteins conferring the optical properties of the eye lens) led me down paths I never would have considered if I were conducting translational research. My investigations ranged from jellyfish to mice and resulted in the gene-sharing concept, which showed that the same protein can have distinct molecular functions depending upon its expression pattern and, conversely, that different proteins can serve similar functional roles. This essay portrays basic science as a creative narrative, comparable to literary and artistic endeavors. Preserving the autonomy of open-ended basic research and recognizing its artistic, narrative qualities will accelerate the development of innovative concepts, create a rich resource of information feeding translational research, and have a positive impact by attracting creative individuals to science. PMID:21037410

  12. Signals for specular Andreev reflection.

    PubMed

    Zhang, Qingyun; Fu, Deyi; Wang, Baigeng; Zhang, R; Xing, D Y

    2008-07-25

    We report a theoretical investigation of the spin-dependent Andreev reflection at the interface of a graphene-based ferromagnet/superconductor junction. It is found that the ferromagnetic exchange interaction in the ferromagnet can suppress Andreev retroreflection but enhance the specular Andreev reflection. There is a transition between the specular Andreev reflection and Andreev retroreflection at which the shot noise vanishes and the Fano factor has a universal value. The present work provides a new method of detecting the specular Andreev reflection, which can be experimentally tested within the present-day technique. PMID:18764360

  13. Weak-shock reflection factors

    SciTech Connect

    Reichenbach, H.; Kuhl, A.L.

    1993-09-07

    The purpose of this paper is to compare reflection factors for weak shocks from various surfaces, and to focus attention on some unsolved questions. Three different cases are considered: square-wave planar shock reflection from wedges; square-wave planar shock reflection from cylinders; and spherical blast wave reflection from a planar surface. We restrict ourselves to weak shocks. Shocks with a Mach number of M{sub O} < 1.56 in air or with an overpressure of {Delta}{sub PI} < 25 psi (1.66 bar) under normal ambient conditions are called weak.

  14. Rapid plasma volume decline upon quiet standing reflects large filtration capacity in dependent limbs.

    PubMed

    Lundvall, J; Bjerkhoel, P; Quittenbaum, S; Lindgren, P

    1996-10-01

    The plasma volume (PV) decline upon 1.5, 3, 5, 8, 10, 15 and 35 min periods of quiet standing was studied (Hb/Hct) in male volunteers (n = 7). This approach permitted detailed definition of the time-course of the volume change. PV decreased by as much as 8.5 +/- 0.4% (328 +/- 15 mL) after 3 min standing and by no less than 11.7 +/- 0.4% (466 +/- 22 mL) after 5 min. The reduction was 14.3 +/- 0.7, 16.8 +/- 0.8, 17.7 +/- 0.8 and 17.4 +/- 0.9% after 8, 10, 15 and 35 min, or 568 +/- 30, 671 +/- 39, 707 +/- 41 and 691 +/- 44 mL. These data, in conjunction with the 1.5 min experiments, indicated a very rapid approximately 125 mL min-1 fluid loss initially on standing. However, the PV loss showed marked decline with time and was virtually completed within 10 min. Finally, the observation was made that the rate of PV recovery after standing was inversely related to the duration of standing. It is suggested that (a) the transcapillary hydraulic conductivity in the dependent limbs, the predominant targets for fluid filtration on standing, is about 0.010 mL min-1 100 mL-1 mmHg-1 and much greater than indicated previously. However, protective mechanisms restrict rapid fluid loss to early phases of standing. (b) Decrease in PV may contribute importantly to haemodynamic stress and to orthostatic, fainting reactions during short quiet standing. Apparently, PV loss may be equally important as pooling of blood, traditionally regarded as a dominant cause of adverse orthostatic reactions. (c) The duration of standing, as such, may be critical for the rate of PV recovery after standing. PMID:8899063

  15. Community Capacity-Building in Schools: Parents' and Teachers' Reflections from an Eating Disorder Prevention Program

    ERIC Educational Resources Information Center

    Russell-Mayhew, Shelly; Arthur, Nancy; Ewashen, Carol

    2008-01-01

    A pilot research study to examine the effect of a wellness-based intervention on improving students' body image, personal attitudes, and eating behaviors highlighted the importance of a healthy school environment. Parent and teacher focus groups were conducted to explore the perceived influences of wellness-based interventions designed for…

  16. Reflections on Building Capacity as a Supervisor in College Student Services

    ERIC Educational Resources Information Center

    McGraw, Cathlene E.

    2011-01-01

    Supervision, as this author discovered, is about building relationships with groups and individuals, as well as implementing policies and practices to create clear expectations. These policies, practices, expectations, and relationships should give rise to a work environment that encourages creativity, learning, and personal growth. In this…

  17. EFFECT OF SELF-REFLECTIVE TRAINING IN ART ON THE CAPACITY FOR CREATIVE ACTION.

    ERIC Educational Resources Information Center

    BEITTEL, KENNETH R.

    SPECIFIC OBJECTIVES WERE TO DETERMINE THE EFFECTS ON CREATIVE PERSONALITY OF--SELF-DISCOVERED AND EXTERNALLY SUPPLIED CRITERIA FOR EVALUATING ONE'S OWN ART WORK, PROCESS FEEDBACK, WHERE EVALUATION IS MADE BY STILL PHOTOS TAKEN AT REGULAR INTERVALS AS THE WORK EMERGES, PRODUCT FEEDBACK, WHERE END PRODUCT VALUES ARE STRESSES, INTERACTIVE AND…

  18. Endothelial Ca2+ oscillations reflect VEGFR signaling-regulated angiogenic capacity in vivo

    PubMed Central

    Yokota, Yasuhiro; Nakajima, Hiroyuki; Wakayama, Yuki; Muto, Akira; Kawakami, Koichi; Fukuhara, Shigetomo; Mochizuki, Naoki

    2015-01-01

    Sprouting angiogenesis is a well-coordinated process controlled by multiple extracellular inputs, including vascular endothelial growth factor (VEGF). However, little is known about when and how individual endothelial cell (EC) responds to angiogenic inputs in vivo. Here, we visualized endothelial Ca2+ dynamics in zebrafish and found that intracellular Ca2+ oscillations occurred in ECs exhibiting angiogenic behavior. Ca2+ oscillations depended upon VEGF receptor-2 (Vegfr2) and Vegfr3 in ECs budding from the dorsal aorta (DA) and posterior cardinal vein, respectively. Thus, visualizing Ca2+ oscillations allowed us to monitor EC responses to angiogenic cues. Vegfr-dependent Ca2+ oscillations occurred in migrating tip cells as well as stalk cells budding from the DA. We investigated how Dll4/Notch signaling regulates endothelial Ca2+ oscillations and found that it was required for the selection of single stalk cell as well as tip cell. Thus, we captured spatio-temporal Ca2+ dynamics during sprouting angiogenesis, as a result of cellular responses to angiogenic inputs. DOI: http://dx.doi.org/10.7554/eLife.08817.001 PMID:26588168

  19. Specular Reflection and Diffuse Reflectance Spectroscopy of Soils

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studies on the occurrence and effects of specular reflection in mid-infrared spectra of soils have shown that distortions due to specular reflection occur for both organic (humic acid) and non-organic fractions (carbonates, silica, ashed fraction of soil). The results demonstrated explain why the s...

  20. Postgraduate Education to Support Organisation Change: A Reflection on Reflection

    ERIC Educational Resources Information Center

    Stewart, Jim; Keegan, Anne; Stevens, Pam

    2008-01-01

    Purpose: This paper aims to explore how teaching and assessing reflective learning skills can support postgraduate practitioners studying organisational change and explores the challenges for tutors in assessing these journals. Design/methodology/approach: Assessment criteria were developed from the literature on reflective practice and…

  1. Studies of the Reflection, Refraction and Internal Reflection of Light

    ERIC Educational Resources Information Center

    Lanchester, P. C.

    2014-01-01

    An inexpensive apparatus and associated experiments are described for studying the basic laws of reflection and refraction of light at an air-glass interface, and multiple internal reflections within a glass block. In order to motivate students and encourage their active participation, a novel technique is described for determining the refractive…

  2. Reflective Practice Interventions: Raising Levels of Reflective Judgment

    ERIC Educational Resources Information Center

    Friedman, Audrey; Schoen, Lea

    2009-01-01

    Reflective practice is a major focus of teacher preparation programs (Cochran-Smith & Lytle, 1992; Putnam & Borko, 2000; Zeichner, 1986; Zeichner & Liston, 1987), yet Zeichner (1986) asserts that developing reflective practice in preservice teachers has focused primarily on short-term, less systematic interventions and that interventions must be…

  3. Embodied Reflection and the Epistemology of Reflective Practice

    ERIC Educational Resources Information Center

    Kinsella, Elizabeth Anne

    2007-01-01

    Donald Schon's theory of reflective practice has been extensively referred to and has had enormous impact in education and related fields. Nonetheless, there continues to be tremendous conceptual and practical confusion surrounding interpretations of reflective practice and philosophical assumptions underlying the theory. In this paper, I argue…

  4. Undertaking capacity assessments for people with dementia in general hospitals.

    PubMed

    Murray, Aileen

    2016-08-01

    Ensuring that older patients are discharged from hospital in a safe and appropriate manner is a fundamental aspect of nursing care. However, it is clear from the literature and clinical practice that determining people's capacity and whether they are able to decide where they live on discharge is a significant challenge. There is variation in practice despite the legal framework provided by the Mental Capacity Act (MCA) 2005, covering England and Wales, which raises questions about adherence to the legislation. Using a case study, this article explores aspects of the MCA and clinical practice that affect older patients' outcomes on discharge from general hospital settings. It demonstrates how effective multidisciplinary working, using the legal frameworks available, can ensure that an individual's independence and well-being are maintained. PMID:27573964

  5. Revisiting advance decision making under the Mental Capacity Act 2005: a tale of mixed messages.

    PubMed

    Heywood, Rob

    2015-01-01

    Whilst most of the existing literature relating to advance decisions has focused on philosophical questions, this article reflects on the significant legal developments that have occurred since the introduction of the Mental Capacity Act 2005. The article provides a critique of the controversial issues which have emerged within contemporary case law. The focus of the discussion centres on capacity, the interpretation of the safeguards, and the bias towards preservation of life. PMID:25016383

  6. Unreasonable reasons: normative judgements in the assessment of mental capacity

    PubMed Central

    Banner, Natalie F

    2012-01-01

    The recent Mental Capacity Act (2005) sets out a test for assessing a person's capacity to make treatment choices. In some cases, particularly in psychiatry, it is unclear how the criteria ought to be interpreted and applied by clinicians. In this paper, I argue that this uncertainty arises because the concept of capacity employed in the Act, and the diagnostic tools developed to assist its assessment, overlook the inherent normativity of judgements made about whether a person is using or weighing information in the decision-making process. Patients may fail on this criterion to the extent that they do not appear to be handling the information given in an appropriate way, on account of a mental impairment disrupting the way the decision process ought to proceed. Using case law and clinical examples, I describe some of the normative dimensions along which judgements of incapacity can be made, namely epistemic, evaluative and affective dimensions. Such judgements are complex and the normative standards by which a clinician may determine capacity cannot be reduced to a set of criteria. Rather, in recognizing this normativity, clinicians may better understand how clinical judgements are structured and what kinds of assumption may inform their assessment. PMID:22995005

  7. Global distribution of plant-extractable water capacity of soil

    USGS Publications Warehouse

    Dunne, K.A.; Willmott, C.J.

    1996-01-01

    Plant-extractable water capacity of soil is the amount of water that can be extracted from the soil to fulfill evapotranspiration demands. It is often assumed to be spatially invariant in large-scale computations of the soil-water balance. Empirical evidence, however, suggests that this assumption is incorrect. In this paper, we estimate the global distribution of the plant-extractable water capacity of soil. A representative soil profile, characterized by horizon (layer) particle size data and thickness, was created for each soil unit mapped by FAO (Food and Agriculture Organization of the United Nations)/Unesco. Soil organic matter was estimated empirically from climate data. Plant rooting depths and ground coverages were obtained from a vegetation characteristic data set. At each 0.5?? ?? 0.5?? grid cell where vegetation is present, unit available water capacity (cm water per cm soil) was estimated from the sand, clay, and organic content of each profile horizon, and integrated over horizon thickness. Summation of the integrated values over the lesser of profile depth and root depth produced an estimate of the plant-extractable water capacity of soil. The global average of the estimated plant-extractable water capacities of soil is 8??6 cm (Greenland, Antarctica and bare soil areas excluded). Estimates are less than 5, 10 and 15 cm - over approximately 30, 60, and 89 per cent of the area, respectively. Estimates reflect the combined effects of soil texture, soil organic content, and plant root depth or profile depth. The most influential and uncertain parameter is the depth over which the plant-extractable water capacity of soil is computed, which is usually limited by root depth. Soil texture exerts a lesser, but still substantial, influence. Organic content, except where concentrations are very high, has relatively little effect.

  8. Relation between lung function, exercise capacity, and exposure to asbestos cement.

    PubMed Central

    Wollmer, P; Eriksson, L; Jonson, B; Jakobsson, K; Albin, M; Skerfving, S; Welinder, H

    1987-01-01

    A group of 137 male workers with known exposure (mean 20 fibre years per millilitre) to asbestos cement who had symptoms or signs of pulmonary disease was studied together with a reference group of 49 healthy industrial workers with no exposure to asbestos. Lung function measurements were made at rest and during exercise. Evidence of lung fibrosis was found as well as of obstructive airways disease in the exposed group compared with the reference group. Asbestos cement exposure was related to variables reflecting lung fibrosis but not to variables reflecting airflow obstruction. Smoking was related to variables reflecting obstructive lung disease. Exercise capacity was reduced in the exposed workers and was related to smoking and to lung function variables, reflecting obstructive airways disease. There was no significant correlation between exercise capacity and exposure to asbestos cement. PMID:3651353

  9. Rethinking health research capacity strengthening.

    PubMed

    Vasquez, Emily E; Hirsch, Jennifer S; Giang, Le Minh; Parker, Richard G

    2013-01-01

    Health research capacity strengthening (HRCS) is a strategy implemented worldwide to improve the ability of developing countries to tackle the persistent and disproportionate burdens of disease they face. Drawing on a review of existing HRCS literature and our experiences over the course of an HRCS project in Vietnam, we summarise major challenges to the HRCS enterprise at the interpersonal, institutional and macro levels. While over the course of several decades of HRCS initiatives many of these challenges have been well documented, we highlight several considerations that remain underarticulated. We advance critical considerations of the HRCS enterprise by discussing (1) how the organisation of US public health funding shapes the ecology of knowledge production in low- and middle-income country contexts, (2) the barriers US researchers face to effectively collaborate in capacity strengthening for research-to-policy translation, and (3) the potential for unintentional negative consequences if HRCS efforts are not sufficiently reflexive about the limitations of dominant paradigms in public health research and intervention. PMID:23651463

  10. Rethinking health research capacity strengthening

    PubMed Central

    Vasquez, Emily; Hirsch, Jennifer S.; Giang, Le Minh; Parker, Richard G.

    2013-01-01

    Health research capacity strengthening (HRCS) is a strategy implemented worldwide to improve the ability of developing countries to tackle the persistent and disproportionate burdens of disease they face. Drawing on a review of existing HRCS literature and our experiences over the course of an NIH-funded HRCS project in Vietnam, we summarise major challenges to the HRCS enterprise at the interpersonal, institutional and macro levels. While over the course of several decades of HRCS initiatives many of these challenges have been well documented, we highlight several considerations that remain under-articulated. We advance critical considerations of the HRCS enterprise by discussing 1) how the organisation of US public health funding shapes the ecology of knowledge production in low- and middle-income country contexts, 2) the barriers US researchers face to effectively collaborating in capacity strengthening for research-to-policy translation, and 3) the potential for unintentional negative consequences if HRCS efforts are not sufficiently reflexive about the limitations of dominant paradigms in public health research and intervention. PMID:23651463

  11. Working memory capacity of biological movements predicts empathy traits.

    PubMed

    Gao, Zaifeng; Ye, Tian; Shen, Mowei; Perry, Anat

    2016-04-01

    Working memory (WM) and empathy are core issues in cognitive and social science, respectively. However, no study so far has explored the relationship between these two constructs. Considering that empathy takes place based on the others' observed experiences, which requires extracting the observed dynamic scene into WM and forming a coherent representation, we hypothesized that a sub-type of WM capacity, i.e., WM for biological movements (BM), should predict one's empathy level. Therefore, WM capacity was measured for three distinct types of stimuli in a change detection task: BM of human beings (BM; Experiment 1), movements of rectangles (Experiment 2), and static colors (Experiment 3). The first two stimuli were dynamic and shared one WM buffer which differed from the WM buffer for colors; yet only the BM conveyed social information. We found that BM-WM capacity was positively correlated with both cognitive and emotional empathy, with no such correlations for WM capacity of movements of rectangles or of colors. Thus, the current study is the first to provide evidence linking a specific buffer of WM and empathy, and highlights the necessity for considering different WM capacities in future social and clinical research. PMID:26174575

  12. Can Reflective Practice Be Taught?

    ERIC Educational Resources Information Center

    Edwards, Gail; Thomas, Gary

    2010-01-01

    Almost ubiquitous in discourses about the development of teachers, reflective practice describes the process that occurs when persons are apprenticed to any meaningful activity. But reflective practice is a descriptive term for that process: it does not imply that the process is itself open to dissection and instruction. We contend that mistaken…

  13. Reflections on Becoming a Researcher

    ERIC Educational Resources Information Center

    Frankel, Katherine K.; Pearson, P. David

    2013-01-01

    In this joint reflection two of the contributors to this issue of the "Journal of Education" consider the processes and practices that led to the publication of their respective pieces. Since one of the authors, Katherine Frankel, was a doctoral advisee of the other, David Pearson, they also reflect on the mentoring practices they shared…

  14. Flexible Bistable Cholesteric Reflective Displays

    NASA Astrophysics Data System (ADS)

    Yang, Deng-Ke

    2006-03-01

    Cholesteric liquid crystals (ChLCs) exhibit two stable states at zero field condition-the reflecting planar state and the nonreflecting focal conic state. ChLCs are an excellent candidate for inexpensive and rugged electronic books and papers. This paper will review the display cell structure,materials and drive schemes for flexible bistable cholesteric (Ch) reflective displays.

  15. Incorporating reflection into veterinary practice.

    PubMed

    2016-05-21

    New graduates are encouraged to reflect on their progress during their Professional Development Phase, but what does reflection really mean, and how can veterinary professionals use it to better their day-to-day practice? This was a topic discussed during an afternoon of sessions at the recent BSAVA congress in Birmingham. Georgina Mills reports. PMID:27199044

  16. Reflections on Justice in Schooling

    ERIC Educational Resources Information Center

    First, Patricia F.

    2012-01-01

    This article is a reflection on the concept of justice as practiced in the public schools in the United States. Examples of justice denied or misconstrued are included. Cases, stories, and concepts invite educational leaders to reflect anew on delivering justice in education to all children. Underlying the article is the belief that understanding…

  17. Children's Literature-Some Reflections.

    ERIC Educational Resources Information Center

    Root, Shelton L., Jr.

    Ten reflections may be made regarding children's literature and its teaching. The reflections are as follows: (1) Teachers can make a profound difference in the lives of students and should attempt to do so. (2) Teachers of children's literature are a badly fragmented lot and need a common meeting ground where they can share their thinking. (3)…

  18. Making Connections to Teach Reflection

    ERIC Educational Resources Information Center

    Correia, Manuel G.; Bleicher, Robert E.

    2008-01-01

    Approaching reflection from the perspective of a teachable skill set implies that research may inform how to help students reflect. Employing a framework of making connections often used in reading comprehension, this study aimed to characterize how making connections between the service-learning experience (SLE) and prior experiences in similar…

  19. Why Reflection in Teacher Education?

    ERIC Educational Resources Information Center

    LaBoskey, Vicki Kubler

    1993-01-01

    Focuses on preservice teacher education by considering teacher reflectivity as an end rather than a means. The article provides a rationale for reflective teacher education in arguing the need to have teachers who are thoughtful, passionate, and principled educational decision makers. (GLR)

  20. Seeding information management capacity to support operational management in hospitals.

    PubMed

    Diers, D; Pelletier, D

    2001-01-01

    There are vast amounts of regularly reported data in the information systems of hospitals, state and federal governments. The increase in accessibility offered by platforms such as the Health Information Exchange (HIE) in New South Wales (NSW) creates a new level of opportunity. Administrative data can also speak to clinical and managerial issues. The capacity to mine these data and use the information for improving quality and efficiency has not been well developed at the "coal face" of operational management. Whilst it has been both possible and useful to track utilisation of services to hospitals and patients as cost and volume, it has not been of interest to track these same data to the operational locus of care--the nursing unit, the operating room, the imaging department. With HIE-type systems, the information is now more readily available and operational managers know this. The challenge is to develop the interdisciplinary capacity to query administrative data to facilitate clinical and managerial decision-making. We report here a possible model of a systematic approach to developing this capacity and some of the results of equipping operational and clinical managers to study problems in their own work settings. These efforts have required no additional internal resources, while the payoffs have been considerable. PMID:11496476

  1. [Concept analysis of reflective thinking].

    PubMed

    Van Vuuren, M; Botes, A

    1999-09-01

    The nursing practice is described as a scientific practice, but also as a practice where caring is important. The purpose of nursing education is to provide competent nursing practitioners. This implies that future practitioners must have both critical analytical thinking abilities, as well as empathy and moral values. Reflective thinking could probably accommodate these thinking skills. It seems that the facilitation of reflective thinking skills is essential in nursing education. The research question that is relevant in this context is: "What is reflective thinking?" The purpose of this article is to report on the concept analysis of reflective thinking and in particular on the connotative meaning (critical attributes) thereof. The method used to perform the concept analysis is based on the original method of Wilson (1987) as described by Walker & Avant (1995). As part of the concept analysis the connotations (critical attributes) are identified, reduced and organized into three categories, namely pre-requisites, processes and outcomes. A model case is described which confirms the essential critical attributes of reflective thinking. Finally a theoretical definition of reflective thinking is derived and reads as follows: Reflective thinking is a cyclic, hierarchical and interactive construction process. It is initiated, extended and continued because of personal cognitive-affective interaction (individual dimension) as well as interaction with the social environment (social dimension). to realize reflective thinking, a level of internalization on the cognitive and affective domain is required. The result of reflective thinking is a integrated framework of knowledge (meaningful learning) and a internalized value system providing a new perspective on and better understanding of a problem. Reflective thinking further leads to more effective decision making- and problem solving skills. PMID:11040626

  2. CLINICAL BIOCHEMISTRY

    EPA Science Inventory

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  3. U.S. Refining Capacity Utilization

    EIA Publications

    1995-01-01

    This article briefly reviews recent trends in domestic refining capacity utilization and examines in detail the differences in reported crude oil distillation capacities and utilization rates among different classes of refineries.

  4. Procoagulant and platelet-derived microvesicle absolute counts determined by flow cytometry correlates with a measurement of their functional capacity

    PubMed Central

    Ayers, Lisa; Harrison, Paul; Kohler, Malcolm; Ferry, Berne

    2014-01-01

    Background Flow cytometry is the most commonly used technology to measure microvesicles (MVs). Despite reported limitations of this technique, MV levels obtained using conventional flow cytometry have yielded many clinically relevant findings, such as associations with disease severity and ability to predict clinical outcomes. This study aims to determine if MV enumeration by flow cytometry correlates with a measurement of their functional capacity, as this may explain how flow cytometry generates clinically relevant results. Methods One hundred samples from healthy individuals and patients with obstructive sleep apnoea were analysed by conventional flow cytometry (FACSCalibur) and by three functional MV assays: Zymuphen MP-activity in which data were given as phosphatidylserine equivalent, STA® Phospholipid Procoag Assay expressed as clotting time and Endogenous Thrombin Potential (ETP) reflecting in vitro thrombin generation. Correlations were determined by Spearman correlation. Results Absolute counts of lactadherin+ procoagulant MVs generated by flow cytometry weakly correlated with the results obtained from the Zymuphen MP-activity (r=0.5370, p<0.0001); correlated with ETP (r=0.7444, p<0.0001); negatively correlated with STA® Phospholipid Procoag Assay clotting time (−0.7872, p<0.0001), reflecting a positive correlation between clotting activity and flow cytometry. Levels of Annexin V+ procoagulant and platelet-derived MVs were also associated with functional assays. Absolute counts of MVs derived from other cell types were not correlated with the functional results. Conclusions Quantitative results of procoagulant and platelet-derived MVs from conventional flow cytometry are associated with the functional capability of the MVs, as defined by three functional MV assays. Flow cytometry is a valuable technique for the quantification of MVs from different cellular origins; however, a combination of several analytical techniques may give the most comprehensive

  5. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool

    PubMed Central

    2014-01-01

    Background Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Methods Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. Results The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. Conclusions This institutional HSR capacity assessment

  6. Working memory is not fixed-capacity: More active storage capacity for real-world objects than for simple stimuli.

    PubMed

    Brady, Timothy F; Störmer, Viola S; Alvarez, George A

    2016-07-01

    Visual working memory is the cognitive system that holds visual information active to make it resistant to interference from new perceptual input. Information about simple stimuli-colors and orientations-is encoded into working memory rapidly: In under 100 ms, working memory ‟fills up," revealing a stark capacity limit. However, for real-world objects, the same behavioral limits do not hold: With increasing encoding time, people store more real-world objects and do so with more detail. This boost in performance for real-world objects is generally assumed to reflect the use of a separate episodic long-term memory system, rather than working memory. Here we show that this behavioral increase in capacity with real-world objects is not solely due to the use of separate episodic long-term memory systems. In particular, we show that this increase is a result of active storage in working memory, as shown by directly measuring neural activity during the delay period of a working memory task using EEG. These data challenge fixed-capacity working memory models and demonstrate that working memory and its capacity limitations are dependent upon our existing knowledge. PMID:27325767

  7. Prognostic Usefulness of Serum Cholesterol Efflux Capacity in Patients With Coronary Artery Disease.

    PubMed

    Zhang, Jianhua; Xu, Jia; Wang, Jingfeng; Wu, Changhao; Xu, Yan; Wang, Yueguo; Deng, Fengfeng; Wang, Zhe; Chen, Xuhua; Wu, Mengzuo; Chen, Yangxin

    2016-02-15

    Cholesterol efflux capacity has been shown to have an inverse relation with coronary artery disease (CAD) and may overcome the limitations of high-density lipoprotein (HDL) cholesterol levels as a predictor for CAD risks. We investigated the predictive value of cholesterol efflux capacity for the prognosis of CAD. Serum cholesterol efflux capacity in 313 patients newly diagnosed with CAD by coronary angiography was measured, and all patients completed a 3-year follow-up. The primary clinical end points were nonfatal myocardial infarction, nonfatal stroke, and cardiovascular mortality. The secondary clinical end points were class IV heart failure requiring hospitalization and coronary artery revascularization. Cholesterol efflux capacity was lower in patients with CAD compared with control group, and decreased cholesterol efflux capacity was associated with an increased risk of acute coronary syndrome (odds ratios, 0.25; 95% confidence interval, 0.14 to 0.46; p <0.01). There was no association between cholesterol efflux capacity and serum HDL cholesterol levels. Follow-up data showed that patients with CAD with lower cholesterol efflux capacity had higher primary clinical end point events (26 of 158 vs 8 of 155, p <0.01). Cox regression and Kaplan-Meier analysis further showed that a decreased cholesterol efflux capacity was associated with an increased risk of the primary end point events regardless of adjustment. There was no association between cholesterol efflux capacity and the secondary end point events. In conclusion, the results provide the important clinical evidence that cholesterol efflux capacity is a predictive index for plaque stability and the prognosis of CAD, independent of HDL cholesterol levels. PMID:26718234

  8. Evidence for practice, epistemology, and critical reflection.

    PubMed

    Avis, Mark; Freshwater, Dawn

    2006-10-01

    Evidence-based practice (EBP) has become a critical concept for ethical, accountable professional nursing practice. However, critical analysis of the concept suggests that EBP overemphasizes the value of scientific evidence while underplaying the role of clinical judgement and individual nursing expertise. This paper explores the empiricist position that valid evidence is the basis for all knowledge claims. We argue against the positivist idea that science should be regarded as the only credible means for generating evidence on which to base knowledge claims. We propose that the process of critically reflecting on evidence is a fundamental feature of empirical epistemology. We suggest that critical reflection on evidence derived from science, arts and humanities and, in particular, nursing practice experience can provide a sound basis for knowledge claims. While we do not attempt to define what counts as evidence, it is argued that there is much to be gained by making the processes of critical reflection explicit, and that it can make a valid contribution to expert nursing practice, without recourse to irreducible concepts such as intuition. PMID:16965303

  9. Capacity Reviews for Trades Training in BC

    ERIC Educational Resources Information Center

    Ministry of Advanced Education, 2007

    2007-01-01

    This report was commissioned in December 2006 to assess the capacity for trades training in the public post-secondary system with the key objectives to identify current levels of utilization for each of the top trades; identify methods of increasing capacity for top trades; and determine future levels of capacity that can be achieved without…

  10. Understanding Dimensions of Organizational Evaluation Capacity

    ERIC Educational Resources Information Center

    Bourgeois, Isabelle; Cousins, J. Bradley

    2013-01-01

    Organizational evaluation capacity building has been a topic of increasing interest in recent years. However, the actual dimensions of evaluation capacity have not been clearly articulated through empirical research. This study sought to address this gap by identifying the key dimensions of evaluation capacity in Canadian federal government…

  11. Rehabilitation Medicine Summit: Building Research Capacity

    ERIC Educational Resources Information Center

    Frontera, Walter R.; Fuhrer, Marcus J.; Jette, Alan M.; Chan, Leighton; Cooper, Rory A.; Duncan, Pamela W.; Kemp, John D.; Ottenbacher, Kenneth J.; Peckham, P. Hunter; Roth, Elliot J.; Tate, Denise G.

    2006-01-01

    The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The 5 elements of research capacity that guided the discussions were (a) researchers; (b) research culture, environment, and infrastructure;…

  12. 25 CFR 167.6 - Carrying capacities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Carrying capacities. 167.6 Section 167.6 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER NAVAJO GRAZING REGULATIONS § 167.6 Carrying capacities. (a) The Commissioner of Indian Affairs on June 26, 1943, promulgated the authorized carrying capacity for each land...

  13. Specific cooling capacity of liquid nitrogen

    NASA Technical Reports Server (NTRS)

    Kilgore, R. A.; Adcock, J. B.

    1977-01-01

    The assumed cooling process and the method used to calculate the specific cooling capacity of liquid nitrogen are described, and the simple equation fitted to the calculated specific cooling capacity data, together with the graphical form calculated values of the specific cooling capacity of nitrogen for stagnation temperatures from saturation to 350 K and stagnation pressures from 1 to 10 atmospheres, are given.

  14. High current capacity electrical connector

    DOEpatents

    Bettis, Edward S.; Watts, Harry L.

    1976-01-13

    An electrical connector is provided for coupling high current capacity electrical conductors such as copper busses or the like. The connector is arranged in a "sandwiched" configuration in which a conductor plate contacts the busses along major surfaces thereof clamped between two stainless steel backing plates. The conductor plate is provided with a plurality of contact buttons affixed therein in a spaced array such that the caps of the buttons extend above the conductor plate surface to contact the busses. When clamping bolts provided through openings in the sandwiched arrangement are tightened, Belleville springs provided under the rim of each button cap are compressed and resiliently force the caps into contact with the busses' contacting surfaces to maintain a predetermined electrical contact area provided by the button cap tops. The contact area does not change with changing thermal or mechanical stresses applied to the coupled conductors.

  15. Capacity of the Hopfield model

    NASA Astrophysics Data System (ADS)

    Feng, Jianfeng; Tirozzi, Brunello

    1997-05-01

    For a given 0305-4470/30/10/016/img5 if 0305-4470/30/10/016/img6 neurons deviating from the memorized patterns are allowed, we constructively show that if and only if 0305-4470/30/10/016/img7 all stored patterns are fixed points of the Hopfield model. If 0305-4470/30/10/016/img8 neurons are allowed with 0305-4470/30/10/016/img9 then 0305-4470/30/10/016/img10 where 0305-4470/30/10/016/img11 is the distribution function of the normal distribution. The result obtained by Amit and co-workers only formally coincides with the latter case which indicates that the replica trick approach to the capacity of the Hopfield model is only valid in the case 0305-4470/30/10/016/img12.

  16. Partnership to build research capacity.

    PubMed

    Boland, Mary G; Kamikawa, Cindy; Inouye, Jillian; Latimer, Renee W; Marshall, Stephanie

    2010-01-01

    Today's nursing leaders are setting the stage for the next evolution--bringing together skilled clinicians and administrators with peers in education to create new approaches to leading the profession forward. Partnerships share goals, common purpose, mutual respect, willingness to negotiate and compromise, informed participation, information giving, and shared decision making. The shared practice academia effort between a public university and a private health care system situated in the island state of Hawai'i is described. The medical center and school of nursing pursued individual strategic efforts to build research capacity and used the opportunity to fund academic practice research projects. The mutual need and recognition of the high stakes involved, in concert with stable, committed leaders at all levels, were key to the early success of their efforts. Through the formal research partnership mechanism, a discrete focus was created for efforts and used to move to tactical, operational, and interpersonal integration in this relationship. PMID:21158252

  17. Programming placental nutrient transport capacity

    PubMed Central

    Fowden, A L; Ward, J W; Wooding, F P B; Forhead, A J; Constancia, M

    2006-01-01

    Many animal studies and human epidemiological findings have shown that impaired growth in utero is associated with physiological abnormalities in later life and have linked this to tissue programming during suboptimal intrauterine conditions at critical periods of development. However, few of these studies have considered the contribution of the placenta to the ensuing adult phenotype. In mammals, the major determinant of intrauterine growth is the placental nutrient supply, which, in turn, depends on the size, morphology, blood supply and transporter abundance of the placenta and on synthesis and metabolism of nutrients and hormones by the uteroplacental tissues. This review examines the regulation of placental nutrient transfer capacity and the potential programming effects of nutrition and glucocorticoid over-exposure on placental phenotype with particular emphasis on the role of the Igf2 gene in these processes. PMID:16439433

  18. Building nurse education capacity in India: insights from a faculty development programme in Andhra Pradesh

    PubMed Central

    2013-01-01

    Background India faces an acute shortage of nurses. Strategies to tackle the human resource crisis depend upon scaling up nursing education provision in a context where the social status and working conditions of nurses are highly variable. Several national and regional situation assessments have revealed significant concerns about educational governance, institutional and educator capacity, quality and standards. Improving educational capacity through nursing faculty development has been proposed as one of several strategies to address a complex health human resource situation. This paper describes and critically reflects upon the experience of one such faculty development programme in the state of Andhra Pradesh. Discussion The faculty development programme involved a 2 year partnership between a UK university and 7 universities in Andhra Pradesh. It adopted a participatory approach and covered training and support in 4 areas: teaching, research/scholarship, leadership/management and clinical education. Senior hospital nurses were also invited to participate. Summary The programme was evaluated positively and some changes to educational practice were reported. However, several obstacles to wider change were identified. At the programme level, there was a need for more intensive individual and institutional mentorship as well as involvement of Indian Centres of Excellence in Nursing to provide local (as well as international) expertise. At the organisational level, the participating Colleges reported heavy workloads, lack of control over working conditions, lack of control over the curriculum and poor infra-structure/resources as ongoing challenges. In the absence of wider educational reform in nursing and government commitment to the profession, faculty development programmes alone will have limited impact. PMID:23537273

  19. Antioxidant capacity, total phenols and color profile during the storage of selected plants used for infusion.

    PubMed

    Jiménez-Zamora, Ana; Delgado-Andrade, Cristina; Rufián-Henares, José A

    2016-05-15

    Many plants, like tea, are widely used for preparing herbal infusions. These plants have an interesting antioxidant capacity that may change after harvesting depending on the technological processing and the storage conditions. We determined the antioxidant capacity (ABTS, DPPH and FRAP methods), total phenolic content and color analysis (reflectance) of 36 plants traditionally consumed in Spain as infusion. Green tea was the most antioxidant herb, although oregano and lemon balm showed also a very high antioxidant capacity, as well as phenolic content. The antioxidant study after 3-month storage at different temperatures showed that up to a 50% of the total antioxidant capacity could be lost. Color analysis correlated with antioxidant capacity evolution, being a quick tool to control the storage conditions. Finally, our data confirm that the intake of one serving of plant infusion could release the equivalent of up to 1,500 μmol trolox, being a good source of antioxidants for the human diet. PMID:26775980

  20. Functional Capacity Evaluation Research: Report from the Second International Functional Capacity Evaluation Research Meeting.

    PubMed

    James, C L; Reneman, M F; Gross, D P

    2016-03-01

    Introduction Functional capacity evaluations are an important component of many occupational rehabilitation programs and can play a role in facilitating reintegration to work thus improving health and disability outcomes. The field of functional capacity evaluation (FCE) research has continued to develop over recent years, with growing evidence on the reliability, validity and clinical utility of FCE within different patient and healthy worker groups. The second International FCE Research Conference was held in Toronto, Canada on October 2nd 2014 adjacent to the 2014 Work Disability Prevention Integration conference. This paper describes the outcomes of the conference. Report Fifty-four participants from nine countries attended the conference where eleven research projects and three workshops were presented. The conference provided an opportunity to discuss FCE practice, present new research and provide a forum for discourse around the issues pertinent to FCE use. Conference presentations covered aspects of FCE use including the ICF-FCE interface, aspects of reliability and validity, consideration of specific injury populations, comparisons of FCE components and a lively debate on the merits of 'Man versus Machine' in FCE's. Future directions Researchers, clinicians, and other professionals in the FCE area have a common desire to improve the content and quality of FCE research and to collaborate to further develop research across systems, cultures and countries. PMID:26108156