Science.gov

Sample records for advanced generalist practice

  1. What Is "Advanced" in Generalist Practice? A Conceptual Discussion

    ERIC Educational Resources Information Center

    Lavitt, Melissa R.

    2009-01-01

    Advanced generalist practice is the fastest growing area of concentration for Master of Social Work (MSW) programs in the United States, yet a definition remains elusive. This article proposes that three key elements should be included within a conceptual schema of advanced generalist practice. Multidimensional problem-setting, self-reflective…

  2. Teaching Note--Beyond Bricoleur: A Guiding Portrait of the Advanced Generalist

    ERIC Educational Resources Information Center

    Dran, David S.

    2014-01-01

    Graduate programs of social work have been challenged to define how the advanced generalist concentration differs from the generalist training at the baccalaureate level. This teaching note likens the generalist to a "bricoleur," or skilled handyman. A role-based portrait of the advanced generalist is offered, which describes how skills…

  3. The Enigma of Graduate Nursing Education: Advanced Generalist? Specialist?

    ERIC Educational Resources Information Center

    Reed, Suellen B.; Hoffman, Sharon E.

    1986-01-01

    To pin down the appropriate parameters for graduate nursing education, the authors say we must explore the meanings of advanced generalist and specialist. They discuss the focus, scope, and depth of the community health major, psychiatric mental health nursing, nursing care of children, maternity nursing, medical-surgical nursing, and nursing…

  4. Attitudes, practices on allergic rhinitis of generalists and specialists in Philippine National Capital Region

    PubMed Central

    Romualdez, Joel A.

    2015-01-01

    Background Treatment of allergic rhinitis (AR) consistent with consensus guidelines is reported to result in better patient outcomes. However, physicians may manage patients independently of guidelines. Asian data on physician perspectives regarding AR diagnosis and management is limited. Objective The study objective is to assess attitudes and practices on AR of Filipino specialists and generalists. Methods A cross sectional survey of 100 specialists and 100 generalists was conducted from November 2014 to January 2015. A previously validated and pilot tested questionnaire was administered via structured face to face interviews. Results Specialists reported greater adequate knowledge of AR (specialists, 58%; generalists, 39%) and adherence to guidelines (specialists, 84%; generalists, 54%). Diagnostic tests were not routinely used (specialists, 81%; generalists, 92%). Monotherapy, specifically antihistamines, was preferred for mild AR. For moderate-severe AR, preference for monotherapy versus combination therapy (specialists, 49% vs. 51%; generalists, 44% vs. 56%) was similar. Both groups preferred intranasal corticosteroid spray (INCS) for monotherapy and antileukotrienes, antihistamines, INCS for combination therapy. For adjuvant therapy, specialists (82%) preferred nasal irrigation/douche. Primary consideration for choice of therapy was efficacy. Cost was the perceived reason for patients' noncompliance with treatment. Conclusion Despite differences in awareness of and adherence to guidelines, prescribing patterns on management of mild and moderate-severe AR are similar among Filipino specialists and generalists. This can be attributed to a shared perception of efficacy and cost as drivers for therapeutic choices. PMID:26539402

  5. Best of Both Worlds: A Conceptual Model for Integrating an Aging Specialization within an Advanced Generalist MSW Program

    ERIC Educational Resources Information Center

    Dakin, Emily K.; Quijano, Louise M.; Bishop, Pamela S.; Sheafor, Bradford W.

    2015-01-01

    Must a master's of social work (MSW) program's orientation be either advanced generalist or some form of specialist? Or is there the possibility of a hybrid curriculum that provides enough breadth to prepare MSW graduates for a wide range of social work jobs, but that also addresses students' and community agencies' demands for student…

  6. Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

    PubMed Central

    2013-01-01

    Background A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Discussion Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a ‘complex intervention’ (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Summary Answers to the complex problem of multi-morbidity won’t come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity. PMID:23919296

  7. Advanced midwifery practice or advancing midwifery practice?

    PubMed

    Smith, Rachel; Leap, Nicky; Homer, Caroline

    2010-09-01

    Advanced midwifery practice is a controversial notion in midwifery, particularly at present in Australia. The proposed changes in legislation around access to the publicly funded Medical Benefits Scheme (MBS) and the Pharmaceutical Benefits Scheme (PBS) in 2009-2010 have meant that the issue of advanced midwifery practice has again taken prominence. Linking midwifery access to MBS and PBS to a safety and quality framework that includes an 'advanced midwifery credentialling framework' is particularly challenging. The Haxton and Fahy paper in the December 2009 edition of Women and Birth is timely as it enables a reflection upon these issues and encourages debate and discussion about exactly what is midwifery, what are we educating our students for and is working to the full scope of practice practising at advanced level? This paper seeks to address some of these questions and open up the topic for further debate. PMID:20018582

  8. Perspectives on key principles of generalist medical practice in public service in sub-saharan africa: a qualitative study

    PubMed Central

    2011-01-01

    Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational

  9. Medical nutrition therapy in adults with chronic kidney disease: integrating evidence and consensus into practice for the generalist registered dietitian nutritionist.

    PubMed

    Beto, Judith A; Ramirez, Wendy E; Bansal, Vinod K

    2014-07-01

    Chronic kidney disease is classified in stages 1 to 5 by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative depending on the level of renal function by glomerular filtration rate and, more recently, using further categorization depending on the level of glomerular filtration rate and albuminuria by the Kidney Disease Improving Global Outcomes initiative. Registered dietitian nutritionists can be reimbursed for medical nutrition therapy in chronic kidney disease stages 3 to 4 for specific clients under Center for Medicare and Medicaid Services coverage. This predialysis medical nutrition therapy counseling has been shown to both potentially delay progression to stage 5 (renal replacement therapy) and decrease first-year mortality after initiation of hemodialysis. The Joint Standards Task Force of the American Dietetic Association (now the Academy of Nutrition and Dietetics), the Renal Nutrition Dietetic Practice Group, and the National Kidney Foundation Council on Renal Nutrition collaboratively published 2009 Standards of Practice and Standards of Professional Performance for generalist, specialty, and advanced practice registered dietitian nutritionists in nephrology care. The purpose of this article is to provide an update on current recommendations for screening, diagnosis, and treatment of adults with chronic kidney disease for application in clinical practice for the generalist registered dietitian nutritionist using the evidence-based library of the Academy of Nutrition and Dietetics, published clinical practice guidelines (ie, National Kidney Foundation Council on Renal Nutrition, Renal Nutrition Dietetic Practice Group, Kidney Disease Outcomes Quality Initiative, and Kidney Disease Improving Global Outcomes), the Nutrition Care Process model, and peer-reviewed literature. PMID:24582998

  10. Revising the Definition of the Generalist Physician.

    ERIC Educational Resources Information Center

    Altman, David F.

    1995-01-01

    Although generalist physicians have traditionally been defined by their specialties (family, internal, pediatric medicine), this approach may not recognize specific competencies and training needed. A new definition based on functional requirements of generalist practice and the central role of the generalist in comprehensive care is proposed.…

  11. Preparing Rehabilitation Counselors for Private Sector Practice within a CORE Accredited Generalist Educational Model

    ERIC Educational Resources Information Center

    Zanskas, Stephen; Leahy, Michael

    2007-01-01

    As private sector rehabilitation has matured as a field of practice, the issue of how rehabilitation counselor educators can effectively prepare rehabilitation counselors for practice in this setting remains. This article reviews the literature regarding the training needs of rehabilitation counselors entering private sector practice, and proposes…

  12. 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

  13. Advanced practice registered nurse certification.

    PubMed

    Alleman, Kim; Houle, Katherine

    2013-01-01

    Advanced practice registered nurses (APRNs) in nephrology began to be certified through the Nephrology Nursing Certification Commission (NNCC) in 2006. Since that time, the APRN Consensus Model has been developed, which addresses licensure, accreditation, certification, and education and which strongly recommends specialty certification for advanced practice nurses. This article discusses NNCC certification for advanced practice in nephrology nursing and describes the major components of the APRN Consensus Model. PMID:23923801

  14. 2013 Update in addiction medicine for the generalist

    PubMed Central

    2013-01-01

    Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and

  15. Preparation for Advanced Nursing Practice.

    ERIC Educational Resources Information Center

    Frik, Seigina M.; Pollock, Susan E.

    1993-01-01

    Lehman College's graduate nursing program uses theory-based courses to prepare advanced nurse practitioners. Students increase scholarly inquiry skills and clinical decision making; use of nursing conceptual models helped them plan and evaluate their practice. (SK)

  16. Advance directives in family practice.

    PubMed Central

    Kohut, N.; Singer, P. A.

    1993-01-01

    Family physicians can play an important role in helping patients and their families to discuss life-sustaining treatments and to complete advance directives. This article reviews the legal status of, and empirical studies on, advance directives and addresses some important clinical questions about their use relevant to family practice. PMID:8499789

  17. Reading and Generalist Genes

    ERIC Educational Resources Information Center

    Haworth, Claire M. A.; Meaburn, Emma L.; Harlaar, Nicole; Plomin, Robert

    2007-01-01

    Twin-study research suggests that many (but not all) of the same genes contribute to genetic influence on diverse learning abilities and disabilities, a hypothesis called "generalist genes". This generalist genes hypothesis was tested using a set of 10 DNA markers (single nucleotide polymorphisms [SNPs]) found to be associated with early reading…

  18. The Nature and Influence of Teacher Beliefs and Knowledge on the Science Teaching Practice of Three Generalist New Zealand Primary Teachers

    NASA Astrophysics Data System (ADS)

    Anderson, Dayle

    2015-06-01

    Students' negative experiences of science in the primary sector have commonly been blamed on poor teacher content knowledge. Yet, teacher beliefs have long been identified as strong influences on classroom practice. Understanding the nature of teacher beliefs and their influence on primary science teaching practice could usefully inform teacher development initiatives. In science education, teacher beliefs about teaching and learning have been proposed as key influences in the development of pedagogical content knowledge for science teaching. This paper uses a multiple qualitative case study design to examine the nature and influence of beliefs on the practice and knowledge development of three generalist primary teachers during the implementation of a unit of work in science. Data for each case study included observations and transcripts of recordings of the lessons forming each science unit, together with multiple interviews with the teacher throughout its implementation. Findings support those of other researchers suggesting that beliefs about purposes of science education, the nature of science, and science teaching and learning strongly influence teacher practice and knowledge. Beliefs about the purposes of science education were found to be a particularly strong influence on practice in the observed cases. However, beliefs about students and the teachers' aims for education generally, as well as teachers' notions concerning vertical science curriculum, were also crucially influential on the type of science learning opportunities that were promoted. Beliefs were found to additionally influence the nature of both subject matter knowledge and pedagogical content knowledge for science developed by the teachers.

  19. Recognizing the Importance of Aging Skills and Knowledge in Generalist Social Work Practice: Effective Strategies for MSW Students

    ERIC Educational Resources Information Center

    Bonifas, Robin P.; Fredriksen-Goldsen, Karen I.; Bailey, Kathleen A.

    2009-01-01

    This article examines the impact of a curricular infusion strategy aimed at integrating gerontological practice issues into social work education. Findings (N = 83) illustrate that student interest, knowledge, and skills in aging practice increased immediately following implementation of a three-tiered infusion approach; however, ongoing exposure…

  20. An ontological view of advanced practice nursing.

    PubMed

    Arslanian-Engoren, Cynthia; Hicks, Frank D; Whall, Ann L; Algase, Donna L

    2005-01-01

    Identifying, developing, and incorporating nursing's unique ontological and epistemological perspective into advanced practice nursing practice places priority on delivering care based on research-derived knowledge. Without a clear distinction of our metatheoretical space, we risk blindly adopting the practice values of other disciplines, which may not necessarily reflect those of nursing. A lack of focus may lead current advanced practice nursing curricula and emerging doctorate of nursing practice programs to mirror the logical positivist paradigm and perspective of medicine. This article presents an ontological perspective for advanced practice nursing education, practice, and research. PMID:16350595

  1. The Nature of Advanced Practice Nursing.

    ERIC Educational Resources Information Center

    Oberle, Kathleen; Allen, Marion

    2001-01-01

    Advanced practice nurses are situated between general knowledge (knowing why, what, and how) and particular knowledge (knowing who--personal knowledge of patients). Integration of the two assists in knowing when a particular action would be most helpful. This practical wisdom is the hallmark of advanced practice. (Contains 45 references.) (SK)

  2. Of Specialists and Generalists.

    ERIC Educational Resources Information Center

    DeVore, Paul W.

    The issues involving the role and impact of specialists and generalists in society are critically examined in this paper. Currently held views on specialization are analyzed and challenged. Perspectives on this dilemma are developed in the following areas: (1) limitations of experts (casts doubt on the assumption that ordinary citizens are…

  3. Clinical practice: new challenges for the advanced practice nurse.

    PubMed

    Bartel, J C; Buturusis, B

    2000-12-01

    This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community? PMID:12029667

  4. Innovative generalist programs: academic health care centers respond to the shortage of generalist physicians.

    PubMed

    Urbina, C; Hickey, M; McHarney-Brown, C; Duban, S; Kaufman, A

    1994-04-01

    Academic health care centers increasingly are exploring innovative ways to increase the supply of generalist physicians. The authors review successful innovations at representative academic health centers in the areas of recruitment and admissions, undergraduate medical education, residency training, and practice support. Lessons learned focus on those areas that have demonstrated improvements in the number and quality of physicians trained in family practice, general pediatrics, and general internal medicine. Successful recruitment of generalism-oriented applicants requires identification and tracking of rural, minority, and other special groups of students at the high school and college levels. Academic health care centers that provide early, sustained, community-based, ambulatory experiences for medical students and residents encourage trainees to maintain and choose generalist careers. Finally, academic health care centers that link with community providers and with state government encourage the retention of generalist physicians through continuing education and teaching networks. PMID:8014749

  5. Specialty practice entrepreneur: the advanced practice nurse.

    PubMed

    Kowal, N

    1998-01-01

    There are many opportunities in the health care arena to make a difference. The structured sense of change is "old school." New "surfers" of the system will be entrepreneurial in spirit, energy, and flexibility. There is no job description for the perfect person, only a sense of excitement and innovation that gives one the feeling energetic change is about to happen. In nursing, the risk takers are abundant in the APN role. It is the reason why they walk the line of provider/nurse. Making a difference to patients is important. Riding the waves of clinical care is the excitement. The final results are "the big waves" of life--a patient's life. A provider who defines the reality of practice creates a vision and skillfully bridges the road between the two. Design the surfboard--catch the wave. PMID:9987328

  6. Training Advanced Practice Palliative Care Nurses.

    ERIC Educational Resources Information Center

    Sherman, Deborah Witt

    1999-01-01

    Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)

  7. Tobacco cessation education for advanced practice nurses.

    PubMed

    Whitehead, Diane; Zucker, Steven B; Stone, Jennifer

    2014-01-01

    The predicted shortfall of primary care physicians and the millions of newly insured beginning in 2014 call for an increase in the number of advanced practice nurses (APRNs). Advanced practice nurses can significantly improve their clients' quality of life and increase their life expectancy through tobacco cessation education. The purpose of this study was to educate APRN students on smoking information and techniques to assist clients with quitting smoking in the primary care setting. PMID:24867074

  8. Making Generalists Out of Specialists.

    ERIC Educational Resources Information Center

    Malinowski, Jon C.

    2001-01-01

    Most camps use specialists to run activities and cabin leaders to manage campers. However, a generalist model offers greater leadership development opportunities. To implement a more generalist paradigm, have camp leaders express their areas of skill and interest, pair up experienced and inexperienced staff, allow specialists to cover activities…

  9. Lessons learned from advanced practice nursing payment.

    PubMed

    Sullivan-Marx, Eileen M

    2008-05-01

    For more than 25 years, advanced practice nurses have been incrementally included as a part of the health care financing structure. Following physician payment revisions at the federal level, advanced practice nurses were overtly recognized as Medicare providers and have participated in the establishment of current procedural terminology codes and the subsequent relative work values associated with payment. Success in this regard has been the result of business, political, and policy savvy that has important lessons for moving forward in any health care restructuring for both nurses and advanced practice nurses. Principles of valuing nurse work, time, and intensity in the Resource-Based Relative Value Scale are discussed with implications for future opportunities of measuring nursing work and any potential relationship to quality outcomes of care. PMID:18650417

  10. Organizing a Community Advanced Pharmacy Practice Experience

    PubMed Central

    Koenigsfeld, Carrie Foust; Tice, Angela L

    2006-01-01

    Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site. PMID:17136163

  11. Advanced Practice Nursing Education: Challenges and Strategies

    PubMed Central

    Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne

    2012-01-01

    Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273

  12. Integrating Practice and Theory for Advancement

    ERIC Educational Resources Information Center

    Bakewell, Thomas

    2005-01-01

    This is the first installment of a multipart practitioners' guide focused on strategic planning, organizational development, and legal issues. It features practical advice and powerful insights for implementing advancement programs that are organized, productive, and legal--and that generate top results. The author, an organizational development…

  13. Survey of US chiropractors' perceptions about their clinical role as specialist or generalist

    PubMed Central

    Smith, Monica; Carber, Lynne A.

    2010-01-01

    Objective The purpose of this study was to provide new information that describes chiropractors' professional identity relative to their perceived clinical role as specialist or generalist. Methods A pragmatic, descriptive, cross-sectional survey was performed of randomly sampled state-board licensed chiropractors in the United States during the period 2002–2003 to assess the chiropractors' perceptions of how their chiropractic patients see them, and how they see themselves, as specialist or generalist. For this exploratory study, we anchored the terms “back pain specialist,” “musculoskeletal specialist,” and “primary care generalist” to brief generic reference definitions in our survey instrument. Results Of our 2598 valid survey contacts, 1343 chiropractors returned their surveys either partially or fully completed, and a total of 720 chiropractor surveys were used in this study. Most of these chiropractors perceived that their new patients viewed them as “back pain specialists.” Chiropractors believed that their established patients (80%), more so than their new patients (58%), were likely to view them as a primary care generalist. Chiropractors described themselves as both specialist and generalist, and they expressed a greater capability to diagnose, rather than to treat, health disorders that were not musculoskeletal. Conclusion Chiropractic physician perceptions as reported in this study suggest that the nature of certain chiropractor-patient relationships may evolve profoundly over time, particularly as patients transition from new to established patients within the chiropractic practice. Understanding the complex nature of chiropractic health care provision may carry implications for advancing evidence-based chiropractic practice and clinical training, enhancing successful and comprehensive management of the complex health concerns of chiropractic patients, fostering beneficial sustained partnerships between chiropractors and their

  14. Advancing practice relating to SEA alternatives

    SciTech Connect

    González, Ainhoa; Thérivel, Riki; Fry, John; Foley, Walter

    2015-07-15

    Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.

  15. Advanced nursing practice: old hat, new design.

    PubMed

    De Grasse, C; Nicklin, W

    2001-01-01

    Advanced practice nurses positively impact the delivery of healthcare and client outcomes. However, in the past these positions have been seen to have variable value and were often vulnerable during budget cuts. Lack of a clear advanced nursing practice (ANP) framework probably contributed to the compromised effectiveness of these roles and evolution of roles with different titles, scopes of practice and reporting structures. To build the foundation for developing an ANP framework, a task force at The Ottawa Hospital (TOH) conducted a literature review related to ANP roles and completed a review of all clinical nursing roles at TOH. In addition, focus groups with nurses and other health professionals elicited ANP perceptions. The ANP framework includes a standardized job description that details competencies under five role components: clinical practice; consultation; research; education; and, leadership. Recommendations for assessment, implementation and evaluation of ANP roles are identified. The process undertaken by our ANP task force proved to be thorough and sound in developing a framework within which to move forward with ANP role implementation throughout TOH. This article, describing the process, may assist other organizations in defining ANP roles to better meet patient needs in changing health care environments. PMID:11803945

  16. Generalist versus specialist occupational therapists.

    PubMed

    Foto, M

    1996-01-01

    The issue is not generalist versus specialist, bachelor's degree versus master's degree, or even registered occupational therapist versus certified occupational therapy assistant. The issue is: What is each professional's product? What is the process by which each produces it? What knowledge, skills, and judgment do each need to competently produce the product? And, under what circumstances and conditions and at what point are each required to assure a quality product? The delineation of the requisite knowledge and skills as well as the delineation of generalist and specialist will flow from the answer to these questions. PMID:8947368

  17. Implementing Cooperative Learning in Australian Primary Schools: Generalist Teachers' Perspectives

    ERIC Educational Resources Information Center

    Hennessey, Angela; Dionigi, Rylee A.

    2013-01-01

    To implement cooperative learning successfully in practice, teachers require knowledge of cooperative learning, its features and terms, and how it functions in classrooms. This qualitative study examined 12 Australian generalist primary teachers', understandings of cooperative learning and perceived factors affecting its implementation. Using…

  18. Advanced clinical insights & practice: ischemic heart disease.

    PubMed

    Benner, Randall W; Zavarella, Matthew S

    2008-03-01

    This issue sees the debut of a new series of continuing education articles. The series, Advanced Clinical Insights & Practice, is designed to provide continuing education to an ever-expanding realm of paramedicine that needs more of it: the critical care transport paramedic. Secondly, and equally important, are the benefits that can be reaped by other certification levels reading this feature. For EMT-Basics and Intermediates, it will provide a great enhancement to your core knowledge, although most of the interventions discussed will be beyond your traditional scope. For paramedics, it will augment both your pathophysiological understanding and clinical assessment/management skills of diseases and injuries discussed. Ultimately though, it is hoped that anyone who reads these articles will become a better clinician. The next article will appear in the July issue. PMID:18814637

  19. The Nature and Influence of Teacher Beliefs and Knowledge on the Science Teaching Practice of Three Generalist New Zealand Primary Teachers

    ERIC Educational Resources Information Center

    Anderson, Dayle

    2015-01-01

    Students' negative experiences of science in the primary sector have commonly been blamed on poor teacher content knowledge. Yet, teacher beliefs have long been identified as strong influences on classroom practice. Understanding the nature of teacher beliefs and their influence on primary science teaching practice could usefully inform teacher…

  20. Advanced practice roles in the managed care environment.

    PubMed

    Madden, M J; Ponte, P R

    1994-01-01

    The role of the advanced practice nurse is based on expert clinical knowledge and skill and is practiced in multiple settings. As healthcare reform emerges, the context in which healthcare is delivered changes. The authors describe a creative approach to packaging and marketing the services of advanced practice nurses to the customers of the managed care system. PMID:8308561

  1. From the primary care organizations consortium's proposal to the Interdisciplinary Generalist Curriculum Project.

    PubMed

    Bazell, C; Kahn, R

    2001-04-01

    The Interdisciplinary Generalist Curriculum (IGC) Project was one element of an overall federal government strategy designed to promote primary care education. This project, undertaken by the Division of Medicine and Dentistry (DMD), Bureau of Health Professions, Health Resources and Services Administration, U.S. Department of Health and Human Services, was the first large-scale medical education contract initiated by DMD. The IGC Project was based on a model proposed by the Primary Care Organizations Consortium (PCOC). The PCOC thesis was that "if students are to decide to pursue a generalist career they must have the opportunity to be taught by generalists." The PCOC Program required an explicit curriculum focusing on generalist knowledge and skills with an emphasis on technology, in the context of education that required training in ambulatory office-based settings. The PCOC Program specified that responsibility for the program's planning, implementation, and evaluation be shared by the three generalist physician faculties of family medicine, general internal medicine, and general pediatrics. In implementation of this demonstration project in ten medical schools across the nation, several lessons have been learned relative to enhancement of generalist education. Among these lessons is that seed money targeted to initiate modest change can act as a catalyst and improve the knowledge and skills afforded medical students concerning generalist practice. Limited funds provided over a sufficient period of time can induce schools to undertake significant curricular change. PMID:11299165

  2. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice

    PubMed Central

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-01-01

    Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923

  3. Development of the role of director of advanced practice nursing.

    PubMed

    Rhodes, Catherine A; Fusilero, Jane; Williams, Christine M

    2010-01-01

    Advanced practice nurses (APNs) are integral to cost-effective delivery of health care in large health care organizations. Development of the leadership position of director of advanced practice nurses in a large teaching institution provides leadership to APNs in various settings, contributes to staff satisfaction, facilitates increased professional growth, and provides improved quality and fiscal outcomes. Job satisfaction, productivity, accountability, and communication may be enhanced through implementation of the role of director of advanced practice nursing and a committee structure of APNs, as was found in this academic health system. PMID:20306882

  4. Legal, professional and ethical considerations of advanced perioperative practice.

    PubMed

    Quick, Julie

    2010-05-01

    Advances within the NHS have recognised nurses in roles that go beyond the historical parameters of their initial training and role characteristics (DH 1999, DH 2000). Working within such a role creates added responsibilities of advancing practice and the continuing development of knowledge and skills. Nurses working at a higher level of practice will require an understanding of not only the professional and legal implications that new roles create, but also an awareness of the ethical dilemmas that will undoubtedly become increasingly complex (Bartter 2002). This article examines the professional, legal and ethical implications of advanced perioperative practice through the author's role as a surgical care practitioner (SCP). PMID:20521577

  5. Advanced practice: the clinical nurse specialist.

    PubMed

    Sparacino, P

    1992-01-01

    Historically, the clinically expert nurse who wanted to continue in direct patient care had few career options. That dilemma is changing in response to the recognised need for greater knowledge and clinical expertise in the domain of patient care. The clinical nurse specialist role is an answer to this concern. The clinical nurse specialist practices within a framework of theoretically-based knowledge and combines that knowledge with clinical expertise. The role is also pivotal in the promotion of patient care focused scientific inquiry and in the generation and refinement of nursing theories. Career options are more versatile than for the educator, researcher, or administrator. While the clinical nurse specialist is an essential person in influencing quality care in the traditional practice settings, there are now opportunities with clientele and practice settings which have expanded beyond the conventional boundaries. PMID:1528295

  6. Advanced or advancing nursing practice: what is the future direction for nursing?

    PubMed

    Gray, Alastair

    Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles. PMID:26768039

  7. How Physicians Integrate Advances into Clinical Practices.

    ERIC Educational Resources Information Center

    Lockyer, Jocelyn M.; And Others

    1985-01-01

    Family physicians and specialists were asked to identify the sources of information they used in the process of making changes in their clinical practices. An average of 3.08 sources of information were utilized for each change and over 50 percent of the changes were complete in less than one year. (CT)

  8. The Interdisciplinary Generalist Curriculum Project at the University of Vermont College of Medicine: The Vermont Generalist Curriculum (VGC) Experience.

    PubMed

    Fogarty, J; First, L R; Levine, M; Reardon, M; Magrane, D

    2001-04-01

    The University of Vermont College of Medicine received its Vermont Generalist Curriculum (VGC) subcontract as one of the second-cycle Interdisciplinary Generalist Curriculum (IGC) Project schools from 1995 to 1998. The Vermont program was jointly codirected by the chairs of family practice and pediatrics and the program director for internal medicine on a rotating basis and was overseen by a multidisciplinary steering committee that included generalists, basic scientists, specialists, and students. This committee provided guidance and support in recruitment of preceptors, continuous assessment and improvement of the courses, development of a clinical correlation manual for students in clinical offices, and cooperation around a jointly sponsored annual primary care meeting that included a joint scientific program, a research forum, and a faculty development workshop. The VGC has provided a pilot for many innovative curricular changes that have served as models for the school-wide curriculum redesign process currently under way at VERMONT: While the funding for this project ended in 1998, the changes, innovations, and collaboration born out of the project are valuable enough for the dean's office to maintain the VGC's funding and its steering committee for the future. PMID:11299185

  9. A Model of Teaching-Learning Transactions in Generalist-Specialist Consultations

    ERIC Educational Resources Information Center

    Shershneva, Marianna B.; Carnes, Molly; Bakken, Lori L.

    2006-01-01

    Introduction: A new paradigm in continuing medical education is characterized by emphasis on physicians' learning in practice. Consistent with this paradigm, our study examined a subset of clinical practice--generalist-specialist consultations--from an educational perspective. Methods: We applied the grounded-theory method with semistructured…

  10. Using evidence-based practice for managing clinical outcomes in advanced practice nursing.

    PubMed

    Glanville, I; Schirm, V; Wineman, N M

    2000-10-01

    Preparation of advanced practice nurses to assume leadership positions for clinical decision making requires that traditional ways of solving clinical problems be augmented with information from relevant, research-derived evidence. In this article, the authors describe how one graduate program prepares advanced practice nurses to use the best scientific evidence with clinical expertise to influence patient outcomes. The assignments that students complete in their program provide examples of evidence-based practice that apply quality improvement principles and science-based nursing interventions to create best practices. PMID:11008434

  11. Predictors of practice patterns for lymphedema care among oncology advanced practice nurses.

    PubMed

    Ryan, Joanne C; Cleland, Charles M; Fu, Mei R

    2012-09-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  12. Predictors of Practice Patterns for Lymphedema Care Among Oncology Advanced Practice Nurses

    PubMed Central

    Ryan, Joanne C.; Cleland, Charles M.; Fu, Mei R.

    2012-01-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  13. An overview of Medicare reimbursement regulations for advanced practice nurses.

    PubMed

    Frakes, Michael A; Evans, Tracylain

    2006-01-01

    The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described. PMID:16676748

  14. On the night shift: advanced nurse practice in emergency medicine.

    PubMed

    Jenkins, Jennifer

    2016-05-01

    Advanced nurse practitioners in the author's emergency department (ED) work autonomously and as part of a team to assess, diagnose and treat patients with unexplained and undiagnosed illnesses and injuries over a 24-hour cycle of care. The complexity of the role in EDs is often not fully understood, and expectations can vary between trusts and between different clinical areas within trusts. This article describes one night shift in the author's ED to explain the complexity of advanced nurse practitioners' roles in this environment. The article focuses on autonomous decision-making skills and the use of advanced clinical skills in the context of evidence-based practice. PMID:27165394

  15. Advanced practice politics and the Oregon nurses' trail.

    PubMed

    Bifano, L C

    1996-01-01

    As health care reform continues to evolve, it is important to consider the context of politics, practice, and power through an examination of nursing's recent history and participation in legislative events. Through a retrospective chronicle that includes interviews, recorded events, and article reviews, the political and legislative history of Oregon nurses in establishing advanced practice for nurse practitioners within the Oregon Nurse Practice Act is described. Prescriptive authority, hospital admitting privileges, and important elements contained in the Oregon Health Plan and Medicare reform are discussed. Questions are posed for the future of health care reform, such as the role of government in determining the quality of care in managed health care. PMID:8710224

  16. Establishing radiation therapy advanced practice in New Zealand

    SciTech Connect

    Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

    2014-02-15

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

  17. Missouri Responses to the Advanced Practice Nurse Role.

    ERIC Educational Resources Information Center

    Armer, Jane M.

    1997-01-01

    A randomly drawn statewide sample of 891 Missouri consumers revealed overall support for the advance practice nurse role to be greater than 75%. Seeking health care consumers' reactions to proposed alternatives is a crucial step in planning and implementing a program of health care reform that will meet current and future health needs. (Author)

  18. Advancing Empirical Scholarship to Further Develop Evaluation Theory and Practice

    ERIC Educational Resources Information Center

    Christie, Christina A.

    2011-01-01

    Good theory development is grounded in empirical inquiry. In the context of educational evaluation, the development of empirically grounded theory has important benefits for the field and the practitioner. In particular, a shift to empirically derived theory will assist in advancing more systematic and contextually relevant evaluation practice, as…

  19. Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Lang, Norma M.; Evans, Lois K.; Swan, Beth Ann

    2002-01-01

    The Penn School of Nursing and the Macy Foundation established a comprehensive institute and technical assistance program to help nursing schools advance academic nursing practice. The Penn School consulted with 21 participating schools, providing institutes, conferences, a listserv and a web-based knowledge center focused on integrating research,…

  20. Training Advanced Writing Skills: The Case for Deliberate Practice

    ERIC Educational Resources Information Center

    Kellogg, Ronald T.; Whiteford, Alison P.

    2009-01-01

    The development of advanced writing skills has been neglected in schools of the United States, with even some college graduates lacking the level of ability required in the workplace (National Commission on Writing, 2003, 2004). The core problem, we argue, is an insufficient degree of appropriate task practice distributed throughout the secondary…

  1. Establishment of Pediatric Cardiac Intensive Care Advanced Practice Provider Services.

    PubMed

    Gilliland, Jill; Donnellan, Amy; Justice, Lindsey; Moake, Lindy; Mauney, Jennifer; Steadman, Page; Drajpuch, David; Tucker, Dawn; Storey, Jean; Roth, Stephen J; Koch, Josh; Checchia, Paul; Cooper, David S; Staveski, Sandra L

    2016-01-01

    The addition of advanced practice providers (APPs; nurse practitioners and physician assistants) to a pediatric cardiac intensive care unit (PCICU) team is a health care innovation that addresses medical provider shortages while allowing PCICUs to deliver high-quality, cost-effective patient care. APPs, through their consistent clinical presence, effective communication, and facilitation of interdisciplinary collaboration, provide a sustainable solution for the highly specialized needs of PCICU patients. In addition, APPs provide leadership, patient and staff education, facilitate implementation of evidence-based practice and quality improvement initiatives, and the performance of clinical research in the PCICU. This article reviews mechanisms for developing, implementing, and sustaining advance practice services in PCICUs. PMID:26714997

  2. Educating advanced level practice within complex health care workplace environments through transformational practice development.

    PubMed

    Hardy, Sally; Jackson, Carrie; Webster, Jonathan; Manley, Kim

    2013-10-01

    Over the past 20 years health care reform has influenced the development of advanced level practitioner roles and expectations. How advanced level practitioners work to survive the highly stimulating, yet sometimes overwhelming aspects of balancing high quality provision with political reform agendas, amidst economic constraint is considered. Transformational approaches (encompassing education and practice led service development) can provide, promote and 'provoke' a harnessing of complex issues workplace environment to produce creative solutions. Transformational Practice Development provides a structured, rigorous, systematic approach that practitioners, teams and health care consumers alike can utilise to achieve skills and attributes needed for successful innovation. The authors present case study materials from action orientated locally delivered Practice Development, as a complex strategic intervention approach to influence and promote advanced level practice expertise. Initiated through facilitation of transformational leadership, and resultant team based improvements, we present how strategic collaborative processes can harness work chaos and complexity to provide sustainable and productive workplace cultures of effectiveness. PMID:23453607

  3. Canadian Educational Approaches for the Advancement of Pharmacy Practice

    PubMed Central

    Louizos, Christopher; Austin, Zubin

    2014-01-01

    Canadian faculties (schools) of pharmacy are actively engaged in the advancement and restructuring of their programs in response to the shift in pharmacy to pharmacists having/assuming an advanced practitioner role. Unfortunately, there is a paucity of evidence outlining optimal strategies for accomplishing this task. This review explores several educational changes proposed in the literature to aid in the advancement of pharmacy education such as program admission requirements, critical-thinking assessment and teaching methods, improvement of course content delivery, value of interprofessional education, advancement of practical experiential education, and mentorship strategies. Collectively, implementation of these improvements to pharmacy education will be crucial in determining the direction the profession will take. PMID:25258448

  4. Generalist Teachers' Self-Efficacy in Primary School Music Teaching

    ERIC Educational Resources Information Center

    de Vries, Peter

    2013-01-01

    This qualitative study focuses on the music teaching experiences of five Australian generalist primary school teachers in their third year of teaching. The aim was to identify these teachers' current practices in teaching music, in particular their self-efficacy in relation to teaching music. A narrative inquiry methodology was employed,…

  5. Establishing advanced practice for medical imaging in New Zealand

    PubMed Central

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-01-01

    IntroductionThis article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). MethodsThe study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. ResultsFindings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. ConclusionsThe authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ. PMID:26229631

  6. Establishing advanced practice for medical imaging in New Zealand

    SciTech Connect

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  7. 'eSimulation'. Part 2: Evaluation of an interactive multimedia mental health education program for generalist nurses.

    PubMed

    Lamont, Scott; Brunero, Scott

    2014-01-01

    This paper reports on an evaluation of an eSimulation mental health education program for generalist nurses; developed using the following five key attributes of simulation: (1) creating a hypothetical opportunity; (2) authentic representation; (3) active participation; (4) integration; (5) repetition, evaluation and reflection. Four themes emerged from a qualitative thematic analysis of semi-structured interview data involving fourteen generalist nurses. The following four themes: (1) authenticity; (2) participation; (3) clinical reasoning; (4) control of learning provide supporting evidence that these attributes are positioned within the learning resource. Participants found the scenarios within the resource realistic, engaging and relevant to their scope of practice. This type of learning resource may help in developing the knowledge, skills and confidence of generalist nurses in delivering safe and competent mental health care in the generalist setting, when access to specialist services and appropriate means of training are unavailable. PMID:24772985

  8. Factors enabling advanced practice nursing role integration in Canada.

    PubMed

    DiCenso, Alba; Bryant-Lukosius, Denise; Martin-Misener, Ruth; Donald, Faith; Abelson, Julia; Bourgeault, Ivy; Kilpatrick, Kelley; Carter, Nancy; Kaasalainen, Sharon; Harbman, Patricia

    2010-12-01

    Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper. PMID:21478695

  9. Improving the utility of colonoscopy: Recent advances in practice.

    PubMed

    Corte, Crispin J; Leong, Rupert W

    2016-01-01

    Colonoscopy is a frequently performed diagnostic and therapeutic test and the primary screening tool in several nationalized bowel cancer screening programs. There has been a considerable focus on maximizing the utility of colonoscopy. This has occurred in four key areas: Optimizing patient selection to reduce unnecessary or low yield colonoscopy has offered cost-benefit improvements in population screening. Improving quality assurance, through the development of widely accepted quality metrics for use in individual practice and the research setting, has offered measurable improvements in colonoscopic yield. Significant improvements have been demonstrated in colonoscopic technique, from the administration of preparation to the techniques employed during withdrawal of the colonoscope. Improved techniques to avoid post-procedural complications have also been developed-further maximizing the utility of colonoscopy. The aim of this review is to summarize the recent evidence-based advances in colonoscopic practice that contribute to the optimal practice of colonoscopy. PMID:26211821

  10. Sinusitis. A review for generalists.

    PubMed Central

    Reuler, J B; Lucas, L M; Kumar, K L

    1995-01-01

    A frequent complication of the common cold, sinusitis is one of the most prevalent problems seen in general medical and emergency department practices. In addition, nosocomial sinus infection, particularly in intensive care units, is being recognized more frequently. Decision making about managing patients with sinusitis is based primarily on the history and, to a lesser extent, the findings of the physical examination. Images Figure 2. Figure 3. PMID:7667982

  11. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care. PMID:20644180

  12. Advanced practice psychiatric nurses legislative update: State of the States, 2010.

    PubMed

    Oleck, Leslie G; Retano, Angela; Tebaldi, Christine; McGuinness, Teena M; Weiss, Steven; Carbray, Julie; Rodgers, Laura; Donelson, Emily E; Ashton, Lisa Lynn; Koehn, Darcy; McCoy, Patricia

    2011-01-01

    This article provides an update regarding individual state legislation for advanced practice psychiatric nursing, building on previous briefings. Specific attention is given to independent versus collaborative practice regulations, titling, and prescriptive authority. There is review of contemporary issues and focus on scope and standards of practice, workforce data, certification, and advanced practice regulatory models. PMID:21659307

  13. Partner for Promotion: An Innovative Advanced Community Pharmacy Practice Experience

    PubMed Central

    Legg, Julie E.; Casper, Kristin A.

    2008-01-01

    Objectives To implement the Partner for Promotion (PFP) program which was designed to enhance the skills and confidence of students and community pharmacy preceptors to deliver and expand advanced patient care services in community pharmacies and also to assess the program's impact. Design A 10-month longitudinal community advanced pharmacy practice experience was implemented that included faculty mentoring of students and preceptors via formal orientation; face-to-face training sessions; online monthly meetings; feedback on service development materials; and a web site offering resources and a discussion board. Pre- and post-APPE surveys of students and preceptors were used to evaluate perceptions of knowledge and skills. Assessment The skills survey results for the first 2 years of the PFP program suggest positive changes occurring from pre- to post-APPE survey in most areas for both students and preceptors. Four of the 7 pharmacies in 2005-2006 and 8 of the 14 pharmacies in 2006-2007 were able to develop an advanced patient care service and begin seeing patients prior to the conclusion of the APPE. As a result of the PFP program from 2005-2007, 14 new experiential sites entered into affiliation agreements with The Ohio State University College of Pharmacy. Conclusion The PFP program offers an innovative method for community pharmacy faculty members to work with students and preceptors in community pharmacies in developing patient care services. PMID:19325954

  14. Educational Changes to Support Advanced Practice Nursing Education

    PubMed Central

    LeFlore, Judy L.; Thomas, Patricia E.

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446

  15. Advancing the practice of systems engineering at JPL

    NASA Technical Reports Server (NTRS)

    Jansma, Patti A.; Jones, Ross M.

    2006-01-01

    In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of

  16. Emerging Lessons of the Interdisciplinary Generalist Curriculum (IGC) Project.

    ERIC Educational Resources Information Center

    Wartman, Steven A.; Davis, Ardis K.; Wilson, Modena E. H.; Kahn, Norman B., Jr.; Kahn, Ruth H.

    1998-01-01

    The interdisciplinary general-curriculum project was designed to develop innovative preclinical generalist curricula in ten medical and osteopathic schools and to encourage generalist careers. After two competitive cycles, much has been learned about interdisciplinary collaboration, recruitment and retention of community preceptors, faculty…

  17. The Virginia Generalist Initiative: Lessons Learned in a Statewide Consortium.

    ERIC Educational Resources Information Center

    Morse, R. Michael; Plungas, Gay S.; Duke, Debra; Rollins, Lisa K.; Barnes, H. Verdain; Brinson, Betsy K.; Martindale, James R.; Marsland, David W.

    1999-01-01

    To increase supply of generalist physicians, three state-supported Virginia medical schools formed a partnership with governmental stakeholders in the Generalist Physician Initiative. Lessons learned concerning stakeholder participation in planning, shared philosophical commitment, support for risk-taking, attitudes toward change, and trust are…

  18. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries. PMID:18773586

  19. Emergency nurse practitioners' perceptions of their role and scope of practice: is it advanced practice?

    PubMed

    McConnell, Donna; Slevin, Oliver D; McIlfatrick, Sonja J

    2013-04-01

    There are multiple interpretations of the nurse practitioner role which appear to be shaped by discourses within and outside the profession and its regulatory body. This study aimed to explore and clarify the role and scope of practice of emergency nurse practitioners in a region in the United Kingdom and determine if they fulfil the proposed criteria for Advanced Nurse Practitioners. A survey approach using questionnaires (n=42) was adopted. The sample included all emergency nurse practitioners working in Accident and Emergency Departments and Minor Injury Units in the region. Statistical data was analysed using SPSS for Windows and qualitative data was content analysed for themes. Results revealed a variation in education. Investigation of role typology and scope of practice revealed a relatively homogenous group where the clinical aspect of the role dominated. The scope of practice was perceived to be influenced by internal factors such as competence; however protocol use, referral rights and prescribing authority could be considered ways that nursing management and medical staff indirectly control the role. Findings suggested that emergency nurse practitioners were working at a level significantly beyond registration, yet do not fulfil the Nursing and Midwifery Council proposed criteria for Advanced Nurse Practitioner. PMID:23615513

  20. [Collaboration with specialists and regional primary care physicians in emergency care at acute hospitals provided by generalists].

    PubMed

    Imura, Hiroshi

    2016-02-01

    A role of acute hospitals providing emergency care is becoming important more and more in regional comprehensive care system led by the Ministry of Health, Labour and Welfare. Given few number of emergent care specialists in Japan, generalists specializing in both general internal medicine and family practice need to take part in the emergency care. In the way collaboration with specialists and regional primary care physicians is a key role in improving the quality of emergency care at acute hospitals. A pattern of collaborating function by generalists taking part in emergency care is categorized into four types. PMID:26915241

  1. Providing a navigable route for acute medicine nurses to advance their practice: a framework of ascending levels of practice.

    PubMed

    Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian

    2016-01-01

    This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge. Uniquely, this article offers an early conceptual framework through which levels of advancement and potential transition points to advance nursing practice in acute medicine are articulated. Determining how to advance requires identification of prior accomplishments such as, tacit knowledge, experiential learning, CPD, specialist courses and management experience. This requires nurses to make judicious decisions to advance their practice and the distinction between 'amassing experience' and 'career progression'. It aims to stimulate thinking around the practicalities of advancement, the value of tacit knowledge and potential realization through the framework trajectory. PMID:27441313

  2. Food-limitation in a generalist predator

    PubMed Central

    Rutz, Christian; Bijlsma, Rob G

    2006-01-01

    Investigating food-limitation in generalist predators is difficult, because they can switch to alternative prey, when one of their staple prey becomes scarce. Apart from data on the dynamics of the predator population, a robust study requires: (i) a documentation of the predator's entire prey base; and (ii) an experimental or natural situation, where profitable dietary shifts are impossible, because several preferred prey species decline simultaneously. Here, we provide a detailed description of how food-supply has limited a generalist avian top predator, the northern goshawk Accipiter gentilis. In our study area, populations of several principal goshawk prey species crashed simultaneously during 1975–2000, whereas other extrinsic factors remained essentially unchanged. The breeding and non-breeding segments of the local goshawk population declined markedly, associated with a significant increase in nest failures. Brood size of successful pairs remained unaffected by changes in prey availability. Breeding recruitment ceased at a time when potential replacement birds (‘floaters’) were still present, providing a rare empirical demonstration of an ‘acceptance threshold’ in raptor territory choice. To investigate how goshawk diet changed in response to varying food-supplies, we make novel use of an analytical tool from biodiversity research—‘abundance–biomass–comparison curves’ (ABC curves). With increasing levels of food-stress, the dominance of principal prey species in the diet decreased, and the number of small-bodied prey species increased, as did intra-guild predation. Our finding that breeder and non-breeder segments declined in concert is unexpected. Our results carry the management implication that, in food-limited raptor populations, externally induced breeder mortality can rapidly depress population size, as losses are no longer buffered when floaters reject breeding opportunities. PMID:16846915

  3. Advances, practice, and clinical perspectives in high-throughput sequencing.

    PubMed

    Park, S-J; Saito-Adachi, M; Komiyama, Y; Nakai, K

    2016-07-01

    Remarkable advances in high-throughput sequencing technologies have fundamentally changed our understanding of the genetic and epigenetic molecular bases underlying human health and diseases. As these technologies continue to revolutionize molecular biology leading to fresh perspectives, it is imperative to thoroughly consider the enormous excitement surrounding the technologies by highlighting the characteristics of platforms and their global trends as well as potential benefits and limitations. To date, with a variety of platforms, the technologies provide an impressive range of applications, including sequencing of whole genomes and transcriptomes, identifying of genome modifications, and profiling of protein interactions. Because these applications produce a flood of data, simultaneous development of bioinformatics tools is required to efficiently deal with the big data and to comprehensively analyze them. This review covers the major achievements and performances of the high-throughput sequencing and further summarizes the characteristics of their applications along with introducing applicable bioinformatics tools. Moreover, a step-by-step procedure for a practical transcriptome analysis is described employing an analytical pipeline. Clinical perspectives with special consideration to human oral health and diseases are also covered. PMID:26602181

  4. Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

    PubMed Central

    Potter, Pamela J.

    2013-01-01

    Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

  5. Advances in computer technology: impact on the practice of medicine.

    PubMed

    Groth-Vasselli, B; Singh, K; Farnsworth, P N

    1995-01-01

    Advances in computer technology provide a wide range of applications which are revolutionizing the practice of medicine. The development of new software for the office creates a web of communication among physicians, staff members, health care facilities and associated agencies. This provides the physician with the prospect of a paperless office. At the other end of the spectrum, the development of 3D work stations and software based on computational chemistry permits visualization of protein molecules involved in disease. Computer assisted molecular modeling has been used to construct working 3D models of lens alpha-crystallin. The 3D structure of alpha-crystallin is basic to our understanding of the molecular mechanisms involved in lens fiber cell maturation, stabilization of the inner nuclear region, the maintenance of lens transparency and cataractogenesis. The major component of the high molecular weight aggregates that occur during cataractogenesis is alpha-crystallin subunits. Subunits of alpha-crystallin occur in other tissues of the body. In the central nervous system accumulation of these subunits in the form of dense inclusion bodies occurs in pathological conditions such as Alzheimer's disease, Huntington's disease, multiple sclerosis and toxoplasmosis (Iwaki, Wisniewski et al., 1992), as well as neoplasms of astrocyte origin (Iwaki, Iwaki, et al., 1991). Also cardiac ischemia is associated with an increased alpha B synthesis (Chiesi, Longoni et al., 1990). On a more global level, the molecular structure of alpha-crystallin may provide information pertaining to the function of small heat shock proteins, hsp, in maintaining cell stability under the stress of disease. PMID:8721907

  6. Spasm or transformation? Advanced practice psychiatric nursing education in the United States.

    PubMed

    Olson, Tom

    2004-08-01

    Psychiatric nursing graduate programs are in precipitous decline in the United States, leading many advanced practice psychiatric nurses to question the viability of their field. This article examines the current crisis in advanced practice psychiatric nursing education in the United States by identifying core concerns and exploring the reasons for these concerns. Suggestions for securing the future of this practice area are also discussed. These suggestions include identifying a more clearly focused role for advanced practice psychiatric nurses, development of realistic educational expectations, achievement of greater uniformity in curricula, and the establishment of a strong and rigorous process of accreditation. PMID:15468608

  7. Exploring the factors that influence the ratio of generalists to other specialists in Canada

    PubMed Central

    Joschko, Justin; Busing, Nick

    2016-01-01

    Abstract Objective To explore perceptions about the factors that influence the ratio of generalists to other specialists. Design Semistructured interviews. Setting Canada. Participants Thirteen individuals who were closely involved in medical education and health human resource planning or had a role in influencing medical education policy. Methods Telephone interviews were conducted with participants until data saturation was reached. Interviews were transcribed and analyzed using constant comparison techniques. For the purpose of simplifying discourse, family medicine and generalism were treated as synonymous throughout the interviews. Main findings Seven themes emerged from participants’ responses: ratio of generalists to specialists, importance of generalism, barriers to generalism, role of the medical education system, role of policy makers, geographic location, and the future of generalism. Conclusion Most respondents perceived the ratio of specialists to generalists as roughly even and believed the reasons for this balance included increased attention from policy makers, a greater presence of family physicians in research and teaching, and a shift toward a more regional and representative distribution of medical education facilities. Respondents also highlighted challenges within family medicine including providers choosing a narrower scope of practice, a shift away from generalism, and ongoing inequities between family physicians and other specialties in terms of remuneration, lifestyle, and prestige. PMID:27427563

  8. Advances in endodontics: Potential applications in clinical practice

    PubMed Central

    Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  9. Advances in endodontics: Potential applications in clinical practice.

    PubMed

    Kishen, Anil; Peters, Ove A; Zehnder, Matthias; Diogenes, Anibal R; Nair, Madhu K

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  10. Implementation of Advanced Access in a Family Medicine Residency Practice.

    PubMed

    Tseng, Ann; Wiser, Eric; Barclay, Emily; Aiello, Karen

    2015-01-01

    Several models of scheduling have been documented in the literature, including the traditional model, the carve-out model, and the advanced access model. We describe the implementation of the advanced access model in our clinic, which has been very successful. Advanced access has decreased third next available appointments to less than seven days for many of our providers and has increased individual primary care physician continuity for 40% of our providers. Interestingly, we had no gains in patient satisfaction, which is consistent with other previously published studies on advanced access. PMID:26665471

  11. Effects of an advanced surgical nursing module on clinical practice.

    PubMed

    Frost, J

    1994-04-01

    1. Innovation and changes in practice can be developed through continuing education. 2. By adapting appropriate change strategies, theories learned in class can be applied in practice. 3. Excellence in quality can be achieved by all qualified nurses by applying theory to practice. PMID:7513891

  12. Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

    ERIC Educational Resources Information Center

    Fierke, Kerry K.; Lepp, Gardner A.

    2015-01-01

    The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

  13. Online, directed journaling in community health advanced practice nursing clinical education.

    PubMed

    Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

    2004-04-01

    The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education. PMID:15098912

  14. Identifying components of advanced-level clinical nutrition practice: a Delphi study.

    PubMed

    Brody, Rebecca A; Byham-Gray, Laura; Touger-Decker, Riva; Passannante, Marian R; O'Sullivan Maillet, Julie

    2012-06-01

    The dietetics profession lacks a comprehensive definition of advanced-level practice. Using a three-round Delphi study with mailed surveys, expert consensus on four dimensions of advanced-level practice that define advanced practice registered dietitians (RDs) in clinical nutrition was explored. Purposive sampling identified 117 RDs who met advanced-level practice criteria. In round 1, experts rated the essentiality of statements on a 7-point ordinal scale and generated open-ended practice activity statements regarding the following four dimensions of advanced-level practice: professional knowledge, abilities and skills, approaches to practice, roles and relationships, and practice behaviors. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 was neutral, and 5.0 to 7.0 were nonessential. In rounds 2 and 3, experts re-rated statements not reaching consensus by evaluating their previous responses, group median rating, and comments. Consensus was reached when the interquartile range of responses to a statement was ≤2.0. Eighty-five experts enrolled (72.6%); 76 (89.4%) completed all rounds. In total, 233 statements were rated, with 100% achieving consensus; 211 (90.6%) were essential to advanced practice RD clinical practice. Having a master's degree; completing an advanced practice residency; research coursework; and advanced continuing education were essential, as were having 8 years of experience; clinical nutrition knowledge/expertise; specialization; participation in research activities; and skills in technology and communication. Highly essential approaches to practice were systematic yet adaptable and used critical thinking and intuition and highly essential values encompassed professional growth and service to patients. Roles emphasized patient care and leadership. Essential practice activities within the nutrition care process included provision of complex patient-centered nutrition care using application of advanced knowledge/expertise and

  15. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations

    PubMed Central

    Ratka, Anna; Gleason, Shaun E.; Ombengi, David N.; Tofade, Toyin; Wigle, Patricia R.; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J.; Ochs, Leslie; Jungnickel, Paul W.; Abrons, Jeanine P.; Alsharif, Naser Z.

    2016-01-01

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students. PMID:27170810

  16. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

    PubMed

    Dornblaser, Emily K; Ratka, Anna; Gleason, Shaun E; Ombengi, David N; Tofade, Toyin; Wigle, Patricia R; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J; Ochs, Leslie; Jungnickel, Paul W; Abrons, Jeanine P; Alsharif, Naser Z

    2016-04-25

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students. PMID:27170810

  17. Framework for analyzing supply and demand for specialist and advanced practice registered dietitians.

    PubMed

    O'Sullivan Maillet, Julie; Brody, Rebecca A; Skipper, Annalynn; Pavlinac, Jessie M

    2012-03-01

    The number of credentialed dietetics specialists--approximately 15% of the profession--is proportionately higher than those in other allied health and nursing professions. Credentialed specialists seem to receive greater compensation earlier in their career, but this advantage neutralizes as length of time in the profession increases. A larger proportion of younger registered dietitians (RDs) are specialists, which may mean an increase in supply of specialists in the future. There is considerable interest in creation of health promotion and foodservice management credentials. Consideration should be given to collaborating with other organizations to explore new models of recognition or credentialing for narrow areas of focus. Creating a methodology that can differentiate the tasks and approaches to practice that are unique to advanced practitioners compared with specialists has been a challenge. Prior research has not succeeded in identifying the differences in what advanced practitioners do. Future research to isolate advanced practice must take practice approach into account. A new, research-based, credential for advanced practitioners is possible, or a recognition program for advanced practice RDs could be considered. Precise supply and demand for specialty and advanced practice RDs cannot be measured. Thus, in this technical article, the authors share the available information regarding supply and demand with regard to dietetics specialists and advanced practitioners. It seems there are distinctions among the various levels of practice and recognition of their value to the profession and to the health of the public. PMID:22709861

  18. Advances in website information resources to aid in clinical practice.

    PubMed

    Rioth, Matthew J; Osterman, Travis J; Warner, Jeremy L

    2015-01-01

    The World Wide Web, which has been widely implemented for roughly two decades, is humankind's most impressive effort to aggregate and organize knowledge to date. The medical community was slower to embrace the Internet than others, but the majority of clinicians now use it as part of their everyday practice. For the practicing oncologist, there is a daunting quantity of information to master. For example, a new article relating to cancer is added to the MEDLINE database approximately every 3 minutes. Fortunately, Internet resources can help organize the deluge of information into useful knowledge. This manuscript provides an overview of resources related to general medicine, oncology, and social media that will be of practical use to the practicing oncologist. It is clear from the vast size of the Internet that we are all life-long learners, and the challenge is to acquire "just-in-time" information so that we can provide the best possible care to our patients. The resources that we have presented in this article should help the practicing oncologist continue along the path of transforming information to knowledge to wisdom. PMID:25993230

  19. How Quality Improvement Practice Evidence Can Advance the Knowledge Base.

    PubMed

    OʼRourke, Hannah M; Fraser, Kimberly D

    2016-01-01

    Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base. PMID:27584696

  20. The APA and the Rise of Pediatric Generalist Network Research

    PubMed Central

    Wasserman, Richard; Serwint, Janet R.; Kuppermann, Nathan; Srivastava, Rajendu; Dreyer, Benard

    2010-01-01

    The Academic Pediatric Association (APA – formerly the Ambulatory Pediatric Association) first encouraged multi-institutional collaborative research among its members over thirty years ago. Individual APA members went on subsequently to figure prominently in establishing formal research networks. These enduring collaborations have been established to conduct investigations in a variety of generalist contexts. At present, four generalist networks – Pediatric Research in Office Settings (PROS), the Pediatric Emergency Care Applied Network (PECARN), the COntinuity Research NETwork (CORNET), and Pediatric Research in Inpatient Settings (PRIS) – have a track record of extensive achievement in generating new knowledge aimed at improving the health and health care of children. This review details the history, accomplishments, and future directions of these networks and summarizes the common themes, strengths, challenges and opportunities inherent in pediatric generalist network research. PMID:21282083

  1. Policy to Practice: A Case Study of Advanced Placement Open Enrollment Programs in New Mexico

    ERIC Educational Resources Information Center

    McIlroy, Ann Lynn

    2010-01-01

    This case study explored Advanced Placement open enrollment programs in New Mexico in an attempt to identify mechanisms embedded within the implementation practices which possibly prevent the equitable enrollment of students of color. Advanced Placement (AP) courses have become a gate-keeper in competitive college admissions. Therefore, a study of…

  2. The practical equity implications of advanced metering infrastructure

    SciTech Connect

    Felder, Frank A.

    2010-07-15

    Reductions in advanced metering costs and the efficiency benefits of dynamic pricing make a compelling case to adopt both, particularly for industrial and commercial facilities. Regulators should seriously consider such policies for residential households as well. Regulators can take meaningful steps to mitigate, if not entirely offset, the possibility that some low-income ratepayers may have higher electricity bills with AM and DP. (author)

  3. Advancing Social Justice in Vocational Theory, Research, and Practice

    ERIC Educational Resources Information Center

    Borgen, Fred H.

    2005-01-01

    David Blustein, Ellen Hawley McWhirter, and Justin Perry present a social justice agenda for action in vocational psychology in their article "An Emancipatory Communitarian Approach to Vocational Development Theory, Research, and Practice." They build on robust work in counseling psychology over recent decades by using the critical work of Isaac…

  4. Translating Advances in Reading Comprehension Research to Educational Practice

    ERIC Educational Resources Information Center

    McNamara, Danielle S.; Kendeou, Panayiota

    2011-01-01

    The authors review five major findings in reading comprehension and their implications for educational practice. First, research suggests that comprehension skills are separable from decoding processes and important at early ages, suggesting that comprehension skills should be targeted early, even before the child learns to read. Second, there is…

  5. Advanced marketing strategies to build the esthetic dental practice.

    PubMed

    Levin, R P

    1994-01-01

    Esthetic dentistry is truly a major part of the future of the fee-for-service practice. There are still many patients who seek high-quality elective care and these individuals need to be swayed to make an initial appointment with you. Whether you reach them through your present patients or through outreach to the community, the important key is your method of handling each of these patients as they join your practice. Customer service needs to be stronger and more obvious than ever before in order to differentiate your practice from others and to attract more referrals. The days of waiting for patients to arrive have clearly come to an end. Managed care and a decline in the need for traditional services has eroded a significant component of the dental market. When you combine that with the realization that only 50% of the population visits the dentist even once a year (and far less in many countries outside the United States), then it becomes obvious that the total available market for the elective services of esthetic dentistry has declined. Esthetic dentistry programs must be better defined, with an ongoing focus to educate present patients and to attract new patients. As I state in my seminars, I firmly believe that any practice today can still be highly successful. I do not feel that I will be making that statement three to five years from now. The time to begin positioning your practice for future growth of esthetic dentistry is now. As managed-care programs increase, it will become more difficult to turn around a declining practice. Having a quality marketing program already in place will make the difference for your esthetic practice. The new patient phone call is critical. It is there that you will begin to help patients understand fully the overall attitude and policies of your office. Successful management of new patients is to win their trust by giving them ultimate customer service while convincing them to fit your present system and schedule. When a

  6. Impact of Selection Practices on Career Advancement of African American Women in Community College Administration

    ERIC Educational Resources Information Center

    Yancy-Tooks, Barbara J.

    2012-01-01

    The purpose of this qualitative ethnographic study was to explore the experiences of African American women about their perceptions of factors (i.e. senior administrator selection practices, institutional practices, barriers, and coping strategies) that hinder or facilitate advancement in community college administration. The following questions…

  7. Cost-effectiveness of a WOC Advanced Practice Nurse in the Acute Care and Outpatient Setting

    PubMed Central

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  8. Cost-effectiveness of a WOC advanced practice nurse in the acute care and outpatient setting.

    PubMed

    Medley, Jenny A

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  9. Integrating Social Neuroscience and Social Work: Innovations for Advancing Practice-Based Research

    ERIC Educational Resources Information Center

    Matto, Holly C.; Strolin-Goltzman, Jessica

    2010-01-01

    Throughout the social work profession, there is ongoing interest in building a social science agenda that can address the complex practice-based questions faced by social work professionals today. Methodological innovations and unique funding opportunities have already significantly advanced research on social work practice. Still, there is…

  10. Family-centered care for children with cerebral palsy: conceptual and practical considerations to advance care and practice.

    PubMed

    King, Gillian; Chiarello, Lisa

    2014-08-01

    This article focuses on conceptual and practical considerations in family-centered care for children with cerebral palsy and their families. In the last 5 years, there have been important advances in our understanding of the components of family-centered care, and initial attempts to understand the client change processes at play. Recent research elaborates on family-centered care by delving into aspects of family-provider partnership, and applying family-centered principles to organizational service delivery to bring about organizational cultures of family-centered care. Recent research has also begun to consider mediators of client change, and new practice models have been proposed that embrace family-centered principles and illustrate the "art" of practice. Future research directions are discussed, including explorations of causal relationships between family-centered care principles, elements of caregiving practice, client change processes, and child and family outcomes. The meaning of the recent literature for pediatric neurology practice is considered. PMID:24810084

  11. [Therapeutic advances and nursing practices, 1914-1918].

    PubMed

    Debout, Christophe

    2014-06-01

    The production and transfer of knowledge in the healthcare field were key factors which enabled the fight against morbidity and mortality during the First World War to be carried out efficiently. The knowledge used to train nurses before the war soon became obsolete and had to be updated. Knowledge and practices were developed in order to meet as best as possible the specific needs of patients in the particular context of this war. PMID:25069355

  12. Preserving the Art and Science of Psychotherapy for Advance Practice Psychiatric Mental Health Nurses.

    PubMed

    Caughill, Ann

    2016-04-01

    Psychiatric Mental Health (PMH) Nurses are challenged to maintain the viability of their roles in today's healthcare climate as advances in research and complexity of mental healthcare needs of society continue to unfold. Today's mental health practice environment includes disciplines with marketable credentials. Roles for PMH nurses in recent decades are less clearly defined than for other disciplines, much of this related to changes in educational and practice settings. This article reviews literature on the topic of psychotherapy and a call for a renewed emphasis on this mode of treatment for psychiatric mental health advance practice nurses. PMID:27077508

  13. The role of Advanced Practice Providers in interdisciplinary oncology care in the United States.

    PubMed

    Reynolds, Rae Brana; McCoy, Kimberly

    2016-06-01

    Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs), generally referred to as Advanced Practice Providers (APPs), are fundamental to interdisciplinary oncology care. As the projected demand for oncology services is anticipated to outpace the supply of oncologists, APPs will become increasingly vital in the delivery of oncology care and services. The training, education, and scope of practice for APPs gives the interdisciplinary care team professionals that deliver high-quality clinical services and provide valuable contributions and leadership to health care quality improvement initiatives. Optimizing the integration of APPs in oncology care offers immense advantages towards improvement of clinical outcomes. PMID:27197514

  14. Meeting report: advancing practical applications of biodiversity ontologies

    PubMed Central

    2014-01-01

    We describe the outcomes of three recent workshops aimed at advancing development of the Biological Collections Ontology (BCO), the Population and Community Ontology (PCO), and tools to annotate data using those and other ontologies. The first workshop gathered use cases to help grow the PCO, agreed upon a format for modeling challenging concepts such as ecological niche, and developed ontology design patterns for defining collections of organisms and population-level phenotypes. The second focused on mapping datasets to ontology terms and converting them to Resource Description Framework (RDF), using the BCO. To follow-up, a BCO hackathon was held concurrently with the 16th Genomics Standards Consortium Meeting, during which we converted additional datasets to RDF, developed a Material Sample Core for the Global Biodiversity Information Framework, created a Web Ontology Language (OWL) file for importing Darwin Core classes and properties into BCO, and developed a workflow for converting biodiversity data among formats.

  15. Review: Coastal groundwater optimization—advances, challenges, and practical solutions

    NASA Astrophysics Data System (ADS)

    Ketabchi, Hamed; Ataie-Ashtiani, Behzad

    2015-09-01

    Decision models are essential tools for coastal groundwater management (CGM). A combined simulation-optimization framework is employed to develop these models. One of the main barriers in the widespread application of these models for real-world cases is their large computational burden. Recent advances in efficient computational approaches and robust optimization methods can crack this barrier. This study surveys the scientific basis of CGM to provide an overview on this subject and reviews the-state-of-the-art to clarify recent developments and to outline ideas for improving the computational performance. Key details are presented on the performance and choice of possible robust tools such as efficient evolutionary algorithms (EAs), surrogate models, and parallel processing techniques. Then, the potential challenges remaining in this context are scrutinized, demonstrating open fields for further research, which include issues related to advances in simulating and optimizing phases such as introducing new robust algorithms and considering multi-objective purposes, implementing novel and high-performance tools, considering global concerns (e.g. climate change impacts), enhancing the existing models to fit the real world, and taking into account the complexities of real-world applications (e.g. uncertainties in the modeling parameters, and data acquisition). Finally, the outcomes of the systematic review are applied to solve a real-world CGM problem in Iran, to quantitatively examine the performance of combined implementation of some of the suggested tools. It is revealed that the required computational time is considerably reduced by as much as three orders of magnitude when correct combinations of robust EAs, surrogate model, and parallelization technique are utilized.

  16. Effect of urbanisation on habitat generalists: starlings not so flexible?

    NASA Astrophysics Data System (ADS)

    Mennechez, Gwénaëlle; Clergeau, Philippe

    2006-09-01

    The small variability of habitat generalist abundances in relation to landscape changes has been related to their behavioural flexibility. We hypothesise that successful generalists, such as the starling, compensate for feeding resource difficulties (poor quality of food, accessibility) in habitats such as urban ecosystems and that its behavioural flexibility allows for similar breeding performance in rural and urban areas. Along an urbanisation gradient we compared simultaneously (1) success factors such as the abundance of breeding starlings, their breeding performance and the fitness of nestlings, and (2) possible flexibility quantified through the rate of parental food-provisioning, and the composition and the amount of food delivered to nestlings. Abundance of breeding starlings are similar throughout the urbanisation gradient, but urbanisation profoundly and negatively affects reproductive parameters of starlings. Differences in the amount of food delivered to nestlings by parents (less food in town centre), and the small masses of nestlings reared in the urban sectors support the idea that urban nestlings received insufficient food loads. Despite modifications to their diurnal food-provisioning rhythm and the incorporation of some human food refuse into their diet, starling parents have a significantly reduced production of young in the urban centre sector. We rebut the idea that the "generalist" starling is able to breed successfully anywhere: other more "specialist" species succeed in producing their young by innovating more in terms of diet resources. We suggest defining successful birds with respect to colonisation or invasion process through behavioural innovation rather than an ambiguous habitat generalist definition.

  17. Description of the clinical practice of advanced practice nurses in family-centered early intervention in two rural settings.

    PubMed

    Kang, R; Barnard, K; Oshio, S

    1994-12-01

    The purpose of this study was to describe the scope of clinical practice of advanced practice nurses who were involved in a project designed to increase access of families with at-risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility, Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory-Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family-centered early intervention services in rural communities. PMID:7870654

  18. Advances and Practices of Bioprocess Scale-up.

    PubMed

    Xia, Jianye; Wang, Guan; Lin, Jihan; Wang, Yonghong; Chu, Ju; Zhuang, Yingping; Zhang, Siliang

    2016-01-01

    : This chapter addresses the update progress in bioprocess engineering. In addition to an overview of the theory of multi-scale analysis for fermentation process, examples of scale-up practice combining microbial physiological parameters with bioreactor fluid dynamics are also described. Furthermore, the methodology for process optimization and bioreactor scale-up by integrating fluid dynamics with biokinetics is highlighted. In addition to a short review of the heterogeneous environment in large-scale bioreactor and its effect, a scale-down strategy for investigating this issue is addressed. Mathematical models and simulation methodology for integrating flow field in the reactor and microbial kinetics response are described. Finally, a comprehensive discussion on the advantages and challenges of the model-driven scale-up method is given at the end of this chapter. PMID:25636486

  19. Characteristics of advanced-level dietetics practice: a model and empirical results.

    PubMed

    Bradley, R T; Young, W Y; Ebbs, P; Martin, J

    1993-02-01

    This article, which is the first of a two-part series, presents results for the first objective of The American Dietetic Association (ADA) 1991 Dietetic Practice Study: to determine the characteristics of advanced-level dietetics practice. A nationwide mail survey of ADA members was conducted on a stratified random sample of 8,012 beyond-entry-level (registered before April 1988) registered dietitians who were members of dietetic practice groups (DPGs). The sample was supplemented with two randomly selected control groups of 1,000 entry-level and 1,000 beyond-entry-level registered dietitians. The overall response rate was 63.1%. The 5,852 usable returns were representative of the dietetics population surveyed. A model of advanced-level professional practice was developed that specified minimum necessary requirements for advanced practitioners on five components: education and experience, professional achievement, approach to practice, professional role positions, and professional role contacts; measurement of a sixth component, advanced-level practice performance, was unsuccessful. A series of validation analyses found the model to be a statistically sound and reliable means of distinguishing advanced practitioners from other groups of dietitians in 8 of every 10 cases. A total of 461 (8.9%) dietitians met all requirements of the model and were classified as advanced practitioners. Projected estimations of advanced practitioners in the population of beyond-entry-level ADA members who are also members of DPGs ranged between 2,126 and 2,640 dietitians (3.5% to 4.3% of the ADA membership).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8423288

  20. Advance Care Planning: practicalities, legalities, complexities and controversies.

    PubMed

    Horridge, Karen A

    2015-04-01

    Increasing numbers, complexities and technology dependencies of children and young people with life-limiting conditions require paediatricians to be well prepared to meet their changing needs. Paediatric Advance Care Planning provides a framework for paediatricians, families and their multidisciplinary teams to consider, reflect and record the outcome of their conversations about what might happen in the future in order to optimise quality of clinical care and inform decision-making. For some children and young people this will include discussions about the possibility of death in childhood. This may be unexpected and sudden, in the context of an otherwise active management plan or may be expected and necessitate discussions about the process of dying and attention to symptoms. Decision-making about appropriate levels of intervention must take place within a legal and ethical framework, recognising that the UK Equality Act (2010) protects the rights of disabled children and young people and infants and children of all ages to the same high quality healthcare as anyone else. PMID:25275088

  1. Psychological Well-Being Revisited: Advances in Science and Practice

    PubMed Central

    Ryff, Carol D.

    2014-01-01

    This article reviews the research and interventions that have grown up around a model of psychological well-being (Ryff, 1989) generated more than two decades ago to address neglected aspects of positive functioning, such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from six thematic areas are examined: (1) how well-being changes across adult development and later life, (2) what are the personality correlates of well-being, (3) how well-being is linked with experiences in family life, (4) how well-being relates to work and other community activities, (5) what are the connections between well-being and health, including biological risk factors, (6) and via clinical and intervention studies, how psychological well-being can be promoted for ever greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience – the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered. PMID:24281296

  2. Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care.

    PubMed

    Fougère, Bertrand; Morley, John E; Decavel, Frédérique; Nourhashémi, Fati; Abele, Patricia; Resnick, Barbara; Rantz, Marilyn; Lai, Claudia Kam Yuk; Moyle, Wendy; Pédra, Maryse; Chicoulaa, Bruno; Escourrou, Emile; Oustric, Stéphane; Vellas, Bruno

    2016-09-01

    Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country. The United States and Canada established "nurse practitioners" (NPs) in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. In other countries, such as Australia, NPs were endorsed more recently in 2000. In France, Belgium, or Singapore, the formal recognition of advanced practice nurses is still in its infancy, whereas in other countries, such as Japan or China, advanced practice nurses are not licensed titles. The aims of this article were to define precisely what is meant by the term "advanced practice nurse (APN)," describe the state of development of APN roles, and review the main factors motivating the implementation of APN in different countries. Then, we examine the main factors that have hindered the development of APN roles. Finally, we explain the need for advanced practice roles in geriatrics. PMID:27321868

  3. Views of newly-qualified GPs about their training and preparedness: lessons for extended generalist training

    PubMed Central

    Sabey, Abigail; Hardy, Holly

    2015-01-01

    Background General practice is becoming increasingly complex due to an ageing population with multiple morbidities and the shift of services from secondary to primary care, yet GP training remains largely the same. Extended training is now recommended, initially proposed as a fourth GP specialty trainee year, but more recently as a broad-based 4-year specialty training programme. Aim To explore the views of newly-qualified GPs about their training and preparedness for specific aspects of the GP’s role. Design and setting Qualitative study with newly-qualified GPs who qualified with Severn Deanery between 2007 and 2010. Method Semi-structured interviews with 18 GPs between November 2011 and April 2012. Results Gaining experience in a variety of primary care environments widens insight into patient populations as well as helping GPs develop adaptability and confidence, although this is not routinely part of GP training. However, alongside variety, having continuity with patients in practice remains important. Opportunities to be involved in the management of a practice or to take on substantial leadership roles also vary widely and this may limit preparedness and development of generalist skills. Conclusion Extended training could help prepare GPs for the current challenges of general practice. It could ensure all trainees are exposed to a greater variety of primary care settings including those outside GP practice, as well as experience of business, finance, and leadership roles. Collectively, these changes have the potential to produce GPs with both generalist and enhanced skills, who are better prepared to work collaboratively across the organisational boundaries between primary, secondary, and community care. PMID:25824188

  4. Advanced technologies in plastic surgery: how new innovations can improve our training and practice.

    PubMed

    Grunwald, Tiffany; Krummel, Thomas; Sherman, Randy

    2004-11-01

    Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering, and popular literature. The goal of this article is to review the emerging intersection between advanced technologies and surgery and how new technology is being utilized in several surgical fields, particularly plastic surgery. The authors also discuss how plastic and reconstructive surgeons can benefit by working to further the development of multimedia and simulated environment technologies in surgical practice and training. PMID:15509950

  5. Pre-participation screening for athletes and the role of advanced practice providers.

    PubMed

    Pickham, David; Chan, Garrett; Carey, Mary

    2015-01-01

    Pre-participation screening of athletes for underlying cardiovascular disease is recommended by the AHA/ACC. However, vigorous debate continues as to whether the ECG should be used as part of a broad-based screening program. The AHA/ACC "do not support national mandatory screening ECGs of athletes, because the logistics, manpower, financial and resource considerations make such a program inapplicable to US". In an effort to address these impediments and to increase access for communities, we explore the use of advanced practice providers (Nurse Practitioners and Physician Assistants) in providing pre-participation screening to athletes with ECG interpretation. In the current healthcare environment with limited primary care resources, advanced practice providers are an important new element in improving access to care. Pre-participation screening with ECG interpretation is currently within an advanced practice provider's scope of practice. Emerging data shows that advanced practice providers perform care that is within acceptable patient care standards, safely, and cost effectively, compared to physician counterparts. To further improve pre-participation screening, a national education and certification program on 12-lead ECG interpretation is needed. Standardized screening tools and mass screening protocols that include screening ECGs for targeted athlete populations who are at high risk for SCD are needed. These recommendations are aimed at addressing some of the barriers raised by the AHA/ACC group to pre-participation screening with ECG. PMID:25791248

  6. Advanced practice nurse entrepreneurs in a multidisciplinary surgical-assisting partnership.

    PubMed

    DeCarlo, Linda

    2005-09-01

    CHANGES IN THE HEALTH CARE environment and reimbursement practices are creating opportunities for nurse entrepreneurs to be partners with other professional nurses and physicians. Advanced practice nurses (APNs) who want to step into an entrepreneurial role must have strong clinical expertise, specific personal characteristics, interpersonal skills, and business acumen. ESTABLISHING A MULTIDISCIPLINARY partnership for providing surgical assisting services has many benefits and presents many challenges. PMID:16309068

  7. Integration of an Introductory Pharmacy Practice Experience With an Advanced Pharmacy Practice Experience in Adult Internal Medicine

    PubMed Central

    Bird, Matthew L.; Vesta, Kimi S.; Harrison, Donald L.; Dennis, Vincent C.

    2012-01-01

    Objective. To describe the development, implementation, and assessment of an internal medicine introductory pharmacy practice experience (IPPE) that was integrated with an existing advanced pharmacy practice experience (APPE) in internal medicine. Design. A structured IPPE was designed for first-, second-, and third-year pharmacy (P1, P2, and P3) students. Activities for the IPPE were based on the established APPE and the individual learner's educational level. Assessment. Students reported a greater understanding of clinical pharmacists’ roles, increased confidence in their clinical skills, and better preparation for APPEs. Peers viewed the approach as innovative and transferable to other practice settings. Participating faculty members provided a greater number of contact hours compared to traditional one-time site visits. Conclusions. Integrating an IPPE with an existing APPE is an effective and efficient way to provide patient care experiences for students in the P1-P3 years in accordance with accreditation standards. PMID:22544969

  8. Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

    PubMed

    Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

    2016-05-01

    This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. PMID:27118546

  9. [Advanced nursing practice: a must for the quality of care and mental health services].

    PubMed

    Ricard, Nicole; Page, Claire; Laflamme, France

    2014-01-01

    New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

  10. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

    PubMed

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

    2015-12-01

    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  11. Faculty rewards for the generalist clinician-teacher.

    PubMed

    Greer, D S

    1990-01-01

    Historically, medicine has regarded itself as a profession of great breadth, encompassing the total range of human activity: biological, behavioral, social and organizational. In the last several decades, however, it has become increasingly reductionist, fragmented, and specialized. Recent developments, as exemplified by the return of the generalist clinician-educator to the academic community, portend a reversal of this trend. Manifestations of a change in the orientation of medicine and medical education toward bolism and bumanism include a movement toward improved compensation for "cognitive" services, development of new promotion tracks for clinician-teachers, and increased support and recognition of applied clinical research. Generalist faculty are in a position to benefit from these trends, but obstacles remain; vigilism and activism are required to maintain momentum. PMID:2303932

  12. Health officials argue that generalists can treat HIV.

    PubMed

    1997-09-01

    AIDS experts continue to debate who is most qualified to care for HIV-positive patients: specialists or generalists. The Federal policy is that HIV is a primary care disease and that primary care physicians can adequately prescribe treatments, but many AIDS specialists say that the complexity of treatments means that most physicians are not equipped to manage AIDS patients. A study published last year in the New England Journal of Medicine showed that patients who were treated by experienced physicians survived longer. New Federal guidelines recommend that primary care physicians consult a specialist or make referrals for complex decisions. However, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease (NIAID), notes that this does not mean that generalists should not treat HIV-positive patients. The Health Resources and Services Administration (HRSA) is currently developing a system of guidelines to ensure that the needs of HIV-positive patients are met by managed care programs. PMID:11364585

  13. A continuum of specialists and generalists in empirical communities.

    PubMed

    Poisot, Timothée; Kéfi, Sonia; Morand, Serge; Stanko, Michal; Marquet, Pablo A; Hochberg, Michael E

    2015-01-01

    Understanding the persistence of specialists and generalists within ecological communities is a topical research question, with far-reaching consequences for the maintenance of functional diversity. Although theoretical studies indicate that restricted conditions may be necessary to achieve co-occurrence of specialists and generalists, analyses of larger empirical (and species-rich) communities reveal the pervasiveness of coexistence. In this paper, we analyze 175 ecological bipartite networks of three interaction types (animal hosts-parasite, plant-herbivore and plant-pollinator), and measure the extent to which these communities are composed of species with different levels of specificity in their biotic interactions. We find a continuum from specialism to generalism. Furthermore, we demonstrate that diversity tends to be greatest in networks with intermediate connectance, and argue this is because of physical constraints in the filling of networks. PMID:25992798

  14. A Continuum of Specialists and Generalists in Empirical Communities

    PubMed Central

    Poisot, Timothée; Kéfi, Sonia; Morand, Serge; Stanko, Michal; Marquet, Pablo A.; Hochberg, Michael E.

    2015-01-01

    Understanding the persistence of specialists and generalists within ecological communities is a topical research question, with far-reaching consequences for the maintenance of functional diversity. Although theoretical studies indicate that restricted conditions may be necessary to achieve co-occurrence of specialists and generalists, analyses of larger empirical (and species-rich) communities reveal the pervasiveness of coexistence. In this paper, we analyze 175 ecological bipartite networks of three interaction types (animal hosts–parasite, plant–herbivore and plant–pollinator), and measure the extent to which these communities are composed of species with different levels of specificity in their biotic interactions. We find a continuum from specialism to generalism. Furthermore, we demonstrate that diversity tends to be greatest in networks with intermediate connectance, and argue this is because of physical constraints in the filling of networks. PMID:25992798

  15. Enhancing Success in Advanced Practice Nursing: a grant-funded project.

    PubMed

    McNeal, Gloria J; Walker, Donita

    2006-01-01

    The Enhancing Success in Advanced Practice Nursing (ESAPN) Project is designed to improve access to a diverse and culturally competent and sensitive health professions workforce by increasing the number of Hispanic, African-American and Asian nurses recruited, enrolled in and graduated from the MSN program at the University of Medicine and Dentistry of New Jersey-School of Nursing (UMDNJ-SN). In addition, the project plan includes the development and implementation of a comprehensive program that incorporates academic support services, career advisement and mentoring activities to retain and graduate an increased number of culturally, racially and ethnically diverse advanced practice nurses for the State of New Jersey. The project also seeks to improve the quality of care by preparing advanced practice nurses to provide culturally competent and sensitive care by assuring that the MSN curriculum includes content and clinical experiences relevant to the development of cultural competence. Faculty participation in workshops, designed to increase knowledge of cultural competence, is a key component. The success of the project will be evaluated using a variety of measures that track increases in the number of diverse students recruited and enrolled, the number of students accessing services associated with the ESAPN program, and increased retention and graduation of Hispanic, African-American and Asian nurses prepared as advanced practice nurses. PMID:16696540

  16. Delta's Key to the TOEFL iBT[R]: Advanced Skill Practice. Revised Edition

    ERIC Educational Resources Information Center

    Gallagher, Nancy

    2012-01-01

    Delta's Key to the TOEFL iBT: Advanced Skill Practice is a revised and updated edition of Delta's Key to the Next Generation TOEFL Test. Since the introduction of the TOEFL iBT in 2005, there have been significant changes to some of the test questions, particularly the integrated writing and integrated speaking tasks. The new 2011 edition of…

  17. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  18. Addressing Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Advanced Practice Nursing Education.

    ERIC Educational Resources Information Center

    Nokes, Kathleen M.; Stein, Gary L.

    1997-01-01

    A survey of 23 advanced practice nursing programs showed only 3 had HIV-specific graduate-level nursing courses. Recommendations were made for HIV-specific courses, integration of HIV content into other courses, use of Centers for Disease Control and Occupational Safety and Health Administration guidelines, and subspecialties in HIV nursing. (SK)

  19. Role performance of psychiatric nurses in advanced practice: a systematic review of the literature.

    PubMed

    Fung, Y L; Chan, Z; Chien, W T

    2014-10-01

    This paper discusses findings from a systematic review of literature pertaining to the role performance of psychiatric nurses in advanced practice. A search of 11 electronic databases was conducted to identify research involving interventions by psychiatric (or mental health) nurses in advanced practice. A total of 14 studies were identified. In this review, the role performance of psychiatric nurses in advanced practice was categorized into three themes: (1) the provision of psychosocial interventions; (2) the provision of nurse-directed services in health-care contexts; and (3) the provision of psychiatric nursing consultation services. Our results document that psychiatric nurses in advanced practice perform multifaceted roles and provide mental health-care services in various contexts. This systematic review reveals that the nurses obtain significant results in managing clients with depression and psychological stress, and demonstrates their value when developing partnerships with non-mental health service providers. One study, however, showed that the nurses had insignificant results in performing transitional care for pre-discharged mental health service users. PMID:24299195

  20. Literacy Agents Online: E-Discussion Forums for Advancing Adults' Literacy Practices

    ERIC Educational Resources Information Center

    Guzzetti, Barbara J.; Foley, Leslie M.

    2014-01-01

    This study explored how adults used a self-selected online forum to advance their own and others' literacy practices. The study was a discourse-centered online ethnography using triangulated methods, including analysis of list archives, semi-structured and informal interviews, and document collection. These data were analyzed by discourse…

  1. Portfolio use as a tool to demonstrate professional development in advanced nursing practice.

    PubMed

    Hespenheide, Molly; Cottingham, Talisha; Mueller, Gail

    2011-01-01

    A concrete way of recognizing and rewarding clinical leadership, excellence in practice, and personal and professional development of the advanced practice registered nurse (APRN) is lacking in the literature and healthcare institutions in the United States. This article presents the process of developing and evaluating a professional development program designed to address this gap. The program uses APRN Professional Performance Standards, Relationship-Based Care, and the Magnet Forces as a guide and theoretical base. A key tenet of the program is the creation of a professional portfolio. Narrative reflections are included that illustrate the convergence of theories. A crosswalk supports this structure, guides portfolio development, and operationalizes the convergence of theories as they specifically relate to professional development in advanced practice. Implementation of the program has proven to be challenging and rewarding. Feedback from APRNs involved in the program supports program participation as a meaningful method to recognize excellence in advanced practice and a clear means to foster ongoing professional growth and development. PMID:22016019

  2. Population-based advanced practice nursing: where does oncology fit in?

    PubMed

    Lattimer, Jennie Greco

    2013-12-01

    A national work group met in 2004 to discuss the future of advanced practice nursing. The representatives were nursing education, certification, accreditation, and regulation experts, and the goal was to develop a consensus model for advanced practice nursing regulation (Nevidjon et al., 2010). As a result, a set of recommendations was published in an article that defined a new consensus model for advanced practice registered nurse (APRN) regulation (APRN Consensus Workgroup, 2008; Goudreau, 2009). The new model included six population-based focuses of practice (i.e., family and individual across the lifespan, adult and gerontology, neonatal, pediatrics, women's health- and gender-related, and psychiatric and mental health) (Johnson, Dawson, & Brassard, 2010). A goal of the new model was to standardize the licensure, certification, and regulation of nurse practitioners into specific focuses. State boards were facing an increasing number of requests to recognize nurse practitioner specialties (e.g., organ specific, body systems, diseases) (Johnson et al., 2010). The new model helped standardize education programs, which may help certifying agencies set up curriculum review processes to ensure appropriate credentials for APRNs (Johnson et al., 2010). It also supported the mission of nursing to meet future healthcare needs of the public and to protect the public (Johnson et al., 2010). Some advantages exist to delineating into population-based focuses, but the new model leaves out many specialties (e.g., oncology) that encompass the whole person as well as concentrate on certain diseases. PMID:24305476

  3. Optimizing Music Learning: Exploring How Blocked and Interleaved Practice Schedules Affect Advanced Performance

    PubMed Central

    Carter, Christine E.; Grahn, Jessica A.

    2016-01-01

    Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the “contextual interference effect.” While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (12 min per piece) and a second concerto exposition and technical excerpt to practice in an interleaved schedule (3 min per piece, alternating until a total of 12 min of practice were completed on each piece). Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated better than those in the blocked schedule

  4. Optimizing Music Learning: Exploring How Blocked and Interleaved Practice Schedules Affect Advanced Performance.

    PubMed

    Carter, Christine E; Grahn, Jessica A

    2016-01-01

    Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the "contextual interference effect." While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (12 min per piece) and a second concerto exposition and technical excerpt to practice in an interleaved schedule (3 min per piece, alternating until a total of 12 min of practice were completed on each piece). Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated better than those in the blocked schedule

  5. Discovering potential sources of emerging pathogens: South America is a reservoir of generalist avian blood parasites.

    PubMed

    Moens, Michaël A J; Pérez-Tris, Javier

    2016-01-01

    Generalist pathogens are capable of infecting a wide range of host species, and may pose serious disease emergence threats if accidentally moved outside their native areas. To date little effort has been devoted to identifying geographic areas that may act as reservoirs of generalist pathogens. According to current theory, where host diversity is high, parasite specialisation in one host species may be penalised by reduced host availability, while generalist parasites may benefit from the exploitation of various host species. Therefore natural selection could favor generalist parasites where host diversity is high. Here we explored if, in a highly diverse bird community in Ecuador, a generalist strategy is promoted among local Haemoproteus and Plasmodium blood-borne parasites compared with similar parasite communities throughout the world. We reconstructed the phylogenetic relationships of every parasite lineage in order to understand the evolution of host specificity in this megadiverse area. We found high levels of host generalisation for both parasite genera, and the mean host range of the Haemoproteus community in Ecuador was significantly higher than other parasite communities in other areas outside the Neotropics. Generalist Haemoproteus parasites in this bird community had diverse phylogenetic ancestry, were closely related to specialist parasites and were apparently endemic to the Amazon, showing that different parasites have independently evolved into host generalists in this region. Finally we show that Haemoproteus communities in Ecuador and South America are more generalist than in temperate areas, making this continent a hotspot of generalist Haemoproteus parasites for wild birds. PMID:26348660

  6. Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

    SciTech Connect

    McCallum, Lindsay C.; Ollson, Christopher A.; Stefanovic, Ingrid L.

    2015-11-15

    Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

  7. Developing a professional poster: four "ps" for advanced practice nurses to consider.

    PubMed

    Bindon, Susan L; Davenport, Joan M

    2013-01-01

    Professional posters play an important role in the dissemination of knowledge and the professional development of advanced practice nurses, graduate students, and clinical faculty. Posters should be considered an integral component in communication of professional work in practice, research, and education. The invitation to submit a poster abstract is an important opportunity for clinicians and faculty alike to consider. Though sometimes misperceived as less prestigious than a podium presentation, posters add a unique element to professional and academic events. The argument is made for posters as an equal among scholarly presentation formats. The poster serves as a tremendous opportunity for collaboration between partners and a way to communicate important findings and advertise the presenters' work. For the advanced practice nurse who is a novice in presenting best practice or evidence from research trials, the poster format may be less intimidating while allowing the invaluable sharing of results. Four critical elements of professional poster development are deciding on a clear Purpose, targeting the right People, outlining key steps in the Process, and delivering a memorable Presentation. Using the "4 Ps" as cornerstones for the work of developing, preparing, and delivering the poster to an audience, the authors aim to help organize the entire process into these essential considerations. The poster, as a means of scholarly work, is a viable and essential activity, as interdisciplinary collaboration and sharing of best practice becomes the expectation for all professional development. PMID:23615014

  8. Impact of new regulatory standards on advanced practice registered nursing: the APRN Consensus Model and LACE.

    PubMed

    Stanley, Joan M

    2012-06-01

    Advanced practice registered nurses (APRNs) represent a crucial resource to meeting growing health care needs. Such resources must be used to the full extent and in the most effective way possible. Through the development of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (LACE), nursing is assuming a leadership role within the health care system and participating as an equal partner in redesigning health care. When fully implemented, the Consensus Model will allow APRNs to practice to the full scope of their education and more easily move from one state to another, increasing access to quality health care for all populations. PMID:22579059

  9. Developing Structured-Learning Exercises for a Community Advanced Pharmacy Practice Experience

    PubMed Central

    Thomas, Renee Ahrens

    2006-01-01

    The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy setting. PMID:17136164

  10. Reflections on ethnocentrism and racism: a challenge for advanced practice nurses.

    PubMed

    Harris, S H; Cummings, S H

    1996-01-01

    As nurses and patient populations increasingly reflect the changing demographics of the United States, it will be necessary for nurses to address the critical issues surrounding a multicultural society. Nurses have been relatively quiet on the topic of ethnocentric and racist behavior. If advanced practice nurses are to be successful in assisting nurses and organizations to embrace cultural diversity, understanding ethnocentric and racist behaviors is key to developing strategies to facilitate the provision of culturally competent care. PMID:9447077

  11. Improving Transitions of Care With an Advanced Practice Nurse: A Pilot Study.

    PubMed

    Hsueh, Martha; Dorcy, Kathleen

    2016-06-01

    Gaps in complex oncology care coordination between inpatient and outpatient settings can result in treatment and monitoring delays and omissions, which can negatively affect patient outcomes. Gaps also exist for patients facing complex treatment modalities and collaborations between multiple care teams working at geographically distant sites. A pilot advanced practice nurse care coordinator 
(APNCC) role to coordinate these complex care transitions and implement processes for safer and more efficient care has shown promise.
. PMID:27206289

  12. Advancing maternal age and trisomy screening: the practice challenges of facilitating choice and gaining consent.

    PubMed

    Birt, Maria

    2015-12-01

    Antenatal screening for chromosomal anomalies such as Trisomy 13, 18 and 21 (Patau's, Edward's and Down's syndrome respectively) is offered to all pregnant women in the first two trimesters.This article explores the varying considerations of consent for this type of screening, particularly in relation to women of advancing age who are at increased risk of carrying a pregnancy affected by a trisomy. The practical challenges or barriers of gaining valid, meaningful informed consent are discussed. PMID:26753259

  13. Advanced practice nursing for enduring health needs management: a global perspective.

    PubMed

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552

  14. Standard practice for reporting uniaxial strength data and estimating Weibull distribution parameters for advanced ceramics

    NASA Astrophysics Data System (ADS)

    1994-04-01

    This practice covers the evaluation and subsequent reporting of uniaxial strength data and the estimation of probability distribution parameters for advanced ceramics that fail in a brittle fashion. The failure strength of advanced ceramics is treated as a continuous random variable. Typically, a number of test specimens with well-defined geometry are failed under well-defined isothermal loading conditions. The load at which each specimen fails is recorded. The resulting failure stresses are used to obtain parameter estimates associated with the underlying population distribution. This practice is restricted to the assumption that the distribution underlying the failure strengths is the two parameter Weibull distribution with size scaling. Furthermore, this practice is restricted to test specimens (tensile, flexural, pressurized ring, etc.) that are primarily subjected to uniaxial stress states. Section 8 outlines methods to correct for bias errors in the estimated Weibull parameters and to calculate confidence bounds on those estimates from data sets where all failures originate from a single flaw population (that is, a single failure mode). In samples where failures originate from multiple independent flaw populations (for example, competing failure modes), the methods outlined in Section 8 for bias correction and confidence bounds are not applicable. Measurements of the strength at failure are taken for one of two reasons: either for a comparison of the relative quality of two materials, or the prediction of the probability of failure (or, alternatively, the fracture strength) for a structure of interest. This practice will permit estimates of the distribution parameters that are needed for either.

  15. Weather Conditions Drive Dynamic Habitat Selection in a Generalist Predator

    PubMed Central

    Sunde, Peter; Thorup, Kasper; Jacobsen, Lars B.; Rahbek, Carsten

    2014-01-01

    Despite the dynamic nature of habitat selection, temporal variation as arising from factors such as weather are rarely quantified in species-habitat relationships. We analysed habitat use and selection (use/availability) of foraging, radio-tagged little owls (Athene noctua), a nocturnal, year-round resident generalist predator, to see how this varied as a function of weather, season and availability. Use of the two most frequently used land cover types, gardens/buildings and cultivated fields varied more than 3-fold as a simple function of season and weather through linear effects of wind and quadratic effects of temperature. Even when controlling for the temporal context, both land cover types were used more evenly than predicted from variation in availability (functional response in habitat selection). Use of two other land cover categories (pastures and moist areas) increased linearly with temperature and was proportional to their availability. The study shows that habitat selection by generalist foragers may be highly dependent on temporal variables such as weather, probably because such foragers switch between weather dependent feeding opportunities offered by different land cover types. An opportunistic foraging strategy in a landscape with erratically appearing feeding opportunities in different land cover types, may possibly also explain decreasing selection of the two most frequently used land cover types with increasing availability. PMID:24516615

  16. Resource assurance predicts specialist and generalist bee activity in drought

    PubMed Central

    Minckley, Robert L.; Roulston, T'ai H.; Williams, Neal M.

    2013-01-01

    Many short-lived desert organisms remain in diapause during drought. Theoretically, the cues desert species use to continue diapause through drought should differ depending on the availability of critical resources, but the unpredictability and infrequent occurrence of climate extremes and reduced insect activity during such events make empirical tests of this prediction difficult. An intensive study of a diverse bee–plant community through a drought event found that bee specialists of a drought-sensitive host plant were absent in the drought year in contrast to generalist bees and to specialist bees of a drought-insensitive host plant. Different responses of bee species to drought indicate that the diapause cues used by bee species allow them to reliably predict host availability. Species composition of the bee community in drought shifted towards mostly generalist species. However, we predict that more frequent and extended drought, predicted by climate change models for southwest North America, will result in bee communities that are species-poor and dominated by specialist species, as found today in the most arid desert region of North America. PMID:23536593

  17. The Interdisciplinary Generalist Curriculum Project: A National Medical School Demonstration Project.

    ERIC Educational Resources Information Center

    Kahn, Norman B., Jr.; And Others

    1995-01-01

    The Interdisciplinary Generalist Curriculum Project was developed to encourage schools of medicine and colleges of osteopathic medicine to implement interdisciplinary generalist curricula in the preclinical years. Five sites were competitively established as demonstration projects, and rigorous attention to creating and maintaining an…

  18. Jumping through "Loops": A Reflective Study on Preparing Generalist Pre-Service Teachers to Teach Music

    ERIC Educational Resources Information Center

    Heyworth, John

    2011-01-01

    Generalist classroom teachers are being given more responsibility for music education in their schools. How confident and competent are they to do this? I find myself in a position where I am expected to train pre-service generalist teachers to be able to facilitate music in their future classrooms within one unit of music study over a four year…

  19. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

    PubMed

    Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-04-25

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

  20. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

    PubMed Central

    Dakkuri, Adnan; Abrons, Jeanine P.; Williams, Dennis; Ombengi, David N.; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O’Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-01-01

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

  1. [Challenges and opportunities: contributions of the Advanced Practice Nurse in the chronicity. Learning from experiences].

    PubMed

    Appleby, Christine; Camacho-Bejarano, Rafaela

    2014-01-01

    Undoubtedly, our society is facing new economic, political, demographic, social and cultural challenges that require healthcare services able to meet the growing health needs of the population, especially in dealing with chronic conditions. In this new context, some countries such as the United Kingdom have made a firm commitment to develop new models for chronic patients care based on the introduction of new figures of Advanced Practice Nurses, which includes 4 cornerstones of professional practice: advanced clinical skills, clinical management, teaching and research. The implementation of this new figures implies a redefinition of professional competencies and has its own accreditation system and a specific catalogue of services adapted to the population requirements, in order to provide chronic care support from Primary Care settings. This trajectory allows us analysing the process of design and implementation of these new models and the organizational structure where it is integrated. In Spain, there are already experiences in some regions such as Andalucia and the Basque Country, focused on the creation of new advanced nursing roles. At present, it is necessary to consider suitable strategic proposals for the complete development of these models and to achieve the best results in terms of overall health and quality of life of patients with chronic conditions, improving the quality of services and cost-effectiveness through a greater cohesion and performance of healthcare teams towards the sustainability of healthcare services and patient satisfaction. PMID:24468497

  2. [How to develop advanced practice nursing in complex health care systems?].

    PubMed

    Lecocq, Dan; Mengal, Yves; Pirson, Magali

    2015-01-01

    Over the last few decades, advanced nursing practitioners (ANP) have developed new roles in health care systems and this tendency is continuing to grow. Postgraduate trainedANP interact directly with the person, i.e. the individual and his/her family - in many fields of practice and in a context of collaboration withfellow nurses and other health care professionals. The potential benefits of ANP interventions have been demonstrated in many fields. In particular, ANP are public health actors, able to participate in the interdisciplinary response to supportive care ofpatients with chronic diseases. However, the development of advanced practice nursing (APN) in a complex health care system requires a systemic approach coordinated with the various levels of training of nursing practitioners and other health care professionals. This is an essential prerequisite to allow ANPs to develop new roles adapted to their capacities (legal qualification, high level, specialist training, modalities of collaboration, etc.). To achieve an added value for patients, for the health care system in terms ofresults and to ensure adequate nursing conditions, the authors emphasize the importance of structured development of APN and propose an awareness phase comprising adoption of a conceptual model of APN and the establishment of a structured list of existing nursing practices in order to prepare a methodical implementation strategy. PMID:26168623

  3. [Triple therapy in cirrhotic patients and those with advanced fibrosis: relevant aspects in clinical practice].

    PubMed

    Albillos, Agustín; Luis Calleja, José; Molina, Esther; Planas, Ramon; Romero-Gómez, Manuel; Turnes, Juan; Hernández-Guerra, Manuel

    2014-07-01

    The first-line option in the treatment of patients with advanced fibrosis and cirrhosis due to genotype 1 hepatitis C virus is currently triple therapy with boceprevir/telaprevir and pegylated interferon-ribavirin. However, certain limitations could constitute a barrier to starting treatment or achieving sustained viral response in these patients. These limitations include the patient's or physician's perception of treatment effectiveness in routine clinical practice-which can weight against the decision to start treatment-, the advanced stage of the disease with portal hypertension and comorbidity, treatment interruption due to poor adherence, and adverse effects, mainly anemia. In addition, it is now possible to identify patients who could benefit from a shorter therapeutic regimen with a similar cure rate. This review discusses these issues and their possible effect on the use of triple therapy. PMID:25907434

  4. Advanced Practice Nursing: Meeting the Caregiving Challenges for Families of Persons with Frontotemporal Dementia

    PubMed Central

    Merrilees, Jennifer; Ketelle, Robin

    2010-01-01

    Frontotemporal dementia (FTD), once thought to be a rare cause for dementia, is now acknowledged to be the most common presenile (before age 65) cause of dementia (1). FTD is associated with profound changes in behavior, personality, emotions, and cognition. The purpose of this paper is to describe two cases of patients with FTD in order to illustrate salient aspects of the caregiving experience. Issues faced by caregivers are organized into 6 categories: diagnosis, behavioral symptoms, function, communication, long term management and care, and maintenance of the caregiver’s emotional and physical health. Examples of interventions directed by advanced practice nurses are described. We suggest that management of FTD requires expertise as scientific advances and discoveries about FTD continually change the landscape of care. PMID:20716977

  5. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

    SciTech Connect

    Not Available

    2013-02-01

    The U.S. Department of Energy developed the K-12 Advanced Energy Retrofit Guide to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. We emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluation of the most promising retrofit measure for each building type. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings.

  6. Seminar for High School Students “Practice on Manufacturing Technology by Advanced Machine Tools”

    NASA Astrophysics Data System (ADS)

    Marui, Etsuo; Yamawaki, Masao; Taga, Yuken; Omoto, Ken'ichi; Miyaji, Reiji; Ogura, Takahiro; Tsubata, Yoko; Sakai, Toshimasa

    The seminar ‘Practice on Manufacturing Technology by Advanced Machine Tools’ for high school students was held at the supporting center for technology education of Gifu University, under the sponsorship of the Japan Society of Mechanical Engineers. This seminar was held, hoping that many students become interested in manufacturing through the experience of the seminar. Operating CNC milling machine and CNC wire-cut electric discharge machine, they made original nameplates. Participants made the program to control CNC machine tools themselves. In this report, some valuable results obtained through such experience are explained.

  7. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance; Grocery Stores (Revised) (Book)

    SciTech Connect

    Hendron, B.

    2013-07-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders successfully plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited in these guides. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. Grocery stores were selected as one of the highest priority sectors, because they represent one of the most energy-intensive market segments.

  8. An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact On Provider and Organizational Outcomes.

    PubMed

    Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly

    2015-01-01

    Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs. PMID:26259336

  9. Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

    PubMed

    Delaney, Colleen; Barrere, Cynthia

    2012-01-01

    The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented. PMID:22694866

  10. Seed dispersal by specialist versus generalist foragers: the plant's perspective

    USGS Publications Warehouse

    Larson, D.L.

    1996-01-01

    I examined the seed dispersal ecology of the stem parasitic plant, desert mistletoe (Phoradendron californicum, Viscaceae), with the objectives of (1) determining the relative effectiveness of specialist and generalist foragers for seed dispersal, (2) determining the extent to which desert mistletoe fruiting characteristics correspond to those predicted for plants attracting specialist versus generalist foragers, and (3) examining the potential consequences of the observed dispersal strategy for mistletoe reproduction. Three species of birds, phainopepla, Gila woodpecker, and northern mockingbird, fed on desert mistletoe at my study site. The specialist, phainopepla, was the most abundant and the most likely to perch in host species, where defecated seeds had a greater probability of lodging in a site suitable for establishment. Gila woodpeckers, although abundant, spent little time in host plants, thus dooming most of the seeds they consumed. Mockingbirds may disperse a small number of seeds, but were abundant enough to consume only a small portion of the available fruits. As expected for plants attracting specialist frugivores, mistletoes produced fruits throughout the 6-month season in which phainopeplas reside in the Sonoran desert. Contrary to expectation, numbers of fruits produced far exceeded the amount that could be consumed by the frugivores at my study site. Fruit crop size was positively related to absolute fruit removal, but not to proportional removal at the scale of the entire study site. However, crop size was positively related to proportional removal within the neighborhood of mistletoes occupying an individual host tree. Frugivores were attracted to infected hosts, host attractiveness increased, although proportional removal of fruit declined, with number of female mistletoes. The observed dispersal ecology of desert mistletoe suggests the likelihood of increasingly clumped distributions of mistletoe plants, as more and more seeds are deposited

  11. Advancing the practice of online psychotherapy: An application of Rogers' diffusion of innovations theory.

    PubMed

    Lovejoy, Travis I; Demireva, Petya D; Grayson, Jessica L; McNamara, John R

    2009-03-01

    With the advancements of technology and its increasing use in all spheres of life, clinicians too are faced with the decision of whether to adopt or refrain from adopting certain innovations in their practice. This article discusses the process of adopting clinical innovations within a theoretical framework, namely diffusion of innovations theory (DIT; Rogers, 2003). DIT constructs are applied to the example of online therapy adoption into clinical practice. Nine adoption barriers are identified, including issues of dehumanizing the therapeutic environment, start-up cost and reimbursement, infrastructure and training, licensure and jurisdiction concerns, ethical guidelines, both client and clinician suitability factors, and professional reputation and acceptance within the field. The authors conclude with a theory-based discussion of activities that may help to accelerate the adoption of online therapy among professional psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved). PMID:22122574

  12. Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

    PubMed

    Farrell, Kathleen; Payne, Camille; Heye, Mary

    2015-01-01

    The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN

  13. Quality of advance care planning policy and practice in residential aged care facilities in Australia

    PubMed Central

    Silvester, William; Fullam, Rachael S; Parslow, Ruth A; Lewis, Virginia J; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Gilchrist, Jane

    2013-01-01

    Objectives To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Design Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. Setting 19 selected RACFs in Victoria. Participants 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Results Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support. Conclusions Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained. PMID:24644755

  14. Research for the advancement of green chemistry practice: Studies in atmospheric and educational chemistry

    NASA Astrophysics Data System (ADS)

    Cullipher, Steven Gene

    Green chemistry is a philosophy of chemistry that emphasizes a decreasing dependence on limited non-renewable resources and an increasing focus on preventing pollution byproducts of the chemical industry. In short, it is the discipline of chemistry practiced through the lens of environmental stewardship. In an effort to advance the practice of green chemistry, three studies will be described that have ramifications for the practice. The first study examines the atmospheric oxidation of a hydrofluorinated ether, a third-generation CFC replacement compound with primarily unknown atmospheric degradation products. Determination of these products has the potential to impact decisions on refrigerant usage in the future. The second study examines chemistry students' development of understanding benefits-costs-risks analysis when presented with two real-world scenarios: refrigerant choice and fuel choice. By studying how benefits-costs-risks thinking develops, curricular materials and instructional approaches can be designed to better foster the development of an ability that is both necessary for green chemists and important in daily decision-making for non-chemists. The final study uses eye tracking technology to examine students' abilities to interpret molecular properties from structural information in the context of global warming. Such abilities are fundamental if chemists are to appropriately assess risks and hazards of chemistry practice.

  15. Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care

    PubMed Central

    Kriebel-Gasparro, Ann Marie

    2016-01-01

    Objective: The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD. Methods: A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening. Results: 89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients. Conclusion: Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders. PMID:27347256

  16. Diversity protects plant communities against generalist molluscan herbivores

    PubMed Central

    Fabian, Yvonne; Sandau, Nadine; Bruggisser, Odile T; Kehrli, Patrik; Aebi, Alexandre; Rohr, Rudolf P; Naisbit, Russell E; Bersier, Louis-Félix

    2012-01-01

    Wildflower strips are used to increase natural enemies of crop pests and to conserve insect diversity on farmland. Mollusks, especially slugs, can affect the vegetation development in these strips considerably. Although recent theoretical work suggests that more diverse plant communities will exhibit greater resistance against herbivore pressure, empirical studies are scarce. We conducted a semi-natural experiment in wildflower strips, manipulating trophic structure (reduction in herbivorous mollusks and reduction in major predators) and plant diversity (2, 6, 12, 20 and 24 sown species). This design allowed us to assess the effect of plant diversity, biomass and composition on mollusks, and vice versa, the effect of mollusc abundance on vegetation. Seven species of mollusks were found in the strips, with the slugs Arion lusitanicus, Deroceras reticulatum and Deroceras panormitanum being most frequent. We found a negative relationship between plant diversity and mollusk abundance, which was due predominantly to a decrease in the agricultural pest species A. lusitanicus. These results are consistent with the hypothesis that plant diversity can reduce the impact of herbivores. However, plant identity also had an effect on mollusks, and accounted for a much larger fraction of the variation in mollusk communities than biodiversity effects. While overall plant diversity decreased during the 3 years of the study, in the final year the highest plant diversity was found in the plots where mollusk populations were experimentally reduced. We conclude that selective feeding by generalist herbivores leads to changes in plant community composition and hence reduced plant diversity. Our results highlight the importance of plant biodiversity as protection against generalist herbivores, which if abundant can in the long term negatively impact plant diversity, driving the system along a “low plant diversity – high mollusk abundance” trajectory. PMID:23145332

  17. How generalist herbivores exploit belowground plant diversity in temperate grasslands

    PubMed Central

    Wallinger, Corinna; Staudacher, Karin; Schallhart, Nikolaus; Mitterrutzner, Evi; Steiner, Eva-Maria; Juen, Anita; Traugott, Michael

    2014-01-01

    Belowground herbivores impact plant performance, thereby inducing changes in plant community composition, which potentially leads to cascading effects onto higher trophic levels and ecosystem processes and productivity. Among soil-living insects, external root-chewing generalist herbivores have the strongest impact on plants. However, the lack of knowledge on their feeding behaviour under field conditions considerably hampers achieving a comprehensive understanding of how they affect plant communities. Here, we address this gap of knowledge by investigating the feeding behaviour of Agriotes click beetle larvae, which are common generalist external root-chewers in temperate grassland soils. Utilizing diagnostic multiplex PCR to assess the larval diet, we examined the seasonal patterns in feeding activity, putative preferences for specific plant taxa, and whether species identity and larval instar affect food choices of the herbivores. Contrary to our hypothesis, most of the larvae were feeding-active throughout the entire vegetation period, indicating that the grassland plants are subjected to constant belowground feeding pressure. Feeding was selective, with members of Plantaginaceae and Asteraceae being preferred; Apiaceae were avoided. Poaceae, although assumed to be most preferred, had an intermediate position. The food preferences exhibited seasonal changes, indicating a fluctuation in plant traits important for wireworm feeding choice. Species- and instar-specific differences in dietary choice of the Agriotes larvae were small, suggesting that species and larval instars occupy the same trophic niche. According to the current findings, the food choice of these larvae is primarily driven by plant identity, exhibiting seasonal changes. This needs to be considered when analysing soil herbivore–plant interactions. PMID:24188592

  18. Difficult-to-manage HIV/AIDS clients with psychiatric illness and substance abuse problems: a collaborative practice with psychiatric advanced practice nurses.

    PubMed

    Morgan, Betty D; Rossi, Anne P

    2007-01-01

    Complex clients with comorbid HIV disease, other medical illness, psychiatric illness, and substance abuse problems present tremendous challenges to providers. Medication adherence and case management become vital issues in providing comprehensive care to this population. This report describes the practice of two advanced practice psychiatric registered nurses who worked collaboratively with each other and with nurse practitioners to provide care to such complex clients. Description of collaborative practices and the model of collaboration used by the two practitioners are highlighted through three case studies. Conclusions about the practice and its use with complex clients are provided. PMID:17991601

  19. Infusing informatics into interprofessional education: the iTEAM (Interprofessional Technology Enhanced Advanced practice Model) project.

    PubMed

    Skiba, Diane J; Barton, Amy J; Knapfel, Sarah; Moore, Gina; Trinkley, Katy

    2014-01-01

    The iTEAM goal is to prepare advanced practice nurses, physicians and pharmacists with the interprofessional (IP) core competencies (informatics, patient centric, quality-focused, evidence based care) to provide technology enhanced collaborative care by: offering technology enhanced learning opportunities through a required informatics course, advanced practice courses (team based experiences with both standardized and virtual patients) and team based clinical experiences including e-health experiences. The innovative features of iTEAM project will be achieved through use of social media strategies, a web accessible Electronic Health Records (EHRs) system, a Virtual Clinic/Hospital in Second Life, various e-health applications including traditional telehealth tools and consumer oriented tools such as patient portals, social media consumer groups and mobile health (m-health) applications for health and wellness functions. It builds upon the schools' rich history of IP education and includes clinical partners, such as the VA and other clinical sites focused on care for underserved patient populations. PMID:24943525

  20. How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

    PubMed Central

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Houttekier, Dirk; Vander Stichele, Robert; Deliens, Luc

    2016-01-01

    Objectives To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice. Methods Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients’ needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of care goals and treatment decisions, (4) the completion of advance directives. Within these themes, ACP was both conceptualised in terms of content of ACP and/or in terms of tasks for the GP. A specific task that was mentioned throughout the discussion of the four different themes was (5) the task of actively initiating ACP by the GP versus passively waiting for patients’ initiation. Conclusions This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. A shared conceptualisation and agreement on the purpose and goals of ACP is needed to ensure successful implementation, as well as a systematic integration of ACP in routine practice that could lead to a better uptake of all the important elements of ACP. PMID:27096846

  1. Mini Review of Integrated Care and Implications for Advanced Practice Nurse Role

    PubMed Central

    McIntosh, Diana; Startsman, Laura F.; Perraud, Suzanne

    2016-01-01

    Literature related to primary care and behavioral health integration initiatives is becoming abundant. The United States’ 2010 Patient Protection and Affordable Care Act included provisions encouraging increased collaboration of care for individuals with behavioral and physical health service needs in the public sector. There is relatively little known of Advanced Practice Registered Nurses’ (APRNs) roles with integrating primary and behavioral healthcare. The goal of this review article is to: (a) define integration of physical and behavioral healthcare and potential models; (b) answer the question as to what are effective evidence based models/strategies for integrating behavioral health and primary care; (c) explore the future role and innovations of APRNs in the integration of physical and behavioral healthcare. Results: The evidence- based literature is limited to three systematic reviews and six randomized controlled trials. It was difficult to generalize the data and the effective integration strategies varied from such interventions as care management to use of sertraline to depression management and to access. There were, though, implications for the integrated care advanced practice nurse to have roles inclusive of competencies, leadership, engagement, collaboration and advocacy. PMID:27347258

  2. Enhancing presentation skills for the advanced practice nurse: strategies for success.

    PubMed

    Vollman, Kathleen M

    2005-01-01

    Professional speaking is a component of the professional practice role of the advanced practice nurse (APN). The skills to communicate effectively to one person or an audience of 100 provide the APN with the essential tools for implementing change, collaborating effectively, presenting information at professional meetings, or communicating the impact of clinical outcomes in the boardroom. Public speaking skills, a professional image, and improved communication can facilitate advancement along any career ladder. The greater your fear, the more self-confidence you will gain by stepping up to a challenge and conquering it. This article describes strategies for organizing and presenting your message in a clear and concise format. Techniques to manage the anxiety produced when attempting to articulate your thoughts is essential for effective communication. Skills for enhancing the delivery of your message through effective body language, professional image, voice modulation, and use of audiovisual aids are addressed. Creative techniques for fielding questions are key in promoting a dynamic closure and provide consistent reinforcement of the key message content. PMID:15714019

  3. Still spending dollars, still searching for sense: advanced practice nursing in an era of regulatory and economic turmoil.

    PubMed

    Safriet, B J

    1998-01-01

    Regulatory and market forces are dramatically affecting the practice prospects for advanced practice nurses (APNs). Examples include the designation of APNs as primary care providers by for-profit capitated systems, the elimination of "geographic" practice boundaries by the advent of telepractice, and the revision of governmental reimbursement provisions for entire categories of APNs. Educational, political, and economic challenges necessitate an increased APN leadership role in national and state policy reform efforts. PMID:9874960

  4. Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

    PubMed

    Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

    2014-07-01

    Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs. PMID:24814999

  5. Health Care Reform and the Federal Transformation Initiatives: Capitalizing on the Potential of Advanced Practice Psychiatric Nurses

    PubMed Central

    Hanrahan, Nancy P.; Delaney, Kathleen; Merwin, Elizabeth

    2012-01-01

    In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed. PMID:21233135

  6. Advancing the quality of oncology nursing care: Interlink Community Cancer Nurses' model for reflective practice.

    PubMed

    Howell, D; Pelton, B

    2001-01-01

    Since 1996, Interlink Community Cancer Nurses have been using reflective practice as a team to share knowledge and experience amongst peers. The use of reflective practice enables the nurse to examine decision-making in patient situations and uncover the knowledge and artistry that is embedded in nursing practice. This article describes how reflection is practised by specialist cancer nurses to advance the quality of caregiving. The use of a structured framework for reflection which incorporates ways of knowing in nursing is an essential feature of the Interlink model for reflection. The development of a process for reflection within the Interlink program has at times been challenging. However, the Interlink nurses' experience with reflection is believed to be critical to the ongoing development of the program and the individual nurse. Interlink nurses have found that guided reflection, the creation of an environmental milieu for reflection and personal knowing, and self-evaluation are critical to the process of becoming a self-reflective practitioner. PMID:11842450

  7. Advances and Best Practices in Airborne Gravimetry from the U.S. GRAV-D Project

    NASA Astrophysics Data System (ADS)

    Diehl, Theresa; Childers, Vicki; Preaux, Sandra; Holmes, Simon; Weil, Carly

    2013-04-01

    The Gravity for the Redefinition of the American Vertical Datum (GRAV-D) project, an official policy of the U.S. National Geodetic Survey as of 2007, is working to survey the entire U.S. and its holdings with high-altitude airborne gravimetry. The goal of the project is to provide a consistent, high-quality gravity dataset that will become the cornerstone of a new gravimetric geoid and national vertical datum in 2022. Over the last five years, the GRAV-D project has surveyed more than 25% of the country, accomplishing almost 500 flights on six different aircraft platforms and producing more than 3.7 Million square km of data thus far. This wealth of experience has led to advances in the collection, processing, and evaluation of high-altitude (20,000 - 35,000 ft) airborne gravity data. This presentation will highlight the most important practical and theoretical advances of the GRAV-D project, giving an introduction to each. Examples of innovation include: 1. Use of navigation grade inertial measurement unit data and precise lever arm measurements for positioning; 2. New quality control tests and software for near real-time analysis of data in the field; 3. Increased accuracy of gravity post-processing by reexamining assumptions and simplifications that were inconsistent with a goal of 1 mGal precision; and 4. Better final data evaluation through crossovers, additional statistics, and inclusion of airborne data into harmonic models that use EGM08 as a base model. The increases in data quality that resulted from implementation of the above advances (and others) will be shown with a case study of the GRAV-D 2008 southern Alaska survey near Anchorage, over Cook Inlet. The case study's statistics and comparisons to global models illustrate the impact that these advances have had on the final airborne gravity data quality. Finally, the presentation will summarize the best practices identified by the project from its last five years of experience.

  8. Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

    NASA Astrophysics Data System (ADS)

    Faruque, F. S.; Finley, R. W.

    2016-06-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

  9. Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.

    PubMed

    Lall, Maureen Patricia

    2014-12-01

    Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan. Such prescribing necessitates careful patient selection; informed consent; prudent opioid dosing and titration; and monitoring for response to treatment, adverse effects, and aberrant drug-taking behavior. Treatment and regulatory guidelines can assist APRNs in providing safe and effective care to patients with chronic low back pain. PMID:25365050

  10. Interactive Web-based Learning Modules Prior to General Medicine Advanced Pharmacy Practice Experiences

    PubMed Central

    Walton, Alison M.; Nisly, Sarah A.

    2015-01-01

    Objective. To implement and evaluate interactive web-based learning modules prior to advanced pharmacy practice experiences (APPEs) on inpatient general medicine. Design. Three clinical web-based learning modules were developed for use prior to APPEs in 4 health care systems. The aim of the interactive modules was to strengthen baseline clinical knowledge before the APPE to enable the application of learned material through the delivery of patient care. Assessment. For the primary endpoint, postassessment scores increased overall and for each individual module compared to preassessment scores. Postassessment scores were similar among the health care systems. The survey demonstrated positive student perceptions of this learning experience. Conclusion. Prior to inpatient general medicine APPEs, web-based learning enabled the standardization and assessment of baseline student knowledge across 4 health care systems. PMID:25995515

  11. Tracking Patient Encounters and Clinical Skills to Determine Competency in Ambulatory Care Advanced Pharmacy Practice Experiences

    PubMed Central

    Pereira, Chrystian R.; Harris, Ila M.; Moon, Jean Y.; Westberg, Sarah M.; Kolar, Claire

    2016-01-01

    Objective. To determine if the amount of exposure to patient encounters and clinical skills correlates to student clinical competency on ambulatory care advanced pharmacy practice experiences (APPEs). Design. Students in ambulatory care APPEs tracked the number of patients encountered by medical condition and the number of patient care skills performed. At the end of the APPE, preceptors evaluated students’ competency for each medical condition and skill, referencing the Dreyfus model for skill acquisition. Assessment. Data was collected from September 2012 through August 2014. Forty-six responses from a student tracking tool were matched to preceptor ratings. Students rated as competent saw more patients and performed more skills overall. Preceptors noted minimal impact on workload. Conclusions. Increased exposure to patient encounters and skills performed had a positive association with higher Dreyfus stage, which may represent a starting point in the conversation for more thoughtful design of ambulatory care APPEs. PMID:26941440

  12. Impact of Instruction and Feedback on Reflective Responses during an Ambulatory Care Advanced Pharmacy Practice Experience.

    PubMed

    Teply, Robyn; Spangler, Mikayla; Klug, Laura; Tilleman, Jennifer; Coover, Kelli

    2016-06-25

    Objective. To investigate whether instruction and feedback on reflective responses are beneficial in developing pharmacy students to become more reflective practitioners. Methods. Students on an advanced pharmacy practice experience answered weekly reflection questions and were randomly assigned to either an intervention (received instruction and feedback on reflection) or control group. The final week's responses were de-identified and two blinded faculty members independently categorized them as reflective or nonreflective. The primary outcome measure was comparing the number of "reflective" responses in each group. Results. The responses were classified as reflective in 83.3% of students in the intervention group (n=18) compared to 37.5% of the control group (n=16). The odds that the response was categorized as reflective were 8.3 times higher in the intervention group. Conclusion. Providing instruction and feedback to students improved the likelihood that their work was reflective. PMID:27402984

  13. An Advanced Pharmacy Practice Experience in a Student-Staffed Medication Therapy Management Call Center

    PubMed Central

    Hall, Anna M.; Roane, Teresa E.; Mistry, Reena

    2012-01-01

    Objective. To describe the implementation of an advanced pharmacy practice experience (APPE) in medication therapy management (MTM) designed to contribute to student pharmacists’ confidence and abilities in providing MTM. Design. Sixty-four student pharmacists provided MTM services during an APPE in a communication and care center. Assessment. Students conducted 1,495 comprehensive medication reviews (CMRs) identifying 6,056 medication-related problems. Ninety-eight percent of the students who completed a survey instrument (52 of 53) following the APPE expressed that they had the necessary knowledge and skills to provide MTM services. Most respondents felt that pharmacist participation in providing Medicare MTM could move the profession of pharmacy forward and that pharmacists will have some role in deciding the specific provisions of the Medicare MTM program (92% and 91%, respectively). Conclusion. Students completing the MTM APPE received patient-centered experiences that supplemented their confidence, knowledge, and skill in providing MTM services in the future. PMID:22919086

  14. Impact of Instruction and Feedback on Reflective Responses during an Ambulatory Care Advanced Pharmacy Practice Experience

    PubMed Central

    Spangler, Mikayla; Klug, Laura; Tilleman, Jennifer; Coover, Kelli

    2016-01-01

    Objective. To investigate whether instruction and feedback on reflective responses are beneficial in developing pharmacy students to become more reflective practitioners. Methods. Students on an advanced pharmacy practice experience answered weekly reflection questions and were randomly assigned to either an intervention (received instruction and feedback on reflection) or control group. The final week’s responses were de-identified and two blinded faculty members independently categorized them as reflective or nonreflective. The primary outcome measure was comparing the number of “reflective” responses in each group. Results. The responses were classified as reflective in 83.3% of students in the intervention group (n=18) compared to 37.5% of the control group (n=16). The odds that the response was categorized as reflective were 8.3 times higher in the intervention group. Conclusion. Providing instruction and feedback to students improved the likelihood that their work was reflective. PMID:27402984

  15. The Role of the Medical School Admission Process in the Production of Generalist Physicians.

    ERIC Educational Resources Information Center

    Rabinowitz, Howard K.

    1999-01-01

    Discusses the medical student characteristics associated with graduates' entering generalist careers, including initial specialty preference, geographic background, gender, age, ethnicity, economic/lifestyle factors, attitudes and personal values, service orientation, and premedical academic performance. Presents strategies medical schools can use…

  16. Host suitability affects odor association in Cotesia marginiventris: implications in generalist parasitoid host-finding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Insect herbivores often induce plant volatile compounds that can attract natural enemies. Cotesia marginiventris (Hymenoptera: Braconidae) is a generalist parasitoid wasp of noctuid caterpillars and is highly attracted to Spodoptera exigua-induced plant volatiles. The plasticity of C. marginiventris...

  17. A survey to determine current practice patterns in the surgical treatment of advanced thumb carpometacarpal osteoarthrosis

    PubMed Central

    Brunton, Lance M.

    2010-01-01

    Background The purpose of this study was to determine current practice patterns and examine the influence of recent evidence in the surgical treatment of advanced thumb carpometacarpal (CMC) osteoarthrosis. Methods A survey was sent to 2,536 American Society for Surgery of the Hand members. Information regarding specialty training, years of experience, annual cases performed, treatment of choice, technique, and postoperative immobilization was collected. Respondents were asked whether their current treatment of choice differs from what they performed 5 years ago and about the importance of ligament reconstruction and “interposition” to thumb CMC arthroplasty success. Results One thousand twenty-four respondents completed the survey (40% response rate). Treatment of choice was trapeziectomy with ligament reconstruction and tendon interposition (68%), regardless of specialty training, years of experience, and annual cases performed. Over 70% favored treatment that was not different from what they performed 5 years ago. Less than 3% of respondents perform a trapeziectomy alone; only 14 surgeons have changed to this procedure in the last 5 years. Only 35% of the 822 respondents who perform a ligament reconstruction and 14% of the 764 respondents who perform an interposition believe those techniques are “extremely important” to thumb CMC arthroplasty success. Conclusions Despite recent evidence that suggests neither ligament reconstruction nor tendon interposition confers any additional benefit over trapeziectomy alone, few respondents have converted to the simpler procedure. Either the current evidence is not convincing enough to drastically change practice patterns, or other factors apart from this evidence have a greater influence on surgical decision-making for advanced thumb CMC osteoarthrosis. Electronic supplementary material The online version of this article (doi:10.1007/s11552-010-9275-7) contains supplementary material, which is available to

  18. Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet

    PubMed Central

    URIBARRI, JAIME; WOODRUFF, SANDRA; GOODMAN, SUSAN; CAI, WEIJING; CHEN, XUE; PYZIK, RENATA; YONG, ANGIE; STRIKER, GARY E.; VLASSARA, HELEN

    2013-01-01

    Modern diets are largely heat-processed and as a result contain high levels of advanced glycation end products (AGEs). Dietary advanced glycation end products (dAGEs) are known to contribute to increased oxidant stress and inflammation, which are linked to the recent epidemics of diabetes and cardiovascular disease. This report significantly expands the available dAGE database, validates the dAGE testing methodology, compares cooking procedures and inhibitory agents on new dAGE formation, and introduces practical approaches for reducing dAGE consumption in daily life. Based on the findings, dry heat promotes new dAGE formation by >10- to 100-fold above the uncooked state across food categories. Animal-derived foods that are high in fat and protein are generally AGE-rich and prone to new AGE formation during cooking. In contrast, carbohydrate-rich foods such as vegetables, fruits, whole grains, and milk contain relatively few AGEs, even after cooking. The formation of new dAGEs during cooking was prevented by the AGE inhibitory compound aminoguanidine and significantly reduced by cooking with moist heat, using shorter cooking times, cooking at lower temperatures, and by use of acidic ingredients such as lemon juice or vinegar. The new dAGE database provides a valuable instrument for estimating dAGE intake and for guiding food choices to reduce dAGE intake. PMID:20497781

  19. Advanced glycation end products in foods and a practical guide to their reduction in the diet.

    PubMed

    Uribarri, Jaime; Woodruff, Sandra; Goodman, Susan; Cai, Weijing; Chen, Xue; Pyzik, Renata; Yong, Angie; Striker, Gary E; Vlassara, Helen

    2010-06-01

    Modern diets are largely heat-processed and as a result contain high levels of advanced glycation end products (AGEs). Dietary advanced glycation end products (dAGEs) are known to contribute to increased oxidant stress and inflammation, which are linked to the recent epidemics of diabetes and cardiovascular disease. This report significantly expands the available dAGE database, validates the dAGE testing methodology, compares cooking procedures and inhibitory agents on new dAGE formation, and introduces practical approaches for reducing dAGE consumption in daily life. Based on the findings, dry heat promotes new dAGE formation by >10- to 100-fold above the uncooked state across food categories. Animal-derived foods that are high in fat and protein are generally AGE-rich and prone to new AGE formation during cooking. In contrast, carbohydrate-rich foods such as vegetables, fruits, whole grains, and milk contain relatively few AGEs, even after cooking. The formation of new dAGEs during cooking was prevented by the AGE inhibitory compound aminoguanidine and significantly reduced by cooking with moist heat, using shorter cooking times, cooking at lower temperatures, and by use of acidic ingredients such as lemon juice or vinegar. The new dAGE database provides a valuable instrument for estimating dAGE intake and for guiding food choices to reduce dAGE intake. PMID:20497781

  20. Design and Implementation of a Laboratory-Based Drug Design and Synthesis Advanced Pharmacy Practice Experience

    PubMed Central

    Philip, Ashok; Stephens, Mark; Mitchell, Sheila L.

    2015-01-01

    Objective. To provide students with an opportunity to participate in medicinal chemistry research within the doctor of pharmacy (PharmD) curriculum. Design. We designed and implemented a 3-course sequence in drug design or drug synthesis for pharmacy students consisting of a 1-month advanced elective followed by two 1-month research advanced pharmacy practice experiences (APPEs). To maximize student involvement, this 3-course sequence was offered to third-year and fourth-year students twice per calendar year. Assessment. Students were evaluated based on their commitment to the project’s success, productivity, and professionalism. Students also evaluated the course sequence using a 14-item course evaluation rubric. Student feedback was overwhelmingly positive. Students found the experience to be a valuable component of their pharmacy curriculum. Conclusion. We successfully designed and implemented a 3-course research sequence that allows PharmD students in the traditional 4-year program to participate in drug design and synthesis research. Students report the sequence enhanced their critical-thinking and problem-solving skills and helped them develop as independent learners. Based on the success achieved with this sequence, efforts are underway to develop research APPEs in other areas of the pharmaceutical sciences. PMID:25995518

  1. Advanced Energy Retrofit Guide (AERG): Practical Ways to Improve Energy Performance; Healthcare Facilities (Book)

    SciTech Connect

    Hendron, R.; Leach, M.; Bonnema, E.; Shekhar, D.; Pless, S.

    2013-09-01

    The Advanced Energy Retrofit Guide for Healthcare Facilities is part of a series of retrofit guides commissioned by the U.S. Department of Energy. By presenting general project planning guidance as well as detailed descriptions and financial payback metrics for the most important and relevant energy efficiency measures (EEMs), the guides provide a practical roadmap for effectively planning and implementing performance improvements in existing buildings. The Advanced Energy Retrofit Guides (AERGs) are intended to address key segments of the U.S. commercial building stock: retail stores, office buildings, K-12 schools, grocery stores, and healthcare facilities. The guides' general project planning considerations are applicable nationwide; the energy and cost savings estimates for recommended EEMs were developed based on energy simulations and cost estimates for an example hospital tailored to five distinct climate regions. These results can be extrapolated to other U.S. climate zones. Analysis is presented for individual EEMs, and for packages of recommended EEMs for two project types: existing building commissioning projects that apply low-cost and no-cost measures, and whole-building retrofits involving more capital-intensive measures.

  2. Differences Between Generalists and Specialists in Characteristics of Patients Receiving Gastrointestinal Procedures

    PubMed Central

    Meyer, Gregg S; Cheng, Eme Y; Elting, Jeffrey

    2000-01-01

    BACKGROUND As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications when gastrointestinal endoscopic procedures were provided by generalists versus specialists. DESIGN Retrospective cohort study. PATIENTS A random 5% sample of aged Medicare beneficiaries who underwent rigid and flexible sigmoidoscopy, colonoscopy, and esophagogastroduodenoscopy (EGD) performed by specialists (gastroenterologists, general surgeons, and colorectal surgeons) or generalists (general practitioners, family practitioners, and general internists). MEASUREMENTS Characteristics of patients, indications for the procedure, procedural complexity, and place of service were compared between generalists and specialists using descriptive statistics and logistic regression. MAIN RESULTS Our sample population had 167,347 gastrointestinal endoscopies. Generalists performed 7.7% of the 57,221 colonoscopies, 8.7% of the 62,469 EGDs, 42.7% of the 38,261 flexible sigmoidoscopies, and 35.2% of the 9,396 rigid sigmoidoscopies. Age and gender of patients were similar between generalists and specialists, but white patients were more likely to receive complex endoscopy from specialists. After adjusting for patient differences in age, race, and gender, generalists were more likely to have provided a simple diagnostic procedure (odds ratio [OR] 4.2; 95% confidence interval [95% CI] 4.0, 4.4), perform the procedure for examination and screening purposes (OR 4.9; 95% CI, 4.3 to 5.6), and provide these procedures in rural areas (OR 1.5; 95% CI 1.4 to 1.6). CONCLUSIONS Although generalists perform the full spectrum of gastrointestinal endoscopies, their procedures are often of lower complexity and less likely to have been performed for investigating severe morbidities

  3. Introductory and Advanced Pharmacy Practice Experiences Within Campus-based Influenza Clinics

    PubMed Central

    Johnson, Eric J.; Hagemann, Tracy M.

    2013-01-01

    Objective. To describe the development, implementation, and assessment of an introductory and an advanced pharmacy practice experience (IPPE and APPE) integrated within campus-based influenza clinics. Design. The influenza clinics were designed to incorporate the learning objectives for the IPPE and APPE, and included preparatory sessions, online learning, and direct patient interactions tailored to the appropriate education level of the learner. Assessment. The clinics provided influenza vaccinations to 2,292 and 2,877 individuals in 2010 and 2011, respectively. The clinics allowed for experiential education of 39 students earning a total of 467 IPPE and APPE hours in 2010 and 58 students earning a total of 656 IPPE and APPE hours in 2011. Third-year students were assessed before and after completing the IPPE, and improvement was seen in knowledge and self-ratings of perceptions and attitudes toward administering immunizations. Conclusions. Integrating pharmacy practice experiences within campus-based influenza clinics was an effective way to provide students with direct patient care experience and preventive health services knowledge. PMID:23610479

  4. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

    SciTech Connect

    Not Available

    2013-12-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit energy efficiency measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings nationwide. U.S. K-12 school districts spend more than $8 billion each year on energy - more than they spend on computers and textbooks combined. Most occupy older buildings that often have poor operational performance - more than 30% of schools were built before 1960. The average age of a school is about 42 years - which is nearly the expected serviceable lifespan of the building. K-12 schools offer unique opportunities for deep, cost-effective energy efficiency improvements, and this guide provides convenient and practical guidance for exploiting these opportunities in the context of public, private, and parochial schools.

  5. Assessing the productivity of advanced practice providers using a time and motion study.

    PubMed

    Ogunfiditimi, Folusho; Takis, Lisa; Paige, Virginia J; Wyman, Janet F; Marlow, Elissa

    2013-01-01

    The Resource-Based Relative Value Scale is widely used to measure healthcare provider productivity and to set payment standards. The scale, however, is limited in its assessment of pre- and postservice work and other potentially non-revenue-generating healthcare services, what we have termed service-valued activity (SVA). In an attempt to quantify SVA, we conducted a time and motion study of providers to assess their productivity in inpatient and outpatient settings. Using the Standard Time and Motion Procedures checklist as a methodological guide, we provided personal digital assistants (PDAs) that were prepopulated with 2010 Current Procedural Terminology codes to 19 advanced practice providers (APPs). The APPs were instructed to identify their location and activity each time the PDA randomly alarmed. The providers collected data for 3 to 5 workdays, and those data were separated into revenue-generating services (RGSs) and SVAs. Multiple inpatient and outpatient departments were assessed. The inpatient APPs spent 61.6 percent of their time on RGSs and 35.1 percent on SVAs. Providers in the outpatient settings spent 59.0 percent of their time on RGSs and 38.2 percent on SVAs. This time and motion study demonstrated an innovative method and tool for the quantification and analysis of time spent on revenue- and non-revenue-generating services provided by healthcare professionals. The new information derived from this study can be used to accurately document productivity, determine clinical practice patterns, and improve deployment strategies of healthcare providers. PMID:23821897

  6. Positioning advanced practice registered nurses for health care reform: consensus on APRN regulation.

    PubMed

    Stanley, Joan M; Werner, Kathryn E; Apple, Kathy

    2009-01-01

    Advanced practice registered nurses (APRNs) have positioned themselves to serve an integral role in national health care reform. This article addresses both the policy and the process to develop this policy that has placed them in a strategic position. A successful transformation of the nation's health system will require utilization of all clinicians, particularly primary care providers, to the full extent of their education and scope of practice. APRNs are highly qualified clinicians who provide cost-effective, accessible, patient-centered care and have the education to provide the range of services at the heart of the reform movement, including care coordination, chronic care management, and wellness and preventive care. The APRN community faces many challenges amidst the opportunities of health reform. However, the APRN community's triumph in reaching consensus on APRN regulation signifies a cohesive approach to overcoming the obstacles. The consensus model for APRN regulation, endorsed by 44 national nursing organizations, will serve as a beacon for nursing, as well as a guidepost for consumers and policymakers, on titling, education, certification, accreditation, and licensing for all four APRN roles. PMID:19942200

  7. Recent advances toward the practical application of embryo transfer in pigs.

    PubMed

    Martinez, Emilio A; Cuello, Cristina; Parrilla, Inmaculada; Martinez, Cristina A; Nohalez, Alicia; Vazquez, Jose L; Vazquez, Juan M; Roca, Jordi; Gil, Maria A

    2016-01-01

    Porcine embryo transfer (ET) technology has been in demand for decades because of its potential to provide considerable improvements in pig production with important sanitary, economic, and animal welfare benefits. Despite these advantages, the commercial use of ET is practically nonexistent. However, the two main obstacles hindering the commercial use of ET in pigs in the past several decades (i.e., surgical transfer and embryo preservation) have recently been overcome. A technique for nonsurgical deep-uterine (NsDU) ET of nonsedated gilts and sows, which was seemingly an impossible challenge just a few years ago, is a reality today. The improvements in embryo preservation that have been achieved in recent years and the excellent reproductive performance of the recipients after the NsDU-ET technique coupled with short-term and long-term-stored embryos represent essential progress for the international trade of porcine embryos and the practical use of ET by the pig industry. This review focuses, with an emphasis on our own findings, on the recent advances in embryo preservation and NsDU-ET technologies, which are starting to show potential for application under field conditions. PMID:26164803

  8. Discovering the nature of advanced nursing practice in high dependency care: a critical care nurse consultant's experience.

    PubMed

    Fairley, Debra

    2005-06-01

    This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described. PMID:15907666

  9. Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice

    PubMed Central

    Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim

    2014-01-01

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193

  10. Toward Advancing Nano-Object Count Metrology: A Best Practice Framework

    PubMed Central

    Boyko, Volodymyr; Meyers, Greg; Voetz, Matthias; Wohlleben, Wendel

    2013-01-01

    Background: A movement among international agencies and policy makers to classify industrial materials by their number content of sub–100-nm particles could have broad implications for the development of sustainable nanotechnologies. Objectives: Here we highlight current particle size metrology challenges faced by the chemical industry due to these emerging number percent content thresholds, provide a suggested best-practice framework for nano-object identification, and identify research needs as a path forward. Discussion: Harmonized methods for identifying nanomaterials by size and count for many real-world samples do not currently exist. Although particle size remains the sole discriminating factor for classifying a material as “nano,” inconsistencies in size metrology will continue to confound policy and decision making. Moreover, there are concerns that the casting of a wide net with still-unproven metrology methods may stifle the development and judicious implementation of sustainable nanotechnologies. Based on the current state of the art, we propose a tiered approach for evaluating materials. To enable future risk-based refinements of these emerging definitions, we recommend that this framework also be considered in environmental and human health research involving the implications of nanomaterials. Conclusion: Substantial scientific scrutiny is needed in the area of nanomaterial metrology to establish best practices and to develop suitable methods before implementing definitions based solely on number percent nano-object content for regulatory purposes. Strong cooperation between industry, academia, and research institutions will be required to fully develop and implement detailed frameworks for nanomaterial identification with respect to emerging count-based metrics. Citation: Brown SC, Boyko V, Meyers G, Voetz M, Wohlleben W. 2013. Toward advancing nano-object count metrology: a best practice framework. Environ Health Perspect 121:1282–1291;

  11. Faba bean forisomes can function in defence against generalist aphids.

    PubMed

    Medina-Ortega, Karla J; Walker, Gregory P

    2015-06-01

    Phloem sieve elements have shut-off mechanisms that prevent loss of nutrient-rich phloem sap when the phloem is damaged. Some phloem proteins such as the proteins that form forisomes in legume sieve elements are one such mechanism and in response to damage, they instantly form occlusions that stop the flow of sap. It has long been hypothesized that one function of phloem proteins is defence against phloem sap-feeding insects such as aphids. This study provides the first experimental evidence that aphid feeding can induce phloem protein occlusion and that the aphid-induced occlusions inhibit phloem sap ingestion. The great majority of phloem penetrations in Vicia faba by the generalist aphids Myzus persicae and Macrosiphum euphorbiae triggered forisome occlusion and the aphids eventually withdrew their stylets without ingesting phloem sap. This contrasts starkly with a previous study on the legume-specialist aphid, Acyrthosiphon pisum, where penetration of faba bean sieve elements did not trigger forisome occlusion and the aphids readily ingested phloem sap. Next, forisome occlusion was demonstrated to be the cause of failed phloem ingestion attempts by M. persicae: when occlusion was inhibited by the calcium channel blocker lanthanum, M. persicae readily ingested faba bean phloem sap. PMID:25311512

  12. Generalist genes and cognitive abilities in Chinese twins.

    PubMed

    Chow, Bonnie Wing-Yin; Ho, Connie Suk-Han; Wong, Simpson Wai-Lap; Waye, Mary M Y; Bishop, Dorothy V M

    2013-03-01

    This study considered how far nonverbal cognitive, language and reading abilities are affected by common genetic influences in a sample of 312 typically developing Chinese twin pairs aged from 3 to 11 years. Children were individually given tasks of Chinese word reading, receptive vocabulary, phonological memory, tone awareness, syllable and rhyme awareness, rapid automatized naming, morphological awareness and orthographic skills, and Raven's Colored Progressive Matrices. Factor analyses on the verbal tasks adjusted for age indicated two factors: Language as the first factor and Reading as the second factor. Univariate genetic analyses indicated that genetic influences were substantial for nonverbal cognitive ability and moderate for language and reading. Multivariate genetic analyses showed that nonverbal cognitive ability, language and reading were influenced by shared genetic origins, although there were specific genetic influences on verbal skills that were distinct from those on nonverbal cognitive ability. This study extends the Generalist Genes Hypothesis to Chinese language and reading skills, suggesting that the general effects of genes could be universal across languages. PMID:23432835

  13. Explaining postnatal growth plasticity in a generalist brood parasite

    NASA Astrophysics Data System (ADS)

    Remeš, Vladimír

    2010-03-01

    Selection of a particular host has clear consequences for the performance of avian brood parasites. Experimental studies showed that growth rate and fledging mass of brood parasites varied between host species independently of the original host species. Finding correlates of this phenotypic plasticity in growth is important for assessing adaptiveness and potential fitness consequences of host choice. Here, I analyzed the effects of several host characteristics on growth rate and fledging mass of the young of brown-headed cowbird ( Molothrus ater), a generalist, non-evicting brood parasite. Cowbird chicks grew better in fast-developing host species and reached higher fledging mass in large hosts with fast postnatal development. A potential proximate mechanism linking fast growth and high fledging mass of cowbird with fast host development is superior food supply in fast-developing foster species. So far, we know very little about the consequences of the great plasticity in cowbird growth for later performance of the adult parasite. Thus, cowbird species could become interesting model systems for investigating the role of plasticity and optimization in the evolution of growth rate in birds.

  14. Impulsive spatial control of invading pests by generalist predators.

    PubMed

    Aniţa, Sebastian; Casas, Jérôme; Suppo, Christelle

    2014-09-01

    We model the conditions for pest eradication in a reaction-diffusion system made of a prey and a generalist predator through spatial impulsive control within a bounded domain. The motivating example is the control of the invasive horse chestnut leafminer moth through the yearly destruction of leaves in autumn, in which both the pest and its parasitoids overwinter. The model is made of two integro-partial differential equations, the integral portion describing the within-year immigration from the whole domain. The problem of pest eradication is strongly related to some appropriate eigenvalue problems. Basic properties of the principal eigenvalues of these problems are derived by using of Krein-Rutman's theorem and of comparison results for parabolic equations with non-local terms. Spatial control of the pest can be achieved, if one of these principal eigenvalues is large enough, at an exponential rate. This is true without and with parasitoids, the latter case being of course more rapid. We discuss the possible implementation of these results to the leafminer invasion problem and discuss complementary methods. PMID:23788257

  15. Costs of resistance and infection by a generalist pathogen.

    PubMed

    Dallas, Tad; Holtackers, Mathieu; Drake, John M

    2016-03-01

    Pathogen infection is typically costly to hosts, resulting in reduced fitness. However, pathogen exposure may also come at a cost even if the host does not become infected. These fitness reductions, referred to as "resistance costs", are inducible physiological costs expressed as a result of a trade-off between resistance to a pathogen and aspects of host fitness (e.g., reproduction). Here, we examine resistance and infection costs of a generalist fungal pathogen (Metschnikowia bicuspidata) capable of infecting a number of host species. Costs were quantified as reductions in host lifespan, total reproduction, and mean clutch size as a function of pathogen exposure (resistance cost) or infection (infection cost). We provide empirical support for infection costs and modest support for resistance costs for five Daphnia host species. Specifically, only one host species examined incurred a significant cost of resistance. This species was the least susceptible to infection, suggesting the possibility that host susceptibility to infection is associated with the detectability and size of resistance cost. Host age at the time of pathogen exposure did not influence the magnitude of resistance or infection cost. Lastly, resistant hosts had fitness values intermediate between unexposed control hosts and infected hosts. Although not statistically significant, this could suggest that pathogen exposure does come at some marginal cost. Taken together, our findings suggest that infection is costly, resistance costs may simply be difficult to detect, and the magnitude of resistance cost may vary among host species as a result of host life history or susceptibility. PMID:26929813

  16. White-nose syndrome fungus: a generalist pathogen of hibernating bats.

    PubMed

    Zukal, Jan; Bandouchova, Hana; Bartonicka, Tomas; Berkova, Hana; Brack, Virgil; Brichta, Jiri; Dolinay, Matej; Jaron, Kamil S; Kovacova, Veronika; Kovarik, Miroslav; Martínková, Natália; Ondracek, Karel; Rehak, Zdenek; Turner, Gregory G; Pikula, Jiri

    2014-01-01

    Host traits and phylogeny can determine infection risk by driving pathogen transmission and its ability to infect new hosts. Predicting such risks is critical when designing disease mitigation strategies, and especially as regards wildlife, where intensive management is often advocated or prevented by economic and/or practical reasons. We investigated Pseudogymnoascus [Geomyces] destructans infection, the cause of white-nose syndrome (WNS), in relation to chiropteran ecology, behaviour and phylogenetics. While this fungus has caused devastating declines in North American bat populations, there have been no apparent population changes attributable to the disease in Europe. We screened 276 bats of 15 species from hibernacula in the Czech Republic over 2012 and 2013, and provided histopathological evidence for 11 European species positive for WNS. With the exception of Myotis myotis, the other ten species are all new reports for WNS in Europe. Of these, M. emarginatus, Eptesicus nilssonii, Rhinolophus hipposideros, Barbastella barbastellus and Plecotus auritus are new to the list of P. destructans-infected bat species. While the infected species are all statistically phylogenetically related, WNS affects bats from two suborders. These are ecologically diverse and adopt a wide range of hibernating strategies. Occurrence of WNS in distantly related bat species with diverse ecology suggests that the pathogen may be a generalist and that all bats hibernating within the distribution range of P. destructans may be at risk of infection. PMID:24820101

  17. Expectations and outcome skills of a generalist health care administrator.

    PubMed

    Jones, V B; Taylor, L C

    1990-01-01

    The question of the degree of technical versus managerial competence to be found in future graduates from health administration programs is not easily resolved. In the HIMSS 1988 survey of CIOs the attributes needed for success are listed in descending rank order as follows: leadership ability, vision/imagination, knowledge of hospital systems, business acumen, decisiveness, and technical competence. CIOs ranked technical competence as less important than other attributes associated with general management success. The expectations for attitudes, knowledge, and skills presented in this article support the greater importance of management abilities relative to pure technical competence. However, it is vital that an appropriate level of technical knowledge and skill be maintained to enable future alumni of health administration programs to function effectively as administrators. Depending on their role in a health care organization, greater or lesser technical knowledge may be needed. Those pursuing a career path toward CIO must, of necessity, have greater technical knowledge and skill. We have discussed necessary and expected attitudes, knowledge, and skills that will be needed by the generalist health administration graduate in the future. It will be important to develop and maintain an attitude that MIS is a strategic tool, that health care technology is a corporate asset, and that information is power. Graduates must recognize the necessity of maintaining and enhancing their knowledge and skills through continuing education. The knowledge base of MIS education should focus on determining information needs to support strategic goals, understanding of general systems theory, principles of systems analysis, design, implementation and maintenance, awareness and exposure to standard application software, and an awareness of external sources of data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10106375

  18. Two invasive acacia species secure generalist pollinators in invaded communities

    NASA Astrophysics Data System (ADS)

    Montesinos, Daniel; Castro, Sílvia; Rodríguez-Echeverría, Susana

    2016-07-01

    Exotic entomophilous plants need to establish effective pollinator interactions in order to succeed after being introduced into a new community, particularly if they are obligatory outbreeders. By establishing these novel interactions in the new non-native range, invasive plants are hypothesised to drive changes in the composition and functioning of the native pollinator community, with potential impacts on the pollination biology of native co-flowering plants. We used two different sites in Portugal, each invaded by a different acacia species, to assess whether two native Australian trees, Acacia dealbata and Acacia longifolia, were able to recruit pollinators in Portugal, and whether the pollinator community visiting acacia trees differed from the pollinator communities interacting with native co-flowering plants. Our results indicate that in the invaded range of Portugal both acacia species were able to establish novel mutualistic interactions, predominantly with generalist pollinators. For each of the two studied sites, only two other co-occurring native plant species presented partially overlapping phenologies. We observed significant differences in pollinator richness and visitation rates among native and non-native plant species, although the study of β diversity indicated that only the native plant Lithodora fruticosa presented a differentiated set of pollinator species. Acacias experienced a large number of visits by numerous pollinator species, but massive acacia flowering resulted in flower visitation rates frequently lower than those of the native co-flowering species. We conclude that the establishment of mutualisms in Portugal likely contributes to the effective and profuse production of acacia seeds in Portugal. Despite the massive flowering of A. dealbata and A. longifolia, native plant species attained similar or higher visitation rates than acacias.

  19. A conceptual framework for advanced practice nursing in a pediatric tertiary care setting: the SickKids' experience.

    PubMed

    LeGrow, Karen; Hubley, Pam; McAllister, Mary

    2010-05-01

    Advanced practice nurses (APNs) at The Hospital for Sick Children (SickKids) are pediatric healthcare providers who integrate principles and theories of advanced nursing with specialty knowledge to provide autonomous, independent, accountable, ethical and developmentally appropriate care in complex, often ambiguous and rapidly changing healthcare environments. Caring for children and adolescents requires culturally sensitive and family-centred approaches to care that incorporate a unique body of knowledge. Family-centred care is an approach to planning, delivery and evaluation of healthcare that is governed by the establishment of mutually beneficial partnerships among APNs, health professionals and children/families. The cornerstone of APN practice at SickKids is the recognition of "family" as the recipients of care. By valuing and developing relationships with families, APNs promote excellence in healthcare across the care continuum to optimize the child's and family's physical, emotional, social, psychological and spiritual well-being. This paper outlines the evolution of advanced practice nursing at SickKids, beginning with the introduction of APN roles in the 1970s and culminating in the current critical mass of APNs who have been integrated throughout the hospital's infrastructure. We describe the process used to create a common vision and a framework to guide pediatric advanced nursing practice. PMID:20530994

  20. A decade of advancement in understanding of rangeland hydrology and erosion and the effects of conservation practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Over the past decade the USDA-ARS Northwest Watershed Research Center (NWRC) has conducted extensive field research to quantify hydrologic and erosion effects of rangeland conservation practices and to develop and advance tools for rangeland assessment and management. Much of what was previously kn...

  1. Feeding Tube Placement in Patients with Advanced Dementia: The Beliefs and Practice Patterns of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Sharp, Helen M.; Shega, Joseph W.

    2009-01-01

    Purpose: To describe the beliefs and practices of speech-language pathologists (SLPs) about the use of percutaneous endoscopic gastrostomy (PEG) among patients with advanced dementia and dysphagia. Method: A survey was mailed to a geographically stratified random sample of 1,050 medical SLPs. Results: The response rate was 57%, and 326 surveys met…

  2. Some Misconceptions in Meiosis Shown by Students Responding to an Advanced Level Practical Examination Question in Biology.

    ERIC Educational Resources Information Center

    Brown, C. R.

    1990-01-01

    Discussed are problems revealed in student responses to a practical task which formed part of an advanced level examination. The frequencies with which some misconceptions about cell reproduction and genetics occurred are presented. The nature of these misconceptions is analyzed and their implications discussed. (CW)

  3. The Institute for the Advancement of Social Work Research: Working to Increase Our Practice and Policy Evidence Base

    ERIC Educational Resources Information Center

    Zlotnik, Joan Levy; Solt, Barbara E.

    2006-01-01

    This invitational update on the Institute for the Advancement of Social Work Research (IASWR) provides an overview of the work and progress toward strengthening the evidence base for social work practice and policy through research. The article includes information regarding IASWR work with its supporting social work organizations to provide a…

  4. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  5. An Evidence-based Medicine Elective Course to Improve Student Performance in Advanced Pharmacy Practice Experiences

    PubMed Central

    Rudisill, Celeste N.; Bickley, A. Rebecca; McAbee, Catherine; Miller, April D.; Piro, Christina C.; Schulz, Richard

    2011-01-01

    Objective To implement and evaluate the impact of an elective evidence-based medicine (EBM) course on student performance during advanced pharmacy practice experiences (APPEs). Design A 2-hour elective course was implemented using active-learning techniques including case studies and problem-based learning, journal club simulations, and student-driven wiki pages. The small class size (15 students) encouraged independent student learning, allowing students to serve as the instructors and guest faculty members from a variety of disciplines to facilitate discussions. Assessment Pre- and posttests found that students improved on 83% of the core evidence-based medicine concepts evaluated. Fifty-four APPE preceptors were surveyed to compare the performance of students who had completed the EBM course prior to starting their APPEs with students who had not. Of the 38 (70%) who responded, the majority (86.9%) agreed that students who had completed the course had stronger skills in applying evidence-based medicine to patient care than other students. The 14 students who completed the elective also were surveyed after completing their APPEs and the 11 who responded agreed the class had improved their skills and provided confidence in using the medical literature. Conclusions The skill set acquired from this EBM course improved students' performance in APPEs. Evidence-based medicine and literature search skills should receive more emphasis in the pharmacy curriculum. PMID:21451761

  6. A survey of oncology advanced practice nurses in Ontario: profile and predictors of job satisfaction.

    PubMed

    Bryant-Lukosius, Denise; Green, Esther; Fitch, Margaret; Macartney, Gail; Robb-Blenderman, Linda; McFarlane, Sandra; Bosompra, Kwadwo; DiCenso, Alba; Matthews, Susan; Milne, Harry

    2007-01-01

    The purpose of this study was to examine role structures and processes and their impact on job satisfaction for oncology advanced practice nurses (APNs) in Ontario. APNs caring for adult, paediatric or palliative patients in integrated regional cancer programs, tertiary care hospitals or community hospitals and agencies were invited to complete a mailed self-report questionnaire. A total of 73 of 77 APNs participated in the study. Most APNs (55%) were acute care nurse practitioners employed by regional cancer programs or tertiary care hospitals. Adult patients with breast or haematological cancers and those receiving initial treatment or palliative care were the primary focus of APN roles. APN education needs related to specialization in oncology, leadership and research were identified. Overall, APNs were minimally satisfied with their roles. Role confidence (beta = .404, p = .001) and the number of overtime hours (beta = -.313, p = .008) were respective positive and negative predictors of APN job satisfaction. Progress in role development is described, and recommendations for improving role development and expanding the delivery of oncology APN services are provided. PMID:17619596

  7. Traumatic brain injury: advanced multimodal neuromonitoring from theory to clinical practice.

    PubMed

    Cecil, Sandy; Chen, Patrick M; Callaway, Sarah E; Rowland, Susan M; Adler, David E; Chen, Jefferson W

    2011-04-01

    Traumatic brain injury accounts for nearly 1.4 million injuries and 52 000 deaths annually in the United States. Intensive bedside neuromonitoring is critical in preventing secondary ischemic and hypoxic injury common to patients with traumatic brain injury in the days following trauma. Advancements in multimodal neuromonitoring have allowed the evaluation of changes in markers of brain metabolism (eg, glucose, lactate, pyruvate, and glycerol) and other physiological parameters such as intracranial pressure, cerebral perfusion pressure, cerebral blood flow, partial pressure of oxygen in brain tissue, blood pressure, and brain temperature. This article highlights the use of multimodal monitoring in the intensive care unit at a level I trauma center in the Pacific Northwest. The trends in and significance of metabolic, physiological, and hemodynamic factors in traumatic brain injury are reviewed, the technical aspects of the specific equipment used to monitor these parameters are described, and how multimodal monitoring may guide therapy is demonstrated. As a clinical practice, multimodal neuromonitoring shows great promise in improving bedside therapy in patients with traumatic brain injury, ultimately leading to improved neurological outcomes. PMID:20592189

  8. Engaging academia to advance the science and practice of environmental public health tracking

    PubMed Central

    Strosnider, Heather; Zhou, Ying; Balluz, Lina; Qualters, Judith

    2015-01-01

    Public health agencies at the federal, state, and local level are responsible for implementing actions and policies that address health problems related to environmental hazards. These actions and policies can be informed by integrating or linking data on health, exposure, hazards, and population. The mission of the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) is to provide information from a nationwide network of integrated health, environmental hazard, and exposure data that drives actions to improve the health of communities. The Tracking Program and federal, state, and local partners collect, integrate, analyze, and disseminate data and information to inform environmental public health actions. However, many challenges exist regarding the availability and quality of data, the application of appropriate methods and tools to link data, and the state of the science needed to link and analyze health and environmental data. The Tracking Program has collaborated with academia to address key challenges in these areas. The collaboration has improved our understanding of the uses and limitations of available data and methods, expanded the use of existing data and methods, and increased our knowledge about the connections between health and environment. Valuable working relationships have been forged in this process, and together we have identified opportunities and improvements for future collaborations to further advance the science and practice of environmental public health tracking. PMID:25038624

  9. Identifying contamination with advanced visualization and analysis practices: metagenomic approaches for eukaryotic genome assemblies

    PubMed Central

    Delmont, Tom O.

    2016-01-01

    High-throughput sequencing provides a fast and cost-effective mean to recover genomes of organisms from all domains of life. However, adequate curation of the assembly results against potential contamination of non-target organisms requires advanced bioinformatics approaches and practices. Here, we re-analyzed the sequencing data generated for the tardigrade Hypsibius dujardini, and created a holistic display of the eukaryotic genome assembly using DNA data originating from two groups and eleven sequencing libraries. By using bacterial single-copy genes, k-mer frequencies, and coverage values of scaffolds we could identify and characterize multiple near-complete bacterial genomes from the raw assembly, and curate a 182 Mbp draft genome for H. dujardini supported by RNA-Seq data. Our results indicate that most contaminant scaffolds were assembled from Moleculo long-read libraries, and most of these contaminants have differed between library preparations. Our re-analysis shows that visualization and curation of eukaryotic genome assemblies can benefit from tools designed to address the needs of today’s microbiologists, who are constantly challenged by the difficulties associated with the identification of distinct microbial genomes in complex environmental metagenomes. PMID:27069789

  10. The Impact of Advanced Pharmacy Practice Experiences on Students' Readiness for Self-directed Learning

    PubMed Central

    Haines, Stuart T.; Plaza, Cecilia M.; Sturpe, Deborah A.; Williams, Greg; Rodriguez de Bittner, Magaly A.; Roffman, David S.

    2009-01-01

    Objective To evaluate the impact of advanced pharmacy practice experiences (APPEs) on doctor of pharmacy (PharmD) students' readiness for self-directed learning. Methods The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning. Results Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05). Conclusion Students at our institution appear to be ready for self-directed learning but APPEs had a minimal impact on their readiness for self-directed learning. PMID:19657498

  11. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2011-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:21808173

  12. Evolutionary rescue and the coexistence of generalist and specialist competitors: an experimental test.

    PubMed

    Bono, Lisa M; Gensel, Catharine L; Pfennig, David W; Burch, Christina L

    2015-12-22

    Competition for resources is thought to play a critical role in both the origins and maintenance of biodiversity. Although numerous laboratory evolution experiments have confirmed that competition can be a key driver of adaptive diversification, few have demonstrated its role in the maintenance of the resulting diversity. We investigate the conditions that favour the origin and maintenance of alternative generalist and specialist resource-use phenotypes within the same population. Previously, we confirmed that competition for hosts among φ6 bacteriophage in a mixed novel (non-permissive) and ancestral (permissive) host microcosm triggered the evolution of a generalist phenotype capable of infecting both hosts. However, because the newly evolved generalists tended to competitively exclude the ancestral specialists, coexistence between the two phenotypes was rare. Here, we show that reducing the relative abundance of the novel host slowed the increase in frequency of the generalist phenotype, allowing sufficient time for the specialist to further adapt to the ancestral host. This adaptation resulted in 'evolutionary rescue' of the specialists, preventing their competitive exclusion by the generalists. Thus, our results suggest that competition promotes both the origin and maintenance of biodiversity when it is strong enough to favour a novel resource-use phenotype, but weak enough to allow adaptation of both the novel and ancestral phenotypes to their respective niches. PMID:26702041

  13. Practical applications that require some of the more advanced features of current visual models

    NASA Astrophysics Data System (ADS)

    Daly, Scott J.; Feng, Xiaofan; Speigle, Jon M.

    2002-06-01

    While the use of visual models for assessing all aspects of the imaging chain is steadily increasing, one hindrance is the complexity of these models. This has impact in two ways - not only does it take longer to run the more complex visual model, making it difficult to place into optimization loops, but it also takes longer to code, test, and calibrate the model. As a result, a number of shortcut models have been proposed and used. Some of the shortcuts involve more efficient frequency transforms, such as using a Cartesian separable wavelet, while other types of shortcuts involve omitting the steps required to simulate certain visual mechanisms, such as masking. A key example of the latter is spatial CIELAB, which only models the opponent color CSFs and does not model the spatial frequency channels. Watson's recent analysis of the Modelfest data showed that while a multi-channel model did give the best performance, versions dispensing with the complex frequency bank and just using frequency attenuation did nearly as well. Of course, the Modelfest data addressed detection of a signal on a uniform field, so no masking properties were probed. On the other end of complexity is the model by D'Zmura, which not only includes radial and orientation channels, but also the interactions between the channels in both luminance and color. This talk will dissect several types of practical distortions that require more advanced visual models. One of these will be the need for orientation channels to predict edge jaggies due to aliasing. Other visual mechanisms in search of an exigent application that we will explore include cross luminance-chrominance masking and facilitation, local contrast, and cross-channel masking.

  14. Practical Considerations of Waste Heat Reuse for a Mars Mission Advanced Life Support System

    NASA Technical Reports Server (NTRS)

    Levri, Julie; Finn, Cory; Luna, Bernadette (Technical Monitor)

    2000-01-01

    Energy conservation is a key issue in design optimization of Advanced Life Support Systems (ALSS) for long-term space missions. By considering designs for conservation at the system level, energy saving opportunities arise that would otherwise go unnoticed. This paper builds on a steady-state investigation of system-level waste heat reuse in an ALSS with a low degree of crop growth for a Mars mission. In past studies, such a system has been defined in terms of technology types, hot and cold stream identification and stream energy content. The maximum steady-state potential for power and cooling savings within the system was computed via the Pinch Method. In this paper, several practical issues are considered for achieving a pragmatic estimate of total system savings in terms of equivalent system mass (ESM), rather than savings solely in terms of power and cooling. In this paper, more realistic ESM savings are computed by considering heat transfer inefficiencies during material transfer. An estimate of the steady-state mass, volume and crewtime requirements associated with heat exchange equipment is made by considering heat exchange equipment material type and configuration, stream flow characteristics and associated energy losses during the heat exchange process. Also, previously estimated power and cooling savings are adjusted to reflect the impact of such energy losses. This paper goes one step further than the traditional Pinch Method of considering waste heat reuse in heat exchangers to include ESM savings that occur with direct reuse of a stream. For example, rather than exchanging heat between crop growth lamp cooling air and air going to a clothes dryer, air used to cool crop lamps might be reused directly for clothes drying purposes. When thermodynamically feasible, such an approach may increase ESM savings by minimizing the mass, volume and crewtime requirements associated with stream routing equipment.

  15. Advancing the State-of-the-Practice for Liquid Rocket Engine Injector Design

    NASA Technical Reports Server (NTRS)

    Tucker, P. K.; Kenny, R. J.; Richardson, B. R.; Anderso, W. E.; Austin, B. J.; Schumaker, S. A.; Muss, J. A.

    2015-01-01

    Current shortcomings in both the overall injector design process and its underlying combustion stability assessment methodology are rooted in the use of empirically based or low fidelity representations of complex physical phenomena and geometry details that have first order effects on performance, thermal environments and combustion stability. The result is a design and analysis capability that is often inadequate to reliably arrive at a suitable injector design in an efficient manner. Specifically, combustion instability has been particularly difficult to predict and mitigate. Large hydrocarbon-fueled booster engines have been especially problematic in this regard. Where combustion instability has been a problem, costly and time-consuming redesign efforts have often been an unfortunate consequence. This paper presents an overview of a recently completed effort at NASA Marshall Space Flight Center to advance the state-of-the-practice for liquid rocket engine injector design. Multiple perturbations of a gas-centered swirl coaxial (GCSC) element that burned gaseous oxygen and RP-1 were designed, assessed for combustion stability, and tested. Three designs, one stable, one marginally unstable and one unstable, were used to demonstrate both an enhanced overall injector design process and an improved combustion stability assessment process. High-fidelity results from state-of-the-art computational fluid dynamics CFD simulations were used to substantially augment and improve the injector design methodology. The CFD results were used to inform and guide the overall injector design process. They were also used to upgrade selected empirical or low-dimensional quantities in the ROCket Combustor Interactive Design (ROCCID) stability assessment tool. Hot fire single element injector testing was used to verify both the overall injector designs and the stability assessments. Testing was conducted at the Air Force Research Laboratory and at Purdue University. Companion papers

  16. Exploring the use of standardized patients for simulation-based learning in preparing advanced practice nurses.

    PubMed

    Kowitlawakul, Yanika; Chow, Yeow Leng; Salam, Zakir Hussian Abdul; Ignacio, Jeanette

    2015-07-01

    The use of standardized patients for simulation-based learning was integrated into the Master of Nursing curriculum in the 2012-2013 academic year. The study aimed to explore the Master of Nursing students' experiences with and perceptions of using standardized patients in simulations, and to identify the students' learning needs in preparing to become advanced practice nurses. The study adopted an exploratory descriptive qualitative design, using a focus group interview. The study was conducted at a university in Singapore. Seven Master of Nursing students who were enrolled in the Acute Care Track of Master of Nursing program in the 2012-2013 academic year participated in the study. The data were gathered at the end of the first semester. Content analysis was used to analyze the data. Three main categories - usefulness, clinical limitations, and realism - were identified in the study. The results revealed that the students felt using standardized patients was useful and realistic for developing skills in history taking, communication, and responding to an emergency situation. On the other hand, they found that the standardized patients were limited in providing critical signs and symptoms of case scenarios. To meet the learning objectives, future development and integration of standardized patients in the Master of Nursing curriculum might need to be considered along with the use of a high-fidelity simulator. This can be an alternative strategy to fill the gaps in each method. Obviously, using standardized patients for simulation-based learning has added value to the students' learning experiences. It is highly recommended that future studies explore the impact of using standardized patients on students' performance in clinical settings. PMID:25819268

  17. Risk of local extinction of Odonata freshwater habitat generalists and specialists.

    PubMed

    Suhonen, Jukka; Korkeamäki, Esa; Salmela, Jukka; Kuitunen, Markku

    2014-06-01

    Understanding the risk of a local extinction in a single population relative to the habitat requirements of a species is important in both theoretical and applied ecology. Local extinction risk depends on several factors, such as habitat requirements, range size of species, and habitat quality. We studied the local extinctions among 31 dragonfly and damselfly species from 1930 to 1975 and from 1995 to 2003 in Central Finland. We tested whether habitat specialists had a higher local extinction rate than generalist species. Approximately 30% of the local dragonfly and damselfly populations were extirpated during the 2 study periods. The size of the geographical range of the species was negatively related to extinction rate of the local populations. In contrast to our prediction, the specialist species had lower local extinction rates than the generalist species, probably because generalist species occurred in both low- and high-quality habitat. Our results are consistent with source-sink theory. PMID:24405332

  18. The role of the medical school admission process in the production of generalist physicians.

    PubMed

    Rabinowitz, H K

    1999-01-01

    Medical education research has identified a number of medical student characteristics that are related to graduates' entering generalist careers. These include initial specialty preference, geographic background, gender, age, ethnicity, economic and lifestyle factors, attitudes and personal values, service orientation, and premedical academic performance. Identifying and giving weight to these factors in the medical school admission process is likely to increase the number of graduates who choose generalist specialties. This paper discusses these medical student characteristics and presents strategies that medical schools could use in the selection process to enhance the matriculation of students who are most likely to become generalists. In this way, medical schools will be able to recruit and select students who are most likely to become excellent physicians, and also produce a more appropriate balance of all specialists to meet the needs of the population. PMID:9934307

  19. Physician choice criteria: factors influencing patient selection of generalists versus specialists.

    PubMed

    Hanna, N; Schoenbachler, D D; Gordon, G L

    1994-01-01

    This paper presents the results of an exploratory study designed to (1) ascertain the primary sources of information patients use when selecting physicians and (2) identify differences in patient selection factor importance by type of physician under consideration (specialists versus generalists). The results support previous research which finds word-of-mouth and physician referrals the primary sources of information. Selection factors considered important when selecting a generalist were significantly different from factors considered important when selecting a specialist. Implications of the study's findings for effective physician marketing and future research are discussed. PMID:10141082

  20. Frequency, efficiency, and physical characteristics of predation by generalist predators of brown marmorated stink bug (Hemiptera: Pentatomidae) eggs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The native generalist predator community of Halyomorpha halys, an invasive species in the United States and Europe, remains poorly studied. The aims of the current study were to determine which generalist predators that are commonly found in mid-Atlantic orchards and vegetable crops are capable of ...

  1. Frequency, intensity, and physical characteristics of predation by generalist predators of brown marmorated stink bug (Hemiptera: Pentatomidae) eggs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The native generalist predator community of Halyomorpha halys, an invasive species in the United States and Europe, remains poorly studied. The aims of the current study were to determine which generalist predators that are commonly found in mid-Atlantic orchards and vegetable crops are capable of ...

  2. Advancing the Interdisciplinary Collaborative Health Team Model: Applying Democratic Professionalism, Implementation Science, and Therapeutic Alliance to Enact Social Justice Practice.

    PubMed

    Murphy, Nancy

    2015-01-01

    This essay reframes the interdisciplinary collaborative health team model by proposing the application of 3 foundational pillars-democratic professionalism, implementation science, and therapeutic alliance to advance this practice. The aim was to address challenges to the model, enhance their functional capacity, and explicate and enact social justice practices to affect individual health outcomes while simultaneously addressing health inequities. The pillars are described and examples from the author's dissertation research illustrate how the pillars were used to bring about action. Related theories, models, and frameworks that have negotiation, capacity building, collaboration, and knowledge/task/power sharing as central concepts are presented under each of the pillars. PMID:26244478

  3. Building Shared Experience to Advance Practical Application of Pathway-Based Toxicology: Liver Toxicity Mode-of-Action

    PubMed Central

    Willett, Catherine; Rae, Jessica Caverly; Goyak, Katy O.; Minsavage, Gary; Westmoreland, Carl; Andersen, Melvin; Avigan, Mark; Duché, Daniel; Harris, Georgina; Hartung, Thomas; Jaeschke, Hartmut; Kleensang, Andre; Landesmann, Brigitte; Martos, Suzanne; Matevia, Marilyn; Toole, Colleen; Rowan, Andrew; Schultz, Terry; Seed, Jennifer; Senior, John; Shah, Imran; Subramanian, Kalyanasundaram; Vinken, Mathieu; Watkins, Paul

    2016-01-01

    Summary A workshop sponsored by the Human Toxicology Project Consortium (HTPC), “Building Shared Experience to Advance Practical Application of Pathway-Based Toxicology: Liver Toxicity Mode-of-Action” brought together experts from a wide range of perspectives to inform the process of pathway development and to advance two prototype pathways initially developed by the European Commission Joint Research Center (JRC): liver-specific fibrosis and steatosis. The first half of the workshop focused on the theory and practice of pathway development; the second on liver disease and the two prototype pathways. Participants agreed pathway development is extremely useful for organizing information and found that focusing the theoretical discussion on a specific AOP is helpful. It is important to include several perspectives during pathway development, including information specialists, pathologists, human health and environmental risk assessors, and chemical and product manufacturers, to ensure the biology is well captured and end use is considered. PMID:24535319

  4. Coordination of care for individuals with advanced progressive conditions: a multi-site ethnographic and serial interview study

    PubMed Central

    Mason, Bruce; Epiphaniou, Eleni; Nanton, Veronica; Donaldson, Anne; Shipman, Cathy; Daveson, Barbara A; Harding, Richard; Higginson, Irene; Munday, Dan; Barclay, Stephen; Boyd, Kirsty; Dale, Jeremy; Kendall, Marilyn; Worth, Allison; Murray, Scott A

    2013-01-01

    Background Coordination of care for individuals with advanced progressive conditions is frequently poor. Aim To identify how care is coordinated in generalist settings for individuals with advanced progressive conditions in the last year of life. Design and setting A mixed methods study of three UK generalist clinical settings producing three parallel case studies: an acute admissions unit in a regional hospital, a large general practice, and a respiratory outpatient service. Method Ethnographic observations in each setting, followed by serial interviews of patients with advanced progressive conditions and their family carers in the community. A spectrum of clinicians and healthcare workers were also interviewed. Results Ethnographic observations were conducted for 22 weeks. A total of 56 patients, 25 family carers and 17 clinicians yielded 198 interviews. Very few participants had been identified for a palliative approach. Rapid throughput of hospital patients and time pressures in primary care hindered identification of palliative care needs. Lack of care coordination was evident during emergency admissions and discharges. Patient, families, and professionals identified multiple problems relating to lack of information, communication, and collaboration at care transitions. Family carers or specialist nurses, where present, usually acted as the main care coordinators. Conclusion Care is poorly coordinated in generalist settings for patients in the last year of life, although those with cancer have better coordinated care than other patients. A model to improve coordination of care for all individuals approaching the end of life must ensure that patients are identified in a timely way, so that they can be assessed and their care planned accordingly. PMID:23972199

  5. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

    SciTech Connect

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia; Pilch, Martin M.

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.

  6. Advanced Technologies and Data Management Practices in Environmental Science: Lessons from Academia

    ERIC Educational Resources Information Center

    Hernandez, Rebecca R.; Mayernik, Matthew S.; Murphy-Mariscal, Michelle L.; Allen, Michael F.

    2012-01-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the…

  7. Meaningful Use of Data in Care Coordination by the Advanced Practice Registered Nurse: The TeleFamilies Project

    PubMed Central

    Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.

    2012-01-01

    Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406

  8. Best Practices in Weathering Climate Risks: Advancing Corporate and Community Resilience

    NASA Astrophysics Data System (ADS)

    Klima, K.; Winkelman, S.

    2012-12-01

    As the annual costs of severe weather events in the US grow into the billions of dollars, companies and communities are examining how best to plan ahead to protect their assets and bolster their bottom line. The Center for Clean Air Policy's Weathering Climate Risks program aims to help cities and companies enhance resilience to the economic impacts of severe weather and a changing climate. This presentation will highlight three communication techniques aimed at different types of audiences such as businesses, policymakers, the media, and society. First, we find that although planning for natural hazards now saves money later, stakeholders must fi¬nd their own self-interest if they are going to engage in a solution. Thus we research best practices and hold informational, off-the-record interviews to better understand the different stakeholders' perspectives, key concerns, and issues surrounding adaptation, resilience, and/or hazard mitigation. Diverse stakeholders find it attractive when a solution has multiple co-benefits such as climate resilience, greenhouse gas reduction, reduced costs, and social benefits. Second, we use off-the-record dialogues emphasizing candid public-private discussion to promote collaborative problem solving. Our high-level workshops typically consist of 30-40 scientists, companies, communities, and policymakers. We begin with presenting background material, such as geographic information systems (GIS) maps. Then we move to informal conservation. Topics include ideas such as "Ask the Climate Question": How will infrastructure, land development, and investment decisions affect GHG emissions and resilience to climate change impacts? We find these dialogues help stakeholders share their perspectives and advance public-private collaboration on climate resilience to protect critical urban infrastructure, ensure business continuity, and increase extreme weather resilience. Third, we find that communication to the general public must capture

  9. Generalist and Specialty Physicians: Supply and Access, 2009-2010

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  10. Power and promise of narrative for advancing physical therapist education and practice.

    PubMed

    Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

    2015-06-01

    This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice. PMID:25524869

  11. Advancing HIV Nursing Practice: The Doctor of Nursing Practice HIV Specialty at Rutgers, the State University of New Jersey.

    PubMed

    Willard, Suzanne; Nelson, John; Reyes, Darcel; Linn, Annē

    2016-01-01

    The move to integrate HIV treatment and care into primary care is a major obstacle for the current U.S. health care workforce. Many HIV specialty providers will soon retire, while few primary care clinicians have been adequately trained in the diagnosis, care, and treatment of people living with HIV. The Health Resources and Services Administration (HRSA) has supported the development of a Doctor of Nursing Practice (DNP) program with an HIV specialty at Rutgers, the State University of New Jersey, to assure successful transition to an HIV primary care workforce. The Rutgers School of Nursing has been at the forefront of the DNP education movement and is among the first to develop an HIV-focused DNP program. Thirty-seven students have enrolled in the 3-year program, and two have graduated from the first cohort. Here we discuss the planning, implementation, successes, and recommendations of the new program. PMID:27086187

  12. Comparative recruitment, morphology and reproduction of a generalist trematode, Dicrocoelium dendriticum, in three species of host.

    PubMed

    Beck, Melissa A; Goater, Cameron P; Colwell, Douglas D

    2015-09-01

    Epidemiological rate parameters of host generalist parasites are difficult to estimate, especially in cases where variation in parasite performance can be attributed to host species. Such cases are likely common for generalist parasites of sympatric grazing mammals. In this study, we combined data from experimental exposures in cattle and sheep and natural infections in elk to compare the recruitment, morphology and reproduction of adult Dicrocoelium dendriticum, a generalist trematode that has emerged in sympatric grazing hosts in Cypress Hills Provincial Park, Alberta. Overall, there were no significant differences in the recruitment of metacercariae and in the pre-patency period of adults in experimentally exposed cattle and sheep. All flukes reached reproductive maturity and the degree of reproductive inequality between individual flukes within each infrapopulation was moderate and approximately equal among the three host species. Neither fluke size nor per capita fecundity was constrained by density dependence. Thus, fitness parameters associated with growth and reproduction were approximately equivalent among at least three species of definitive host, two of which are sympatric on pastures in this Park. The generalist life-history strategy of this trematode, which is known to extend to other stages of its life cycle, has likely contributed to its invasion history outside its native range in Europe. PMID:26059630

  13. The Case for the Generalist in Rural Development. Peace Corps Faculty Paper No. 4.

    ERIC Educational Resources Information Center

    Lodge, George C.

    Veraguas province, Panama, is an example of the need to have generalists, not specialists, deal with the interrelated aspects of rural areas in developing nations. Intricate connections between living standards, agricultural production, market and credit structures, land tenure, the political system, the social structure, education, health,…

  14. Host-pathogen interactions and genome evolution in two generalist and specialist microsporidian pathogens of mosquitoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The adaptation of two distantly related microsporidia to their mosquito hosts was investigated. Edhazardia aedis is a specialist pathogen that infects Aedes aegypti, the main vector of dengue and yellow fever arboviruses. Vavraia culicis is a generalist pathogen of several insects including Anophele...

  15. Preparing Pre-Service Generalist Teachers to Use Creative Movement in K-6

    ERIC Educational Resources Information Center

    Kaufmann, Karen; Ellis, Becky

    2007-01-01

    University courses preparing elementary education majors to incorporate creative movement into their teaching methodology are becoming requirements in many schools of education around the country. The article addresses three questions pertinent to preparing upcoming teachers: 1. How can pre-service generalist teachers develop an appreciation of…

  16. Heuristic versus Systematic Processing of Specialist versus Generalist Sources in Online Media

    ERIC Educational Resources Information Center

    Koh, Yoon Jeon; Sundar, S. Shyam

    2010-01-01

    In exploring why specialist sources (e.g., CNN.com) are more persuasive than generalist sources (e.g., CBS.com), this study examines theoretical mechanisms related to information-processing differences caused by these sources. When we have a chain of sources (Websites and agents) in online media, does specialization of one of them bias the…

  17. Influences of Plant Traits on Immune Responses of Specialist and Generalist Herbivores

    PubMed Central

    Lampert, Evan

    2012-01-01

    Specialist and generalist insect herbivore species often differ in how they respond to host plant traits, particularly defensive traits, and these responses can include weakened or strengthened immune responses to pathogens and parasites. Accurate methods to measure immune response in the presence and absence of pathogens and parasites are necessary to determine whether susceptibility to these natural enemies is reduced or increased by host plant traits. Plant chemical traits are particularly important in that host plant metabolites may function as antioxidants beneficial to the immune response, or interfere with the immune response of both specialist and generalist herbivores. Specialist herbivores that are adapted to process and sometimes accumulate specific plant compounds may experience high metabolic demands that may decrease immune response, whereas the metabolic demands of generalist species differ due to more broad-substrate enzyme systems. However, the direct deleterious effects of plant compounds on generalist herbivores may weaken their immune responses. Further research in this area is important given that the ecological relevance of plant traits to herbivore immune responses is equally important in natural systems and agroecosystems, due to potential incompatibility of some host plant species and cultivars with biological control agents of herbivorous pests. PMID:26466545

  18. Predator interference effects on biological control: The "paradox" of the generalist predator revisited

    NASA Astrophysics Data System (ADS)

    Parshad, Rana D.; Bhowmick, Suman; Quansah, Emmanuel; Basheer, Aladeen; Upadhyay, Ranjit Kumar

    2016-10-01

    An interesting conundrum in biological control questions the efficiency of generalist predators as biological control agents. Theory suggests, generalist predators are poor agents for biological control, primarily due to mutual interference. However field evidence shows they are actually quite effective in regulating pest densities. In this work we provide a plausible answer to this paradox. We analyze a three species model, where a generalist top predator is introduced into an ecosystem as a biological control, to check the population of a middle predator, that in turn is depredating on a prey species. We show that the inclusion of predator interference alone, can cause the solution of the top predator equation to blow-up in finite time, while there is global existence in the no interference case. This result shows that interference could actually cause a population explosion of the top predator, enabling it to control the target species, thus corroborating recent field evidence. Our results might also partially explain the population explosion of certain species, introduced originally for biological control purposes, such as the cane toad (Bufo marinus) in Australia, which now functions as a generalist top predator. We also show both Turing instability and spatio-temporal chaos in the model. Lastly we investigate time delay effects.

  19. Specialist versus generalist life histories and nucleotide diversity in Caenorhabditis nematodes

    PubMed Central

    Li, Shuning; Jovelin, Richard; Yoshiga, Toyoshi; Tanaka, Ryusei; Cutter, Asher D.

    2014-01-01

    Species with broad ecological amplitudes with respect to a key focal resource, niche generalists, should maintain larger and more connected populations than niche specialists, leading to the prediction that nucleotide diversity will be lower and more subdivided in specialists relative to their generalist relatives. This logic describes the specialist-generalist variation hypothesis (SGVH). Some outbreeding species of Caenorhabditis nematodes use a variety of invertebrate dispersal vectors and have high molecular diversity. By contrast, Caenorhabditis japonica lives in a strict association and synchronized life cycle with its dispersal host, the shield bug Parastrachia japonensis, itself a diet specialist. Here, we characterize sequence variation for 20 nuclear loci to investigate how C. japonica's life history shapes nucleotide diversity. We find that C. japonica has more than threefold lower polymorphism than other outbreeding Caenorhabditis species, but that local populations are not genetically disconnected. Coupled with its restricted range, we propose that its specialist host association contributes to a smaller effective population size and lower genetic variation than host generalist Caenorhabditis species with outbreeding reproductive modes. A literature survey of diverse organisms provides broader support for the SGVH. These findings encourage further testing of ecological and evolutionary hypotheses with comparative population genetics in Caenorhabditis and other taxa. PMID:24403340

  20. Selection Mosaic Exerted by Specialist and Generalist Herbivores on Chemical and Physical Defense of Datura stramonium

    PubMed Central

    Castillo, Guillermo; Cruz, Laura L.; Tapia-López, Rosalinda; Olmedo-Vicente, Eika; Carmona, Diego; Anaya-Lang, Ana Luisa; Fornoni, Juan; Andraca-Gómez, Guadalupe; Valverde, Pedro L.; Núñez-Farfán, Juan

    2014-01-01

    Selection exerted by herbivores is a major force driving the evolution of plant defensive characters such as leaf trichomes or secondary metabolites. However, plant defense expression is highly variable among populations and identifying the sources of this variation remains a major challenge. Plant populations are often distributed across broad geographic ranges and are exposed to different herbivore communities, ranging from generalists (that feed on diverse plant species) to specialists (that feed on a restricted group of plants). We studied eight populations of the plant Datura stramonium usually eaten by specialist or generalist herbivores, in order to examine whether the pattern of phenotypic selection on secondary compounds (atropine and scopolamine) and a physical defense (trichome density) can explain geographic variation in these traits. Following co-evolutionary theory, we evaluated whether a more derived alkaloid (scopolamine) confers higher fitness benefits than its precursor (atropine), and whether this effect differs between specialist and generalist herbivores. Our results showed consistent directional selection in almost all populations and herbivores to reduce the concentration of atropine. The most derived alkaloid (scopolamine) was favored in only one of the populations, which is dominated by a generalist herbivore. In general, the patterns of selection support the existence of a selection mosaic and accounts for the positive correlation observed between atropine concentration and plant damage by herbivores recorded in previous studies. PMID:25051169

  1. Effects of generalist herbivory on resistance and resource allocation by the invasive plant, Phytolacca americana.

    PubMed

    Huang, Wei; Ding, Jianqing

    2016-04-01

    Successful invasions by exotic plants are often attributed to a loss of co-evolved specialists and a re-allocation of resources from defense to growth and reproduction. However, invasive plants are rarely completely released from insect herbivory because they are frequently attacked by generalists in their introduced ranges. The novel generalist community may also affect the invasive plant's defensive strategies and resource allocation. Here, we tested this hypothesis using American pokeweed (Phytolacca americana L.), a species that has become invasive in China, which is native to North America. We examined resistance, tolerance, growth and reproduction of plant populations from both China and the USA when plants were exposed to natural generalist herbivores in China. We found that leaf damage was greater for invasive populations than for native populations, indicating that plants from invasive ranges had lower resistance to herbivory than those from native ranges. A regression of the percentage of leaf damage against mass showed that there was no significant difference in tolerance between invasive and native populations, even though the shoot, root, fruit and total mass were larger for invasive populations than for native populations. These results suggest that generalist herbivores are important drivers mediating the defensive strategies and resource allocation of the invasive American pokeweed. PMID:26097089

  2. Generalist Behavior Describes Pollen Foraging for Perceived Oligolectic and Polylectic Bees.

    PubMed

    Ritchie, Alan D; Ruppel, Rebecca; Jha, Shalene

    2016-08-01

    Native bees provide essential pollination services to cultivated and wild plants worldwide. Despite the need to conserve pollinators, the foraging patterns of native bees are poorly understood. Classic concepts of resource use have typically categorized bee species as specialists or generalists based on floral visitation patterns. While intraspecific variation in bee foraging likely depends on local land use, sex, and phenological period, among other factors, these potential drivers of floral visitation are rarely explicitly investigated. In this study, we explore the potential for inter- and intra-specific variation in floral visitation by investigating the pollen loads of two solitary, similarly sized, ground-nesting native bee species within the Apinae, Melissodes tepaneca (Cresson) and Diadasia rinconis (Cockerell), categorized as generalist and specialist based on past floral visitation studies, respectively. Our analyses reveal generalist foraging and indicate that natural habitat availability significantly drives pollen load composition for both species. The putative specialist, D. rinconis, exhibited significant differences in pollen load composition between males and females, between pan and net collection methods, and between the different phenological periods. The putative generalist, M. tepaneca, exhibited significant differences in pollen load composition between the sexes, but only in the late season. Both species exhibited significant preference levels for multiple native plant species across the study region. Given that pollen collection is essential for native bee population persistence across natural and human-dominated habitats, our findings suggest consideration of both pollen collection and floral visitation patterns to holistically describe floral usage and develop pollinator conservation strategies. PMID:27271950

  3. Self-Assessment in Generalist Preservice Kindergarten Teachers' Education: Insights on Training, Ability, Environments, and Policies

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2010-01-01

    Self-assessment can play an important role in teachers' personal and professional development and is encouraged by educational programs worldwide. This article reports on a Greek study that aimed to investigate generalist preservice kindergarten teachers' self-assessment of their music teaching ability. One hundred participants were asked to…

  4. The Importance of Pollinator Generalization and Abundance for the Reproductive Success of a Generalist Plant

    PubMed Central

    Maldonado, María Belén; Lomáscolo, Silvia Beatriz; Vázquez, Diego Pedro

    2013-01-01

    Previous studies have examined separately how pollinator generalization and abundance influence plant reproductive success, but none so far has evaluated simultaneously the relative importance of these pollinator attributes. Here we evaluated the extent to which pollinator generalization and abundance influence plant reproductive success per visit and at the population level on a generalist plant, Opuntia sulphurea (Cactaceae). We used field experiments and path analysis to evaluate whether the per-visit effect is determined by the pollinator’s degree of generalization, and whether the population level effect (pollinator impact) is determined by the pollinator’s degree of generalization and abundance. Based on the models we tested, we concluded that the per-visit effect of a pollinator on plant reproduction was not determined by the pollinators’ degree of generalization, while the population-level impact of a pollinator on plant reproduction was mainly determined by the pollinators’ degree of generalization. Thus, generalist pollinators have the greatest species impact on pollination and reproductive success of O. sulphurea. According to our analysis this greatest impact of generalist pollinators may be partly explained by pollinator abundance. However, as abundance does not suffice as an explanation of pollinator impact, we suggest that vagility, need for resource consumption, and energetic efficiency of generalist pollinators may also contribute to determine a pollinator’s impact on plant reproduction. PMID:24116049

  5. Delivering the Primary Curriculum: The Use of Subject Specialist and Generalist Teachers in NSW

    ERIC Educational Resources Information Center

    Ardzejewska, Kathie; McMaugh, Anne; Coutts, Pamela

    2010-01-01

    The delivery of the primary curriculum has been subject to recent debate in Western countries. In Australia, the primary teacher is by and large considered a generalist; however a current paradox exists whereby there are claims that specialists are needed to deliver the curriculum. This study explores this claim by first addressing the prevalence…

  6. Neuroscience, Music Education and the Pre-Service Primary (Elementary) Generalist Teacher

    ERIC Educational Resources Information Center

    Collins, Anita

    2014-01-01

    For three decades, research on training in music education for pre-service primary (elementary) generalist teachers has consistently highlighted four main issues that limit its effectiveness: 1) the influence of past experiences; 2) a lack of confidence 3) a lack of musical competence and 4) limited time to address these issues in teacher…

  7. Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 2008-2009

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  8. The Influence of Advanced General Dentistry Training on Practice Patterns of Iowa Dental Graduates.

    ERIC Educational Resources Information Center

    Bolden, Aljernon J.; And Others

    1992-01-01

    A study compared the practice patterns of 41 dentists with graduate training in general dentistry with those of 41 dentists without such training, in terms of number and types of procedures performed, patient characteristics, professional and community activities, and practice characteristics. Some differences were found, particularly in patient…

  9. Evaluation of the Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Evans, Lois K.; Swan, Beth Ann; Lang, Norma E.

    2003-01-01

    In the Penn Macy Initiative, 21 nursing schools participated in summer institutes and follow-up consultations to refine practice. Evaluation data from participants' daily and postinstitute feedback, institutional self-evaluations, and comparison of school accomplishments identified critical indicators of progress in academic practice. A key…

  10. Practical Intelligence and Tacit Knowledge: Advancements in the Measurement of Developing Expertise

    ERIC Educational Resources Information Center

    Cianciolo, Anna T.; Grigorenko, Elena L.; Jarvin, Linda; Gil, Guillermo; Drebot, Michael E.; Sternberg, Robert J.

    2006-01-01

    Practical intelligence as measured by tacit-knowledge inventories generally has shown a weak relation to other intelligence constructs. However, the use of assessments capturing specialized, job-related knowledge may obscure the generality of practical intelligence and its relation to general intelligence. This article presents three studies in…

  11. Re-Storying Practice: Using Stories about Students to Advance Mathematics Education Reform

    ERIC Educational Resources Information Center

    Sengupta-Irving, Tesha; Redman, Elizabeth; Enyedy, Noel

    2013-01-01

    We apply a literary definition of story (struggle, protagonist, and resolution) to an American primary school teacher's reflections on experimenting with new teaching practices. This definition makes issues of equity explicit and revealed what the teacher saw as possible for changing her practice. By re-storying her stories--offering evidence from…

  12. Leading the Ongoing Development of Collaborative Data Practices: Advancing a Schema for Diagnosis and Intervention

    ERIC Educational Resources Information Center

    Cosner, Shelby

    2012-01-01

    Research suggests that school leaders play an important role in cultivating and developing collaborative data practices by teachers. Although diagnosis and intervention are critical facets of leaders' work to support collaborative data practice development, this work remains poorly understood. Missing from data-use literature is more explicit and…

  13. Conditions for Building a Community of Practice in an Advanced Physics Laboratory

    ERIC Educational Resources Information Center

    Irving, Paul W.; Sayre, Eleanor C.

    2014-01-01

    We use the theory of communities of practice and the concept of accountable disciplinary knowledge to describe how a learning community develops in the context of an upper-division physics laboratory course. The change in accountable disciplinary knowledge motivates students' enculturation into a community of practice. The enculturation…

  14. Community Introduction of Practice Parameters for Autistic Spectrum Disorders: Advancing Early Recognition

    ERIC Educational Resources Information Center

    Holzer, Laurent; Mihailescu, Raluca; Rodrigues-Degaeff, Catherine; Junier, Laurent; Muller-Nix, Carole; Halfon, Oliver; Ansermet, Francois

    2006-01-01

    Objectives: Within a strong interdisciplinary framework, improvement in the quality of care for children with autistic spectrum disorders through a 2 year implementation program of Practice Parameters, aimed principally at improving early detection and intervention. Method: We developed Practice Parameters (PPs) for Pervasive Developmental…

  15. Catching the Wave: Next Steps in Advancing the Vision-in-Practice Agenda

    ERIC Educational Resources Information Center

    Pekarsky, Daniel

    2008-01-01

    Building on insights of Seymour Fox, I explore the often-decisive role of "good timing" in the introduction of potentially powerful innovations (ideas, practices, etc.) into practical domains like education. After examining key readiness conditions that make for good timing, I argue that the field of Jewish education is in many ways now ready to…

  16. Evolution of pollination niches and floral divergence in the generalist plant Erysimum mediohispanicum

    PubMed Central

    Gómez, J. M.; Muñoz-Pajares, A. J.; Abdelaziz, M.; Lorite, J.; Perfectti, F.

    2014-01-01

    Background and Aims How generalist plants diverge in response to pollinator selection without becoming specialized is still unknown. This study explores this question, focusing on the evolution of the pollination system in the pollination generalist Erysimum mediohispanicum (Brassicaceae). Methods Pollinator assemblages were surveyed from 2001 to 2010 in 48 geo-referenced populations covering the entire geographic distribution of E. mediohispanicum. Bipartite modularity, a complex network tool, was used to find the pollination niche of each population. Evolution of the pollination niches and the correlated evolution of floral traits and pollination niches were explored using within-species comparative analyses. Key Results Despite being generalists, the E. mediohispanicum populations studied can be classified into five pollination niches. The boundaries between niches were not sharp, the niches differing among them in the relative frequencies of the floral visitor functional groups. The absence of spatial autocorrelation and phylogenetic signal indicates that the niches were distributed in a phylogeographic mosaic. The ancestral E. mediohispanicum populations presumably belonged to the niche defined by a high number of beetle and ant visits. A correlated evolution was found between pollination niches and some floral traits, suggesting the existence of generalist pollination ecotypes. Conclusions It is conjectured that the geographic variation in pollination niches has contributed to the observed floral divergence in E. mediohispanicum. The process mediating this floral divergence presumably has been adaptive wandering, but the adaptation to the local pollinator faunas has been not universal. The outcome is a landscape where a few populations locally adapted to their pollination environment (generalist pollination ecotypes) coexist with many populations where this local adaptation has failed and where the plant phenotype is not primarily shaped by pollinators. PMID

  17. Parasite specialization in a unique habitat: hummingbirds as reservoirs of generalist blood parasites of Andean birds.

    PubMed

    Moens, Michaël A J; Valkiūnas, Gediminas; Paca, Anahi; Bonaccorso, Elisa; Aguirre, Nikolay; Pérez-Tris, Javier

    2016-09-01

    Understanding how parasites fill their ecological niches requires information on the processes involved in the colonization and exploitation of unique host species. Switching to hosts with atypical attributes may favour generalists broadening their niches or may promote specialization and parasite diversification as the consequence. We analysed which blood parasites have successfully colonized hummingbirds, and how they have evolved to exploit such a unique habitat. We specifically asked (i) whether the assemblage of Haemoproteus parasites of hummingbirds is the result of single or multiple colonization events, (ii) to what extent these parasites are specialized in hummingbirds or shared with other birds and (iii) how hummingbirds contribute to sustain the populations of these parasites, in terms of both prevalence and infection intensity. We sampled 169 hummingbirds of 19 species along an elevation gradient in Southern Ecuador to analyse the host specificity, diversity and infection intensity of Haemoproteus by molecular and microscopy techniques. In addition, 736 birds of 112 species were analysed to explore whether hummingbird parasites are shared with other birds. Hummingbirds hosted a phylogenetically diverse assemblage of generalist Haemoproteus lineages shared with other host orders. Among these parasites, Haemoproteus witti stood out as the most generalized. Interestingly, we found that infection intensities of this parasite were extremely low in passerines (with no detectable gametocytes), but very high in hummingbirds, with many gametocytes seen. Moreover, infection intensities of H. witti were positively correlated with the prevalence across host species. Our results show that hummingbirds have been colonized by generalist Haemoproteus lineages on multiple occasions. However, one of these generalist parasites (H. witti) seems to be highly dependent on hummingbirds, which arise as the most relevant reservoirs in terms of both prevalence and

  18. Intraspecific variation in defense against a generalist lepidopteran herbivore in populations of Eruca sativa (Mill.).

    PubMed

    Ogran, Ariel; Landau, Netanel; Hanin, Nir; Levy, Maggie; Gafni, Yedidya; Barazani, Oz

    2016-01-01

    Populations of Eruca sativa (Brassicaceae) from desert and Mediterranean (Med) habitats in Israel differ in their defense against larvae of the generalist Spodoptera littoralis but not the specialist Pieris brassicae. Larvae of the generalist insect feeding on plants of the Med population gained significantly less weight than those feeding on the desert plants, and exogenous application of methyl jasmonate (MJ) on leaves of the Med plants significantly reduced the level of damage created by the generalist larvae. However, MJ treatment significantly induced resistance in plants of the desert population, whereas the generalist larvae caused similar damage to MJ-induced and noninduced plants. Analyses of glucosinolates and expression of genes in their synthesis pathway indicated that defense in plants of the Med population against the generalist insect is governed by the accumulation of glucosinolates. In plants of the desert population, trypsin proteinase inhibitor activity was highly induced in response to herbivory by S. littoralis. Analysis of genes in the defense-regulating signaling pathways suggested that in response to herbivory, differences between populations in the induced levels of jasmonic acid, ethylene, and salicylic acid mediate the differential defenses against the insect. In addition, expression analysis of myrosinase-associated protein NSP2 suggested that in plants of the desert population, glucosinolates breakdown products were primarily directed to nitrile production. We suggest that proteinase inhibitors provide an effective defense in the desert plants, in which glucosinolate production is directed to the less toxic nitriles. The ecological role of nitrile production in preventing infestation by specialists is discussed. PMID:26811800

  19. Modelling invasion for a habitat generalist and a specialist plant species

    USGS Publications Warehouse

    Evangelista, P.H.; Kumar, S.; Stohlgren, T.J.; Jarnevich, C.S.; Crall, A.W.; Norman, J. B., III; Barnett, D.T.

    2008-01-01

    Predicting suitable habitat and the potential distribution of invasive species is a high priority for resource managers and systems ecologists. Most models are designed to identify habitat characteristics that define the ecological niche of a species with little consideration to individual species' traits. We tested five commonly used modelling methods on two invasive plant species, the habitat generalist Bromus tectorum and habitat specialist Tamarix chinensis, to compare model performances, evaluate predictability, and relate results to distribution traits associated with each species. Most of the tested models performed similarly for each species; however, the generalist species proved to be more difficult to predict than the specialist species. The highest area under the receiver-operating characteristic curve values with independent validation data sets of B. tectorum and T. chinensis was 0.503 and 0.885, respectively. Similarly, a confusion matrix for B. tectorum had the highest overall accuracy of 55%, while the overall accuracy for T. chinensis was 85%. Models for the generalist species had varying performances, poor evaluations, and inconsistent results. This may be a result of a generalist's capability to persist in a wide range of environmental conditions that are not easily defined by the data, independent variables or model design. Models for the specialist species had consistently strong performances, high evaluations, and similar results among different model applications. This is likely a consequence of the specialist's requirement for explicit environmental resources and ecological barriers that are easily defined by predictive models. Although defining new invaders as generalist or specialist species can be challenging, model performances and evaluations may provide valuable information on a species' potential invasiveness.

  20. [Domains in the clinical practice of Clinical Nursing Experts in Germany and their correspondence with the internationally described "Advanced Nursing Practice"].

    PubMed

    Mendel, Simon; Feuchtinger, Johanna

    2009-06-01

    In spite of a growing trend toward academic education and increasing numbers of "nursing experts" functioning as change agents in Germany, actual nursing experts as in the internationally described Advanced Nursing Practice (ANP) are scarce. Drawing from a ten-year experience in implementing the international concept, the University Hospital Freiburg (UKF), Germany, constitutes a notable exception, as it presently employs ten clinically practicing nursing experts. Based on this background of educating nursing experts, this presentation aims at describing the implementation of the nursing expert's role and its fit and conformance with the international ANP. A 3-stage Delphi design was used for interviewing all the nursing experts at the hospital (n = 10) about their expert opinions; in addition, all nursing managers (n = 7) as well as unit and team leaders (n = 49) were asked about their opinion to relevant functions and domains of nursing experts. The following clinical practice domains of nursing experts were identified: Direct patient care, patient education, support and supervision of nurses, maintenance and expansion of professional skills and knowledge of the nursing staff, counselling of managers, quality assurance and organizational development, theory to practice transfer, nursing research, maintenance of own professional skills and knowledge and continuing education, and publicity work. Additionally, a three-year nursing education, a longer lasting professional experience, a degree in nursing science or nursing education, and specialist skills in the respective area of expertise were identified as credentials for nursing expert practice. The nursing expert concept at UKF shows elements of the international ANP with similarities to the role of a Clinical Nurse Specialist. PMID:19496033

  1. Multi-center development and testing of a simulation-based cardiovascular assessment curriculum for advanced practice nurses.

    PubMed

    Jeffries, Pamela R; Beach, Michael; Decker, Sharon I; Dlugasch, Lucie; Groom, Jeffrey; Settles, Julie; O'Donnell, John M

    2011-01-01

    Cardiovascular assessment skills are deficient among advanced practice nursing students, and effective instructional methods to improve assessment skills are needed. The purpose of this study was to develop, implement, and evaluate outcomes of a cardiovascular assessment curriculum for advanced practice nurses at four institutions. Each institution used a one-group pre-to-post-intervention design. Educational interventions included faculty-led, simulation-based case presentations using the Harvey cardiopulmonary patient simulator (CPS), and independent learning sessions using the CPS and a multimedia, computer-based CD-ROM program. Outcome measures included a 31-item cognitive written exam, a 13-item skills checklist used in each of a three-station objective structured clinical exam, learner self-efficacy and satisfaction survey, instructor satisfaction and self-efficacy survey, and a participant logbook to record practice time using the self-learning materials. Thirty-six students who received the simulation-based training showed statistically significant pre-to-post-test improvement in cognitive knowledge and cardiovascular assessment skills. PMID:22029244

  2. Sustainable practice improvements: impact of the Comprehensive Advanced Palliative Care Education (CAPCE) program.

    PubMed

    Harris, Diane; Hillier, Loretta M; Keat, Nancy

    2007-01-01

    This paper describes an education program designed to improve palliative care practice through the development of workplace hospice palliative care resources (PCRs), and its impact on knowledge transfer and longer-term changes to clinical practice. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical practice. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care practice. PMID:18251444

  3. The Integration of Research by Nurse Educators: Advancing Practice through Professional Development Programs.

    ERIC Educational Resources Information Center

    Waddell, Janice; Durrant, Michele; Avery, Shirley

    1999-01-01

    A nurse preceptorship program used narrative to help participants explore the complexity of pediatric clinical practice. Through narratives they shared clinical decision making, knowledge, and skills, transforming knowing into story telling into learning. (SK)

  4. Advances in the theory and practice of DNA-hybridization as a systematic method.

    PubMed

    Sheldon, F H

    1994-01-01

    DNA hybridization continues in the 1990s to provide insight into phylogeny and evolution. The resilience of this 30-year-old distance technique may be attributed to its fundamental power as a comparative method, as well as to advances in our understanding of its operation and improvements in experimental design and data analysis. These attributes and advances, along with the assumptions and limitations of DNA hybridization, are discussed in this paper. Examples are provided of recent DNA hybridization studies of molecular, morphological, and behavioral systematics and evolution. PMID:7994110

  5. Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

    PubMed

    Nagel, Daniel A; Penner, Jamie L

    2016-03-01

    Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. PMID:25858897

  6. Timing of Therapies in the Multidisciplinary Treatment of Locally Advanced Rectal Cancer: Available Evidence and Implications for Routine Practice.

    PubMed

    Sclafani, Francesco; Chau, Ian

    2016-07-01

    A multimodality disciplinary approach is paramount for the management of locally advanced rectal cancer. Over the last decade, (chemo)radiotherapy followed by surgery plus or minus adjuvant chemotherapy has represented the mainstay of treatment for this disease. Nevertheless, robust evidence suggesting the optimal timing and sequence of therapies in this setting has been overall limited. A number of questions are still unsolved including the length of the interval between neoadjuvant radiotherapy and surgery or the timing of systemic chemotherapy. Interestingly, emerging data support the contention that altering sequence or timing or both of the components of this multimodality approach may provide an opportunity to implement treatment strategies that far better address the risk and expectations of individual patients. In this article, we review the available evidence on timing of therapies in the multidisciplinary treatment of locally advanced rectal cancer and discuss the potential implications for routine practice that may derive from a change of the currently accepted treatment paradigm. PMID:27238468

  7. Do Geriatricians Practice What They Preach?: Geriatricians' Personal Establishment of Advance Directives

    ERIC Educational Resources Information Center

    Lester, Paula E.; Sykora, Alzbeta; Wolf-Klein, Gisele P.; Pekmezaris, Renee; Auerbach, Charles; Feuerman, Martin

    2009-01-01

    Previous research has been conducted regarding preferences of physicians for life-sustaining treatments for themselves, but there is a dearth of data on personal use of advance directives (ADs) by geriatricians specifically. Using a phone survey, we contacted all graduates of the geriatric fellowship program to assess their personal use of advance…

  8. Multisectoral Strategies for Advancing Girls' Education: Principles and Practice. SAGE Technical Report.

    ERIC Educational Resources Information Center

    Williams, Howard

    This paper describes issues, experiences, and strategies used in developing successful multisectoral partnerships to advance girls' education, using Guinea and Morocco as examples. Chapter 1 introduces the issue, discussing barriers to girls' education and describing the multisectoral response to interrelated barriers. Chapter 2 defines the…

  9. Advancing High-Quality Literacy Research in Juvenile Justice: Methodological and Practical Considerations

    ERIC Educational Resources Information Center

    Houchins, David E.; Jolivette, Kristine; Shippen, Margaret E.; Lambert, Richard

    2010-01-01

    Special education researchers have made noteworthy progress toward conceptualizing literacy research questions, designing quality studies, and disseminating the results of their research. These advancements have been made through the establishment and refinement of quality research indicators. Unfortunately, this progress has mostly eluded the…

  10. Advanced Mathematical Knowledge in Teaching Practice: Perceptions of Secondary Mathematics Teachers

    ERIC Educational Resources Information Center

    Zazkis, Rina; Leikin, Roza

    2010-01-01

    For the purpose of our research we define Advanced Mathematical Knowledge (AMK) as knowledge of the subject matter acquired during undergraduate studies at colleges or universities. We examine the responses of secondary school teachers about their usage of AMK in teaching. We find that the majority of teachers focus on the purposes and advantages…

  11. Meeting Students Where They Are: Advancing a Theory and Practice of Archives in the Classroom

    ERIC Educational Resources Information Center

    Saidy, Christina; Hannah, Mark; Sura, Tom

    2011-01-01

    This article uses theories of technical communication and archives to advance a pedagogy that includes archival production in the technical communication classroom. By developing and maintaining local classroom archives, students directly engage in valuable processes of appraisal, selection, collaboration, and retention. The anticipated outcomes…

  12. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) NORTH AMERICAN FREE TRADE AGREEMENT Advance Ruling... Regulations and Rulings, Office of International Trade at Headquarters, U. S. Customs and Border Protection... Mexico for repair or alteration qualifies for duty-free treatment in accordance with § 181.64 of...

  13. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) NORTH AMERICAN FREE TRADE AGREEMENT Advance Ruling... Regulations and Rulings, Office of International Trade at Headquarters, U. S. Customs and Border Protection... Mexico for repair or alteration qualifies for duty-free treatment in accordance with § 181.64 of...

  14. Advanced oxidation for indirect potable reuse: a practical application in Australia.

    PubMed

    Poussade, Y; Roux, A; Walker, T; Zavlanos, V

    2009-01-01

    December 2008 marked the completion of Stage 2B of the Western Corridor Recycled Water (WCRW) Project in South East Queensland, Australia. With a maximum combined production capacity of 232 million litres of purified recycled water a day, it is the third largest recycled water scheme in the world and the largest in southern hemisphere. A seven-barrier approach has been used to ensure very highest quality, safe water is produced at all times for the purpose of indirect potable reuse. Three of these barriers occur in the advanced water treatment section of the WCRW Project: micro- or ultra-filtration (MF), reverse osmosis (RO), and H(2)O(2)/UV advanced oxidation. In addition to providing very efficient disinfection, the advanced oxidation process specifically aims at destroying compounds not fully rejected by RO that are potential health hazards. This includes N-nitrosodimethylamine (NDMA), which is a potential carcinogenic product likely to be formed by chlorination or chloramination of wastewaters. As in many other countries, Australia has adopted a stringent guideline limit for this compound of 10 ng/L in purified recycled water. After 16 months of operations of the WCRW Project's first plant, the advanced oxidation system has been proven effective in removing NDMA and ensuring 100% compliance with the regulation at a controlled cost. PMID:19901475

  15. Behavioral Disorders: Practice Concerns and Students with EBD. Advances in Special Education. Volume 23

    ERIC Educational Resources Information Center

    Bakken, Jeffrey P., Ed.; Obiakor, Festus E., Ed.; Rotatori, Anthony F., Ed.

    2012-01-01

    Volumes 22 and 23 of the "Advances in Special Education" address the current top perspectives and issues in the field of emotional and behavioral disorders (EBD) by providing chapters written by active researchers and scholarly university professors who specialize in this area. Volume 22 first delineates legal issues, themes, and dimensions…

  16. Strategies for Increasing Advanced Placement Participation for Underrepresented Students: Barriers, Practices, and Positive Outcomes

    ERIC Educational Resources Information Center

    Flores, Sergio; Gomez, Martin O.

    2011-01-01

    Some school leaders have viewed programs such as Advanced Placement (AP) as an attractive option to resolve the ongoing achievement gap problem. However, the ongoing debate in the field about maintaining the ostensible purity of the AP program versus diluting it with program expansion has hindered the full utilization of AP classes to close the…

  17. Violence risk assessment and psychological treatment in correctional and forensic settings: Advances in research and practice.

    PubMed

    Magaletta, Philip R; VandenBos, Gary R

    2016-08-01

    This article is an introduction to the special section "Correctional and Criminal Justice Psychology." The eight articles in this issue advance the goals of delivering and assessing psychological services within the legal and correctional systems and achieving lasting change in individuals, groups, and systems. (PsycINFO Database Record PMID:27504641

  18. Cytotoxic Chemotherapy as First-Line Therapy for Advanced Non-Small-Cell Lung Cancer in Taiwan: Daily Practice

    PubMed Central

    Liang, Yi-Hsin; Shao, Yu-Yun; Liao, Bin-Chi; Lee, Ho-Sheng; Yang, James Chih-Hsin; Chen, Ho-Min; Chiang, Chun-Ju; Cheng, Ann-Lii; Lai, Mei-Shu

    2016-01-01

    Aim: Cytotoxic chemotherapy is the standard first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) without specific gene alterations. This study examined the prescription pattern and the survival outcome of cytotoxic chemotherapy regimens in daily practice in Taiwan. Methods:We established a population-based cohort of patients diagnosed with advanced NSCLC between 2005 and 2009 using the databases of Taiwan Cancer Registry and National Health Insurance in Taiwan. We then analyzed chemotherapy prescriptions and the survival outcomes of patients. Results:A total of 25,008 patients with advanced NSCLC were identified, 17,443 (70.0%) of which received first-line chemotherapy and were therefore included in this study. Among them, 11,551 (66.2%) patients had adenocarcinoma and 3,292 (18.9%) patients had squamous cell carcinoma (SCC). Approximately 70% of the patients were diagnosed with NSCLC in medical centers. Platinum-based doublet chemotherapy was administered to 66.9% of the patients. Among all chemotherapy regimens, platinum with gemcitabine (33.8%) was the most common, irrespective of geographic region. The second and third most common regimens were vinorelbine alone (13.0%) and platinum with docetaxel (11.6%). The prevalence of platinum-based doublet chemotherapy regimens decreased from 71.4% in 2005 to 64.1% in 2009. Among patients with adenocarcinoma histology, those who received platinum with pemetrexed had longer OS than did patients who received other platinum-based regimens (p < 0.001). Conclusion: Our findings reaffirm that in real-world practice, treatment plans of advanced NSCLC should be drawn up according to histology type. PMID:27471567

  19. Advocacy and leadership when parental rights and child welfare collide: the role of the advanced practice nurse.

    PubMed

    Walton, Mary K

    2002-02-01

    This article describes the experience of an advanced practice nurse in a challenging clinical situation. A mother with mental illness and mental retardation seeks to retain parental rights and care for her newborn with cystic fibrosis. The nurse provides leadership to the hospital team and serves as an advocate throughout legal proceedings. A systematic, nonjudgmental, and empathic approach to gathering information, working with the family, welfare, and legal representatives is described. Enacting a complex and court-mandated homecare education regimen to the disabled mother is discussed. Preparation to testify in a termination of parental rights proceeding is outlined and a summary description of the testimony provided. PMID:11891494

  20. Bare Bones Young Adult Services: Tips for Public Library Generalists.

    ERIC Educational Resources Information Center

    Vaillancourt, Renee J.

    This book is a hands-on guide to the philosophy and practice of young adult services in the public libraries. The following chapters are included: (1) "Young Adult Services Philosophy," including reasons to serve teens, why teens are the way they are, who serves young adults, and how to interact with teens; (2) "Youth Participation," including…

  1. The intention of advanced practice registered nurses to remain in positions at family planning clinics serving low-income women.

    PubMed

    Cheng, An-Lin; Kelly, Patricia J; Carlson, Kimberly; Witt, Jacki

    2014-01-01

    Federally funded Title X Family Planning Clinics are critical safety nets for reproductive health services in which advanced practice nurses (APRNs) provide the majority of care. The goal of this study was to identify factors affecting APRN's intention to remain in positions at these clinics. An Internet-administered survey was completed by 406 APRNs working in Title X clinics. The survey, based on a causal model of retention adapted for APRN practice, included 10 factors. Factor significance and model selection criteria were used to determine model fit. Intention to remain in current positions was associated with greater family responsibilities and lower levels of involvement in professional associations. Less routinization, more integration, and a greater sense of distributive justice were significant causal paths to job satisfaction (a significant mediator for intention to remain). Results provide Title X administrators information that can guide them in policy development to maximize APRN retention. PMID:24503318

  2. Liminality in cultural transition: applying ID-EA to advance a concept into theory-based practice.

    PubMed

    Baird, Martha B; Reed, Pamela G

    2015-01-01

    As global migration increases worldwide, nursing interventions are needed to address the effects of migration on health. The concept of liminality emerged as a pivotal concept in the situation-specific theory of well-being in refugee women experiencing cultural transition. As a relatively new concept in the discipline of nursing, liminality is explored using a method, called ID-EA, which we developed to advance a theoretical concept for application to nursing practice. Liminality in the context of cultural transition is further developed using the five steps of inquiry of the ID-EA method. The five steps are as follows: (1) inductive inquiry: qualitative research, (2) deductive inquiry: literature review, (3) synthesis of inductive and deductive inquiry, (4) evaluation inquiry, and (5) application-to-practice inquiry. The overall goal of this particular work was to develop situation-specific, theory-based interventions that facilitate cultural transitions for immigrants and refugees. PMID:25799694

  3. Advanced practice quality improvement project: how to influence physician radiologic imaging ordering behavior.

    PubMed

    Durand, Daniel J; Kohli, Marc D

    2014-12-01

    With growing pressure on the health care sector to improve quality and reduce costs, the stakes associated with imaging appropriateness have never been higher. Although radiologists historically functioned as imaging gatekeepers, this role has been deprioritized in the recent past. This article discusses several potential practice quality improvement projects that can help radiologists regain their role as valued consultants and integral members of the care team. By applying the PDSA framework, radiologists can incrementally optimize their practice's consultation service. While it can be expected that different strategies will gain traction in different environments, it is our hope that the methodology described here will prove useful to most or all practices as a starting point. In addition, we discuss several other influencing techniques that extend beyond traditional consultation services. PMID:25467728

  4. Advancing Organizational Cultural Competency With Dissemination and Implementation Frameworks: Towards Translating Standards into Clinical Practice.

    PubMed

    Ogbolu, Yolanda; Fitzpatrick, Grace A

    2015-01-01

    Substantial public health efforts have been activated to reduce health disparities and ensure health equity for patients through the provision of culturally and linguistically appropriate services; yet associated policies and standards are sluggishly translating into practice. Little attention and resources have been dedicated to translation of public health policies into practice settings. Dissemination and implementation is presented as an active, strategic approach to enhance uptake of public health standards; reviews dissemination and implementation concepts; poses a systematic model to adoption, implementation, and dissemination; and concludes with recommendations for hospital-based implementation teams and complementary interprofessional collaboration. PMID:26244477

  5. Conducting Reflective, Hands-On Research with Advanced Characterization Instruments: A High-Level Undergraduate Practical Exploring Solid-State Polymorphism

    ERIC Educational Resources Information Center

    Coles, S. J.; Mapp, L. K.

    2016-01-01

    An undergraduate practical exercise has been designed to provide hands-on, instrument-based experience of advanced characterization techniques. A research experience approach is taken, centered around the concept of solid-state polymorphism, which requires a detailed knowledge of molecular and crystal structure to be gained by advanced analytical…

  6. Real-world treatment practice in patients with advanced melanoma in the era before ipilimumab: results from the IMAGE study.

    PubMed

    Middleton, Mark R; Dalle, Stéphane; Claveau, Joel; Mut, Pilar; Hallmeyer, Sigrun; Plantin, Patrice; Highley, Martin; Kotapati, Srividya; Le, Trong Kim; Brokaw, Jane; Abernethy, Amy P

    2016-07-01

    The therapeutic landscape for advanced melanoma has recently been transformed by several novel agents (immune checkpoint inhibitors and molecular-targeted agents). The prospective, multi-site, observational study IMAGE (ipilimumab: management of advanced melanoma in real practice) included a retrospective cohort to describe real-world treatment prior to approval of the immune checkpoint inhibitor ipilimumab. This retrospective cohort of patients, who started second-line/subsequent treatment (index therapy) for advanced melanoma within 3 years before ipilimumab approval, was selected randomly by chart review. Collected data included treatment history, patient outcomes, and healthcare resource utilization. All patients had ≥1 year of follow-up data. This analysis included 177 patients from Europe (69%) and North America (31%). The most common index therapies (used alone or in combination) were fotemustine (23%), dacarbazine (21%), temozolomide (14%), and platinum-based chemotherapy (14%). Most patients (89%) discontinued index treatment during the study period; the most common reason was disease progression (59%). Among patients with tumor assessment (153/177; 86%), 2% had complete response, 5% had partial response, and 12% had stable disease on last tumor assessment. At 1-year study follow-up, median progression-free survival was 2.6 months (95% confidence interval [CI], 2.1-2.9) and median overall survival was 8.8 months (95% CI, 6.5-9.7). During follow-up, 95% of the patients had healthcare visits for advanced melanoma, 74% of whom were hospitalized or admitted to a hospice facility. These results provide insights into patient care with advanced melanoma in the era before ipilimumab and may serve as a benchmark for new agents in future real-world studies. PMID:27118102

  7. Advanced practice in neurocritical care: an innovative orientation and competency model.

    PubMed

    Vicari-Christensen, Michele

    2014-02-01

    The advanced registered nurse practitioner (ARNP) began in the 1960s as an alternative provider to meet the demands of an escalating healthcare resource deficit. As the role evolved and ARNPs demonstrated safe and effective care, these providers began to appear in critical care settings. It is believed that in the specialty of Neurocritical Care, about half the providers are ARNPs. Hiring and training practitioners for this complex environment is daunting. At the University of Florida & Shands Jacksonville, an innovative orientation and competency model for ARNPs hired for the newly opened Neurocritical Care unit was developed and implemented. The program contains a roadmap for knowledge base and skill acquisition as well as competency training and maintenance. Experience with appropriate hiring and screening standards, internally developed training tools, and identification of necessary advanced classes are discussed. This model may be used as a guideline for Neurocritical Care ARNP training as well as adapted for all other critical care settings. PMID:24399169

  8. Palliative radiotherapy for advanced malignancies in a changing oncologic landscape: guiding principles and practice implementation.

    PubMed

    Jones, Joshua A; Simone, Charles B

    2014-07-01

    Radiotherapy can provide safe, cost-effective, efficient palliation of various symptoms of advanced cancer with minimal side effects. Radiotherapy can palliate pain related to bone metastases and growing visceral metastases or primary cancers, neurologic symptoms related to brain and spine metastases, other symptoms including cough and dyspnea from advanced cancers in the lung, bleeding from various internal and external tumors, and obstructive symptoms. Palliative radiotherapy should be offered in the context of a multidisciplinary oncology team including medical oncologists, palliative care clinicians and various surgical and interventional subspecialists. The prescription of radiotherapy should balance the convenience and fewer side effects associated with short, hypofractionated courses of radiotherapy with the potential greater durability associated with longer courses of radiotherapy in patients with more prolonged life expectancies. The judicious use of advanced techniques in radiotherapy, including intensity-modulated radiotherapy and stereotactic radiotherapy (SRT), may be warranted in select patients, and they can potentially improve symptom control and durability but are associated with increased technical and economic costs. PMID:25841695

  9. A University-Community Partnership to Advance Research in Practice Settings: The HUB Research Model

    ERIC Educational Resources Information Center

    Dulmus, Catherine N.; Cristalli, Maria E.

    2012-01-01

    Human service organizations are uniquely positioned, given their scope of practice and access to consumers with the widest range of needs to significantly increase the national capacity for research if they were effectively equipped with the knowledge, skills, and funding to integrate research and development into their ongoing organizational…

  10. Evaluating and Advancing the Effective Teaching of Special Educators with a Dynamic Instructional Practices Portfolio

    ERIC Educational Resources Information Center

    Elliott, Stephen N.; Roach, Andrew T.; Kurz, Alexander

    2014-01-01

    We describe the concept of a dynamic instructional practices portfolio to evaluate special education teachers. This portfolio features the My Instructional Learning Opportunities Guidance System (MyiLOGS) as the core component. MyiLOGS is an online, daily self-report measure of opportunity to learn (OTL) that provides detailed information on…

  11. Advances in Special Education Volume 11, Issues, Practices and Concerns in Special Education.

    ERIC Educational Resources Information Center

    Rotatori, Anthony F., Ed.; Schwenn, John O., Ed.; Burkhardt, Sandra, Ed.

    This volume presents 14 papers which address current issues and practices in special education. The papers are: (1) "National Educational Reform: General and Special Education" (Joyce Fiddler and Freddie W. Litton); (2) "Linguistically Appropriate Special Education" (Herbert Grossman); (3) "Portfolio Assessment: An Individualized Approach for…

  12. Advancing Transdisciplinary and Translational Research Practice: Issues and Models of Doctoral Education in Public Health

    ERIC Educational Resources Information Center

    Neuhauser, Linda; Richardson, Dawn; Mackenzie, Sonja; Minkler, Meredith

    2007-01-01

    Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional…

  13. Practice-Based Evidence for Children and Adolescents: Advancing the Research Agenda in Schools

    ERIC Educational Resources Information Center

    Kratochwill, Thomas R.; Hoagwood, Kimberly Eaton; Kazak, Anne E.; Weisz, John R.; Hood, Korey; Vargas, Luis A.; Banez, Gerard A.

    2012-01-01

    The American Psychological Association Task Force on Evidence- Based Practice for Children and Adolescents (2008) recommended a systems approach to enhancing care in order to improve outcomes for children and adolescents with mental health needs and redress persistent systemic problems with the structure of services. Recommendations for enhancing…

  14. Conditions for building a community of practice in an advanced physics laboratory

    NASA Astrophysics Data System (ADS)

    Irving, Paul W.; Sayre, Eleanor C.

    2014-06-01

    We use the theory of communities of practice and the concept of accountable disciplinary knowledge to describe how a learning community develops in the context of an upper-division physics laboratory course. The change in accountable disciplinary knowledge motivates students' enculturation into a community of practice. The enculturation process is facilitated by four specific structural features of the course and supported by a primary instructional choice. The four structural features are "paucity of instructor time," "all in a room together," "long and difficult experiments," and "same experiments at different times." The instructional choice is the encouragement of the sharing and development of knowledge and understanding by the instructor. The combination of the instructional choice and structural features promotes the development of the learning community in which students engage in authentic practices of a physicist. This results in a classroom community that can provide students with the opportunity to have an accelerated trajectory towards being a more central participant of the community of a practice of physicists. We support our claims with video-based observations of laboratory classroom interactions and individual, semistructured interviews with students about their laboratory experiences and physics identity.

  15. Technological Advances in the Treatment of Trauma: A Review of Promising Practices

    ERIC Educational Resources Information Center

    Paul, Lisa A.; Hassija, Christina M.; Clapp, Joshua D.

    2012-01-01

    Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention,…

  16. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    PubMed

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate. PMID:24720938

  17. Associated disease risk from the introduced generalist pathogen Sphaerothecum destruens: management and policy implications.

    PubMed

    Andreou, Demetra; Gozlan, Rodolphe Elie

    2016-08-01

    The rosette agent Sphaerothecum destruens is a novel pathogen, which is currently believed to have been introduced into Europe along with the introduction of the invasive fish topmouth gudgeon Pseudorasbora parva (Temminck & Schlegel, 1846). Its close association with P. parva and its wide host species range and associated host mortalities, highlight this parasite as a potential source of disease emergence in European fish species. Here, using a meta-analysis of the reported S. destruens prevalence across all reported susceptible hosts species; we calculated host-specificity providing support that S. destruens is a true generalist. We have applied all the available information on S. destruens and host-range to an established framework for risk-assessing non-native parasites to evaluate the risks posed by S. destruens and discuss the next steps to manage and prevent disease emergence of this generalist parasite. PMID:27216376

  18. Altitudinal gradients of generalist and specialist herbivory on three montane Asteraceae

    NASA Astrophysics Data System (ADS)

    Scheidel, U.; Röhl, S.; Bruelheide, H.

    Different functional types of herbivory on three montane Asteraceae were investigated in natural populations in central Germany to test the hypothesis that herbivory is decreasing with altitude. Generalist herbivory was assessed as leaf area loss, mainly caused by slugs, and, in Petasites albus, as rhizome mining by oligophagous insect larvae. Capitules were found to be parasitized by oligophagous insects in Centaurea pseudophrygia and by the specialist fly Tephritis arnicae in Arnica montana. Only the damage to leaves of P. albus showed the hypothesized decrease with increasing altitude. No altitudinal gradient could be found in the leaf and capitule damage to C. pseudophrygia. In A. montana, capitule damage increased with increasing elevation. The data suggest that abundance and activity of generalist herbivores are more affected by climatic conditions along altitudinal gradients than specialist herbivores. In all probability, specialist herbivores depend less on abiotic conditions than on their host's population characteristics, such as host population size.

  19. More and more generalists: two decades of changes in the European avifauna.

    PubMed

    Le Viol, Isabelle; Jiguet, Frédéric; Brotons, Lluis; Herrando, Sergi; Lindström, Ake; Pearce-Higgins, James W; Reif, Jirí; Van Turnhout, Chris; Devictor, Vincent

    2012-10-23

    Biotic homogenization (BH) is a process whereby some species (losers) are systematically replaced by others (winners). While this process has been related to the effects of anthropogenic activities, whether and how BH is occurring across regions and the role of native species as a driver of BH has hardly been investigated. Here, we examine the trend in the community specialization index (CSI) for 234 native species of breeding birds at 10,111 sites in six European countries from 1990 to 2008. Unlike many BH studies, CSI uses abundance information to estimate the balance between generalist and specialist species in local assemblages. We show that bird communities are more and more composed of native generalist species across regions, revealing a strong, ongoing BH process. Our result suggests a rapid and non-random change in community composition at a continental scale is occurring, most likely driven by anthropogenic activities. PMID:22809721

  20. Response of pest control by generalist predators to local-scale plant diversity: a meta-analysis.

    PubMed

    Dassou, Anicet Gbèblonoudo; Tixier, Philippe

    2016-02-01

    Disentangling the effects of plant diversity on the control of herbivores is important for understanding agricultural sustainability. Recent studies have investigated the relationships between plant diversity and arthropod communities at the landscape scale, but few have done so at the local scale. We conducted a meta-analysis of 32 papers containing 175 independent measures of the relationship between plant diversity and arthropod communities. We found that generalist predators had a strong positive response to plant diversity, that is, their abundance increased as plant diversity increased. Herbivores, in contrast, had an overall weak and negative response to plant diversity. However, specialist and generalist herbivores differed in their response to plant diversity, that is, the response was negative for specialists and not significant for generalists. While the effects of scale remain unclear, the response to plant diversity tended to increase for specialist herbivores, but decrease for generalist herbivores as the scale increased. There was no clear effect of scale on the response of generalist predators to plant diversity. Our results suggest that the response of herbivores to plant diversity at the local scale is a balance between habitat and trophic effects that vary according to arthropod specialization and habitat type. Synthesis and applications. Positive effects of plant diversity on generalist predators confirm that, at the local scale, plant diversification of agroecosystems is a credible and promising option for increasing pest regulation. Results from our meta-analysis suggest that natural control in plant-diversified systems is more likely to occur for specialist than for generalist herbivores. In terms of pest management, our results indicate that small-scale plant diversification (via the planting of cover crops or intercrops and reduced weed management) is likely to increase the control of specialist herbivores by generalist predators. PMID

  1. From "Producing" to "Consuming" Research: Incorporating Evidence-Based Practice into Advanced Research Courses in a Master of Social Work Program

    ERIC Educational Resources Information Center

    Yankeelov, Pamela A.; Sar, Bibhuti K.; Antle, Becky F.

    2010-01-01

    Schools of social work have begun to explore teaching evidence-based practice (EBP) across their curriculum. Although the current literature offers ideas on how to incorporate EBP in foundation research and practice courses, the literature seems nonexistent on how to teach EBP in an advanced research sequence, which could clearly address the…

  2. Kestrel-Prey Dynamic in a Mediterranean Region: The Effect of Generalist Predation and Climatic Factors

    PubMed Central

    Fargallo, Juan A.; Martínez-Padilla, Jesús; Viñuela, Javier; Blanco, Guillermo; Torre, Ignasi; Vergara, Pablo; De Neve, Liesbeth

    2009-01-01

    Background Most hypotheses on population limitation of small mammals and their predators come from studies carried out in northern latitudes, mainly in boreal ecosystems. In such regions, many predators specialize on voles and predator-prey systems are simpler compared to southern ecosystems where predator communities are made up mostly of generalists and predator-prey systems are more complex. Determining food limitation in generalist predators is difficult due to their capacity to switch to alternative prey when the basic prey becomes scarce. Methodology We monitored the population density of a generalist raptor, the Eurasian kestrel Falco tinnunculus over 15 years in a mountainous Mediterranean area. In addition, we have recorded over 11 years the inter-annual variation in the abundance of two main prey species of kestrels, the common vole Microtus arvalis and the eyed lizard Lacerta lepida and a third species scarcely represented in kestrel diet, the great white-toothed shrew Crocidura russula. We estimated the per capita growth rate (PCGR) to analyse population dynamics of kestrel and predator species. Principal Findings Multimodel inference determined that the PCGR of kestrels was better explained by a model containing the population density of only one prey species (the common vole) than a model using a combination of the densities of the three prey species. The PCGR of voles was explained by kestrel abundance in combination with annual rainfall and mean annual temperature. In the case of shrews, growth rate was also affected by kestrel abundance and temperature. Finally, we did not find any correlation between kestrel and lizard abundances. Significance Our study showed for the first time vertebrate predator-prey relationships at southern latitudes and determined that only one prey species has the capacity to modulate population dynamics of generalist predators and reveals the importance of climatic factors in the dynamics of micromammal species and lizards

  3. Practical Guidance on How to Handle Levodopa/Carbidopa Intestinal Gel Therapy of Advanced PD in a Movement Disorder Clinic

    PubMed Central

    Pedersen, Stephen Wørlich; Clausen, Jesper; Gregerslund, Mie Manon

    2012-01-01

    Continuous dopaminergic delivery is recognized for the capacity to ameliorate symptoms in Parkinson’s disease (PD). In advanced PD the short comings of orally administered Levodopa/Carbidopa include fluctuations resulting in unstable effect and dyskinesia. Levodopa/Carbidopa intestinal gel, LCIG, (Duodopa®, Abbott Laboratories) is delivered continuously through a percutaneous endoscopic gastrostomy with the inner tube placed in the duodenum by means of a device (CADD legacy Duodopa pump (CE 0473)). The therapy implies continuous dopaminergic delivery directly to the duodenum and is therefore unaffected by gastric emptying and represents a major adjuvant in the treatment of advanced PD with significant improvement in motor and non-motor symptoms. The aim of this paper is to suggest the prerequisites for a LCIG clinic and propose a feasible set-up and lean organization of a movement disorder clinic. Secondly, the paper proposes practical handling of patients in LCIG treatment for advanced PD based on experience and initiation of LCIG treatment and follow-up in forty patients. PMID:22848335

  4. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

    PubMed

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

    2015-01-01

    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed. PMID:26115330

  5. Data Management Practices and Advanced Technologies in Environmental Science: Lessons from Academia

    NASA Astrophysics Data System (ADS)

    Hernandez, R. R.; Mayernik, M. S.; Murphy-Mariscal, M. L.; Allen, M. F.

    2013-12-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the students had not taken courses related to information science and the analysis of complex data. Seventy-four percent of the students reported no skill in programming languages or computational applications. Of the students who had completed research projects, 26% had created metadata for research data sets, and 29% had archived their data so that it was available online. One-third of these students used an environmental sensor. The results differed according to the students' research status, degree type, and university type. Changes may be necessary in the curricula of university programs that seek to prepare environmental scientists for this technologically advanced and data-intensive age. Figure 1. Weighted mean percent of graduate students who had none, basic, proficient, or expert knowledge in programming languages or computational applications. Weights were assigned to university means (n = 23). Error bars are 95% confidence interval. Table 1. Weighted mean percent of graduate students who responded 'YES' they plan to (n = 326) or have already completed (n = 131) research decisions 1-5. Weights were assigned to university means (n = 23). Uncertainties are 95% confidence intervals. Statistical differences are reported between responses of 1) students with thesis/dissertation research ';in progress' and 2) students who have ';completed' their research.

  6. Advancing Clinical Practice and Policy through Guidelines. The Role of the American Thoracic Society

    PubMed Central

    Gould, Michael K.

    2013-01-01

    In the face of an overwhelmingly large and growing medical literature, providers often turn to clinical practice guidelines to inform the decisions they make with patients. By systematically appraising the evidence and providing transparent recommendations for practice, guidelines have the potential to improve both bedside decision-making and health policy. This potential has not been fully realized because most guidelines lack transparency, are tainted by conflicts of interest, or fail to employ rigorous methods to appraise the evidence. To address the shortcomings of past guidelines, the Institute of Medicine (IOM) published recommendations for trustworthy guidelines, effectively setting the “gold standard” for what constitutes a high-quality guideline. Along with many other groups that develop guidelines, the American Thoracic Society (ATS) is rapidly evolving processes for development and implementation to meet many of the IOM standards. This Pulmonary Perspective describes the rapidly changing landscape of clinical practice guidelines, the role of the ATS in this landscape, and the activities the ATS is engaged in to ensure that the guidelines it produces are of the highest quality with the broadest impact. PMID:23392437

  7. Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

    PubMed

    Kogi, Kazutaka

    2006-01-01

    Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential. PMID:16610530

  8. Practice.

    PubMed

    Chambers, David W

    2008-01-01

    Practice refers to a characteristic way professionals use common standards to customize solutions to a range of problems. Practice includes (a) standards for outcomes and processes that are shared with one's colleagues, (b) a rich repertoire of skills grounded in diagnostic acumen, (c) an ability to see the actual and the ideal and work back and forth between them, (d) functional artistry, and (e) learning by doing that transcends scientific rationality. Communities of practice, such as dental offices, are small groups that work together in interlocking roles to achieve these ends. PMID:19413050

  9. Admission, recruitment, and retention: finding and keeping the generalist-oriented student. SGIM Task Force on Career Choice in Primary Care and Internal Medicine.

    PubMed

    Linzer, M; Slavin, T; Mutha, S; Takayama, J I; Branda, L; VanEyck, S; McMurray, J E; Rabinowitz, H K

    1994-04-01

    As the country strives to produce larger numbers of generalist physicians, considerable controversy has arisen over whether or not generalist applicants can be identified, recruited, and influenced to keep a generalist-oriented commitment throughout medical training. The authors present new and existing data to show that: 1) preadmission (BA/MD or post-baccalaureate) programs can help to identify generalist-oriented students; 2) characteristics determined at admission to medical school are predictive of future generalist career choice; 3) current inpatient-oriented training programs strongly push students away from a primary care career; 4) women are more likely than men to choose generalist careers, primarily because of those careers' interpersonal orientation; and 5) residency training programs are able to select applicants likely to become generalists. Therefore, to produce more generalists, attempts should be made to encourage generalist-oriented students to enter medical schools and to revise curricula to focus on outpatient settings in which students can establish effective and satisfying relationships with patients. These strategies are most likely to be successful if enacted within the context of governmental and medical school-based changes that allow for more reimbursement and respect for the generalist disciplines. PMID:8014739

  10. Specialists in ancient trees are more affected by climate than generalists.

    PubMed

    Gough, Leonie A; Sverdrup-Thygeson, Anne; Milberg, Per; Pilskog, Hanne E; Jansson, Nicklas; Jonsell, Mats; Birkemoe, Tone

    2015-12-01

    Ancient trees are considered one of the most important habitats for biodiversity in Europe and North America. They support exceptional numbers of specialized species, including a range of rare and endangered wood-living insects. In this study, we use a dataset of 105 sites spanning a climatic gradient along the oak range of Norway and Sweden to investigate the importance of temperature and precipitation on beetle species richness in ancient, hollow oak trees. We expected that increased summer temperature would positively influence all wood-living beetle species whereas precipitation would be less important with a negligible or negative impact. Surprisingly, only oak-specialist beetles with a northern distribution increased in species richness with temperature. Few specialist beetles and no generalist beetles responded to the rise of 4°C in summer as covered by our climatic gradient. The negative effect of precipitation affected more specialist species than did temperature, whereas the generalists remained unaffected. In summary, we suggest that increased summer temperature is likely to benefit a few specialist beetles within this dead wood community, but a larger number of specialists are likely to decline due to increased precipitation. In addition, generalist species will remain unaffected. To minimize adverse impacts of climate change on this important community, long-term management plans for ancient trees are important. PMID:27069612

  11. Plant neighborhood influences colonization of Brassicaceae by specialist and generalist aphids.

    PubMed

    Le Guigo, Pauline; Rolier, Alexandre; Le Corff, Josiane

    2012-07-01

    A plant's own characteristics, but also those of its neighbors, might have an impact on its probability of being colonized by herbivorous insects. A plant might be less colonized and experience associational resistance when it grows near repellent neighbors. In contrast, it might be more colonized and experience associational susceptibility near attractive neighbors. To date, mechanisms that drive associational defense are not really understood. In order to gain insights into the occurrence of associational resistance versus associational susceptibility under field conditions, we conducted an experiment to determine the influence of neighboring plants on the colonization of a focal plant by aphids. The focal plant was always Brassica oleracea. The neighbors were B. oleracea (control), B. napus, B. nigra, or Solanum lycopersicum, which represent contrasting levels of physical and chemical defenses. The focal plant, B. oleracea, was more colonized by the specialist aphid Brevicoryne brassicae, and experienced associational susceptibility when it was surrounded by B. nigra or B. napus. In contrast, B. oleracea was less colonized by the generalist aphid Myzus persicae, and experienced associational resistance when it was surrounded by S. lycopersicum, B. nigra or B. napus. Neighboring plants had no significant impact on host plant choice by the generalist aphid Macrosiphum euphorbiae. In conclusion, attraction or repulsion of the specialist aphid B. brassicae and the generalist aphid M. persicae by B. nigra, B. napus, and S. lycopersicum resulted in associational susceptibility or associational resistance for B. oleracea. PMID:22218942

  12. Pyrrolizidine Alkaloids Negatively Affect a Generalist Herbivore Feeding on the Chemically Protected Legume Crotalaria pallida.

    PubMed

    Cogni, R; Trigo, J R

    2016-06-01

    Plant secondary metabolites can have opposing effects on adapted specialist and non-adapted, generalist herbivores. In this study, we used Heliothis virescens (Fabricius) (Lepidoptera: Noctuidae) as a generalist, non-adapted model herbivore to test the possible effects of Crotalaria pallida (Fabaceae: Papilionoideae) defenses on herbivore performance. Neonate H. virescens larvae were able to consume C. pallida leaves and fruits and grow for a few instars, but none of them survived to pupation. We added isolated pyrrolizidine alkaloids (PAs) to an artificial diet at different concentrations, and PA concentration significantly affected the number of larvae that achieved pupation. Larval survival was not reduced at a PA concentration similar to the concentration on green seeds of C. pallida, but it was significantly reduced at PA concentration 5 and 100 times higher. These results suggest that PAs in isolation are not the defense responsible for the mortality in fresh C. pallida plants, indicating the importance of other possible defenses. The negative effect of PAs on fitness of the non-adapted, generalist herbivore is in agreement with few previous studies, but it is in clear contrast to a previous study on the effects of PAs on the adapted specialist herbivore Utetheisa ornatrix (L.) that were able to sequester PAs with no fitness costs. PMID:26830432

  13. Biotic resistance via granivory: establishment by invasive, naturalized, and native asters reflects generalist preference.

    PubMed

    Pearson, Dean E; Callaway, Ragan M; Maron, John L

    2011-09-01

    Escape from specialist natural enemies is frequently invoked to explain exotic plant invasions, but little attention has been paid to how generalist consumers in the recipient range may influence invasion. We examined how seed preferences of the widespread generalist granivore Peromyscus maniculatus related to recruitment of the strongly invasive exotic Centaurea stoebe and several weakly invasive exotics and natives by conducting laboratory feeding trials and seed addition experiments in the field. Laboratory feeding trials showed that P. maniculatus avoided consuming seeds of C. stoebe relative to the 12 other species tested, even when seeds of alternative species were 53-94% smaller than those of C. stoebe. Seed addition experiments conducted in and out of rodent exclosures revealed that weakly invasive exotics experienced relatively greater release from seed predation than C. stoebe, although this was not the case for natives. Seed mass explained 81% of the variation in recruitment associated with rodent exclusion for natives and weak invaders, with larger-seeded species benefiting most from protection from granivores. However, recruitment of C. stoebe was unaffected by rodent exclusion, even though the regression model predicted seeds of correspondingly large mass should experience substantial predation. These combined laboratory and field results suggest that generalist granivores can be an important biological filter in plant communities and that species-specific seed attributes that determine seed predation may help to explain variation in native plant recruitment and the success of exotic species invasions. PMID:21939071

  14. The Music Specialist among Generalists: Learning to Lead in a Community of Practice

    ERIC Educational Resources Information Center

    Luebke, Linda

    2013-01-01

    Music education leadership in public schools has often been the responsibility of a department chair or a district music supervisor. Nevertheless, budget constraints have forced districts to consolidate supervisory positions, frequently eliminating district chairs in music and the arts among other curricular areas. Without a strong advocate at the…

  15. Advancing the theory and practice of impact assessment: Setting the research agenda

    SciTech Connect

    Pope, Jenny; Bond, Alan; Morrison-Saunders, Angus; Retief, Francois

    2013-07-15

    Impact assessment has been in place for over 40 years and is now practised in some form in all but two of the world's nations. In this paper we reflect on the state of the art of impact assessment theory and practice, focusing on six well-established forms: EIA, SEA, policy assessment, SIA, HIA and sustainability assessment. We note that although the fundamentals of impact assessment have their roots in the US National Environmental Policy Act 1969 (NEPA) each branch of the field is distinct in also drawing on other theoretical and conceptual bases that in turn shape the prevailing discourse in each case, generating increasing degrees of specialisation within each sub-field. Against this backdrop, we consider the strengths and weaknesses of collective impact assessment practice, concluding that although there are substantial strengths, the plethora of specialist branches is generating a somewhat confusing picture and lack of clarity regarding how the pieces of the impact assessment jigsaw puzzle fit together. We use this review to suggest an overarching research agenda that will enable impact assessment to evolve in line with changing expectations for what it should deliver. -- Highlights: ► Strengths, weakness, opportunities and threats for IA are explored in this paper ► EIA, SEA, policy assessment, SIA, HIA and sustainability assessment are reviewed ► Diversity of practice is both a strength and weakness in the current economic climate ► There are opportunities to simplify IA by focusing on common and fundamental elements ► Continued research into theory related to IA effectiveness is also essential.

  16. Bench to bedside: integrating advances in basic science into daily clinical practice.

    PubMed

    McGoldrick, Rory B; Hui, Kenneth; Chang, James

    2014-08-01

    This article focuses on the initial steps of commercial development of a patentable scientific discovery from an academic center through to marketing a clinical product. The basics of partnering with a technology transfer office (TTO) and the complex process of patenting are addressed, followed by a discussion on marketing and licensing the patent to a company in addition to starting a company. Finally, the authors address the basic principles of obtaining clearance from the Food and Drugs Administration, production in a good manufacturing practice (GMP) facility, and bringing the product to clinical trial. PMID:25066849

  17. Advanced image reconstruction strategies for 4D prostate DCE-MRI: steps toward clinical practicality

    NASA Astrophysics Data System (ADS)

    Stinson, Eric G.; Borisch, Eric A.; Froemming, Adam T.; Kawashima, Akira; Young, Phillip M.; Warndahl, Brent A.; Grimm, Roger C.; Manduca, Armando; Riederer, Stephen J.; Trzasko, Joshua D.

    2015-09-01

    Dynamic contrast-enhanced (DCE) MRI is an important tool for the detection and characterization of primary and recurring prostate cancer. Advanced reconstruction strategies (e.g., sparse or low-rank regression) provide improved depiction of contrast dynamics and pharmacokinetic parameters; however, the high computation cost of reconstructing 4D (3D+time, 50+ frames) datasets typically inhibits their routine clinical use. Here, a novel alternating direction method-of-multipliers (ADMM) optimization strategy is described that enables these methods to be executed in ∠5 minutes, and thus within the standard clinical workflow. After overviewing the mechanics of this approach, high-performance implementation strategies will be discussed and demonstrated through clinical cases.

  18. Planning and scheduling the Hubble Space Telescope: Practical application of advanced techniques

    NASA Technical Reports Server (NTRS)

    Miller, Glenn E.

    1994-01-01

    NASA's Hubble Space Telescope (HST) is a major astronomical facility that was launched in April, 1990. In late 1993, the first of several planned servicing missions refurbished the telescope, including corrections for a manufacturing flaw in the primary mirror. Orbiting above the distorting effects of the Earth's atmosphere, the HST provides an unrivaled combination of sensitivity, spectral coverage and angular resolution. The HST is arguably the most complex scientific observatory ever constructed and effective use of this valuable resource required novel approaches to astronomical observation and the development of advanced software systems including techniques to represent scheduling preferences and constraints, a constraint satisfaction problem (CSP) based scheduler and a rule based planning system. This paper presents a discussion of these systems and the lessons learned from operational experience.

  19. Current practices and reform proposals for the regulation of advanced medicinal products in Canada.

    PubMed

    Viswanathan, Sowmya; Bubela, Tania

    2015-01-01

    We describe the Canadian regulatory framework for evaluating advanced medicinal products based on current policies, guidance documents and regulations and analyze proposed reforms. Our analysis is based on a documentary review supplemented by discussions with Health Canada officials. We present an overview of the Canadian regulatory framework for cell and gene therapy, medical devices and manufacturing facilities. We use the approval of Prochymal™ to highlight Canada's conditional marketing approval system. Finally, we discuss proposed changes to the regulatory framework in response to identified gaps, stakeholder consultations and international harmonization initiatives. Based on our analyses, we suggest that Canadian regulators have taken a reasonable approach in applying their regulatory framework without compromising on product safety. PMID:26237706

  20. Planning and scheduling the Hubble Space Telescope: Practical application of advanced techniques

    NASA Astrophysics Data System (ADS)

    Miller, Glenn E.

    1994-10-01

    NASA's Hubble Space Telescope (HST) is a major astronomical facility that was launched in April, 1990. In late 1993, the first of several planned servicing missions refurbished the telescope, including corrections for a manufacturing flaw in the primary mirror. Orbiting above the distorting effects of the Earth's atmosphere, the HST provides an unrivaled combination of sensitivity, spectral coverage and angular resolution. The HST is arguably the most complex scientific observatory ever constructed and effective use of this valuable resource required novel approaches to astronomical observation and the development of advanced software systems including techniques to represent scheduling preferences and constraints, a constraint satisfaction problem (CSP) based scheduler and a rule based planning system. This paper presents a discussion of these systems and the lessons learned from operational experience.

  1. Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice

    PubMed Central

    Mayden,, Kelley D.

    2012-01-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

  2. Mind-body therapies: evidence and implications in advanced oncology practice.

    PubMed

    Mayden, Kelley D

    2012-11-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

  3. Improving medical graduates’ training in palliative care: advancing education and practice

    PubMed Central

    Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A

    2016-01-01

    The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. PMID:26955298

  4. Advancing the field of pharmaceutical risk minimization through application of implementation science best practices.

    PubMed

    Smith, Meredith Y; Morrato, Elaine

    2014-08-01

    Regulators are increasingly mandating the use of pharmaceutical risk-minimization programs for a variety of medicinal products. To date, however, evaluations of these programs have shown mixed results and relatively little attention has been directed at diagnosing the specific factors contributing to program success or lack thereof. Given the growing use of these programs in many different patient populations, it is imperative to understand how best to design, deliver, disseminate, and assess them. In this paper, we argue that current approaches to designing, implementing, and evaluating risk-minimization programs could be improved by applying evidence- and theory-based 'best practices' from implementation science. We highlight commonly encountered challenges and gaps in the design, implementation, and evaluation of pharmaceutical risk-minimization initiatives and propose three key recommendations to address these issues: (1) risk-minimization program design should utilize models and frameworks that guide what should be done to produce successful outcomes and what questions should be addressed to evaluate program success; (2) intervention activities and tools should be theoretically grounded and evidence based; and (3) evaluation plans should incorporate a mixed-methods approach, pragmatic trial designs, and a range of outcomes. Regulators, practitioners, policy makers, and researchers are encouraged to apply these best practices in order to improve the public health impact of this important regulatory tool. PMID:25005707

  5. Advancing refinement through training: is there a role for reflective practice?

    PubMed

    Lloyd, Maggie

    2009-04-01

    In the fifty years since the publication of Russell and Burch's The Principles of Humane Experimental Technique, considerable progress has been made implementing the Three Rs in scientific research which involves the use of animals. However, there are still many areas where refinements are slow to be introduced, which may be due in part to a lack of knowledge by the experimenter. Information retrieval is increasingly difficult in the modern age, and there is information overload. This is combined with a fear of confounding the science by changing methods, as well as a natural instinct to defend one's methods from criticism by others. To overcome this, it is necessary for scientists to receive training in best practice throughout their careers, not just at the beginning, and to be encouraged to be actively self-critical, by evaluating their own techniques and methods and seeking to introduce refinements. Reflective practice is increasingly used in professional training programmes, and could encourage scientists to take the first step toward implementing refinements. PMID:19453211

  6. Early Childhood Teachers Reconstruct Beliefs and Practices through Reflexive Action

    ERIC Educational Resources Information Center

    Riojas-Cortez, Mari; Alanis, Iliana; Flores, Belinda Bustos

    2013-01-01

    Professional development, which results in sustained transformative change, requires that teachers engage in critical reflection regarding teaching practices. In this study, a group of five bilingual and generalist early childhood teachers engaged in a journey in which they elected to try to reconstruct their beliefs and practices about teaching…

  7. Factors influencing the development and implementation of advanced radiographer practice in Australia – a qualitative study using an interpretative phenomenological approach

    SciTech Connect

    Page, Barbara A; Bernoth, Maree; Davidson, Rob

    2014-09-15

    The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs and timing as critical factors influencing advanced practice in Australia. Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia.

  8. Factors influencing the development and implementation of advanced radiographer practice in Australia – a qualitative study using an interpretative phenomenological approach

    PubMed Central

    Page, Barbara A; Bernoth, Maree; Davidson, Rob

    2014-01-01

    Introduction The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. Methods This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. Results In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs and timing as critical factors influencing advanced practice in Australia. Conclusions Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia. PMID:26229650

  9. Swedish Students' and Preceptors' Perceptions of What Students Learn in a Six-Month Advanced Pharmacy Practice Experience

    PubMed Central

    Sporrong, Sofia Kälvemark; Gustavsson, Maria; Lindblad, Åsa Kettis; Johansson, Markus; Ring, Lena

    2011-01-01

    Objective. To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden. Methods. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories. Results. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development. Conclusions. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire. PMID:22345716

  10. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students.

    PubMed

    Defenbaugh, Nicole; Chikotas, Noreen E

    2016-01-01

    The purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting. The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student. PMID:26122938

  11. Determining the hydraulic properties of saturated, low-permeability geological materials in the laboratory: Advances in theory and practice

    USGS Publications Warehouse

    Zhang, M.; Takahashi, M.; Morin, R.H.; Endo, H.; Esaki, T.

    2002-01-01

    The accurate hydraulic characterization of low-permeability subsurface environments has important practical significance. In order to examine this issue from the perspective of laboratory-based approaches, we review some recent advancements in the theoretical analyses of three different laboratory techniques specifically applied to low-permeability geologic materials: constant-head, constant flow-rate and transient-pulse permeability tests. Some potential strategies for effectively decreasing the time required to confidently estimate the permeability of these materials are presented. In addition, a new and versatile laboratory system is introduced that can implement any of these three test methods while simultaneously subjecting a specimen to high confining pressures and pore pressures, thereby simulating in situ conditions at great depths. The capabilities and advantages of this innovative system are demonstrated using experimental data derived from Shirahama sandstone and Inada granite, two rock types widely encountered in Japan.

  12. Recent evidence, advances, and current practices in surgical treatment of lung cancer.

    PubMed

    Suda, Kenichi; Sato, Katsuaki; Mizuuchi, Hiroshi; Kobayashi, Yoshihisa; Shimoji, Masaki; Tomizawa, Kenji; Takemoto, Toshiki; Iwasaki, Takuya; Sakaguchi, Masahiro; Mitsudomi, Tetsuya

    2014-11-01

    In the last 10-15 years, strategies and modalities of lung cancer treatment have changed dramatically. Meanwhile, the treatment objectives, the lung cancers themselves, have also changed, probably owing to early detection by computed tomography and aging of the population. In particular, the proportions of smaller lung cancers, lung adenocarcinomas with ground-glass opacity, and lung cancers in older patients are increasing. Along with these changes, surgeons have innovated and evaluated novel procedures for pulmonary resection. These include the application of minimally invasive surgical techniques, such as video-assisted thoracoscopic surgery (VATS) and robotic surgery, and sub-lobar resection, such as wedge resection and segmentectomy, for small peripheral lung cancers. Currently, VATS has gained wide acceptance and several institutions in Japan have started using robotic surgery for lung cancers. Two important clinical trials of sub-lobar resection for small peripheral lung cancers are now underway in Japan. In addition, surgery itself is of growing importance in lung cancer treatment. In particular, recent evidence supports the use of surgery in strictly selected patients with locally advanced disease, lung cancers with N2 lymph node metastases, small cell lung cancers, recurrent oligo-metastasis after pulmonary resection, or relapsed tumors after drug treatment. Surgical treatment also provides abundant tumor samples for molecular analysis, which can be used for drug selection in the adjuvant setting or after disease relapse. In the era of personalized treatment, surgery is still one of the most important treatment modalities to combat lung cancer. PMID:25453375

  13. Advanced Practice Registered Nurses and Physician Assistants in Sleep Centers and Clinics: A Survey of Current Roles and Educational Background

    PubMed Central

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E.; Rogers, Ann E.

    2014-01-01

    Study Objectives: To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Methods: Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Results: Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through “on the job” training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. Conclusions: APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap. Citation: Colvin L, Cartwright Ann, Collop N, Freedman N, McLeod D, Weaver TE, Rogers AE. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. J Clin Sleep Med 2014;10(5):581-587. PMID:24812545

  14. Advances in the management of multiple sclerosis spasticity: experiences from recent studies and everyday clinical practice.

    PubMed

    Pozzilli, Carlo

    2013-12-01

    Although spasticity of varying severity affects up to 80% of patients with multiple sclerosis (MS) during the course of their disease, the symptom is often overlooked and undertreated. Despite the availability of oral antispasticity treatments (baclofen, tizanidine and others), approximately one-third of MS patients in Europe and the USA experience moderate or severe nonfocalized spasticity. At present, a thorough clinical evaluation of MS-related spasticity that takes into account the patient's own perception of spasms, spasticity-related pain and other associated symptoms is not common in daily neurological practice. Some of the usual spasticity scales, such as the Ashworth and modified Ashworth scales, reflect the observer's measurement of spasticity at a particular point in time. Herbal (smoked) cannabis has long been recognized as a possible option for relief of spasticity and neuropathic pain, but pertinent concerns about psychoactive effects and addiction risk have prevented its common use. An innovative method of benefiting from the mode of action of cannabinoids while limiting their drawbacks is to reduce peak plasma levels of 9-delta-tetrahydrocannabinol and counteract psychoactivity with higher than naturally occurring proportions of a second cannabinoid, cannabidiol. Sativex® oromucosal spray (1:1 ratio of 9-delta-tetrahydrocannabinol/cannabidiol) has recently been approved in a number of EU countries and elsewhere for use in patients with MS-related spasticity who are resistant to treatment with other antispasticity medications. In clinical trials, Sativex provided initial relief of spasticity symptoms within the first 4 weeks of treatment (trial period) in up to about half of patients resistant to other available oral antispasticity medications and demonstrated clinically significant improvement in spasticity (30% or higher reduction from baseline) in three-quarters of the initial responders. Adverse events were limited mainly to mild or moderate

  15. Develop, Discuss, and Decide: How New Science Teachers Use Technologies to Advance Their Practice

    NASA Astrophysics Data System (ADS)

    Ellis, Joshua Alexander

    For decades, there has been a nationwide demand to increase the number of science teachers in K-12 education (National Commission on Excellence in Education, 1983; National Research Council [NRC], 2007). This demand is in large part due to increases in state science graduation requirements. Teacher preparation programs have been preparing new science teachers on pace with the resulting increase in demand (Ingersoll & Merrill, 2010), however, shortages have continued as up to 50% of these new teachers leave the profession within their first five years of teaching (Smith & Ingersoll, 2004), creating a "revolving door" phenomenon as districts scramble to address this early attrition with yet more beginning teachers. We need to address what Ingersoll (2012) describes as the "greening" of the teaching force: the fact that an increasingly large segment of the teaching force is comprised of beginning teachers who are at a high risk of leaving the profession. The three related studies that comprise this dissertation focus on the role of technological interventions for in-service and pre-service science teachers. The context for the first two studies is TIN, an online induction program for beginning secondary science teachers. These two studies consider the impact of technological supports on the reflective practice of participating teachers. The design interventions included VideoANT (an online video annotation tool) and Teachers as Leaders roles (a structured response protocol) for the Venture/Vexation online forum activity. The context for the third study is T3-S, a university licensure course for pre-service science teachers designed to explore technology integration in secondary science classrooms. This study investigated the impact of pre-service teacher participation in the creation of an Adventure Learning (AL) environment (Doering, 2006) on their understanding of technological, pedagogical, and content knowledge (TPACK) and its role in their future science

  16. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    SciTech Connect

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  17. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    SciTech Connect

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  18. Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan. Part 2, Mappings for the ASC software quality engineering practices. Version 1.0.

    SciTech Connect

    Ellis, Molly A.; Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, 'ASCI Software Quality Engineering: Goals, Principles, and Guidelines'. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  19. Psychological well-being revisited: advances in the science and practice of eudaimonia.

    PubMed

    Ryff, Carol D

    2014-01-01

    This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered. PMID:24281296

  20. Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice

    PubMed Central

    di Pietro, Massimiliano; Alzoubaidi, Durayd; Fitzgerald, Rebecca C.

    2014-01-01

    Barrett’s esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally invasive endoscopic techniques. There is a large variation in clinical practice for endoscopic surveillance, and dysplasia as a marker of increased risk is affected by sampling error and high interobserver variability. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by upper gastrointestinal endoscopy. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by widespread indication to upper gastrointestinal endoscopy. In fact, it is currently difficult to formulate an accurate algorithm to confidently target the population at risk, based on the known clinical risk factors for BE and EAC. This review will focus on the clinical and molecular factors that are involved in the development of BE and its conversion to cancer and on how increased knowledge in these areas can improve the clinical management of the disease. PMID:25071900

  1. Barrett's esophagus and cancer risk: how research advances can impact clinical practice.

    PubMed

    di Pietro, Massimiliano; Alzoubaidi, Durayd; Fitzgerald, Rebecca C

    2014-07-01

    Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally invasive endoscopic techniques. There is a large variation in clinical practice for endoscopic surveillance, and dysplasia as a marker of increased risk is affected by sampling error and high interobserver variability. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by upper gastrointestinal endoscopy. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by widespread indication to upper gastrointestinal endoscopy. In fact, it is currently difficult to formulate an accurate algorithm to confidently target the population at risk, based on the known clinical risk factors for BE and EAC. This review will focus on the clinical and molecular factors that are involved in the development of BE and its conversion to cancer and on how increased knowledge in these areas can improve the clinical management of the disease. PMID:25071900

  2. Development of Appropriate Spot Welding Practice for Advanced High Strength Steels (TRP 0114)

    SciTech Connect

    Brian Girvin; Warren Peterson; Jerry Gould

    2004-09-17

    This program evaluated the effects of common manufacturing variables on spike-tempering effectiveness. The investigation used design-of-experiment (DOE) techniques, and examined both dual-phase and martensitic grades of high-strength steels (HSS). The specific grades chosen for this project were: Dual-phase (DP) 600, galvannealed (GA), 1.55 mm (DP) 600; Dual-phase (DP) 980 (uncoated), 1.55 mm (DP) 980; and Martensitic (M) 1300, 1.55 mm (M) 1300. Common manufacturing conditions of interest included tempering practice (quench and temper time), button size, simulated part fitup (sheet angular misalignment and fitup), and electrode wear (increased electrode face diameter). All of these conditions were evaluated against mechanical performance (static and dynamic tensile shear). Weld hardness data was also used to examine correlations between mechanical performance and the degree of tempering. Mechanical performance data was used to develop empirical models. The models were used to examine the robustness of weld strength and toughness to the selected processing conditions. This was done using standard EWI techniques. Graphical representations of robustness were then coupled with metallographic data to relate mechanical properties to the effectiveness of spike tempering. Mechanical properties for all three materials were relatively robust to variation in tempering. Major deviations in mechanical properties were caused by degradation of the weld itself. This was supported by a lack of correlation between hardness data and mechanical results. Small button sizes and large electrode face diameters (worn electrodes) produced large reductions in both static and dynamic strength levels when compared to standard production setups. Dynamic strength was further degraded by edge-located welds.

  3. Diagnosing COPD: advances in training and practice – a systematic review

    PubMed Central

    Koblizek, Vladimir; Novotna, Barbora; Zbozinkova, Zuzana; Hejduk, Karel

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung syndrome, caused by long-term inhalation of noxious gases and particles, which leads to gradual airflow limitation. All health care professionals who care for COPD patients should have full access to high-quality spirometry testing, as postbronchodilator spirometry constitutes the principal method of COPD diagnosis. One out of four smokers 45 years or older presenting respiratory symptoms in primary care, have non-fully reversible airflow limitation compatible with COPD and are mostly without a known diagnosis. Approximately 50.0%–98.3% of patients are undiagnosed worldwide. The majority of undiagnosed COPD patients are isolated at home, are in nursing or senior-assisted living facilities, or are present in oncology and cardiology clinics as patients with lung cancers and coronary artery disease. At this time, the prevalence and mortality of COPD subjects is increasing, rapidly among women who are more susceptible to risk factors. Since effective management strategies are currently available for all phenotypes of COPD, correctly performed and well-interpreted postbronchodilator spirometry is still an essential component of all approaches used. Simple educational training can substantially improve physicians’ knowledge relating to COPD diagnosis. Similarly, a physician inhaler education program can improve attitudes toward inhaler teaching and facilitate its implementation in routine clinical practices. Spirometry combined with inhaled technique education improves the ability of predominantly nonrespiratory physicians to correctly diagnose COPD, to adequately assess its severity, and to increase the percentage of correct COPD treatment used in a real-life setting. PMID:27099544

  4. Nitrogen Use Efficiency of California Almond Orchards Using Advanced Farming Practices

    NASA Astrophysics Data System (ADS)

    Smart, David; Schellenberg, Daniel; Saa Silva, Sebastian; Muhammad, Saiful; Sanden, Blake; Brown, Patrick

    2014-05-01

    Mobilization of reactive nitrogen species (NH3, NH4+, NOx, N2O, NO2- and NO3-) is perceived as one of the foremost challenges for modern agricultural production systems. Yet information to address the question of how advanced nitrogen (N) management alters reactive N mobilization is lacking. During 2009 to 2012 we monitored spatially constrained N2O emissions and potential leachable NO3-, along with yield-N content to examine their contribution to nitrogen use efficiency (NUE, fruit-N exported/fertilizer-N applied) for a modern, high yielding almond production system. This modern production system schedules irrigation to match evapotranspiration (ETc) estimated from the Penman-Montieth calculation of a reference evapotranspiration (ETo) times a seasonal crop coefficient (Kc) which was verified using eddy covariance and surface renewal latent heat flux estimates. Split N-fertilizer applications were targeted to tree-N demand and root proliferation. These production systems demand upwards of 300 kg N ha-1. NUE was found to be nearly 80% at an N application level allowing for economic sustainability of the system (308 kg N ha-1). When mobilization of N2O and NO3- were included in the NUE assessment, these systems were still highly sustainable in terms of N applied. We also monitored production and consumption of the greenhouse gases of carbon dioxide (CO2) and methane (CH4). These systems had relatively low levels of N2O emissions with emissions of N2O as a fraction of N-fertilizer applied being consistently less than IPCC Tier 1 emissions factors, and lower than the average estimated for most continental US farming systems. The system also demonstrated a capacity for net CH4 oxidation over the course of a season that occurred mainly in the driveways between tree rows that are kept dry over the course of the season in this arid environment. Our study indicated that tight management of water resources and targeted applications of N-fertilizer resulted in net positive

  5. Management practices for end-of-life cathode ray tube glass: Review of advances in recycling and best available technologies.

    PubMed

    Iniaghe, Paschal O; Adie, Gilbert U

    2015-11-01

    Cathode ray tubes are image display units found in computer monitors and televisions. In recent years, cathode ray tubes have been generated as waste owing to the introduction of newer and advanced technologies in image displays, such as liquid crystal displays and high definition televisions, among others. Generation and subsequent disposal of end-of-life cathode ray tubes presents a challenge owing to increasing volumes and high lead content embedded in the funnel and neck sections of the glass. Disposal in landfills and open dumping are anti-environmental practices considering the large-scale contamination of environmental media by the potential of toxic metals leaching from glass. Mitigating such environmental contamination will require sound management strategies that are environmentally friendly and economically feasible. This review covers existing and emerging management practices for end-of-life cathode ray tubes. An in-depth analysis of available technologies (glass smelting, detoxification of cathode ray tube glass, lead extraction from cathode ray tube glass) revealed that most of the techniques are environmentally friendly, but are largely confined to either laboratory scale, or are often limited owing to high cost to mount, or generate secondary pollutants, while a closed-looped method is antiquated. However, recycling in cementitious systems (cement mortar and concrete) gives an added advantage in terms of quantity of recyclable cathode ray tube glass at a given time, with minimal environmental and economic implications. With significant quantity of waste cathode ray tube glass being generated globally, cementitious systems could be economically and environmentally acceptable as a sound management practice for cathode ray tube glass, where other technologies may not be applicable. PMID:26463115

  6. The importance of neutral and niche processes for bacterial community assembly differs between habitat generalists and specialists.

    PubMed

    Liao, Jingqiu; Cao, Xiaofeng; Zhao, Lei; Wang, Jie; Gao, Zhe; Wang, Michael Cai; Huang, Yi

    2016-11-01

    The mechanisms of community assembly are a central focus in the field of microbial ecology. However, to what extent these mechanisms differ in importance by traits of groups is poorly understood. Here we quantified the importance of neutral and niche processes in community assembly for bacteria, habitat specialists and generalists in 21 plateau lakes of China. Results showed that both neutral and niche processes played a critical role in the assembly of entire bacterial communities, shaping a unique biogeographical pattern. A few habitat generalists and many specialists were identified. Interestingly, habitat specialists were only governed by niche process, with seven significant environmental variables-salinity, dissolved oxygen, water transparency, total phosphorus, ammonium-nitrogen, temperature and total nitrogen-independently explaining 40.3% of the biological variation. By contrast, habitat generalists were strongly driven by neutral process, with 50.9% of the variation of detection frequency explained in neutral community model. Only three environmental variables-salinity, total nitrogen and dissolved oxygen-significantly affected the distribution of habitat generalists, independently explaining 13.6% of the variation. Governed by different assembly mechanisms, habitat specialists and generalists presented disparate biogeographical patterns. Our result emphasizes the importance of investigating the bacterial community assembly at more refined levels than entire communities. PMID:27543321

  7. Host phenology and geography as drivers of differentiation in generalist fungal mycoparasites.

    PubMed

    Pintye, Alexandra; Ropars, Jeanne; Harvey, Nick; Shin, Hyeon-Dong; Leyronas, Christel; Nicot, Philippe C; Giraud, Tatiana; Kiss, Levente

    2015-01-01

    The question as to why parasites remain generalist or become specialist is a key unresolved question in evolutionary biology. Ampelomyces spp., intracellular mycoparasites of powdery mildew fungi, which are themselves plant pathogens, are a useful model for studies of this issue. Ampelomyces is used for the biological control of mildew. Differences in mycohost phenology promote temporal isolation between sympatric Ampelomyces mycoparasites. Apple powdery mildew (APM) causes spring epidemics, whereas other powdery mildew species on plants other than apple cause epidemics later in the season. This has resulted in genetic differentiation between APM and non-APM strains. It is unclear whether there is genetic differentiation between non-APM Ampelomyces lineages due to their specialization on different mycohosts. We used microsatellites to address this question and found no significant differentiation between non-APM Ampelomyces strains from different mycohosts or host plants, but strong differentiation between APM and non-APM strains. A geographical structure was revealed in both groups, with differences between European countries, demonstrating restricted dispersal at the continent scale and a high resolution for our markers. We found footprints of recombination in both groups, possibly more frequent in the APM cluster. Overall, Ampelomyces thus appears to be one of the rare genuine generalist pathogenic fungi able to parasitize multiple hosts in natural populations. It is therefore an excellent model for studying the evolution of pathogens towards a generalist rather than host-specific strategy, particularly in light of the tritrophic interaction between Ampelomyces mycoparasites, their powdery mildew fungal hosts and the mildew host plants. PMID:25803832

  8. Local adaptation in adult feeding preference and juvenile performance in the generalist herbivore Idotea balthica.

    PubMed

    Bell, Tina M; Sotka, Erik E

    2012-10-01

    Populations can respond to environmental heterogeneity by genetic adaptation to local conditions. Evidence for local adaptation in herbivores with relatively broad host breadth is scarce, either because generalists rarely locally adapt or because fewer studies have tested for local adaptation. The marine isopod Idotea balthica, a small (<3 cm) generalist herbivore common to estuaries of the northwestern Atlantic, is found on multiple macroalgae and sea grasses north of 42°N, while more southerly populations utilize sea grass-dominated and macroalgal-poor habitats. Feeding preference assays revealed a latitudinal shift in preference hierarchy that mirrors this geographic variation in host availability. Northern populations have higher feeding preference for fresh and freeze-dried tissue of the brown macroalga Fucus vesiculosus and consumed more of its water-soluble and lipophilic extracts relative to southern populations. In contrast, southern populations have a relatively higher preference for the green macroalga Ulva linza and sea grass Zostera marina. The rank of hosts in feeding assays exhibited by northern adults (Fucus = Ulva > Zostera) and southern adults (Ulva > Fucus > Zostera) closely mirrored ranking of juvenile growth rates, suggesting that preference and performance are strongly correlated across these macrophytes. Several of our assays included isopods that had parents reared under uniform laboratory conditions, indicating that geographic differences are genetically mediated and unlikely to reflect phenotypic plasticity or maternal effects. Local adaptation in host use traits may be common in broadly distributed, generalist herbivores in marine and terrestrial systems, and will manifest itself as local shifts in the preference ranking of hosts. PMID:22451011

  9. Molecular tracking of individual host use in the Shiny Cowbird - a generalist brood parasite.

    PubMed

    de la Colina, Ma Alicia; Hauber, Mark E; Strausberger, Bill M; Reboreda, Juan Carlos; Mahler, Bettina

    2016-07-01

    Generalist parasites exploit multiple host species at the population level, but the individual parasite's strategy may be either itself a generalist or a specialist pattern of host species use. Here, we studied the relationship between host availability and host use in the individual parasitism patterns of the Shiny Cowbird Molothrus bonariensis, a generalist avian obligate brood parasite that parasitizes an extreme range of hosts. Using five microsatellite markers and an 1120-bp fragment of the mtDNA control region, we reconstructed full-sibling groups from 359 cowbird eggs and chicks found in nests of the two most frequent hosts in our study area, the Chalk-browed Mockingbird Mimus saturninus and the House Wren Troglodytes aedon. We were able to infer the laying behavior of 17 different females a posteriori and found that they were mostly faithful to a particular laying area and host species along the entire reproductive season and did not avoid using previously parasitized nests (multiple parasitism) even when other nests were available for parasitism. Moreover, we found females using the same host nest more than once (repeated parasitism), which had not been previously reported for this species. We also found few females parasitizing more than one host species. The use of an alternative host was not related to the main hosts' nest availability. Overall, female shiny cowbirds use a spatially structured and host species specific approach for parasitism, but they do so nonexclusively, resulting in both detectable levels of multiple parasitism and generalism at the level of individual parasites. PMID:27547305

  10. Performance of Generalist and Specialist Herbivores and their Endoparasitoids Differs on Cultivated and Wild Brassica Populations

    PubMed Central

    Bukovinszky, Tibor; van Dam, Nicole M.; Dicke, Marcel; Bullock, James M.; Harvey, Jeffrey A.

    2008-01-01

    Through artificial selection, domesticated plants often contain modified levels of primary and secondary metabolites compared to their wild progenitors. It is hypothesized that the changed chemistry of cultivated plants will affect the performance of insects associated with these plants. In this paper, the development of several specialist and generalist herbivores and their endoparasitoids were compared when reared on a wild and cultivated population of cabbage, Brassica oleracea, and a recently established feral Brassica species. Irrespective of insect species or the degree of dietary specialization, herbivores and parasitoids developed most poorly on the wild population. For the specialists, plant population influenced only development time and adult body mass, whereas for the generalists, plant populations also affected egg-to-adult survival. Two parasitoid species, a generalist (Diadegma fenestrale) and a specialist (D. semiclausum), were reared from the same host (Plutella xylostella). Performance of D. semiclausum was closely linked to that of its host, whereas the correlation between survival of D. fenestrale and host performance was less clear. Plants in the Brassicaceae characteristically produce defense-related glucosinolates (GS). Levels of GS in leaves of undamaged plants were significantly higher in plants from the wild population than from the domesticated populations. Moreover, total GS concentrations increased significantly in wild plants after herbivory, but not in domesticated or feral plants. The results of this study reveal that a cabbage cultivar and plants from a wild cabbage population exhibit significant differences in quality in terms of their effects on the growth and development of insect herbivores and their natural enemies. Although cultivated plants have proved to be model systems in agroecology, we argue that some caution should be applied to evolutionary explanations derived from studies on domesticated plants, unless some knowledge

  11. The importance of the ontogenetic niche in resource-associated divergence: evidence from a generalist grasshopper.

    PubMed

    Dopman, Erik B; Sword, Gregory A; Hillis, David M

    2002-04-01

    Geographic variation in resource use can produce locally adapted populations that exhibit genetic and phenotypic divergence. In the bird-winged grasshopper (Schistocerca emarginata = [lineata]), we investigate whether genetic data exist in accordance with geographic variation in resource (host) use and coloration. In Texas, juvenile grasshoppers feed almost exclusively on one of two host plants, Rubus trivialis (Rosaceae) or Ptelea trifoliata (Rutaceae), whereas adults of both forms are dietary generalists and consume many plants from unrelated families. Along with differences in juvenile feeding, differences in a density-dependent color polyphenism are concordant with genetic (mitochondrial DNA) variation among eight populations of the bird-winged grasshopper. Forms feeding on R. trivialis and those feeding on P. trifoliata represent monophyletic lineages according to phylogenetic analysis and maximum-likelihood tests of two alternative phylogeographic hypotheses for geographic variation in host use. Character-state optimization of host-plant acceptability on a phylogeny containing S. emarginata and outgroup taxa indicates that populations consuming R. trivialis gave rise to populations consuming P. trifoliata. Juvenile grasshoppers that consume P. trifoliata acquire deterrence against predation, suggesting that enemy-free space facilitated this host shift. In extant populations, adaptations stemming from alternative resource use during ontogeny present possible barriers to gene exchange. This study represents the first demonstration of resource-associated divergence in an otherwise generalist insect that exhibits temporal variation in resource use, characterized as developmental changes in host specialization. Our findings suggest that exploitation of different resources may have unexplored significance for generalist species that compartmentalize specialization to particular life stages. PMID:12038531

  12. Trophic Shifts of a Generalist Consumer in Response to Resource Pulses

    PubMed Central

    Shaner, Pei-Jen L.; Macko, Stephen A.

    2011-01-01

    Trophic shifts of generalist consumers can have broad food-web and biodiversity consequences through altered trophic flows and vertical diversity. Previous studies have used trophic shifts as indicators of food-web responses to perturbations, such as species invasion, and spatial or temporal subsidies. Resource pulses, as a form of temporal subsidies, have been found to be quite common among various ecosystems, affecting organisms at multiple trophic levels. Although diet switching of generalist consumers in response to resource pulses is well documented, few studies have examined if the switch involves trophic shifts, and if so, the directions and magnitudes of the shifts. In this study, we used stable carbon and nitrogen isotopes with a Bayesian multi-source mixing model to estimate proportional contributions of three trophic groups (i.e. producer, consumer, and fungus-detritivore) to the diets of the White-footed mouse (Peromyscus leucopus) receiving an artificial seed pulse or a naturally-occurring cicadas pulse. Our results demonstrated that resource pulses can drive trophic shifts in the mice. Specifically, the producer contribution to the mouse diets was increased by 32% with the seed pulse at both sites examined. The consumer contribution to the mouse diets was also increased by 29% with the cicadas pulse in one of the two grids examined. However, the pattern was reversed in the second grid, with a 13% decrease in the consumer contribution with the cicadas pulse. These findings suggest that generalist consumers may play different functional roles in food webs under perturbations of resource pulses. This study provides one of the few highly quantitative descriptions on dietary and trophic shifts of a key consumer in forest food webs, which may help future studies to form specific predictions on changes in trophic interactions following resource pulses. PMID:21437248

  13. Diet dependent metabolic responses in three generalist insect herbivores Spodoptera spp.

    PubMed

    Roy, A; Walker, W B; Vogel, H; Chattington, S; Larsson, M C; Anderson, P; Heckel, D G; Schlyter, F

    2016-04-01

    Adaption to dietary changes is critical in the evolution of host plant ranges in polyphagous insects. We compared three taxa of lepidopteran herbivores from the predominantly generalist genus Spodoptera showing different degrees of polyphagy: Spodoptera littoralis, with a broad host range including both mono- and dicotyledonous plants, and two Spodoptera frugiperda strains [Corn (i.e. maize) (C) and Rice (R)] adapted primarily to different grass species. When feeding on maize we show a lower performance in the broad generalist taxon compared to the grass adapted taxa. Among these taxa, the maize adapted S. frugiperda C-strain generally performed better than the R-strain on maize leaves. On artificial pinto diet, all taxa performed well. Our RNA-Seq analysis of midgut transcriptomes from 3rd instar larvae feeding on maize showed broader transcriptional readjustments in the generalist S. littoralis compared to grass adapted S. frugiperda strains. Substantial alteration in the expression levels of midgut physiological function related transcripts, such as digestive and detoxifying enzymes, transporters, immunity, and peritrophic membrane associated transcripts, existed in all taxa. We found high background expression of UDP-glucosyl transferases, which are known to neutralize maize leaf toxins, in the maize adapted S. frugiperda C-strain, contributing to its fitness on maize compared to the R-strain. Our findings provide evidence for divergent diet specific response of digestive physiology within these Spodoptera taxa. Unexpectedly, the C- and R-strains of S. frugiperda fed on the same diet showed large differences in expression patterns between these two closely related taxa. PMID:26908076

  14. Host Phenology and Geography as Drivers of Differentiation in Generalist Fungal Mycoparasites

    PubMed Central

    Harvey, Nick; Shin, Hyeon-Dong; Leyronas, Christel; Nicot, Philippe C.; Giraud, Tatiana; Kiss, Levente

    2015-01-01

    The question as to why parasites remain generalist or become specialist is a key unresolved question in evolutionary biology. Ampelomyces spp., intracellular mycoparasites of powdery mildew fungi, which are themselves plant pathogens, are a useful model for studies of this issue. Ampelomyces is used for the biological control of mildew. Differences in mycohost phenology promote temporal isolation between sympatric Ampelomyces mycoparasites. Apple powdery mildew (APM) causes spring epidemics, whereas other powdery mildew species on plants other than apple cause epidemics later in the season. This has resulted in genetic differentiation between APM and non-APM strains. It is unclear whether there is genetic differentiation between non-APM Ampelomyces lineages due to their specialization on different mycohosts. We used microsatellites to address this question and found no significant differentiation between non-APM Ampelomyces strains from different mycohosts or host plants, but strong differentiation between APM and non-APM strains. A geographical structure was revealed in both groups, with differences between European countries, demonstrating restricted dispersal at the continent scale and a high resolution for our markers. We found footprints of recombination in both groups, possibly more frequent in the APM cluster. Overall, Ampelomyces thus appears to be one of the rare genuine generalist pathogenic fungi able to parasitize multiple hosts in natural populations. It is therefore an excellent model for studying the evolution of pathogens towards a generalist rather than host-specific strategy, particularly in light of the tritrophic interaction between Ampelomyces mycoparasites, their powdery mildew fungal hosts and the mildew host plants. PMID:25803832

  15. Dynamics of Leslie-Gower type generalist predator in a tri-trophic food web system

    NASA Astrophysics Data System (ADS)

    Priyadarshi, A.; Gakkhar, S.

    2013-11-01

    In this paper, the dynamics of a tri-trophic food web system consists of Leslie-Gower type generalist predator has been explored. The system is bounded under certain conditions. The Hopf-bifurcation has been established in the phase planes. The bifurcation diagrams exhibit coexistence of all three species in the form of periodic/chaotic solutions. The "snail-shell" chaotic attractor has very high Lyapunov exponents. The coexistence in the form of stable equilibrium is also possible for lower values of parameters. The two-parameter bifurcation diagrams are drawn for critical parameters.

  16. (Mis) Perceptions and Interactions of Sleep Specialists and Generalists: Obstacles to Referrals to Sleep Specialists and the Multidisciplinary Team Management of Sleep Disorders

    PubMed Central

    Hayes, Sean M.; Murray, Suzanne; Castriotta, Richard J.; Landrigan, Christopher P.; Malhotra, Atul

    2012-01-01

    Study Objectives: This study assessed generalists' perceptions and challenges in providing care to sleep disorders patients and the role of sleep specialists in improving gaps in care. Methods: A mixed-method approach included qualitative (semi-structured interviews, discussion groups) and quantitative (online surveys) data collection techniques regarding care of patients with obstructive sleep apnea (OSA) and shift work disorder (SWD). Results: Participants: OSA: generalists n = 165, specialists (internists, neurologists, psychiatrists, pulmonologists) n = 12; SWD: generalists n = 216, specialists n = 108. Generalists reported challenges in assessing sleep disorders and diagnosing patients with sleep complaints. Generalists lacked confidence (selected ≤ 3 on a 5-pt Likert scale) in managing polypharmacy and drug interactions (OSA: 54.2%; SWD: 62.6%), addiction (OSA: 61.8%), and continuous positive airway pressure (OSA: 66.5%). Generalists in both studies reported deficits in knowledge of monitoring sleep disorders (OSA: 57.7%; SWD: 78.7%), rather relying on patients' subjective reports; 23% of SWD generalists did not identify SWD as a medical condition. Challenges to generalist-specialist collaboration were reported, with 66% of generalists and 68% of specialists in the SWD study reporting lack of coordination as a barrier. Generalists reported lack of consistency in sleep medicine and a perceived lack of value in consulting with sleep specialists. Conclusions: Knowledge and attitudinal challenges were found in primary care of patients with sleep disorders. Sleep specialists need to clarify and educate practitioners regarding primary care's approach. Citation: Hayes SM; Murray S; Castriotta RJ; Landrigan CP; Malhotra A. (Mis) perceptions and interactions of sleep specialists and generalists: obstacles to referrals to sleep specialists and the multidisciplinary team management of sleep disorders. J Clin Sleep Med 2012;8(6):633-642. PMID:23243396

  17. Sorafenib treatment of radioiodine-refractory advanced thyroid cancer in daily clinical practice: a cohort study from a single center.

    PubMed

    Gallo, Marco; Michelon, Federica; Castiglione, Anna; Felicetti, Francesco; Viansone, Alessandro Adriano; Nervo, Alice; Zichi, Clizia; Ciccone, Giovannino; Piovesan, Alessandro; Arvat, Emanuela

    2015-08-01

    Treatment options for recurrent or metastatic differentiated thyroid cancer (DTC) refractory to radioactive iodine (RAI) are inadequate. Multitargeted kinase inhibitors have recently shown promising results in phase 2-3 studies. This retrospective study aimed to document our clinical experience on the effects of sorafenib in the setting of daily clinical practice. Retrospective study evaluating the efficacy and safety of sorafenib in a cohort of patients consecutively treated with sorafenib at a single center. Twenty patients with advanced RAI-refractory thyroid carcinoma were enrolled (March 2011-March 2014). Patients generally started with 400 mg of sorafenib twice daily, tapering the dose in case of side effects. Radiological response and toxicity were measured during follow-up, together with safety parameters. CT scans were performed by a single experienced radiologist every 3-4 months. Five patients stopped sorafenib within 90 days due to severe toxicities. Median progression-free survival was 248 days. Five patients had a partial response (PR), achieved in all cases within 3 months, whereas 5 had stable disease (SD) at 12 months. Durable response rate (PR plus SD) for at least 6 months was 50 %, among those who received sorafenib for at least 3 months. Commonest adverse events included skin toxicity, gastrointestinal and constitutional symptoms. In our cohort of patients with advanced RAI-refractory thyroid carcinoma, sorafenib confirmed antitumor activity leading to SD or PR in the majority of cases, at the expense of clinically relevant side effects. More effective and tolerable agents are still needed in the treatment of RAI-refractory DTC. PMID:25414068

  18. Increasing the activity and enantioselectivity of lipases by sol-gel immobilization: further advancements of practical interest

    NASA Astrophysics Data System (ADS)

    Tielmann, Patrick; Kierkels, Hans; Zonta, Albin; Ilie, Adriana; Reetz, Manfred T.

    2014-05-01

    The entrapment of lipases in hydrophobic silicate matrices formed by sol-gel mediated hydrolysis of RSi(OCH3)3/Si(OCH3)4 as originally reported in 1996 has been improved over the years by a number of modifications. In the production of second-generation sol-gel lipase immobilizates, a variety of additives during the sol-gel process leads to increased activity and enhanced stereoselectivity in esterifying kinetic resolution. Recent advances in this type of lipase immobilization are reviewed here, in addition to new results regarding the sol-gel entrapment of the lipase from Burkholderia cepacia. It constitutes an excellent heterogeneous biocatalyst in the acylating kinetic resolution of two synthetically and industrially important chiral alcohols, rac-sulcatol and rac-trans-2-methoxycyclohexanol. The observation that the catalyst can be used 10 times in recycling experiments without losing its significant activity or enantioselectivity demonstrates the practical viability of the sol-gel approach.The entrapment of lipases in hydrophobic silicate matrices formed by sol-gel mediated hydrolysis of RSi(OCH3)3/Si(OCH3)4 as originally reported in 1996 has been improved over the years by a number of modifications. In the production of second-generation sol-gel lipase immobilizates, a variety of additives during the sol-gel process leads to increased activity and enhanced stereoselectivity in esterifying kinetic resolution. Recent advances in this type of lipase immobilization are reviewed here, in addition to new results regarding the sol-gel entrapment of the lipase from Burkholderia cepacia. It constitutes an excellent heterogeneous biocatalyst in the acylating kinetic resolution of two synthetically and industrially important chiral alcohols, rac-sulcatol and rac-trans-2-methoxycyclohexanol. The observation that the catalyst can be used 10 times in recycling experiments without losing its significant activity or enantioselectivity demonstrates the practical viability of

  19. Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians

    PubMed Central

    2014-01-01

    Background Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians’ ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations. Methods Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n = 26,716). Results In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p < 0.0001 for provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p < 0.01 for provider type). Conclusions Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform. PMID:24685149

  20. Chlorophyll degradation in the gut of generalist and specialist Lepidopteran caterpillars.

    PubMed

    Badgaa, Amarsanaa; Jia, Aiqun; Ploss, Kerstin; Boland, Wilhelm

    2014-12-01

    Plant feeding herbivores excrete most of the ingested chlorophyll (Chl) as partly degraded derivatives lacking the phytol side chain and the central magnesium ion. An ecological role of digested and degraded Chls in the interactions between insects, their food plant and other insects has been described recently. To gain more information on common degradation patterns in plant-feeding insects, the orals secretions and frass of five Lepidopteran caterpillars covering generalists and specialists, namely Spodoptera littoralis, Spodoptera eridania, Heliothis virescens, Helicoverpa armigera, Manduca sexta, and, for comparison, of the leaf beetle larva Chrysomela lapponica were analyzed for chlorophyll catabolites. The major degradation products were determined as pheohorbide a/b and pyropheophorbide a/b by using LC-MS, LC-NMR, UV, and fluorescence spectrometry. The compounds were not present in fresh leaves of the food plants (Phaseolus lunatus, Nicotiana tabacum). The catabolite spectrum in generalists and specialists was qualitatively similar and could be attributed to the action of gut proteins and the strongly alkaline milieu in the digestive tract. Due to the anaerobic environment of the larval gut, the tetrapyrrole core of the Chl catabolites was not cleaved. Substantial amounts of Chl a/b metabolites were strongly complexed by a protein in the mid-gut. PMID:25416033

  1. Are mountain habitats becoming more suitable for generalist than cold-adapted lizards thermoregulation?

    PubMed Central

    Mencía, Abraham; Pérez-Mellado, Valentín

    2016-01-01

    Mountain lizards are highly vulnerable to climate change, and the continuous warming of their habitats could be seriously threatening their survival. We aim to compare the thermal ecology and microhabitat selection of a mountain lizard, Iberolacerta galani, and a widely distributed lizard, Podarcis bocagei, in a montane area. Both species are currently in close syntopy in the study area, at 1,400 m above the sea level. We determined the precision, accuracy and effectiveness of thermoregulation, and the thermal quality of habitat for both species. We also compared the selection of thermal microhabitats between both species. Results show that I. galani is a cold-adapted thermal specialist with a preferred temperature range of 27.9–29.7 °C, while P. bocagei would be a thermal generalist, with a broader and higher preferred temperature range (30.1–34.5 °C). In addition, I. galani selects rocky substrates while P. bocagei selects warmer soil and leaf litter substrates. The thermal quality of the habitat is higher for P. bocagei than for I. galani. Finally, P. bocagei achieves a significantly higher effectiveness of thermoregulation (0.87) than I. galani (0.80). Therefore, these mountain habitat conditions seem currently more suitable for performance of thermophilic generalist lizards than for cold-specialist lizards. PMID:27280076

  2. The generalist Inga subnuda subsp. luschnathiana (Fabaceae): negative effect of floral visitors on reproductive success?

    PubMed

    Avila, R; Pinheiro, M; Sazima, M

    2015-05-01

    Inga species are characterised by generalist or mixed pollination system. However, this feature does not enhance reproductive rates in species with very low fruit set under natural conditions. Some ecological and genetic factors are associated with this feature, and to test the effect of massive visits on pollination success in Inga subnuda subsp. luschnathiana, we studied the efficacy of polyads deposited on stigmas of flowers isolated from visitors and polyads exposed to visitors. The proportion of polyads fixed in stigmas decreased after exposure to visitors (24 h) in comparison to stigmas isolated from visitors (hummingbirds, bees, wasps, hawkmoths and bats), and fruit set was very low. Furthermore, nectar production, sugar composition and other floral biology traits were evaluated. Increased nectar production, sugar availability and sucrose dominance during the night indicates adaptation to nocturnal visitors and supports their role as main pollinators; although the brush-flower morphology, time of anthesis, nectar dynamics and chemical composition also allow daytime visitors. Thus the species is an important resource for a diverse group of floral visitors. We conclude that excess visits (diurnal and nocturnal) are responsible for the decrease in fixed polyads in stigmas of I. subnuda subsp. luschnathiana flowers, thus contributing, with others factors, to its low fruit set. Therefore, the generalist pollination system does not result in reproductive advantages because the low fruit set in natural conditions could be the result of a negative effect of visitors/pollinators. PMID:25488371

  3. Community-integrated omics links dominance of a microbial generalist to fine-tuned resource usage

    PubMed Central

    Muller, Emilie E. L.; Pinel, Nicolás; Laczny, Cédric C.; Hoopmann, Michael R.; Narayanasamy, Shaman; Lebrun, Laura A.; Roume, Hugo; Lin, Jake; May, Patrick; Hicks, Nathan D.; Heintz-Buschart, Anna; Wampach, Linda; Liu, Cindy M.; Price, Lance B.; Gillece, John D.; Guignard, Cédric; Schupp, James M.; Vlassis, Nikos; Baliga, Nitin S.; Moritz, Robert L.; Keim, Paul S.; Wilmes, Paul

    2014-01-01

    Microbial communities are complex and dynamic systems that are primarily structured according to their members’ ecological niches. To investigate how niche breadth (generalist versus specialist lifestyle strategies) relates to ecological success, we develop and apply an integrative workflow for the multi-omic analysis of oleaginous mixed microbial communities from a biological wastewater treatment plant. Time- and space-resolved coupled metabolomic and taxonomic analyses demonstrate that the community-wide lipid accumulation phenotype is associated with the dominance of the generalist bacterium Candidatus Microthrix spp. By integrating population-level genomic reconstructions (reflecting fundamental niches) with transcriptomic and proteomic data (realised niches), we identify finely tuned gene expression governing resource usage by Candidatus Microthrix parvicella over time. Moreover, our results indicate that the fluctuating environmental conditions constrain the accumulation of genetic variation in Candidatus Microthrix parvicella likely due to fitness trade-offs. Based on our observations, niche breadth has to be considered as an important factor for understanding the evolutionary processes governing (microbial) population sizes and structures in situ. PMID:25424998

  4. Role of supplemental foods and habitat structural complexity in persistence and coexistence of generalist predatory mites

    PubMed Central

    Pozzebon, Alberto; Loeb, Gregory M.; Duso, Carlo

    2015-01-01

    Plant traits can influence the interactions between herbivore arthropods and their natural enemies. In these interactions generalist predators are often present, preying on herbivores and also on other arthropods in the same trophic guild. Variation in the strength of intraguild predation (IGP) may be related to habitat structural complexity and to additional resources outside the narrow predator-prey relationship. In this paper we study the food web interactions on grape, which involves two generalist predatory mites. We evaluated the effects of grape powdery mildew (GPM) as supplemental food, and habitat structural complexity provided by domatia. The inoculation of GPM resulted in higher predatory mite densities and reduced the negative impact of unfavorable leaf structure for one species. Access to domatia was the main factor in promoting population abundance and persistence of predatory mites. Access to domatia and GPM availability favored the coexistence of predatory mites at a low density of the intraguild prey. Our findings suggest that structural and nutritional diversity/complexity promote predatory mite abundance and can help to maintain the beneficial mites - plants association. The effect of these factors on coexistence between predators is influenced by the supplemental food quality and relative differences in body size of interacting species. PMID:26450810

  5. Experimental evidence that livestock grazing intensity affects the activity of a generalist predator

    NASA Astrophysics Data System (ADS)

    Villar, Nacho; Lambin, Xavier; Evans, Darren; Pakeman, Robin; Redpath, Steve

    2013-05-01

    Grazing by domestic ungulates has substantial impacts on ecosystem structure and composition. In grasslands of the northern hemisphere, livestock grazing limits populations of small mammals, which are a main food source for a variety of vertebrate predators. However, no experimental studies have described the impact of livestock grazing on vertebrate predators. We experimentally manipulated sheep and cattle grazing intensity in the Scottish uplands to test its impact on a relatively abundant small mammal, the field vole (Microtus agrestis), and its archetypal generalist predator, the red fox (Vulpes vulpes). We demonstrate that ungulate grazing had a strong consistent negative impact on both vole densities and indices of fox activity. Ungulate grazing did not substantially affect the relationship between fox activity and vole densities. However, the data suggested that, as grazing intensity increased i) fox activity indices tended to be higher when vole densities were low, and ii) the relationship between fox activity and vole density was weaker. All these patterns are surprising given the relative small scale of our experiment compared to large red fox territories in upland habitats of Britain, and suggest that domestic grazing intensity causes a strong response in the activity of generalist predators important for their conservation in grassland ecosystems.

  6. Escherichia coli d-Malate Dehydrogenase, a Generalist Enzyme Active in the Leucine Biosynthesis Pathway*

    PubMed Central

    Vorobieva, Anastassia A.; Khan, Mohammad Shahneawz; Soumillion, Patrice

    2014-01-01

    The enzymes of the β-decarboxylating dehydrogenase superfamily catalyze the oxidative decarboxylation of d-malate-based substrates with various specificities. Here, we show that, in addition to its natural function affording bacterial growth on d-malate as a carbon source, the d-malate dehydrogenase of Escherichia coli (EcDmlA) naturally expressed from its chromosomal gene is capable of complementing leucine auxotrophy in a leuB− strain lacking the paralogous isopropylmalate dehydrogenase enzyme. To our knowledge, this is the first example of an enzyme that contributes with a physiologically relevant level of activity to two distinct pathways of the core metabolism while expressed from its chromosomal locus. EcDmlA features relatively high catalytic activity on at least three different substrates (l(+)-tartrate, d-malate, and 3-isopropylmalate). Because of these properties both in vivo and in vitro, EcDmlA may be defined as a generalist enzyme. Phylogenetic analysis highlights an ancient origin of DmlA, indicating that the enzyme has maintained its generalist character throughout evolution. We discuss the implication of these findings for protein evolution. PMID:25160617

  7. Chytrid fungus acts as a generalist pathogen infecting species-rich amphibian families in Brazilian rainforests.

    PubMed

    Valencia-Aguilar, Anyelet; Ruano-Fajardo, Gustavo; Lambertini, Carolina; da Silva Leite, Domingos; Toledo, Luís Felipe; Mott, Tamí

    2015-05-11

    The fungus Batrachochytrium dendrobatidis (Bd) is among the main causes of declines in amphibian populations. This fungus is considered a generalist pathogen because it infects several species and spreads rapidly in the wild. To date, Bd has been detected in more than 100 anuran species in Brazil, mostly in the southern portion of the Atlantic forest. Here, we report survey data from some poorly explored regions; these data considerably extend current information on the distribution of Bd in the northern Atlantic forest region. In addition, we tested the hypothesis that Bd is a generalist pathogen in this biome. We also report the first positive record for Bd in an anuran caught in the wild in Amazonia. In total, we screened 90 individuals (from 27 species), of which 39 individuals (from 22 species) were Bd-positive. All samples collected in Bahia (2 individuals), Pernambuco (3 individuals), Pará (1 individual), and Minas Gerais (1 individual) showed positive results for Bd. We found a positive correlation between anuran richness per family and the number of infected species in the Atlantic forest, supporting previous observations that Bd lacks strong host specificity; of 38% of the anuran species in the Atlantic forest that were tested for Bd infection, 25% showed positive results. The results of our study exemplify the pandemic and widespread nature of Bd infection in amphibians. PMID:25958806

  8. The Development of Evidence Briefs to Transfer Knowledge About Advanced Practice Nursing Roles to Providers, Policymakers and Administrators.

    PubMed

    Kilpatrick, Kelley; Carter, Nancy; Bryant-Lukosius, Denise; Charbonneau-Smith, Renee; DiCenso, Alba

    2015-03-01

    The transfer of health-related research knowledge between producers and users is a complex, dynamic and iterative process. There has been little research describing the preferred knowledge transfer strategies used by different stakeholder groups, including healthcare providers, policymakers and administrators. The purpose of the survey was to gain an understanding of the content and preferred dissemination strategies of knowledge users of briefing notes about the effectiveness of advanced practice nursing (APN) roles in Canada. An on-line cross-sectional survey was conducted from December 2011 to January 2012. Purposeful sampling was used to identify the target audience. The questionnaire included six items. The response rate was 44% (n=75/170). Participants identified that the briefing note should concisely summarize definitions for APN roles and information about the safety, effectiveness, cost savings and effective role implementation strategies. Multiple approaches were favoured to disseminate the information. Preferred dissemination strategies included personalized emails, meeting with briefing note recipients, engaging nurse practitioners and clinical nurse specialists in organizations where APN roles have been successfully implemented, engaging the media and using social media. The use of briefing notes has shown promise. More research is needed to evaluate the effectiveness of tailored briefing notes. PMID:26154117

  9. [Breast Care Nurses - nursing experts for breast cancer care. A path to "Advanced Nursing Practice" in Germany?].

    PubMed

    Gerlach, Anja; Wiedemann, Regina

    2010-12-01

    The role of Breast Care Nurses (BCNs) has been discussed since Breast Centres have been opened in Germany. This article introduces the concept of the Breast Care Nurses on a national and an international level in the context of Advanced Nursing Practice (ANP). Within a descriptive study, graduates of a German BCN-education programme were interrogated regarding their current work, their main activities as a BCN, about general conditions in their work environment, experienced barriers, and supporting factors. 122 questionnaires were evaluated. The return rate was 71 % (n = 171). Results showed that 58.1 % (n = 71) of the graduates were employed as a Breast Care Nurse, however only 28.1 % (n = 20) in a full-time and 35.2 % (n = 25) in a part-time position. This first German study about BCN-services showed a lack of basic work conditions, for example regarding a consultation room, access to literature, or templates for documentation. In the discussion part, the situation of the BCNs is reviewed in the German context and in relation to ANP concepts as well as regarding future demands for the position of a BCN. PMID:21154250

  10. Computer vision-based technologies and commercial best practices for the advancement of the motion imagery tradecraft

    NASA Astrophysics Data System (ADS)

    Phipps, Marja; Capel, David; Srinivasan, James

    2014-06-01

    Motion imagery capabilities within the Department of Defense/Intelligence Community (DoD/IC) have advanced significantly over the last decade, attempting to meet continuously growing data collection, video processing and analytical demands in operationally challenging environments. The motion imagery tradecraft has evolved accordingly, enabling teams of analysts to effectively exploit data and generate intelligence reports across multiple phases in structured Full Motion Video (FMV) Processing Exploitation and Dissemination (PED) cells. Yet now the operational requirements are drastically changing. The exponential growth in motion imagery data continues, but to this the community adds multi-INT data, interoperability with existing and emerging systems, expanded data access, nontraditional users, collaboration, automation, and support for ad hoc configurations beyond the current FMV PED cells. To break from the legacy system lifecycle, we look towards a technology application and commercial adoption model course which will meet these future Intelligence, Surveillance and Reconnaissance (ISR) challenges. In this paper, we explore the application of cutting edge computer vision technology to meet existing FMV PED shortfalls and address future capability gaps. For example, real-time georegistration services developed from computer-vision-based feature tracking, multiple-view geometry, and statistical methods allow the fusion of motion imagery with other georeferenced information sources - providing unparalleled situational awareness. We then describe how these motion imagery capabilities may be readily deployed in a dynamically integrated analytical environment; employing an extensible framework, leveraging scalable enterprise-wide infrastructure and following commercial best practices.

  11. Effectiveness and safety of first-generation protease inhibitors in clinical practice: Hepatitis C virus patients with advanced fibrosis

    PubMed Central

    Salmerón, Javier; Vinaixa, Carmen; Berenguer, Rubén; Pascasio, Juan Manuel; Sánchez Ruano, Juan José; Serra, Miguel Ángel; Gila, Ana; Diago, Moisés; Romero-Gómez, Manuel; Navarro, José María; Testillano, Milagros; Fernández, Conrado; Espinosa, Dolores; Carmona, Isabel; Pons, José Antonio; Jorquera, Francisco; Rodriguez, Francisco Javier; Pérez, Ramón; Montero, José Luis; Granados, Rafael; Fernández, Miguel; Martín, Ana Belén; Muñoz de Rueda, Paloma; Quiles, Rosa

    2015-01-01

    AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-naïve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment

  12. Genetic differentiation across North America in Heliothis virescens and H. subflexa: A generalist versus a specialist moth

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The two moth species Heliothis virescens (F.) and H. subflexa Guenée are closely related, but have vastly different feeding habits. The tobacco budworm, H. virescens, is a generalist and an important pest in many crops in the US, while H. subflexa is a specialist feeding only on plants in the genus ...

  13. Initial Music Training of Generalist Kindergarten Teachers in Greece: What Do They Ask for and What Do They Receive?

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2010-01-01

    This article investigates generalist kindergarten teachers' academic music training based on data collected from students undertaking an undergraduate degree in preschool (kindergarten) education (students aged 4-6 years) in Greece. The study was carried out through a questionnaire survey that addressed students' aspirations when entering the…

  14. Self-Study of an Elementary Generalist Physical Education Teacher Educator: School-Integrated Teacher Education and Structural Coupling

    ERIC Educational Resources Information Center

    Hopper, Tim

    2015-01-01

    This paper will focus on my last 8 years of teaching generalist pre-service teachers (GPTs) to teach elementary physical education (PE) within a school-integrated teacher education (SITE) course design. Self-study as a method of inquiry will be used to chart structural shifts in the course and my assumptions about teaching GPTs how to teach PE…

  15. Diversity and phenology of the generalist predator community in apple orchards of Central Washington State (insecta, araneae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Predatory insects and spiders were collected from apple orchards in two geographic regions of Central Washington State to assess seasonal phenology and diversity of the generalist predator community. Arthropods were collected from orchard canopy every 3-7 d over two growing seasons (March-October) ...

  16. Where Do Standards Come from? A Phenomenological Study of the Development of National Board Early Childhood/Generalist Standards

    ERIC Educational Resources Information Center

    Camp, Deborah Graves

    2007-01-01

    The purpose of this phenomenological study was to construct a description and interpretation of the standards development process of the Early Childhood/Generalist Standards documents, both first edition and second edition, using an analysis of the actions of and interactions between committee members, professional organization representatives,…

  17. Genetic architecture of pollination syndrome transition between hummingbird-specialist and generalist species in the genus Rhytidophyllum (Gesneriaceae)

    PubMed Central

    Vrignaud, Justine; Mangin, Brigitte; Joly, Simon

    2015-01-01

    Adaptation to pollinators is a key factor of diversification in angiosperms. The Caribbean sister genera Rhytidophyllum and Gesneria present an important diversification of floral characters. Most of their species can be divided in two major pollination syndromes. Large-open flowers with pale colours and great amount of nectar represent the generalist syndrome, while the hummingbird-specialist syndrome corresponds to red tubular flowers with a less important nectar volume. Repeated convergent evolution toward the generalist syndrome in this group suggests that such transitions rely on few genes of moderate to large effect. To test this hypothesis, we built a linkage map and performed a QTL detection for divergent pollination syndrome traits by crossing one specimen of the generalist species Rhytidophyllum auriculatum with one specimen of the hummingbird pollinated R. rupincola. Using geometric morphometrics and univariate traits measurements, we found that floral shape among the second-generation hybrids is correlated with morphological variation observed between generalist and hummingbird-specialist species at the genus level. The QTL analysis showed that colour and nectar volume variation between syndromes involve each one major QTL while floral shape has a more complex genetic basis and rely on few genes of moderate effect. Finally, we did not detect any genetic linkage between the QTLs underlying those traits. This genetic independence of traits could have facilitated evolution toward optimal syndromes. PMID:26157613

  18. Genetic architecture of pollination syndrome transition between hummingbird-specialist and generalist species in the genus Rhytidophyllum (Gesneriaceae).

    PubMed

    Alexandre, Hermine; Vrignaud, Justine; Mangin, Brigitte; Joly, Simon

    2015-01-01

    Adaptation to pollinators is a key factor of diversification in angiosperms. The Caribbean sister genera Rhytidophyllum and Gesneria present an important diversification of floral characters. Most of their species can be divided in two major pollination syndromes. Large-open flowers with pale colours and great amount of nectar represent the generalist syndrome, while the hummingbird-specialist syndrome corresponds to red tubular flowers with a less important nectar volume. Repeated convergent evolution toward the generalist syndrome in this group suggests that such transitions rely on few genes of moderate to large effect. To test this hypothesis, we built a linkage map and performed a QTL detection for divergent pollination syndrome traits by crossing one specimen of the generalist species Rhytidophyllum auriculatum with one specimen of the hummingbird pollinated R. rupincola. Using geometric morphometrics and univariate traits measurements, we found that floral shape among the second-generation hybrids is correlated with morphological variation observed between generalist and hummingbird-specialist species at the genus level. The QTL analysis showed that colour and nectar volume variation between syndromes involve each one major QTL while floral shape has a more complex genetic basis and rely on few genes of moderate effect. Finally, we did not detect any genetic linkage between the QTLs underlying those traits. This genetic independence of traits could have facilitated evolution toward optimal syndromes. PMID:26157613

  19. Management of apple orchards to conserve generalist phytoseiid mites suppresses two-spotted spider mite, Tetranychus urticae (Acari: Tetranychidae).

    PubMed

    Funayama, Ken; Komatus, Michiyo; Sonoda, Shoji; Takahashi, Isao; Hara, Kazuko

    2015-01-01

    To improve the success of integrated pest management (IPM) in apple orchards, we investigated whether generalist phytoseiid mites have suppressed the occurrence of Tetranychus urticae. In Akita Prefecture, northern Japan, in 2012 and 2013, two types of experimental plot were compared. Conservation plots had been managed for the conservation of generalist phytoseiid mites by selective chemical spraying without mowing since 2009. Conventional plots were managed by non-selective chemical spraying with regular mowing. The conservation plots had significantly fewer T. urticae adult females per tree in both years. Two species of generalist phytoseiid mites-Typhlodromus vulgaris and Amblyseius tsugawai-were continuously present in the conservation plots, with only a few T. urticae. The conservation plots had significantly more A. tsugawai adult females in the undergrowth in both years, and significantly more T. vulgaris adult females on apple leaves in 2012. Typhlodromus vulgaris was continuously present in the conservation plots but was scarce from late May to early August in the conventional plots. In the presence of T. vulgaris, low numbers of T. urticae did not increase on apple leaves. These results indicate that the generalist phytoseiid mites serve as important biological control agents in IPM in apple orchards. PMID:25234440

  20. "Good Enough" Psychiatric Residency Training in Borderline Personality Disorder: Challenges, Choice Points, and a Model Generalist Curriculum.

    PubMed

    Unruh, Brandon T; Gunderson, John G

    2016-01-01

    While the public health burden posed by borderline personality disorder (BPD) rivals that associated with other major mental illnesses, the prevailing disposition of psychiatrists toward the disorder remains characterized by misinformation, stigma, aversive attitudes, and insufficient familiarity with effective generalist treatments that can be delivered in nonspecialized health care settings. Residency training programs are well positioned to better equip the next generation of psychiatrists to address these issues, but no consensus or guidelines currently exist for what and how residents should be taught about managing BPD. Instead, disproportionately limited curricular time, teaching of non-evidence-based approaches, and modeling of conceptually confused combinations of techniques drawn from specialty BPD treatments are offered. In this article, we (1) explain why training in a generalist model is sensible and why alternative approaches are not appropriate for residents, (2) propose a plan for giving residents adequate training via a generalist model, highlighting minimal didactic and clinical-training objectives (dubbed "core competencies" and "milestones") and a model curriculum developed at the Massachusetts General Hospital/McLean Hospital residency program, and (3) describe obstacles to implementation of effective generalist training posed by infrastructural, faculty-centered, and resident-centered variables. PMID:27603744

  1. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    SciTech Connect

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  2. How did we make the Interdisciplinary Generalist Curriculum Project work? National efforts to facilitate success.

    PubMed

    Lesky, L; Davis, A; Cooke, M

    2001-04-01

    The Interdisciplinary Generalist Curriculum (IGC) Project created curricular changes at the participating schools with very little direct financial support. A reconsideration of the process of this national effort reveals many intangible elements that were as critical to the project's successes as were the direct dollars. Those factors included careful attention to the criteria for school selection, specific project requirements that allowed institutional flexibility in project evolution, national assistance in program implementation, early and ongoing national recognition for project schools, and a highly organized, involved, and goal-oriented national organization. This national initiative provides a successful model for future funding of projects in this era of dwindling financial support for medical education innovation. PMID:11299167

  3. Forest species diversity reduces disease risk in a generalist plant pathogen invasion

    USGS Publications Warehouse

    Haas, Sarah E.; Hooten, Mevin B.; Rizzo, David M.; Meentemeyer, Ross K.

    2011-01-01

    Empirical evidence suggests that biodiversity loss can increase disease transmission, yet our understanding of the 'diversity-disease hypothesis' for generalist pathogens in natural ecosystems is limited. We used a landscape epidemiological approach to examine two scenarios regarding diversity effects on the emerging plant pathogen Phytophthora ramorum across a broad, heterogeneous ecoregion: (1) an amplification effect exists where disease risk is greater in areas with higher plant diversity due to the pathogen's wide host range, or (2) a dilution effect where risk is reduced with increasing diversity due to lower competency of alternative hosts. We found evidence for pathogen dilution, whereby disease risk was lower in sites with higher species diversity, after accounting for potentially confounding effects of host density and landscape heterogeneity. Our results suggest that although nearly all plants in the ecosystem are hosts, alternative hosts may dilute disease transmission by competent hosts, thereby buffering forest health from infectious disease.

  4. Infaunal Benthic Communities from the Inner Shelf off Southwestern Africa Are Characterised by Generalist Species

    PubMed Central

    Steffani, Nina; Sedick, Safiyya; Rogers, John; Gibbons, Mark John

    2015-01-01

    Infaunal communities of benthic macro-organisms (≥ 1mm length) were studied from 81 samples collected across nine sites to the north and south of the Orange River in the Benguela upwelling ecosystem in 2003, with a view to describing communities and understanding the drivers of regional community structure, as well as to document diversity and to examine geographic affinities. Although the fauna was dominated by polychaetes and peracarid crustaceans, patterns in community structure could only weakly be explained by the measured environment (~35%). This is attributed to the generalist nature of the species recovered, which were widely distributed amongst different sediments, water-depths and latitudes. The fauna is dominated by species that enjoy a widespread regional and global distribution and is characterised by relatively low diversity, which is discussed. PMID:26618477

  5. Infaunal Benthic Communities from the Inner Shelf off Southwestern Africa Are Characterised by Generalist Species.

    PubMed

    Steffani, Nina; Sedick, Safiyya; Rogers, John; Gibbons, Mark John

    2015-01-01

    Infaunal communities of benthic macro-organisms (≥ 1mm length) were studied from 81 samples collected across nine sites to the north and south of the Orange River in the Benguela upwelling ecosystem in 2003, with a view to describing communities and understanding the drivers of regional community structure, as well as to document diversity and to examine geographic affinities. Although the fauna was dominated by polychaetes and peracarid crustaceans, patterns in community structure could only weakly be explained by the measured environment (~35%). This is attributed to the generalist nature of the species recovered, which were widely distributed amongst different sediments, water-depths and latitudes. The fauna is dominated by species that enjoy a widespread regional and global distribution and is characterised by relatively low diversity, which is discussed. PMID:26618477

  6. Transgressive phenotypes and generalist pollination in the floral evolution of Nicotiana polyploids.

    PubMed

    McCarthy, Elizabeth W; Chase, Mark W; Knapp, Sandra; Litt, Amy; Leitch, Andrew R; Le Comber, Steven C

    2016-01-01

    Polyploidy is an important driving force in angiosperm evolution, and much research has focused on genetic, epigenetic and transcriptomic responses to allopolyploidy. Nicotiana is an excellent system in which to study allopolyploidy because half of the species are allotetraploids of different ages, allowing us to examine the trajectory of floral evolution over time. Here, we study the effects of allopolyploidy on floral morphology in Nicotiana, using corolla tube measurements and geometric morphometrics to quantify petal shape. We show that polyploid morphological divergence from the intermediate phenotype expected (based on progenitor morphology) increases with time for floral limb shape and tube length, and that most polyploids are distinct or transgressive in at least one trait. In addition, we show that polyploids tend to evolve shorter and wider corolla tubes, suggesting that allopolyploidy could provide an escape from specialist pollination via reversion to more generalist pollination strategies. PMID:27501400

  7. Geographic variation in feeding preference of a generalist herbivore: the importance of seaweed chemical defenses.

    PubMed

    McCarty, Amanda T; Sotka, Erik E

    2013-08-01

    The ecological impacts of generalist herbivores depend on feeding preferences, which can vary across and within herbivore species. Among mesoherbivores, geographic variation in host use can occur because host plants have a more restricted geographic distribution than does the herbivore, or there is local evolution in host preference, or both. We tested the role of local evolution using the marine amphipod Ampithoe longimana by rearing multiple amphipod populations from three regions (subtropical Florida, warm-temperate North Carolina and cold-temperate New England) and assaying their feeding preferences toward ten seaweeds that occur in some but not all regions. Six of the ten seaweeds produce anti-herbivore secondary metabolites, and we detected geographic variation in feeding preference toward five (Dictyota menstrualis, Dictyota ciliolata, Fucus distichus, Chondrus crispus and Padina gymnospora, but not Caulerpa sertularioides). Amphipod populations that co-occur with a chemically-rich seaweed tended to have stronger feeding preferences for that seaweed, relative to populations that do not co-occur with the seaweed. A direct test indicated that geographic variation in feeding preference toward one seaweed (D. ciliolata) is mediated by feeding tolerance for lipophilic secondary metabolites. Among the four seaweeds that produce no known secondary metabolites (Acanthophora, Ectocarpus, Gracilaria and Hincksia/Feldmannia spp.), we detected no geographic variation in feeding preference. Thus, populations are more likely to evolve greater feeding preferences for local hosts when those hosts produce secondary metabolites. Microevolution of feeding behaviors of generalist marine consumers likely depends on the availability and identity of local hosts and the strength of their chemical defenses. PMID:23263529

  8. Generalist birds govern the seed dispersal of a parasitic plant with strong recruitment constraints.

    PubMed

    Mellado, Ana; Zamora, Regino

    2014-09-01

    Mistletoes constitute instructive study cases with which to address the role of generalist consumers in the study of plant-animal interactions. Their ranges of safe sites for recruitment are among the most restricted of any plant; therefore, frugivores specializing in mistletoe have been considered almost indispensable for the seed dispersal of these parasitic plants. However, the absence of such specialists in numerous regions inhabited by many mistletoe species raises the question of whether unspecialized vectors may successfully disperse mistletoe seeds to narrowly defined safe sites. Using the European mistletoe Viscum album subsp. austriacum as a study case, we recorded a broad range of 11 bird species that disperse mistletoe seeds. For these species, we studied the mistletoe-visitation rate and feeding behavior to estimate the quantity component of dispersal effectiveness, and the post-foraging microhabitat use, seed handling, and recruitment probabilities of different microhabitats as a measure of the quality component of effectiveness. Both endozoochory and ectozoochory are valid dispersal mechanisms, as the seeds do not need to be ingested to germinate, increasing seed-dispersal versatility. Thrushes were the most effective dispersers, although they were rather inefficient, whereas small birds (both frugivores and non-frugivores) offered low-quantity but high-quality services for depositing seeds directly upon safe sites. As birds behave similarly on parasitized and non-parasitized hosts, and vectors have broad home ranges, reinfection within patches and the colonization of new patches are ensured by an ample assemblage of generalist birds. Thus, a parasitic plant requiring precision in seed dispersal can rely on unspecialized dispersers. PMID:25004870

  9. Utilization of prey from the decomposer system by generalist predators of grassland.

    PubMed

    Oelbermann, Katja; Langel, Reinhard; Scheu, Stefan

    2008-03-01

    We investigated the linkage between the detrital subsystem and generalist predators of meadow ecosystems by manipulating prey availability in two different ways: we increased resource availability for the decomposer subsystem and thereby decomposer prey by adding mulch materials (detritus enhancement), and we added fruitflies (Drosophila melanogaster, Diptera; prey enhancement) to fenced plots. Both supplemented materials significantly differed in their (13)C/(12)C and (15)N/(14)N ratios from those of the natural litter. We measured density responses of detritivorous, herbivorous and predaceous arthropods to the increased resource supply. We used ratios of natural stable isotopes of N and C in arthropod tissues to trace the flux from the added resources to consumers and to relate density responses of consumers to changes in resource supply. Effects of resource enhancement propagated through at least two trophic levels, resulting in higher densities of major decomposer and predator taxa. Effects of detritus enhancement were much stronger than those of prey enhancement. Signatures of delta(13)C proved density responses of Collembola taxa to be related to the added mulch materials. Among generalist predators, densities of juvenile wolf spiders (Lycosidae) responded more to detritus-enhancement than to prey-enhancement treatments. In contrast, the density of the web-building linyphiid and the non-web gnaphosid spiders remained unaffected. Each spider taxon, including those which did not respond numerically, was significantly enriched in (13)C in detritus-enhancement treatments, suggesting that they gain energy from the decomposer system. Numbers of herbivores-cicadellids and aphids-were similar in each of the treatments, indicating that they were unaffected by changes in predator density. Our results indicate that the lack of a numerical response to resource supplementation is not necessarily due to the absence of a trophic linkage, but may be caused by compensatory

  10. Limber Pine (Pinus flexilis James), a Flexible Generalist of Forest Communities in the Intermountain West

    PubMed Central

    Windmuller-Campione, Marcella A.; Long, James N.

    2016-01-01

    As forest communities continue to experience interactions between climate change and shifting disturbance regimes, there is an increased need to link ecological understanding to applied management. Limber pine (Pinus flexilis James.), an understudied species of western North America, has been documented to dominate harsh environments and thought to be competitively excluded from mesic environments. An observational study was conducted using the Forest Inventory and Analysis Database (FIAD) to test the competitive exclusion hypothesis across a broad elevational and geographic area within the Intermountain West, USA. We anticipated that competitive exclusion would result in limber pine’s absence from mid-elevation forest communities, creating a bi-modal distribution. Using the FIAD database, limber pine was observed to occur with 22 different overstory species, which represents a surprising number of the woody, overstory species commonly observed in the Intermountain West. There were no biologically significant relationships between measures of annual precipitation, annual temperature, or climatic indices (i.e. Ombrothermic Index) and limber pine dominance. Limber pine was observed to be a consistent component of forest communities across elevation classes. Of the plots that contained limber pine regeneration, nearly half did not have a live or dead limber pine in the overstory. However, limber pine regeneration was greater in plots with higher limber pine basal area and higher average annual precipitation. Our results suggest limber pine is an important habitat generalist, playing more than one functional role in forest communities. Generalists, like limber pine, may be increasingly important, as managers are challenged to build resistance and resilience to future conditions in western forests. Additional research is needed to understand how different silvicultural systems can be used to maintain multi-species forest communities. PMID:27575596

  11. Limber Pine (Pinus flexilis James), a Flexible Generalist of Forest Communities in the Intermountain West.

    PubMed

    Windmuller-Campione, Marcella A; Long, James N

    2016-01-01

    As forest communities continue to experience interactions between climate change and shifting disturbance regimes, there is an increased need to link ecological understanding to applied management. Limber pine (Pinus flexilis James.), an understudied species of western North America, has been documented to dominate harsh environments and thought to be competitively excluded from mesic environments. An observational study was conducted using the Forest Inventory and Analysis Database (FIAD) to test the competitive exclusion hypothesis across a broad elevational and geographic area within the Intermountain West, USA. We anticipated that competitive exclusion would result in limber pine's absence from mid-elevation forest communities, creating a bi-modal distribution. Using the FIAD database, limber pine was observed to occur with 22 different overstory species, which represents a surprising number of the woody, overstory species commonly observed in the Intermountain West. There were no biologically significant relationships between measures of annual precipitation, annual temperature, or climatic indices (i.e. Ombrothermic Index) and limber pine dominance. Limber pine was observed to be a consistent component of forest communities across elevation classes. Of the plots that contained limber pine regeneration, nearly half did not have a live or dead limber pine in the overstory. However, limber pine regeneration was greater in plots with higher limber pine basal area and higher average annual precipitation. Our results suggest limber pine is an important habitat generalist, playing more than one functional role in forest communities. Generalists, like limber pine, may be increasingly important, as managers are challenged to build resistance and resilience to future conditions in western forests. Additional research is needed to understand how different silvicultural systems can be used to maintain multi-species forest communities. PMID:27575596

  12. Closely related Campylobacter jejuni strains from different sources reveal a generalist rather than a specialist lifestyle

    PubMed Central

    2011-01-01

    flexibility and high genetic microdiversity, revealing properties of a generalist. High genetic flexibility might allow generalist variants of C. jejuni to reversibly express diverse fitness factors in changing environments. PMID:22122991

  13. Contrasting infection strategies in generalist and specialist wasp parasitoids of Drosophila melanogaster.

    PubMed

    Schlenke, Todd A; Morales, Jorge; Govind, Shubha; Clark, Andrew G

    2007-10-26

    Although host-parasitoid interactions are becoming well characterized at the organismal and cellular levels, much remains to be understood of the molecular bases for the host immune response and the parasitoids' ability to defeat this immune response. Leptopilina boulardi and L. heterotoma, two closely related, highly infectious natural parasitoids of Drosophila melanogaster, appear to use very different infection strategies at the cellular level. Here, we further characterize cellular level differences in the infection characteristics of these two wasp species using newly derived, virulent inbred strains, and then use whole genome microarrays to compare the transcriptional response of Drosophila to each. While flies attacked by the melanogaster group specialist L. boulardi (strain Lb17) up-regulate numerous genes encoding proteolytic enzymes, components of the Toll and JAK/STAT pathways, and the melanization cascade as part of a combined cellular and humoral innate immune response, flies attacked by the generalist L. heterotoma (strain Lh14) do not appear to initiate an immune transcriptional response at the time points post-infection we assayed, perhaps due to the rapid venom-mediated lysis of host hemocytes (blood cells). Thus, the specialist parasitoid appears to invoke a full-blown immune response in the host, but suppresses and/or evades downstream components of this response. Given that activation of the host immune response likely depletes the energetic resources of the host, the specialist's infection strategy seems relatively disadvantageous. However, we uncover the mechanism for one potentially important fitness tradeoff of the generalist's highly immune suppressive infection strategy. PMID:17967061

  14. Preference and prey switching in a generalist predator attacking local and invasive alien pests.

    PubMed

    Jaworski, Coline C; Bompard, Anaïs; Genies, Laure; Amiens-Desneux, Edwige; Desneux, Nicolas

    2013-01-01

    Invasive pest species may strongly affect biotic interactions in agro-ecosystems. The ability of generalist predators to prey on new invasive pests may result in drastic changes in the population dynamics of local pest species owing to predator-mediated indirect interactions among prey. On a short time scale, the nature and strength of such indirect interactions depend largely on preferences between prey and on predator behavior patterns. Under laboratory conditions we evaluated the prey preference of the generalist predator Macrolophus pygmaeus Rambur (Heteroptera: Miridae) when it encounters simultaneously the local tomato pest Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) and the invasive alien pest Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae). We tested various ratios of local vs. alien prey numbers, measuring switching by the predator from one prey to the other, and assessing what conditions (e.g. prey species abundance and prey development stage) may favor such prey switching. The total predation activity of M. pygmaeus was affected by the presence of T. absoluta in the prey complex with an opposite effect when comparing adult and juvenile predators. The predator showed similar preference toward T. absoluta eggs and B. tabaci nymphs, but T. absoluta larvae were clearly less attacked. However, prey preference strongly depended on prey relative abundance with a disproportionately high predation on the most abundant prey and disproportionately low predation on the rarest prey. Together with the findings of a recent companion study (Bompard et al. 2013, Population Ecology), the insight obtained on M. pygmaeus prey switching may be useful for Integrated Pest Management in tomato crops, notably for optimal simultaneous management of B. tabaci and T. absoluta, which very frequently co-occur on tomato. PMID:24312646

  15. Darwin's finches and their diet niches: the sympatric coexistence of imperfect generalists.

    PubMed

    De León, L F; Podos, J; Gardezi, T; Herrel, A; Hendry, A P

    2014-06-01

    Adaptive radiation can be strongly influenced by interspecific competition for resources, which can lead to diverse outcomes ranging from competitive exclusion to character displacement. In each case, sympatric species are expected to evolve into distinct ecological niches, such as different food types, yet this expectation is not always met when such species are examined in nature. The most common hypotheses to account for the coexistence of species with substantial diet overlap rest on temporal variation in niches (often diets). Yet spatial variation in niche overlap might also be important, pointing to the need for spatiotemporal analyses of diet and diet overlap between closely related species persisting in sympatry. We here perform such an analysis by characterizing the diets of, and diet overlap among, four sympatric Darwin's ground finch species at three sites and over 5 years on a single Galápagos island (Santa Cruz). We find that the different species have broadly similar and overlapping diets - they are to some extent generalists and opportunists - yet we also find that each species retains some 'private' resources for which their morphologies are best suited. Importantly, use of these private resources increased considerably, and diet overlap decreased accordingly, when the availability of preferred shared foods, such as arthropods, was reduced during drought conditions. Spatial variation in food resources was also important. These results together suggest that the ground finches are 'imperfect generalists' that use overlapping resources under benign conditions (in space or time), but then retreat to resources for which they are best adapted during periods of food limitation. These conditions likely promote local and regional coexistence. PMID:24750315

  16. Contrasting Infection Strategies in Generalist and Specialist Wasp Parasitoids of Drosophila melanogaster

    PubMed Central

    Schlenke, Todd A; Morales, Jorge; Govind, Shubha; Clark, Andrew G

    2007-01-01

    Although host–parasitoid interactions are becoming well characterized at the organismal and cellular levels, much remains to be understood of the molecular bases for the host immune response and the parasitoids' ability to defeat this immune response. Leptopilina boulardi and L. heterotoma, two closely related, highly infectious natural parasitoids of Drosophila melanogaster, appear to use very different infection strategies at the cellular level. Here, we further characterize cellular level differences in the infection characteristics of these two wasp species using newly derived, virulent inbred strains, and then use whole genome microarrays to compare the transcriptional response of Drosophila to each. While flies attacked by the melanogaster group specialist L. boulardi (strain Lb17) up-regulate numerous genes encoding proteolytic enzymes, components of the Toll and JAK/STAT pathways, and the melanization cascade as part of a combined cellular and humoral innate immune response, flies attacked by the generalist L. heterotoma (strain Lh14) do not appear to initiate an immune transcriptional response at the time points post-infection we assayed, perhaps due to the rapid venom-mediated lysis of host hemocytes (blood cells). Thus, the specialist parasitoid appears to invoke a full-blown immune response in the host, but suppresses and/or evades downstream components of this response. Given that activation of the host immune response likely depletes the energetic resources of the host, the specialist's infection strategy seems relatively disadvantageous. However, we uncover the mechanism for one potentially important fitness tradeoff of the generalist's highly immune suppressive infection strategy. PMID:17967061

  17. Handbook of Institutional Advancement. A Practical Guide to College and University Relations, Fund Raising, Alumni Relations, Government Relations, Publications, and Executive Management for Continued Advancement.

    ERIC Educational Resources Information Center

    Rowland, A. Westley, Ed.

    The guide's purpose is to provide administrators with essential information that will maintain public confidence in higher education and ensure continued financial support. Six major aspects of institutional advancement are considered: (1) institutional relation (programs to improve communication and understanding among students, administrators,…

  18. A Framework for Teaching Practice-Based Research with a Focus on Service Users

    ERIC Educational Resources Information Center

    Austin, Michael J.; Isokuortti, Nanne

    2016-01-01

    The integration of research and practice in social work education and agency practice is both complex and challenging. The analysis presented here builds upon the classic social work generalist framework (engagement, assessment, service planning and implementation, service evaluation, and termination) by developing a three-part framework to…

  19. Irrigation Principles and Practices. Appropriate Technologies for Development. Reprint R-5.

    ERIC Educational Resources Information Center

    Development and Resources Corp.

    This manual was prepared for use by Peace Corps trainees and volunteers as a resource in gaining understanding and knowledge of basic irrigation principles and practices. It is intended as a practical handbook that can be understood by a generalist, with subject areas limited to those observed as being of most frequent concern to volunteers in…

  20. Development of a practical fuel management system for PSBR based on advanced three-dimensional Monte Carlo coupled depletion methodology

    NASA Astrophysics Data System (ADS)

    Tippayakul, Chanatip

    The main objective of this research is to develop a practical fuel management system for the Pennsylvania State University Breazeale research reactor (PSBR) based on several advanced Monte Carlo coupled depletion methodologies. Primarily, this research involved two major activities: model and method developments and analyses and validations of the developed models and methods. The starting point of this research was the utilization of the earlier developed fuel management tool, TRIGSIM, to create the Monte Carlo model of core loading 51 (end of the core loading). It was found when comparing the normalized power results of the Monte Carlo model to those of the current fuel management system (using HELIOS/ADMARC-H) that they agreed reasonably well (within 2%--3% differences on average). Moreover, the reactivity of some fuel elements was calculated by the Monte Carlo model and it was compared with measured data. It was also found that the fuel element reactivity results of the Monte Carlo model were in good agreement with the measured data. However, the subsequent task of analyzing the conversion from the core loading 51 to the core loading 52 using TRIGSIM showed quite significant difference of each control rod worth between the Monte Carlo model and the current methodology model. The differences were mainly caused by inconsistent absorber atomic number densities between the two models. Hence, the model of the first operating core (core loading 2) was revised in light of new information about the absorber atomic densities to validate the Monte Carlo model with the measured data. With the revised Monte Carlo model, the results agreed better to the measured data. Although TRIGSIM showed good modeling and capabilities, the accuracy of TRIGSIM could be further improved by adopting more advanced algorithms. Therefore, TRIGSIM was planned to be upgraded. The first task of upgrading TRIGSIM involved the improvement of the temperature modeling capability. The new TRIGSIM was

  1. Advancing the application of systems thinking in health: exploring dual practice and its management in Kampala, Uganda

    PubMed Central

    2014-01-01

    Background Many full-time Ugandan government health providers take on additional jobs – a phenomenon called dual practice. We describe the complex patterns that characterize the evolution of dual practice in Uganda, and the local management practices that emerged in response, in five government facilities. An in-depth understanding of dual practice can contribute to policy discussions on improving public sector performance. Methods A multiple case study design with embedded units of analysis was supplemented by interviews with policy stakeholders and a review of historical and policy documents. Five facility case studies captured the perspective of doctors, nurses, and health managers through semi-structured in-depth interviews. A causal loop diagram illustrated interactions and feedback between old and new actors, as well as emerging roles and relationships. Results The causal loop diagram illustrated how feedback related to dual practice policy developed in Uganda. As opportunities for dual practice grew and the public health system declined over time, government providers increasingly coped through dual practice. Over time, government restrictions to dual practice triggered policy resistance and protest from government providers. Resulting feedback contributed to compromising the supply of government providers and, potentially, of service delivery outcomes. Informal government policies and restrictions replaced the formal restrictions identified in the early phases. In some instances, government health managers, particularly those in hospitals, developed their own practices to cope with dual practice and to maintain public sector performance. Management practices varied according to the health manager’s attitude towards dual practice and personal experience with dual practice. These practices were distinct in hospitals. Hospitals faced challenges managing internal dual practice opportunities, such as those created by externally-funded research projects based

  2. Pollen mixing in pollen generalist solitary bees: a possible strategy to complement or mitigate unfavourable pollen properties?

    PubMed

    Eckhardt, Michael; Haider, Mare; Dorn, Silvia; Müller, Andreas

    2014-05-01

    Generalist herbivorous insects, which feed on plant tissue that is nutritionally heterogeneous or varies in its content of secondary metabolites, often benefit from dietary mixing through more balanced nutrient intake or reduced exposure to harmful secondary metabolites. Pollen is similarly heterogeneous as other plant tissue in its content of primary and secondary metabolites, suggesting that providing their offspring with mixed pollen diets might be a promising strategy for pollen generalist bees to complement nutrient imbalances or to mitigate harmful secondary metabolites of unfavourable pollen. In the present study, we compared larval performance of the pollen generalist solitary bee species Osmia cornuta (Megachilidae) on five experimental pollen diets that consisted of different proportions of unfavourable pollen diet of Ranunculus acris (Ranunculaceae) and favourable pollen diet of Sinapis arvensis (Brassicaceae). In addition, we microscopically analysed the pollen contained in the scopal brushes of field-collected females of O. cornuta and three closely related species to elucidate to what degree these pollen generalist bees mix pollen of different hosts in their brood cells. In striking contrast to a pure Ranunculus pollen diet, which had a lethal effect on most developing larvae of O. cornuta, larval survival, larval development time and adult body mass of both males and females remained nearly unaffected by the admixture of up to 50% of Ranunculus pollen diet to the larval food. Between 42% and 66% of all female scopal pollen loads analysed contained mixtures of pollen from two to six plant families, indicating that pollen mixing is a common behaviour in O. cornuta and the three related bee species. The present study provides the first evidence that the larvae of pollen generalist bees can benefit from the nutrient content of unfavourable pollen without being negatively affected by its unfavourable chemical properties if such pollen is mixed with

  3. Proof of Learning Outcome by the Advanced Clinical Competency Examination Trial after the Long-term Student's Practice in Pharmaceutical Education.

    PubMed

    Komori, Koji; Kataoka, Makoto; Kuramoto, Nobuyuki; Tsuji, Takumi; Nakatani, Takafumi; Yasuhara, Tomohisa; Mitamura, Shinobu; Hane, Yumiko; Ogita, Kiyokazu

    2016-01-01

    At Setsunan University, a debrief session (a poster session) is commonly performed by the students who have completed the long-term students' practice. Since the valuable changes in practical competency of the students cannot be evaluated through this session, we specified items that can help evaluate and methods that can help estimate the students' competency as clinical pharmacists. We subsequently carried out a trial called the "Advanced Clinical Competency Examination". We evaluated 103 students who had concluded the students' practice for the second period (Sep 1, 2014, to Nov 16, 2014): 70 students (called "All finish students") who had completed the practice in a hospital and pharmacy, and 33 students (called "Hospital finish students") who had finished the practice at a hospital only. The trial was executed in four stages. In the first stage, students drew pictures of something impressive they had learned during the practice. In the second stage, students were given patient cases and were asked, "What is this patient's problem?" and "How would you solve this problem?". In the third stage, the students discussed their answers in a group. In the fourth stage, each group made a poster presentation in separate rooms. By using a rubric, the teachers evaluated each student individually, the results of which showed that the "All finish students" could identify more problems than the "Hospital finish students". PMID:27592830

  4. Advancing the Africentric Paradigm Shift Discourse: Building toward Evidence-Based Africentric Interventions in Social Work Practice with African Americans

    ERIC Educational Resources Information Center

    Gilbert, Dorie J.; Harvey, Aminifu R.; Belgrave, Faye Z.

    2009-01-01

    For over a decade, a number of social work scholars have advocated for an Africentric paradigm shift in social work practice with African Americans; yet the paradigm shift has been slow in coming with respect to infusing Africentric theory and interventions into social work practice, education, and research. Interventions that infuse Africentric…

  5. A Collaboration of School Administrators and a University Faculty to Advance School Administrator Practices Using Appreciative Inquiry

    ERIC Educational Resources Information Center

    Calabrese, Raymond

    2015-01-01

    Purpose: An appreciative inquiry (AI) collaborative study with 11 school administrators in a highly diverse suburban school district sought to understand if observing and sharing successful school practices/events in a whole group setting led to change in their perceptions, attitudes, and administrative practice. The paper aims to discuss these…

  6. Contrasting host-pathogen interactions and genome evolution in two generalist and specialist microsporidian pathogens of mosquitoes.

    PubMed

    Desjardins, Christopher A; Sanscrainte, Neil D; Goldberg, Jonathan M; Heiman, David; Young, Sarah; Zeng, Qiandong; Madhani, Hiten D; Becnel, James J; Cuomo, Christina A

    2015-01-01

    Obligate intracellular pathogens depend on their host for growth yet must also evade detection by host defenses. Here we investigate host adaptation in two Microsporidia, the specialist Edhazardia aedis and the generalist Vavraia culicis, pathogens of disease vector mosquitoes. Genomic analysis and deep RNA-Seq across infection time courses reveal fundamental differences between these pathogens. E. aedis retains enhanced cell surface modification and signalling capacity, upregulating protein trafficking and secretion dynamically during infection. V. culicis is less dependent on its host for basic metabolites and retains a subset of spliceosomal components, with a transcriptome broadly focused on growth and replication. Transcriptional profiling of mosquito immune responses reveals that response to infection by E. aedis differs dramatically depending on the mode of infection, and that antimicrobial defensins may play a general role in mosquito defense against Microsporidia. This analysis illuminates fundamentally different evolutionary paths and host interplay of specialist and generalist pathogens. PMID:25968466

  7. Contrasting host–pathogen interactions and genome evolution in two generalist and specialist microsporidian pathogens of mosquitoes

    PubMed Central

    Desjardins, Christopher A.; Sanscrainte, Neil D.; Goldberg, Jonathan M.; Heiman, David; Young, Sarah; Zeng, Qiandong; Madhani, Hiten D.; Becnel, James J.; Cuomo, Christina A

    2015-01-01

    Obligate intracellular pathogens depend on their host for growth yet must also evade detection by host defenses. Here we investigate host adaptation in two Microsporidia, the specialist Edhazardia aedis and the generalist Vavraia culicis, pathogens of disease vector mosquitoes. Genomic analysis and deep RNA-Seq across infection time courses reveal fundamental differences between these pathogens. E. aedis retains enhanced cell surface modification and signalling capacity, upregulating protein trafficking and secretion dynamically during infection. V. culicis is less dependent on its host for basic metabolites and retains a subset of spliceosomal components, with a transcriptome broadly focused on growth and replication. Transcriptional profiling of mosquito immune responses reveals that response to infection by E. aedis differs dramatically depending on the mode of infection, and that antimicrobial defensins may play a general role in mosquito defense against Microsporidia. This analysis illuminates fundamentally different evolutionary paths and host interplay of specialist and generalist pathogens. PMID:25968466

  8. Sympatric genetic differentiation of a generalist pathogenic fungus, Botrytis cinerea, on two different host plants, grapevine and bramble.

    PubMed

    Fournier, E; Giraud, T

    2008-01-01

    Prime candidates for sympatric ecological divergence include parasites that differentiate via host shifts, because different host species exert strong disruptive selection and because both hosts and parasites are continually co-evolving. Sympatric divergence may be fostered even more strongly in phytopathogenic fungi, in particular those where sex must occur on the host, which allows adaptation alone to restrict gene flow between populations developing on different hosts. We sampled populations of Botrytis cinerea, a generalist ascomycete fungus, on sympatric grapes and brambles in six regions in France. Microsatellite data were analyzed using standard population genetics, a population graph analysis and a Bayesian approach. In addition to confirming that B. cinerea reproduces sexually, our results showed that the fungal populations on the two hosts were significantly differentiated, indicating restricted gene flow, even in sympatry. In contrast, only weak geographical differentiation could be detected. These results support the possibility of sympatric divergence associated with host use in generalist parasites. PMID:18028352

  9. Evidence for a Common Toolbox Based on Necrotrophy in a Fungal Lineage Spanning Necrotrophs, Biotrophs, Endophytes, Host Generalists and Specialists

    PubMed Central

    Andrew, Marion; Barua, Reeta; Short, Steven M.; Kohn, Linda M.

    2012-01-01

    The Sclerotiniaceae (Ascomycotina, Leotiomycetes) is a relatively recently evolved lineage of necrotrophic host generalists, and necrotrophic or biotrophic host specialists, some latent or symptomless. We hypothesized that they inherited a basic toolbox of genes for plant symbiosis from their common ancestor. Maintenance and evolutionary diversification of symbiosis could require selection on toolbox genes or on timing and magnitude of gene expression. The genes studied were chosen because their products have been previously investigated as pathogenicity factors in the Sclerotiniaceae. They encode proteins associated with cell wall degradation: acid protease 1 (acp1), aspartyl protease (asps), and polygalacturonases (pg1, pg3, pg5, pg6), and the oxalic acid (OA) pathway: a zinc finger transcription factor (pac1), and oxaloacetate acetylhydrolase (oah), catalyst in OA production, essential for full symptom production in Sclerotinia sclerotiorum. Site-specific likelihood analyses provided evidence for purifying selection in all 8 pathogenicity-related genes. Consistent with an evolutionary arms race model, positive selection was detected in 5 of 8 genes. Only generalists produced large, proliferating disease lesions on excised Arabidopsis thaliana leaves and oxalic acid by 72 hours in vitro. In planta expression of oah was 10–300 times greater among the necrotrophic host generalists than necrotrophic and biotrophic host specialists; pac1 was not differentially expressed. Ability to amplify 6/8 pathogenicity related genes and produce oxalic acid in all genera are consistent with the common toolbox hypothesis for this gene sample. That our data did not distinguish biotrophs from necrotrophs is consistent with 1) a common toolbox based on necrotrophy and 2) the most conservative interpretation of the 3-locus housekeeping gene phylogeny – a baseline of necrotrophy from which forms of biotrophy emerged at least twice. Early oah overexpression likely expands the host

  10. A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa

    PubMed Central

    2013-01-01

    Background The health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services. Methods We reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs. Results A total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services. Conclusions This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in

  11. Current Molecular Targeted Therapy in Advanced Gastric Cancer: A Comprehensive Review of Therapeutic Mechanism, Clinical Trials, and Practical Application

    PubMed Central

    Li, Kaichun; Li, Jin

    2016-01-01

    Despite the great progress in the treatment of gastric cancer, it is still the third leading cause of cancer death worldwide. Patients often miss the opportunity for a surgical cure, because the cancer has already developed into advanced cancer when identified. Compared to best supportive care, chemotherapy can improve quality of life and prolong survival time, but the overall survival is often short. Due to the molecular study of gastric cancer, new molecular targeted drugs have entered the clinical use. Trastuzumab, an antibody targeting human epidermal growth factor receptor 2 (HER2), can significantly improve survival in advanced gastric cancer patients with HER2 overexpression. Second-line treatment of advanced gastric cancer with ramucirumab, an antibody targeting VEGFR-2, alone or in combination with paclitaxel, has been proved to provide a beneficial effect. The VEGFR-2 tyrosine kinase inhibitor, apatinib, can improve the survival of advanced gastric cancer patients after second-line chemotherapy failure. Unfortunately, none of the EGFR targeting antibodies (cetuximab or panitumumab), VEGF targeting monoclonal antibodies (bevacizumab), mTOR inhibitor (everolimus), or HGF/MET pathway targeting drugs has a significant survival benefit. Many other clinical trials based on molecular markers are underway. This review will summarize targeted therapies for advanced gastric cancer. PMID:26880889

  12. Current Molecular Targeted Therapy in Advanced Gastric Cancer: A Comprehensive Review of Therapeutic Mechanism, Clinical Trials, and Practical Application.

    PubMed

    Li, Kaichun; Li, Jin

    2016-01-01

    Despite the great progress in the treatment of gastric cancer, it is still the third leading cause of cancer death worldwide. Patients often miss the opportunity for a surgical cure, because the cancer has already developed into advanced cancer when identified. Compared to best supportive care, chemotherapy can improve quality of life and prolong survival time, but the overall survival is often short. Due to the molecular study of gastric cancer, new molecular targeted drugs have entered the clinical use. Trastuzumab, an antibody targeting human epidermal growth factor receptor 2 (HER2), can significantly improve survival in advanced gastric cancer patients with HER2 overexpression. Second-line treatment of advanced gastric cancer with ramucirumab, an antibody targeting VEGFR-2, alone or in combination with paclitaxel, has been proved to provide a beneficial effect. The VEGFR-2 tyrosine kinase inhibitor, apatinib, can improve the survival of advanced gastric cancer patients after second-line chemotherapy failure. Unfortunately, none of the EGFR targeting antibodies (cetuximab or panitumumab), VEGF targeting monoclonal antibodies (bevacizumab), mTOR inhibitor (everolimus), or HGF/MET pathway targeting drugs has a significant survival benefit. Many other clinical trials based on molecular markers are underway. This review will summarize targeted therapies for advanced gastric cancer. PMID:26880889

  13. AM fungal diversity and modularity reveal different trends in the mycorrhizal association with generalist and specialist plant species.

    NASA Astrophysics Data System (ADS)

    Torrecillas, Emma; del Mar Alguacil, Mª; Roldán, Antonio; Díaz, Gisela; Montesinos-Navarro, Alicia; Torres, Mª Pilar

    2013-04-01

    The plant communities present on gypsum soils include one of the most remarkable groups of edaphic "specialists", which coexist with edaphic "generalists". This study hypothesized that plant-arbuscular mycorrhizal fungi(AMF) associations can be related with specific functional plant strategies in gypsum soils.We analyzed, using network analysis, a plant-AMF mutualistic system in a gypsum environment, to characterize the plant-AMF interaction patterns according to their modularity or the tendency of species to be grouped into modules.Taking into account the total area studied (gypsum soil and marly-limestone soil), our results show that the factors determining the AM fungal community's distribution were soil type and plant species, with gypsovags harboring a different AM fungal community in gypsum and non-gypsum soils. But, there were no differences in the community diversity between specialist and generalist plants. Modularity analysis revealed that, when only gypsum soils are considered, there were some AM fungal groups with a tendency to interact differently with gypsophytes(specialists) and gypsovags (generalists).

  14. New parasitoid-predator associations: female parasitoids do not avoid competition with generalist predators when sharing invasive prey

    NASA Astrophysics Data System (ADS)

    Chailleux, Anaïs; Wajnberg, Eric; Zhou, Yuxiang; Amiens-Desneux, Edwige; Desneux, Nicolas

    2014-12-01

    Optimal habitat selection is essential for species survival in ecosystems, and interspecific competition is a key ecological mechanism for many observed species association patterns. Specialized animal species are commonly affected by resource and interference competition with generalist and/or omnivorous competitors, so avoidance behavior could be expected. We hypothesize that specialist species may exploit broad range cues from such potential resource competitors (i.e., cues possibly common to various generalist and/or omnivorous predators) to avoid costly competition regarding food or reproduction, even in new species associations. We tested this hypothesis by studying short-term interactions between a native larval parasitoid and a native generalist omnivorous predator recently sharing the same invasive host/prey, the leaf miner Tuta absoluta. We observed a strong negative effect of kleptoparasitism (food resource stealing) instead of classical intraguild predation on immature parasitoids. There was no evidence that parasitoid females avoided the omnivorous predator when searching for oviposition sites, although we studied both long- and short-range known detection mechanisms. Therefore, we conclude that broad range cue avoidance may not exist in our biological system, probably because it would lead to too much oviposition site avoidance which would not be an efficient and, thus, beneficial strategy. If confirmed in other parasitoids or specialist predators, our findings may have implications for population dynamics, especially in the current context of increasing invasive species and the resulting creation of many new species associations.

  15. Comparisons among three types of generalist physicians: Personal characteristics, medical school experiences, financial aid, and other factors influencing career choice.

    PubMed

    Xu, G; Veloski, J J; Barzansky, B; Hojat, M; Diamond, J; Silenzio, V M

    1996-01-01

    A national survey of family physicians, general internists, and general pediatricians was conducted in the US to examine differences among the three groups of generalists physicians, with particular regard to the factors influencing their choice of generalist career. Family physicians were more likely to have made their career decision before medical school, and were more likely to have come from inner-city or rural areas. Personal values and early role models play a very important role in influencing their career choice. In comparison, a higher proportion of general internists had financial aid service obligations and their choice of the specialty was least influenced by personal values. General pediatricians had more clinical experiences either in primary care or with underserved populations, and they regarded medical school experiences as more important in influencing their specialty choice than did the other two groups. Admission committees may use these specialty-related factors to develop strategies to attract students into each type of generalist career. PMID:24179019

  16. Novel Concordance Between Geographic, Environmental, and Genetic Structure in the Ecological Generalist Prickly Sculpin (Cottus asper) in California.

    PubMed

    Baumsteiger, Jason; Kinziger, Andrew P; Aguilar, Andres

    2016-11-01

    Ecological generalists may contain a wealth of information concerning diversity, ecology, and geographic connectivity throughout their range. We explored these ideas in prickly sculpin (Cottus asper), a small generalist freshwater fish species where coastal forms have potentially undergone radiations into inland lacustrine and riverine environments. Using a 962bp cytochrome b mtDNA marker and 11 microsatellites, we estimated diversity, divergence times, gene flow, and structure among populations at 43 locations throughout California. We then incorporated genetic and GIS data into ecological niche models to assess ecological conditions within identified groups. Though not reciprocally monophyletic, unique mtDNA haplotypes, microsatellite clustering, and measures of isolation by distance (Coastal: r = 0.960, P < 0.001; Inland: r = 0.277, P = 0.148) suggest 2 novel taxonomic groups, Coastal and Inland (constrained to Great Central Valley). Divergence estimates of 41-191 kya combined with the regional biogeographic history suggest geographic barriers are absent between groups since divergence, but ecological niche modeling revealed significant environmental differences (t = 10.84, P < 0.001). Introgressed individuals were also discovered between groups in an ecologically and geographically intermediate region. Population structure was limited, predominately found in tributaries of the San Joaquin basin in the Inland group. Overall, C. asper exhibited substantial genetic diversity, despite its ecological generality, reflecting California's historically unique and complex hydrology. More broadly, this study illustrates variable environments within the range of a generalist species may mask genetic divergences and should not be overlooked in biodiversity assessments. PMID:27489253

  17. Landscape structure affects specialists but not generalists in naturally fragmented grasslands.

    PubMed

    Miller, Jesse E D; Damschen, Ellen I; Harrison, Susan P; Grace, James B

    2015-12-01

    Understanding how biotic communities respond to landscape spatial structure is critically important for conservation management as natural habitats become increasingly fragmented. However, empirical studies of the effects of spatial structure on plant species richness have found inconsistent results, suggesting that more comprehensive approaches are needed. We asked how landscape structure affects total plant species richness and the richness of a guild of specialized plants in a multivariate context. We sampled herbaceous plant communities at 56 dolomite glades (insular, fire-adapted grasslands) across the Missouri Ozarks, USA, and used structural equation modeling (SEM) to analyze the relative importance of landscape structure, soil resource availability, and fire history for plant communities. We found that landscape spatial structure, defined as the area-weighted proximity of glade habitat surrounding study sites (proximity index), had a significant effect on total plant species richness, but only after we controlled for environmental covariates. Richness of specialist species, but not generalists, was positively related to landscape spatial structure. Our results highlight that local environmental filters must be considered to understand the influence of landscape structure on communities and that unique species guilds may respond differently to landscape structure than the community as a whole. These findings suggest that both local environment and landscape context should be considered when developing management strategies for species of conservation concern in fragmented habitats. PMID:26909437

  18. The Interdisciplinary Generalist Curriculum Project at Joan C. Edwards School of Medicine at Marshall University.

    PubMed

    Veitia, M; McCarty, S; Kelly, P; Szarek, J; Harvey, H

    2001-04-01

    The Interdisciplinary Generalist Curriculum (IGC) Project was designed to enhance interest in and support of generalism during the first two years of medical education. The original goals at Joan C. Edwards School of Medicine at Marshall University included the design and implementation of a core curriculum, Introduction to Patient Care (IPC), and enhancement of teaching excellence through faculty development. The core curriculum facilitated integration with the basic sciences and early introduction of physical examination skills, which were further developed in longitudinal clinical experiences with mentors. Although it was not originally intended to include basic scientists in the preceptor groups, they became important additions and created additional opportunities for interdisciplinary teaching and reciprocal learning. The mentor program, another well-received and intended curriculum change, evolved from a structured experience to a more flexible component of the curriculum. The program met the requirements of the IGC Project but 53% of the originally intended mentor time was achievable, due to curriculum constraints. Faculty development, another success, was originally intended to target IPC faculty but ultimately became a university-wide effort. The changes implemented as a result of the IGC Project continue to flourish beyond the funding period and have become integral aspects of the curriculum and the medical school. PMID:11299178

  19. Dietary plasticity of generalist and specialist ungulates in the Namibian Desert: a stable isotopes approach.

    PubMed

    Lehmann, David; Mfune, John Kazgeba Elijah; Gewers, Erick; Cloete, Johann; Brain, Conrad; Voigt, Christian Claus

    2013-01-01

    Desert ungulates live in adverse ecosystems that are particularly sensitive to degradation and global climate change. Here, we asked how two ungulate species with contrasting feeding habits, grazing gemsbok (Oryx g. gazella) and browsing springbok (Antidorcas marsupialis), respond to an increase in food availability during a pronounced rain period. We used a stable isotope approach to delineate the feeding habits of these two ungulates in the arid Kunene Region of Namibia. Our nineteen months field investigation included two time periods of drought when food availability for ungulates was lowest and an intermediate period with extreme, unusual rainfalls. We documented thirteen isotopically distinct food sources in the isotopic space of the study area. Our results indicated a relatively high dietary plasticity of gemsbok, which fed on a mixture of plants, including more than 30% of C3 plants during drought periods, but almost exclusively on C4 and CAM plant types when food was plentiful. During drought periods, the inferred gemsbok diets also consisted of up to 25% of Euphorbia damarana; an endemic CAM plant that is rich in toxic secondary plant compounds. In contrast, springbok were generalists, feeding on a higher proportion of C3 than C4/CAM plants, irrespective of environmental conditions. Our results illustrate two dietary strategies in gemsbok and springbok which enable them to survive and coexist in the hostile Kunene arid ecosystem. PMID:23977249

  20. Jack-of-all-trades master of all? Snake vertebrae have a generalist inner organization

    NASA Astrophysics Data System (ADS)

    Houssaye, Alexandra; Boistel, Renaud; Böhme, Wolfgang; Herrel, Anthony

    2013-11-01

    Snakes are a very speciose group of squamates that adapted to various habitats and ecological niches. Their ecological diversity is of particular interest and functional demands associated with their various styles of locomotion are expected to result in anatomical specializations. In order to explore the potential adaptation of snakes to their environment we here analyze variation in vertebral structure at the microanatomical level in species with different locomotor adaptations. Vertebrae, being a major element of the snake body, are expected to display adaptations to the physical constraints associated with the different locomotor modes and environments. Our results revealed a rather homogenous vertebral microanatomy in contrast to what has been observed for other squamates and amniotes more generally. We here suggest that the near-absence of microanatomical specializations in snake vertebrae might be correlated to their rather homogeneous overall morphology and reduced range of morphological diversity, as compared to lizards. Thus, snakes appear to retain a generalist inner morphology that allows them to move efficiently in different environments. Only a few ecologically highly specialized taxa appear to display some microanatomical specializations that remain to be studied in greater detail.

  1. Synergistic effects of three Piper amides on generalist and specialist herbivores.

    PubMed

    Dyer, L A; Dodson, C D; Stireman, J O; Tobler, M A; Smilanich, A M; Fincher, R M; Letourneau, D K

    2003-11-01

    The tropical rainforest shrub Piper cenocladum, which is normally defended against herbivores by a mutualistic ant, contains three amides that have various defensive functions. While the ants are effective primarily against specialist herbivores, we hypothesized that these secondary compounds would be effective against a wider range of insects, thus providing a broad array of defenses against herbivores. We also tested whether a mixture of amides would be more effective against herbivores than individual amides. Diets spiked with amides were offered to five herbivores: a naïve generalist caterpillar (Spodoptera frugiperda), two caterpillar species that are monophagous on P. cenocladum (Eois spp.), leaf-cutting ants (Atta cephalotes), and an omnivorous ant (Paraponera clavata). Amides had negative effects on all insects, whether they were naïve, experienced, generalized, or specialized feeders. For Spodoptera, amide mixtures caused decreased pupal weights and survivorship and increased development times. Eois pupal weights, larval mass gain, and development times were affected by additions of individual amides, but increased parasitism and lower survivorship were caused only by the amide mixture. Amide mixtures also deterred feeding by the two ant species, and crude plant extracts were strongly deterrent to P. clavata. The mixture of all three amides had the most dramatic deterrent and toxic effects across experiments, with the effects usually surpassing expected additive responses, indicating that these compounds can act synergistically against a wide array of herbivores. PMID:14682530

  2. Increased resistance to a generalist herbivore in a salinity-stressed non-halophytic plant

    PubMed Central

    Renault, Sylvie; Wolfe, Scott; Markham, John; Avila-Sakar, Germán

    2016-01-01

    Plants often grow under the combined stress of several factors. Salinity and herbivory, separately, can severely hinder plant growth and reproduction, but the combined effects of both factors are still not clearly understood. Salinity is known to reduce plant tissue nitrogen content and growth rates. Since herbivores prefer tissues with high N content, and biochemical pathways leading to resistance are commonly elicited by salt-stress, we hypothesized that plants growing in saline conditions would have enhanced resistance against herbivores. The non-halophyte, Brassica juncea, and the generalist herbivore Trichoplusia ni were used to test the prediction that plants subjected to salinity stress would be both more resistant and more tolerant to herbivory than those growing without salt stress. Plants were grown under different NaCl levels, and either exposed to herbivores and followed by removal of half of their leaves, or left intact. Plants were left to grow and reproduce until senescence. Tissue quality was assessed, seeds were counted and biomass of different organs measured. Plants exposed to salinity grew less, had reduced tissue nitrogen, protein and chlorophyll content, although proline levels increased. Specific leaf area, leaf water content, transpiration and root:shoot ratio remained unaffected. Plants growing under saline condition had greater constitutive resistance than unstressed plants. However, induced resistance and tolerance were not affected by salinity. These results support the hypothesis that plants growing under salt-stress are better defended against herbivores, although in B. juncea this may be mostly through resistance, and less through tolerance. PMID:27169610

  3. Interspecific competition between two generalist parasitoids that attack the leafroller Epiphyas postvittana (Lepidoptera: Tortricidae).

    PubMed

    Feng, Y; Wratten, S; Sandhu, H; Keller, M

    2015-08-01

    Two generalist parasitoids, Dolichogenidea tasmanica (Cameron) (Hymenoptera: Braconidae) and Therophilus unimaculatus (Turner) (Hymenoptera: Braconidae) attack early instars of tortricid moths, including the light brown apple moth, Epiphyas postvittana (Walker) (Lepidoptera: Tortricidae). The two parasitoids co-exist in natural habitats, while D. tasmanica is dominant in vineyards, whereas T. unimaculatus occurs mainly in adjacent native vegetation. This difference suggests possible competition between the two species, mediated by habitat. Here, we report on the extent of interspecific differences in host discrimination and the outcome of interspecific competition between the two parasitoids. The parasitoids did not show different behavioural responses to un-parasitized hosts or those that were parasitized by the other species. Larvae of D. tasmanica out-competed those of T. unimaculatus, irrespective of the order or interval between attacks by the two species. The host larvae that were attacked by two parasitoids died more frequently before a parasitoid completed its larval development than those that were attacked by a single parasitoid. Dissection of host larvae parasitized by both species indicated that first instars of D. tasmanica attacked and killed larval T. unimaculatus. PMID:25572341

  4. Increased resistance to a generalist herbivore in a salinity-stressed non-halophytic plant.

    PubMed

    Renault, Sylvie; Wolfe, Scott; Markham, John; Avila-Sakar, Germán

    2016-01-01

    Plants often grow under the combined stress of several factors. Salinity and herbivory, separately, can severely hinder plant growth and reproduction, but the combined effects of both factors are still not clearly understood. Salinity is known to reduce plant tissue nitrogen content and growth rates. Since herbivores prefer tissues with high N content, and biochemical pathways leading to resistance are commonly elicited by salt-stress, we hypothesized that plants growing in saline conditions would have enhanced resistance against herbivores. The non-halophyte, Brassica juncea, and the generalist herbivore Trichoplusia ni were used to test the prediction that plants subjected to salinity stress would be both more resistant and more tolerant to herbivory than those growing without salt stress. Plants were grown under different NaCl levels, and either exposed to herbivores and followed by removal of half of their leaves, or left intact. Plants were left to grow and reproduce until senescence. Tissue quality was assessed, seeds were counted and biomass of different organs measured. Plants exposed to salinity grew less, had reduced tissue nitrogen, protein and chlorophyll content, although proline levels increased. Specific leaf area, leaf water content, transpiration and root:shoot ratio remained unaffected. Plants growing under saline condition had greater constitutive resistance than unstressed plants. However, induced resistance and tolerance were not affected by salinity. These results support the hypothesis that plants growing under salt-stress are better defended against herbivores, although in B. juncea this may be mostly through resistance, and less through tolerance. PMID:27169610

  5. Flap or soar? How a flight generalist responds to its aerial environment.

    PubMed

    Shamoun-Baranes, Judy; Bouten, Willem; van Loon, E Emiel; Meijer, Christiaan; Camphuysen, C J

    2016-09-26

    The aerial environment is heterogeneous in space and time and directly influences the costs of animal flight. Volant animals can reduce these costs by using different flight modes, each with their own benefits and constraints. However, the extent to which animals alter their flight modes in response to environmental conditions has rarely been studied in the wild. To provide insight into how a flight generalist can reduce the energetic cost of movement, we studied flight behaviour in relation to the aerial environmental and landscape using hundreds of hours of global positioning system and triaxial acceleration measurements of the lesser black-backed gull (Larus fuscus). Individuals differed largely in the time spent in flight, which increased linearly with the time spent in flight at sea. In general, flapping was used more frequently than more energetically efficient soaring flight. The probability of soaring increased with increasing boundary layer height and time closer to midday, reflecting improved convective conditions supportive of thermal soaring. Other forms of soaring flight were also used, including fine-scale use of orographic lift. We explore the energetic consequences of behavioural adaptations to the aerial environment and underlying landscape and implications for individual energy budgets, foraging ecology and reproductive success.This article is part of the themed issue 'Moving in a moving medium: new perspectives on flight'. PMID:27528785

  6. Evidence of unique and generalist microbes in distantly related sympatric intertidal marine sponges (Porifera: Demospongiae).

    PubMed

    Alex, Anoop; Silva, Vitor; Vasconcelos, Vitor; Antunes, Agostinho

    2013-01-01

    The diversity and specificity of microbial communities in marine environments is a key aspect of the ecology and evolution of both the eukaryotic hosts and their associated prokaryotes. Marine sponges harbor phylogenetically diverse and complex microbial lineages. Here, we investigated the sponge bacterial community and distribution patterns of microbes in three sympatric intertidal marine demosponges, Hymeniacidon perlevis, Ophlitaspongia papilla and Polymastia penicillus, from the Atlantic coast of Portugal using classical isolation techniques and 16S rRNA gene clone libraries. Microbial composition assessment, with nearly full-length 16S rRNA gene sequences (ca. 1400 bp) from the isolates (n = 31) and partial sequences (ca. 280 bp) from clone libraries (n = 349), revealed diverse bacterial communities and other sponge-associated microbes. The majority of the bacterial isolates were members of the order Vibrionales and other symbiotic bacteria like Pseudovibrio ascidiaceiocola, Roseobacter sp., Hahellaceae sp. and Cobetia sp. Extended analyses using ecological metrics comprising 142 OTUs supported the clear differentiation of bacterial community profiles among the sponge hosts and their ambient seawater. Phylogenetic analyses were insightful in defining clades representing shared bacterial communities, particularly between H. perlevis and the geographically distantly-related H. heliophila, but also among other sponges. Furthermore, we also observed three distinct and unique bacterial groups, Betaproteobactria (~81%), Spirochaetes (~7%) and Chloroflexi (~3%), which are strictly maintained in low-microbial-abundance host species O. papilla and P. penicillus. Our study revealed the largely generalist nature of microbial associations among these co-occurring intertidal marine sponges. PMID:24265835

  7. Landscape structure affects specialists but not generalists in naturally fragmented grasslands

    USGS Publications Warehouse

    Miller, Jesse E.D.; Damschen, Ellen Ingman; Harrison, Susan P.; Grace, James B.

    2015-01-01

    Understanding how biotic communities respond to landscape spatial structure is critically important for conservation management as natural landscapes become increasingly fragmented. However, empirical studies of the effects of spatial structure on plant species richness have found inconsistent results, suggesting that more comprehensive approaches are needed. In this study, we asked how landscape structure affects total plant species richness and the richness of a guild of specialized plants in a multivariate context. We sampled herbaceous plant communities at 56 dolomite glades (insular, fire-adapted grasslands) across the Missouri Ozarks, and used structural equation modeling (SEM) to analyze the relative importance of landscape structure, soil resource availability, and fire history for plant communities. We found that landscape spatial structure-defined as the area-weighted proximity of glade habitat surrounding study sites (proximity index)-had a significant effect on total plant species richness, but only after we controlled for environmental covariates. Richness of specialist species, but not generalists, was positively related to landscape spatial structure. Our results highlight that local environmental filters must be considered to understand the influence of landscape structure on communities, and that unique species guilds may respond differently to landscape structure than the community as a whole. These findings suggest that both local environment and landscape context should be considered when developing management strategies for species of conservation concern in fragmented habitats.

  8. Specialist and generalist oviposition strategies in butterflies: maternal care or precocious young?

    PubMed

    Schäpers, Alexander; Nylin, Sören; Carlsson, Mikael A; Janz, Niklas

    2016-02-01

    Herbivorous insects specialized on a narrow set of plants are believed to be better adapted to their specific hosts. This hypothesis is supported by observations of herbivorous insect species with a broader diet breadth which seemingly pay a cost through decreased oviposition accuracy. Despite many studies investigating female oviposition behavior, there is a lack of knowledge on how larvae cope behaviorally with their mothers' egg-laying strategies. We have examined a unique system of five nymphalid butterfly species with different host plant ranges that all feed on the same host plant. The study of this system allowed us to compare at the species level how oviposition preference is related to neonate larval responses in several disadvantageous situations. We found a general co-adaptation between female and larval abilities, where species with more discriminating females had larvae that were less able to deal with a suboptimal initial feeding site. Conversely, relatively indiscriminate females had more precocious larvae with better abilities to cope with suboptimal sites. Despite similarities between the tested species with similar host ranges, there were also striking differences. Generalist and specialist species can be found side by side in many clades, with each clade having a specific evolutionary history. Such clade-specific, phylogenetically determined preconditions apparently have affected how precisely a broad or narrow diet breadth can be realized. PMID:26141793

  9. Foraging mode affects the evolution of egg size in generalist predators embedded in complex food webs.

    PubMed

    Verdeny-Vilalta, O; Fox, C W; Wise, D H; Moya-Laraño, J

    2015-06-01

    Ecological networks incorporate myriad biotic interactions that determine the selection pressures experienced by the embedded populations. We argue that within food webs, the negative scaling of abundance with body mass and foraging theory predict that the selective advantages of larger egg size should be smaller for sit-and-wait than active-hunting generalist predators, leading to the evolution of a difference in egg size between them. Because body mass usually scales negatively with predator abundance and constrains predation rate, slightly increasing egg mass should simultaneously allow offspring to feed on more prey and escape from more predators. However, the benefits of larger offspring would be relatively smaller for sit-and-wait predators because (i) due to their lower mobility, encounters with other predators are less common, and (ii) they usually employ a set of alternative hunting strategies that help to subdue relatively larger prey. On the other hand, for active predators, which need to confront prey as they find them, body-size differences may be more important in subduing prey. This difference in benefits should lead to the evolution of larger egg sizes in active-hunting relative to sit-and-wait predators. This prediction was confirmed by a phylogenetically controlled analysis of 268 spider species, supporting the view that the structure of ecological networks may serve to predict relevant selective pressures acting on key life history traits. PMID:25882583

  10. Risk of damage to tomato crops by the generalist zoophytophagous predator Nesidiocoris tenuis (Reuter) (Hemiptera: Miridae).

    PubMed

    Arnó, J; Castañé, C; Riudavets, J; Gabarra, R

    2010-02-01

    Nesidiocoris tenuis (Reuter) (Hem. Miridae) is a native zoophytophagous predator of the Mediterranean region, and its populations colonize tomato crops when they are not heavily treated with insecticides. This generalist predator has a high capacity for controlling insect pests, and it is currently commercially produced and released in some areas to control Bemisia tabaci (Gennadius) (Hem. Aleyrodidae). However, its status as a pest and/or as beneficial is controversial. Therefore, the aim of this study was to evaluate the risk of damage to tomatoes in extreme conditions of prey scarcity, as well as high predator populations. Three predator densities were tested in a greenhouse cage experiment during a summer tomato crop. The crop did not display any negative effect caused by the predators during the first six weeks of interaction, independently of the density released. However, subsequently, the effect was dramatic, both on the vegetative growth of the plant and on the production of fruits. The reduction in vegetative growth was located at truss eight and it was expressed mainly by a lower number of leaves and a shorter length of the shoot above the truss. There was a significant reduction of yield with a lower number of fruits collected and a smaller mean weight, although this was not observable until truss seven. It seems that feeding on the plant by this mirid bug competed with the vegetative growth and fruiting processes of the plant in the extreme conditions of prey shortage maintained in our experiment. PMID:19366476

  11. Development of a generalist predator, Podisus maculiventris, on glucosinolate sequestering and nonsequestering prey

    NASA Astrophysics Data System (ADS)

    van Geem, Moniek; Harvey, Jeffrey A.; Gols, Rieta

    2014-09-01

    Insect herbivores exhibit various strategies to counter the toxic effects of plant chemical defenses. These strategies include the detoxification, excretion, and sequestration of plant secondary metabolites. The latter strategy is often considered to provide an additional benefit in that it provides herbivores with protection against natural enemies such as predators. Profiles of sequestered chemicals are influenced by the food plants from which these chemicals are derived. We compared the effects of sequestration and nonsequestration of plant secondary metabolites in two specialist herbivores on the development of a generalist predator, Podisus maculiventris. Profiles of glucosinolates, secondary metabolites characteristic for the Brassicaceae, are known to differ considerably both inter- and intraspecifically. Throughout their immature (=nymphal) development, the predator was fed on larval stages of either sequestering (turnip sawfly, Athalia rosae) or nonsequestering (small cabbage white butterfly, Pieris rapae) prey that in turn had been feeding on plants originating from three wild cabbage ( Brassica oleracea) populations that have previously been shown to differ in their glucosinolate profiles. We compared survival, development time, and adult body mass as parameters for bug performance. Our results show that sequestration of glucosinolates by A. rosae only marginally affected the development of P. maculiventris. The effects of plant population on predator performance were variable. We suggest that sequestration of glucosinolates by A. rosae functions not only as a defensive mechanism against some predators, but may also be an alternative way of harmlessly dealing with plant allelochemicals.

  12. Development of a generalist predator, Podisus maculiventris, on glucosinolate sequestering and nonsequestering prey.

    PubMed

    van Geem, Moniek; Harvey, Jeffrey A; Gols, Rieta

    2014-09-01

    Insect herbivores exhibit various strategies to counter the toxic effects of plant chemical defenses. These strategies include the detoxification, excretion, and sequestration of plant secondary metabolites. The latter strategy is often considered to provide an additional benefit in that it provides herbivores with protection against natural enemies such as predators. Profiles of sequestered chemicals are influenced by the food plants from which these chemicals are derived. We compared the effects of sequestration and nonsequestration of plant secondary metabolites in two specialist herbivores on the development of a generalist predator, Podisus maculiventris. Profiles of glucosinolates, secondary metabolites characteristic for the Brassicaceae, are known to differ considerably both inter- and intraspecifically. Throughout their immature (=nymphal) development, the predator was fed on larval stages of either sequestering (turnip sawfly, Athalia rosae) or nonsequestering (small cabbage white butterfly, Pieris rapae) prey that in turn had been feeding on plants originating from three wild cabbage (Brassica oleracea) populations that have previously been shown to differ in their glucosinolate profiles. We compared survival, development time, and adult body mass as parameters for bug performance. Our results show that sequestration of glucosinolates by A. rosae only marginally affected the development of P. maculiventris. The effects of plant population on predator performance were variable. We suggest that sequestration of glucosinolates by A. rosae functions not only as a defensive mechanism against some predators, but may also be an alternative way of harmlessly dealing with plant allelochemicals. PMID:25008387

  13. Building a Community of Collaborative Inquiry: A Pathway to Re-Imagining Practice in Health and Physical Education

    ERIC Educational Resources Information Center

    Petrie, Kirsten; Burrows, Lisette; Cosgriff, Marg

    2014-01-01

    On-going critiques of existing practices in primary schools focus on the ability of generalist teachers to deliver quality Health and Physical Education (HPE). As well, there are concerns regarding the influx of outsider providers in school spaces and the potentially damaging body pedagogies and practices that are pervading education settings. Our…

  14. Teaching Groups as Foci for Evaluating Performance in Cost-Effectiveness of GCE Advanced Level Provision: Some Practical Methodological Innovations.

    ERIC Educational Resources Information Center

    Fielding, Antony

    2002-01-01

    Analyzes subject teaching-group effectiveness in English and Welsh General Certification of Education (GCE) Advanced Level prior to a linking to resources; suggests cross-classified multilevel models with weighted random effects for disentangling student, group, and teacher effects; finds that teacher effects are considerable, but cannot find…

  15. The Advanced Placement Program in Pennsylvania: Implications for Policy and Practice in K-12 and Higher Education

    ERIC Educational Resources Information Center

    Liekar, Christine Y.

    2012-01-01

    Since the time of Sputnik, American educators and policymakers have recognized the need to raise expectations by increasing rigor in high schools across the United States. Copious studies attest to the fact that students who take Advanced Placement coursework experience success in college (Adelman, 1999; Camara, 2003; College Board, 2005;…

  16. A Portrait of Advanced Placement Teachers' Practices. Research Report No. 2005-7. ETS RR-05-09

    ERIC Educational Resources Information Center

    Paek, Pamela L.; Ponte, Eva; Sigel, Irv; Braun, Henry; Powers, Don

    2005-01-01

    The Advanced Placement Program® (AP®) is dedicated to providing high school students opportunities to enroll in college-level courses while in high school. The advantages of such accelerated opportunities are both financial and educational. The AP Program is available internationally. As a result of its widespread availability, considerable effort…

  17. The Extraction and Partial Purification of Bacterial DNA as a Practical Exercise for GCE Advanced Level Students.

    ERIC Educational Resources Information Center

    Falconer, A. C.; Hayes, L. J.

    1986-01-01

    Describes a relatively simple method of extraction and purification of bacterial DNA. This technique permits advanced secondary-level science students to obtain adequate amounts of DNA from very small pellets of bacteria and to observe some of its polymer properties. (ML)

  18. Survey of a Pelvic Health Physiotherapy Community of Practice: A Pilot Study to Gain Member Input to Help Sustain and Advance the Group

    PubMed Central

    MacIntyre, Donna L.

    2015-01-01

    ABSTRACT Purpose: To gather input and perspectives from members of the Calgary Pelvic Health Physiotherapists' Community of Practice (PHPT CoP) to ensure common goals that help sustain and advance the group. Method: An online survey grounded in CoP theory was used to elicit feedback from 23 PHPTs. Descriptive statistics summarized survey results. Results: The response rate was 96%; all respondents worked in women's pelvic health. Respondents expressed interest in continuing regular face-to-face meetings, a speaker series, case studies, and connecting with other PHPTs. Conclusion: The findings suggest continuation of regular meetings, with a focus on clinical skill development, and an annual Alberta PHPT conference. Members of this community of practice seek a strategy to promote PHPT to the public and develop referral sources. PMID:25931649

  19. Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control.

    PubMed

    Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

    2015-09-01

    The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. PMID:25673578

  20. Transforming health care from the inside out: advancing evidence-based practice in the 21st century.

    PubMed

    Fineout-Overholt, Ellen; Melnyk, Bernadette Mazurek; Schultz, Alyce

    2005-01-01

    Health care is in need of change. Major professional and health care organizations as well as federal agencies and policy-making bodies are emphasizing the importance of evidence-based practice (EBP). Using this problem solving approach to clinical care that incorporates the conscientious use of current best evidence from well designed studies, a clinician's expertise, and patient values and preferences, nurses and other health care providers can provide care that goes beyond the status quo. Health care that is evidence-based and conducted in a caring context leads to better clinical decisions and patient outcomes. Gaining knowledge and skills in the EBP process provides nurses and other clinicians the tools needed to take ownership of their practices and transform health care. Key elements of a best practice culture are EBP mentors, partnerships between academic and clinical settings, EBP champions, clearly written research, time and resources, and administrative support. This article provides an overview of EBP and offers recommendations for accelerating the adoption of EBP as a culture in education, practice and research. PMID:16311228

  1. W(h)ither human cardiac and body magnetic resonance at ultrahigh fields? technical advances, practical considerations, applications, and clinical opportunities.

    PubMed

    Niendorf, Thoralf; Paul, Katharina; Oezerdem, Celal; Graessl, Andreas; Klix, Sabrina; Huelnhagen, Till; Hezel, Fabian; Rieger, Jan; Waiczies, Helmar; Frahm, Jens; Nagel, Armin M; Oberacker, Eva; Winter, Lukas

    2016-09-01

    The objective of this study was to document and review advances and groundbreaking progress in cardiac and body MR at ultrahigh fields (UHF, B0 ≥ 7.0 T) with the goal to attract talent, clinical adopters, collaborations and resources to the biomedical and diagnostic imaging communities. This review surveys traits, advantages and challenges of cardiac and body MR at 7.0 T. The considerations run the gamut from technical advances to clinical opportunities. Key concepts, emerging technologies, practical considerations, frontier applications and future directions of UHF body and cardiac MR are provided. Examples of UHF cardiac and body imaging strategies are demonstrated. Their added value over the kindred counterparts at lower fields is explored along with an outline of research promises. The achievements of cardiac and body UHF-MR are powerful motivators and enablers, since extra speed, signal and imaging capabilities may be invested to overcome the fundamental constraints that continue to hamper traditional cardiac and body MR applications. If practical obstacles, concomitant physics effects and technical impediments can be overcome in equal measure, sophisticated cardiac and body UHF-MR will help to open the door to new MRI and MRS approaches for basic research and clinical science, with the lessons learned at 7.0 T being transferred into broad clinical use including diagnostics and therapy guiding at lower fields. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25706103

  2. Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review.

    PubMed

    Kassianos, A P; Emery, J D; Murchie, P; Walter, F M

    2015-06-01

    Smartphone health applications ('apps') are widely available but experts remain cautious about their utility and safety. We reviewed currently available apps for the detection of melanoma (July 2014), aimed at general community, patient and generalist clinician users. A proforma was used to extract and assess each app that met the inclusion criteria, and we undertook content analysis to evaluate their content and the evidence applied in their development. Thirty-nine apps were identified with the majority available only for Apple users. Over half (n = 22) provided information or education about melanoma, ultraviolet radiation exposure prevention advice, and skin self-examination strategies, mainly using the ABCDE (A, Asymmetry; B, Border; C, Colour; D, Diameter; E, Evolving) method. Half (n = 19) helped users take and store images of their skin lesions either for review by a dermatologist or for self-monitoring to identify change, an important predictor of melanoma; a similar number (n = 18) used reminders to help users monitor their skin lesions. A few (n = 9) offered expert review of images. Four apps provided a risk assessment to patients about the probability that a lesion was malignant or benign, and one app calculated users' future risk of melanoma. None of the apps appeared to have been validated for diagnostic accuracy or utility using established research methods. Smartphone apps for detecting melanoma by nonspecialist users have a range of functions including information, education, classification, risk assessment and monitoring change. Despite their potential usefulness, and while clinicians may choose to use apps that provide information to educate their patients, apps for melanoma detection require further validation of their utility and safety. PMID:25600815

  3. From community approaches to single-cell genomics: the discovery of ubiquitous hyperhalophilic Bacteroidetes generalists

    PubMed Central

    Gomariz, María; Martínez-García, Manuel; Santos, Fernando; Rodriguez, Francisco; Capella-Gutiérrez, Salvador; Gabaldón, Toni; Rosselló-Móra, Ramon; Meseguer, Inmaculada; Antón, Josefa

    2015-01-01

    The microbiota of multi-pond solar salterns around the world has been analyzed using a variety of culture-dependent and molecular techniques. However, studies addressing the dynamic nature of these systems are very scarce. Here we have characterized the temporal variation during 1 year of the microbiota of five ponds with increasing salinity (from 18% to >40%), by means of CARD-FISH and DGGE. Microbial community structure was statistically correlated with several environmental parameters, including ionic composition and meteorological factors, indicating that the microbial community was dynamic as specific phylotypes appeared only at certain times of the year. In addition to total salinity, microbial composition was strongly influenced by temperature and specific ionic composition. Remarkably, DGGE analyses unveiled the presence of most phylotypes previously detected in hypersaline systems using metagenomics and other molecular techniques, such as the very abundant Haloquadratum and Salinibacter representatives or the recently described low GC Actinobacteria and Nanohaloarchaeota. In addition, an uncultured group of Bacteroidetes was present along the whole range of salinity. Database searches indicated a previously unrecognized widespread distribution of this phylotype. Single-cell genome analysis of five members of this group suggested a set of metabolic characteristics that could provide competitive advantages in hypersaline environments, such as polymer degradation capabilities, the presence of retinal-binding light-activated proton pumps and arsenate reduction potential. In addition, the fairly high metagenomic fragment recruitment obtained for these single cells in both the intermediate and hypersaline ponds further confirm the DGGE data and point to the generalist lifestyle of this new Bacteroidetes group. PMID:24926861

  4. Glycoalkaloids of wild and cultivated Solanum: effects on specialist and generalist insect herbivores.

    PubMed

    Altesor, Paula; García, Álvaro; Font, Elizabeth; Rodríguez-Haralambides, Alejandra; Vilaró, Francisco; Oesterheld, Martín; Soler, Roxina; González, Andrés

    2014-06-01

    Plant domestication by selective breeding may reduce plant chemical defense in favor of growth. However, few studies have simultaneously studied the defensive chemistry of cultivated plants and their wild congeners in connection to herbivore susceptibility. We compared the constitutive glycoalkaloids (GAs) of cultivated potato, Solanum tuberosum, and a wild congener, S. commersonii, by liquid chromatography coupled to mass spectrometry. We also determined the major herbivores present on the two species in field plots, and tested their preference for the plants and their isolated GAs in two-choice bioassays. Solanum commersonii had a different GA profile and higher concentrations than S. tuberosum. In the field, S. tuberosum was mostly attacked by the generalist aphids Myzus persicae and Macrosiphum euphorbiae, and by the specialist flea beetle Epitrix argentinensis. In contrast, the most common herbivore on S. commersonii was the specialist sawfly Tequus sp. Defoliation levels were higher on the wild species, probably due to the chewing feeding behavior of Tequus sp. As seen in the field, M. persicae and E. argentinensis preferred leaf disks of the cultivated plant, while Tequus sp. preferred those of the wild one. Congruently, GAs from S. commersonii were avoided by M. persicae and preferred by Tequus sp. The potato aphid performed well on both species and was not deterred by S. commersonii GAs. These observations suggest that different GA profiles explain the feeding preferences of the different herbivores, and that domestication has altered the defensive capacity of S. tuberosum. However, the wild relative is still subject to severe defoliation by a specialist herbivore that may cue on the GAs. PMID:24863489

  5. Seasonal Trophic Niche Shift and Cascading Effect of a Generalist Predator Fish

    PubMed Central

    Gong, Zhijun; Zhang, Min; Xie, Ping; Hansson, Lars-Anders

    2012-01-01

    Few studies have examined how foraging niche shift of a predator over time cascade down to local prey communities. Here we examine patterns of temporal foraging niche shifts of a generalist predator (yellow catfish, Pelteobagrus fulvidraco) and the abundance of prey communities in a subtropical lake. We predicted that the nature of these interactions would have implications for patterns in diet shifts and growth of the predator. Our results show significant decreases in planktivory and benthivory from late spring to summer and autumn, whereas piscivory increased significantly from mid-summer until late autumn and also increased steadily with predator body length. The temporal dynamics in predator/prey ratios indicate that the predation pressure on zooplankton and zoobenthos decreased when the predation pressure on the prey fish and shrimps was high. Yellow catfish adjusted their foraging strategies to temporal changes in food availability, which is in agreement with optimal foraging theory. Meanwhile the decrease in planktivory and benthivory of yellow catfish enabled primary consumers, such as zooplankton and benthic invertebrates, to develop under low grazing pressure via trophic cascading effects in the local food web. Thus, yellow catfish shifts its foraging niche to intermediate consumers in the food web to benefit the energetic demand on growth and reproduction during summer, which in turn indirectly facilitate the primary consumers. In complex food webs, trophic interactions are usually expected to reduce the strength and penetrance of trophic cascades. However, our study demonstrates strong associations between foraging niche of piscivorous fish and abundance of prey. This relationship appeared to be an important factor in producing top-down effects on both benthic and planktonic food webs. PMID:23251347

  6. Inoculation of Transgenic Resistant Potato by Phytophthora infestans Affects Host Plant Choice of a Generalist Moth.

    PubMed

    Abreha, Kibrom B; Alexandersson, Erik; Vossen, Jack H; Anderson, Peter; Andreasson, Erik

    2015-01-01

    Pathogen attack and the plant's response to this attack affect herbivore oviposition preference and larval performance. Introduction of major resistance genes against Phytophthora infestans (Rpi-genes), the cause of the devastating late blight disease, from wild Solanum species into potato changes the plant-pathogen interaction dynamics completely, but little is known about the effects on non-target organisms. Thus, we examined the effect of P. infestans itself and introduction of an Rpi-gene into the crop on host plant preference of the generalist insect herbivore, Spodoptera littoralis (Lepidoptera: Noctuidae). In two choice bioassays, S. littoralis preferred to oviposit on P. infestans-inoculated plants of both the susceptible potato (cv. Desiree) and an isogenic resistant clone (A01-22: cv. Desiree transformed with Rpi-blb1), when compared to uninoculated plants of the same genotype. Both cv. Desiree and clone A01-22 were equally preferred for oviposition by S. littoralis when uninoculated plants were used, while cv. Desiree received more eggs compared to the resistant clone when both were inoculated with the pathogen. No significant difference in larval and pupal weight was found between S. littoralis larvae reared on leaves of the susceptible potato plants inoculated or uninoculated with P. infestans. Thus, the herbivore's host plant preference in this system was not directly associated with larval performance. The results indicate that the Rpi-blb1 based resistance in itself does not influence insect behavior, but that herbivore oviposition preference is affected by a change in the plant-microbe interaction. PMID:26053171

  7. Generalists at the interface: Nematode transmission between wild and domestic ungulates

    PubMed Central

    Walker, Josephine G.; Morgan, Eric R.

    2014-01-01

    Many parasitic nematode species are generalists capable of infecting multiple host species. The complex life cycle of nematodes, involving partial development outside of the host, facilitates transmission of these parasites between host species even when there is no direct contact between hosts. Infective nematode larvae persist in the environment, and where grazing or water sources are shared ingestion of parasite larvae deposited by different host species is likely. In this paper we examine the extent to which nematode parasite species have been observed in sympatric wild and domestic ungulates. First, using existing host–parasite databases, we describe expected overlap of 412 nematode species between 76 wild and 8 domestic ungulate host species. Our results indicate that host-specific parasites make up less than half of the nematode parasites infecting any particular ungulate host species. For wild host species, between 14% (for common warthog) and 76% (for mouflon) of parasitic nematode species are shared with domestic species. For domestic host species, between 42% (for horse) and 77% (for llamas/alpacas) of parasitic nematode species are shared with wild species. We also present an index of liability to describe the risk of cross-boundary parasites to each host species. We then examine specific examples from the literature in which transmission of nematode parasites between domestic and wild ungulates is described. However, there are many limitations in the existing data due to geographical bias and certain host species being studied more frequently than others. Although we demonstrate that many species of parasitic nematode are found in both wild and domestic hosts, little work has been done to demonstrate whether transmission is occurring between species or whether similar strains circulate separately. Additional research on cross-species transmission, including the use of models and of genetic methods to define strains, will provide evidence to answer

  8. Rapid host switching in generalist Campylobacter strains erodes the signal for tracing human infections.

    PubMed

    Dearlove, Bethany L; Cody, Alison J; Pascoe, Ben; Méric, Guillaume; Wilson, Daniel J; Sheppard, Samuel K

    2016-03-01

    Campylobacter jejuni and Campylobacter coli are the biggest causes of bacterial gastroenteritis in the developed world, with human infections typically arising from zoonotic transmission associated with infected meat. Because Campylobacter is not thought to survive well outside the gut, host-associated populations are genetically isolated to varying degrees. Therefore, the likely origin of most strains can be determined by host-associated variation in the genome. This is instructive for characterizing the source of human infection. However, some common strains, notably isolates belonging to the ST-21, ST-45 and ST-828 clonal complexes, appear to have broad host ranges, hindering source attribution. Here whole-genome sequencing has the potential to reveal fine-scale genetic structure associated with host specificity. We found that rates of zoonotic transmission among animal host species in these clonal complexes were so high that the signal of host association is all but obliterated, estimating one zoonotic transmission event every 1.6, 1.8 and 12 years in the ST-21, ST-45 and ST828 complexes, respectively. We attributed 89% of clinical cases to a chicken source, 10% to cattle and 1% to pig. Our results reveal that common strains of C. jejuni and C. coli infectious to humans are adapted to a generalist lifestyle, permitting rapid transmission between different hosts. Furthermore, they show that the weak signal of host association within these complexes presents a challenge for pinpointing the source of clinical infections, underlining the view that whole-genome sequencing, powerful though it is, cannot substitute for intensive sampling of suspected transmission reservoirs. PMID:26305157

  9. Asymmetric competition via induced resistance: specialist herbivores indirectly suppress generalist preference and populations.

    PubMed

    Long, Jeremy D; Hamilton, Rebecca S; Mitchell, Jocelyn L

    2007-05-01

    . These plant-mediated interactions were asymmetric with a specialist (L. obtusata) competitively superior to a generalist (L. littorea). PMID:17536409

  10. Competition and coexistence between a syntrophic consortium and a metabolic generalist, and its effect on productivity.

    PubMed

    Stump, Simon M; Klausmeier, Christopher A

    2016-09-01

    Syntrophic interactions, where species consume metabolites excreted by others, are common in microbial communities, and have uses in synthetic biology. Syntrophy is likely to arise when trade-offs favor an organism that specializes on particular metabolites, rather than all possible metabolites. Several trade-offs have been suggested; however, few models consider different trade-offs to test which are most consistent with observed patterns. Here, we develop a differential equation model to study competition between a syntrophic processing chain, where each microbe can perform one step in metabolizing an initial resource to a final state, and a metabolic generalist that can perform all metabolic functions. We also examine how competition affects the production of the final metabolic compound. We find that competitive outcomes can be predicted by a generalization of the R(⁎)-rule and relative nonlinearity. Therefore, the species that can persist at the lowest resource level is the competitive dominant in a constant environment, and species can coexist by partitioning variation in resources. We derive a simple rule for predicting production rates of the final metabolite, and show that competition may not maximize final metabolite production. We show that processing chains are inherently less efficient, because resources are lost during each step of the process. Our results also suggest which trade-offs are capable of explaining certain empirical observations. For example, processing chains appear to be more common in nutrient-rich environments; our model suggests that a specificity trade-off and an affinity-yield trade-off would not predict this, but a yield-maximum growth trade-off might. PMID:27320679

  11. Evidence of Unique and Generalist Microbes in Distantly Related Sympatric Intertidal Marine Sponges (Porifera: Demospongiae)

    PubMed Central

    Alex, Anoop; Silva, Vitor; Vasconcelos, Vitor; Antunes, Agostinho

    2013-01-01

    The diversity and specificity of microbial communities in marine environments is a key aspect of the ecology and evolution of both the eukaryotic hosts and their associated prokaryotes. Marine sponges harbor phylogenetically diverse and complex microbial lineages. Here, we investigated the sponge bacterial community and distribution patterns of microbes in three sympatric intertidal marine demosponges, Hymeniacidon perlevis, Ophlitaspongia papilla and Polymastia penicillus, from the Atlantic coast of Portugal using classical isolation techniques and 16S rRNA gene clone libraries. Microbial composition assessment, with nearly full-length 16S rRNA gene sequences (ca. 1400 bp) from the isolates (n = 31) and partial sequences (ca. 280 bp) from clone libraries (n = 349), revealed diverse bacterial communities and other sponge-associated microbes. The majority of the bacterial isolates were members of the order Vibrionales and other symbiotic bacteria like Pseudovibrio ascidiaceiocola, Roseobacter sp., Hahellaceae sp. and Cobetia sp. Extended analyses using ecological metrics comprising 142 OTUs supported the clear differentiation of bacterial community profiles among the sponge hosts and their ambient seawater. Phylogenetic analyses were insightful in defining clades representing shared bacterial communities, particularly between H. perlevis and the geographically distantly-related H. heliophila, but also among other sponges. Furthermore, we also observed three distinct and unique bacterial groups, Betaproteobactria (∼81%), Spirochaetes (∼7%) and Chloroflexi (∼3%), which are strictly maintained in low-microbial-abundance host species O. papilla and P. penicillus. Our study revealed the largely generalist nature of microbial associations among these co-occurring intertidal marine sponges. PMID:24265835

  12. Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics

    PubMed Central

    Morgan, Colin; Barry, Catherine; Barnes, Katie

    2012-01-01

    The advanced nurse practitioner (ANP) role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master’s programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum. We explore the evidence for the importance of ANP role definition, supervision, and identity among other health professionals to secure a successful role transition. We describe how recent advances in technology can be used to innovate with new styles of teaching and learning to overcome some of the difficulties in running master’s programs for small subspecialties. We illustrate, through our own experience, how a thorough assessment of the available literature can be used to innovate and develop strategies to create an individual MSc programs that are designed to meet the needs of highly specialized advanced neonatal and pediatric nursing practice. PMID:23762011

  13. Improvisation in the English Primary Music Classroom: Teachers' Perceptions and Practices

    ERIC Educational Resources Information Center

    Koutsoupidou, Theano

    2005-01-01

    This study investigated teachers' perceptions and practices concerning musical improvisation in the English primary classroom. A questionnaire survey was carried out with participants drawn from primary teachers--both generalists and specialists--working in various regions of England. The findings demonstrate a positive view of teachers'…

  14. [Nursing development at the Solothurn hospitals. Towards clinically oriented nursing expertise and practice development].

    PubMed

    Schäfer, Ursi Barandun; Hirsbrunner, Therese; Jäger, Susanne; Näf, Ernst; Römmich, Sabine; Horlacher, Kathrin

    2011-02-01

    At the Solothurn Hospitals (soH), 13 academically educated nurses are responsible for the development of nursing care with the goal to improve patient-oriented, effective, appropriate, and economic care. The strategy contains three priorities: a) expert care of single patients in demanding situations, b) sustained application of organisational methods such as primary nursing, nursing process, and skill/grade mix, and c) design and management of practice development projects related to specific patient groups. A first evaluation with qualitative and quantitative methods showed that the exemplary care of single patients by expert nurses was evaluated as positive for the patients as well as for the teams on two wards by nurses who were interviewed. After the introduction of primary nursing, the application rate was 81 to 90 % and the introduction of fall prevention methods in geriatric rehabilitation decreased the fall rate from 8.2 to 5.5 per 1000 patient days. A comparision with the literature shows that the expert nurses of soH perform both, working at the bedside and being responsible for practice development projects, as specialised Advanced Practice Nurses (APNs). APNs at the Solothurn Hospitals work also as generalists when organisational methods need to be consolidated. Their successes depend from their integration into the hierarchy and both, into the nursing as well as into the interprofessional teams. Competencies in Transformational Leadership also are essential at all management levels. PMID:21274841

  15. Use of the International Pharmaceutical Federation’s Basel Statements to Assess and Advance Hospital Pharmacy Practice: A Scoping Review

    PubMed Central

    Penm, Jonathan; Chaar, Betty; Moles, Rebekah J

    2016-01-01

    Background: The Basel statements of the International Pharmaceutical Federation, which provide the first global, unified vision for the hospital pharmacy profession, have recently been revised. Originally released in 2008, the Basel statements have since been made available in 21 languages, and thus have the potential for great impact around the world. Objective: To conduct a scoping review to examine the extent and nature of research activity related to the Basel statements. Methods: Google Scholar, PubMed, and International Pharmaceutical Abstracts were searched using the key term “Basel statements” for relevant research articles. From each included study, data were extracted on geographic location, study design, study outcomes, and use of the Basel statements. Results: The search strategy generated 113 results. Further refinement resulted in 14 English-language articles that met the inclusion criteria. Four of these articles focused on adapting the Basel statements to European practice, an initiative of the European Association of Hospital Pharmacists that led to development of the European statements of Hospital Pharmacy. Six studies focused on monitoring hospital pharmacy practice in Uganda, the Pacific island countries, and the Western Pacific Region. These studies provide valuable baseline data to measure and track the development of hospital pharmacy practices in their respective countries and regions. The remaining 4 studies used qualitative methods to explore the barriers to and facilitators of implementation of the Basel statements in South Africa, China, and Australia. Conclusion: The Basel statements have led to multiple initiatives around the world, involving more than 70 countries. The European and Western Pacific regions have been the most active. Current initiatives should be continued to ensure identification and resolution of issues related to sustaining their use over time. PMID:27168634

  16. Evaluation of the evolution of increased competitive ability (EICA) hypothesis: loss of defense against generalist but not specialist herbivores.

    PubMed

    Hull-Sanders, Helen M; Clare, Robert; Johnson, Robert H; Meyer, Gretchen A

    2007-04-01

    The evolution of increased competitive ability (EICA) hypothesis predicts that invasive plant species may escape their specialized natural enemies in their introduced range and subsequently evolve with a decrease in investment in anti-herbivore chemical defenses relative to native conspecifics. We compared the chemical profile of 10 populations of US native and 20 populations of European invasive Solidago gigantea. To test for differences in inducibility between native and invasive populations, we measured secondary chemistry in both damaged and undamaged plants. We also performed bioassays with three specialist and two generalist insect herbivores from four different feeding guilds. There was no evidence that invasive populations had reduced concentrations of sesquiterpenes, diterpenes, or short-chain hydrocarbons (SCH), although significant variation among populations was detected. Sesquiterpene and diterpene concentrations were not influenced by damage to the host plant, whereas SCH concentrations were decreased by damage for both native and invasive plants. Performance of the three specialist insects was not affected by the continental origin of the host plant. However, larval mass of the generalist caterpillar Spodoptera exigua was 37% lower on native plants compared to invasive plants. The other generalist insect, a xylem-tapping spittlebug that occurs on both continents, performed equally well on native and invasive plants. These results offer partial support for the defense predictions of the EICA hypothesis: the better growth of Spodoptera caterpillars on European plants shows that some defenses have been lost in the introduced range, even though our measures of secondary chemistry did not detect differences between continents. Our results show significant variation in chemical defenses and herbivore performance across populations on both continents and emphasize the need for analysis across a broad spatial scale and the use of multiple herbivores. PMID

  17. Advance directives

    PubMed Central

    O’Sullivan, Rory; Mailo, Kevin; Angeles, Ricardo; Agarwal, Gina

    2015-01-01

    Abstract Objective To establish the prevalence of patients with advance directives in a family practice, and to describe patients’ perspectives on a family doctor’s role in initiating discussions about advance directives. Design A self-administered patient questionnaire. Setting A busy urban family medicine teaching clinic in Hamilton, Ont. Participants A convenience sample of adult patients attending the clinic over the course of a typical business week. Main outcome measures The prevalence of advance directives in the patient population was determined, and the patients’ expectations regarding the role of their family doctors were elucidated. Results The survey population consisted of 800 participants (a response rate of 72.5%) well distributed across age groups; 19.7% had written advance directives and 43.8% had previously discussed the topic of advance directives, but only 4.3% of these discussions had occurred with family doctors. In 5.7% of cases, a family physician had raised the issue; 72.3% of respondents believed patients should initiate the discussion. Patients who considered advance directives extremely important were significantly more likely to want their family doctors to start the conversation (odds ratio 3.98; P < .05). Conclusion Advance directives were not routinely addressed in the family practice. Most patients preferred to initiate the discussion of advance directives. However, patients who considered the subject extremely important wanted their family doctors to initiate the discussion. PMID:25873704

  18. Making Connections: Linking Generalist and Specialist Essentials in Baccalaureate Community/Public Health Nursing Education and Practice.

    ERIC Educational Resources Information Center

    Kaiser, Katherine Laux; Carter, Kimberly Ferren; O'Hare, Patricia A.; Callister, Lynn Clark

    2002-01-01

    Describes the work of a task force to revise public health nursing curriculum that combined the expertise of the American Association of Colleges of Nursing and specialty organizations. Discusses the current state of community/public health nursing and the model used to identify core professional knowledge and values underpinning the curriculum.…

  19. A Game of Russian Roulette for a Generalist Dinoflagellate Parasitoid: Host Susceptibility Is the Key to Success

    PubMed Central

    Alacid, Elisabet; Park, Myung G.; Turon, Marta; Petrou, Katherina; Garcés, Esther

    2016-01-01

    Marine microbial interactions involving eukaryotes and their parasites play an important role in shaping the structure of phytoplankton communities. These interactions may alter population densities of the main host, which in turn may have consequences for the other concurrent species. The effect generalist parasitoids exert on a community is strongly dependent on the degree of host specificity. Parvilucifera sinerae is a generalist parasitoid able to infect a wide range of dinoflagellates, including toxic-bloom-forming species. A density-dependent chemical cue has been identified as the trigger for the activation of the infective stage. Together these traits make Parvilucifera-dinoflagellate hosts a good model to investigate the degree of specificity of a generalist parasitoid, and the potential effects that it could have at the community level. Here, we present for the first time, the strategy by which a generalist dinoflagellate parasitoid seeks out its host and determine whether it exhibits host preferences, highlighting key factors in determining infection. Our results demonstrate that in its infective stage, P. sinerae is able to sense potential hosts, but does not actively select among them. Instead, the parasitoids contact the host at random, governed by the encounter probability rate and once encountered, the chance to penetrate inside the host cell and develop the infection strongly depends on the degree of host susceptibility. As such, their strategy for persistence is more of a game of Russian roulette, where the chance of survival is dependent on the susceptibility of the host. Our study identifies P. sinerae as a potential key player in community ecology, where in mixed dinoflagellate communities consisting of hosts that are highly susceptible to infection, parasitoid preferences may mediate coexistence between host species, reducing the dominance of the superior competitor. Alternatively, it may increase competition, leading to species exclusion. If

  20. Experimental demography and the vital rates of generalist and specialist insect herbivores on native and novel host plants.

    PubMed

    García-Robledo, Carlos; Horvitz, Carol C

    2011-09-01

    1. Colonization success of species when confronted with novel environments is of interest in ecological, evolutionary and conservation contexts. Such events may represent the first step for ecological diversification. They also play an important role in adaptive divergence and speciation. 2. A species that is able to do well across a range of environments has a higher plasticity than one whose success is restricted to a single or few environments. The breadth of environments in which a species can succeed is ultimately determined by the full pattern of its vital rates in each environment. 3. Examples of organisms colonizing novel environments are insect herbivores expanding their diets to novel host plants. One expectation for insect herbivores is that species with specialized diets may display less plasticity when faced with novel hosts than generalist species. 4. We examine this hypothesis for two generalist and two specialist neotropical beetles (genus Cephaloleia: Chrysomelidae) currently expanding their diets from native to novel plants of the order Zingiberales. Using an experimental approach, we estimated changes in vital rates, life-history traits and lifetime fitness for each beetle species when feeding on native or novel host plants. 5. We did not find evidence supporting more plasticity for generalists than for specialists. Instead, we found similar patterns of survival and fecundity for all herbivores. Larvae survived worse on novel hosts; adults survived at least as well or better, but reproduced less on the novel host than on natives. 6. Some of the novel host plants represent challenging environments where population growth was negative. However, in four novel plant-herbivore interactions, instantaneous population growth rates were positive. 7. Positive instantaneous population growth rates during initial colonization of novel host plants suggest that both generalist and specialist Cephaloleia beetles may be pre-adapted to feed on some novel hosts

  1. Who Wrote This Clinical Practice Guideline?

    PubMed

    Tunkel, David E; Jones, Stephanie L

    2015-12-01

    The American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guidelines address a variety of otolaryngologic diseases and/or procedures. It may seem reasonable to create these guidelines by assembling a team of expert clinicians familiar with the pertinent clinical issues and the available evidence, with debate and eventual agreement leading to recommendations. However, trustworthy clinical practice guidelines are in fact created via a defined process to assemble a guideline development group composed of diverse stakeholders: clinician generalists and specialists, content experts, methodologists, physicians and nonphysicians, patients, and advocates. Such a guideline development group can create a valuable and trusted guideline for clinicians and affected patients. PMID:26443479

  2. Cohort Study Design: An Underutilized Approach for Advancement of Evidence-Based and Patient-Centered Practice in Athletic Training

    PubMed Central

    Wilkerson, Gary B.; Denegar, Craig R.

    2014-01-01

    Objective: Providing patient-centered care requires consideration of numerous factors when making decisions that will influence a patient's health status. Background: Clinical decisions should be informed by relevant research evidence, but the literature often lacks pertinent information for problems encountered in routine clinical practice. Although a randomized clinical trial provides the best research design to ensure the internal validity of study findings, ethical considerations and the competitive culture of sport often preclude random assignment of patients or participants to a control condition. Clinical Advantages: A cohort study design and Bayesian approach to data analysis can provide valuable evidence to support clinical decisions. Dichotomous classification of both an outcome and 1 or more predictive factors permits quantification of the likelihood of occurrence of a specified outcome. Conclusions: Multifactorial prediction models can reduce uncertainty in clinical decision making and facilitate the individualization of treatment, thereby supporting delivery of clinical services that are both evidence based and patient centered. PMID:24933432

  3. 2015 ACC Health Policy Statement on Cardiovascular Team-Based Care and the Role of Advanced Practice Providers.

    PubMed

    Brush, John E; Handberg, Eileen M; Biga, Cathleen; Birtcher, Kim K; Bove, Alfred A; Casale, Paul N; Clark, Michael G; Garson, Arthur; Hines, Jerome L; Linderbaum, Jane A; Rodgers, George P; Shor, Robert A; Thourani, Vinod H; Wyman, Janet F

    2015-05-19

    The mission of the American College of Cardiology is "to transform cardiovascular care and improve heart health." Cardiovascular team-based care is a paradigm for practice that can transform care, improve heart health, and help meet the demands of the future. One strategic goal of the College is to help members successfully transition their clinical practices to the future, with all its complexity, challenges, and opportunities. The ACC's strategic plan is aligned with the triple aim of improved care, improved population health, and lower costs per capita. The traditional understanding of quality, access, and cost is that you cannot improve one component without diminishing the others. With cardiovascular team-based care, it is possible to achieve the triple aim of improving quality, access, and cost simultaneously to also improve cardiovascular health. Striving to serve the best interests of patients is the true north of our guiding principles. Cardiovascular team-based care is a model that can improve care coordination and communication and allow each team member to focus more on the quality of care. In addition, the cardiovascular team-based care model increases access to cardiovascular care and allows expansion of services to populations and geographic areas that are currently underserved. This document will increase awareness of the important components of cardiovascular team-based care and create an opportunity for more discussion about the most creative and effective means of implementing it. We hope that this document will stimulate further discussions and activities within the ACC and beyond about team-based care. We have identified areas that need improvement, specifically in APP education and state regulation. The document encourages the exploration of collaborative care models that should enable team members to optimize their education, training, experience, and talent. Improved team leadership, coordination, collaboration, engagement, and efficiency

  4. Innate and Learned Prey-Searching Behavior in a Generalist Predator.

    PubMed

    Ardanuy, Agnès; Albajes, Ramon; Turlings, Ted C J

    2016-06-01

    Early colonization by Zyginidia scutellaris leafhoppers might be a key factor in the attraction and settling of generalist predators, such as Orius spp., in maize fields. In this paper, we aimed to determine whether our observations of early season increases in field populations of Orius spp. reflect a specific attraction to Z. scutellaris-induced maize volatiles, and how the responses of Orius predators to herbivore-induced volatiles (HIPVs) might be affected by previous experiences on plants infested by herbivorous prey. Therefore, we examined the innate and learned preferences of Orius majusculus toward volatiles from maize plants attacked by three potential herbivores with different feeding strategies: the leafhopper Z. scutellaris (mesophyll feeder), the lepidopteran Spodoptera littoralis (chewer), and another leafhopper Dalbulus maidis (phloem feeder). In addition, we examined the volatile profiles emitted by maize plants infested by the three herbivores. Our results show that predators exhibit a strong innate attraction to volatiles from maize plants infested with Z. scutellaris or S. littoralis. Previous predation experience in the presence of HIPVs influences the predator's odor preferences. The innate preference for plants with cell or tissue damage may be explained by these plants releasing far more volatiles than plants infested by the phloem-sucking D. maidis. However, a predation experience on D. maidis-infested plants increased the preference for D. maidis-induced maize volatiles. After O. majusculus experienced L3-L4 larvae (too large to serve as prey) on S. littoralis-infested plants, they showed reduced attraction toward these plants and an increased attraction toward D. maidis-infested plants. When offered young larvae of S. littoralis, which are more suitable prey, preference toward HIPVs was similar to that of naive individuals. The HIPVs from plants infested by herbivores with distinctly different feeding strategies showed distinguishable

  5. How Many Wolves (Canis lupus) Fit into Germany? The Role of Assumptions in Predictive Rule-Based Habitat Models for Habitat Generalists

    PubMed Central

    Fechter, Dominik; Storch, Ilse

    2014-01-01

    Due to legislative protection, many species, including large carnivores, are currently recolonizing Europe. To address the impending human-wildlife conflicts in advance, predictive habitat models can be used to determine potentially suitable habitat and areas likely to be recolonized. As field data are often limited, quantitative rule based models or the extrapolation of results from other studies are often the techniques of choice. Using the wolf (Canis lupus) in Germany as a model for habitat generalists, we developed a habitat model based on the location and extent of twelve existing wolf home ranges in Eastern Germany, current knowledge on wolf biology, different habitat modeling techniques and various input data to analyze ten different input parameter sets and address the following questions: (1) How do a priori assumptions and different input data or habitat modeling techniques affect the abundance and distribution of potentially suitable wolf habitat and the number of wolf packs in Germany? (2) In a synthesis across input parameter sets, what areas are predicted to be most suitable? (3) Are existing wolf pack home ranges in Eastern Germany consistent with current knowledge on wolf biology and habitat relationships? Our results indicate that depending on which assumptions on habitat relationships are applied in the model and which modeling techniques are chosen, the amount of potentially suitable habitat estimated varies greatly. Depending on a priori assumptions, Germany could accommodate between 154 and 1769 wolf packs. The locations of the existing wolf pack home ranges in Eastern Germany indicate that wolves are able to adapt to areas densely populated by humans, but are limited to areas with low road densities. Our analysis suggests that predictive habitat maps in general, should be interpreted with caution and illustrates the risk for habitat modelers to concentrate on only one selection of habitat factors or modeling technique. PMID:25029506

  6. How many wolves (Canis lupus) fit into Germany? The role of assumptions in predictive rule-based habitat models for habitat generalists.

    PubMed

    Fechter, Dominik; Storch, Ilse

    2014-01-01

    Due to legislative protection, many species, including large carnivores, are currently recolonizing Europe. To address the impending human-wildlife conflicts in advance, predictive habitat models can be used to determine potentially suitable habitat and areas likely to be recolonized. As field data are often limited, quantitative rule based models or the extrapolation of results from other studies are often the techniques of choice. Using the wolf (Canis lupus) in Germany as a model for habitat generalists, we developed a habitat model based on the location and extent of twelve existing wolf home ranges in Eastern Germany, current knowledge on wolf biology, different habitat modeling techniques and various input data to analyze ten different input parameter sets and address the following questions: (1) How do a priori assumptions and different input data or habitat modeling techniques affect the abundance and distribution of potentially suitable wolf habitat and the number of wolf packs in Germany? (2) In a synthesis across input parameter sets, what areas are predicted to be most suitable? (3) Are existing wolf pack home ranges in Eastern Germany consistent with current knowledge on wolf biology and habitat relationships? Our results indicate that depending on which assumptions on habitat relationships are applied in the model and which modeling techniques are chosen, the amount of potentially suitable habitat estimated varies greatly. Depending on a priori assumptions, Germany could accommodate between 154 and 1769 wolf packs. The locations of the existing wolf pack home ranges in Eastern Germany indicate that wolves are able to adapt to areas densely populated by humans, but are limited to areas with low road densities. Our analysis suggests that predictive habitat maps in general, should be interpreted with caution and illustrates the risk for habitat modelers to concentrate on only one selection of habitat factors or modeling technique. PMID:25029506

  7. "Is there nothing more practical than a good theory?": Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory.

    PubMed

    Rothman, Alexander J

    2004-07-27

    Theoretical and practical innovations are needed if we are to advance efforts to persuade and enable people to make healthy changes in their behavior. In this paper, I propose that progress in our understanding of and ability to promote health behavior change depends upon greater interdependence in the research activities undertaken by basic and applied behavioral scientists. In particular, both theorists and interventionists need to treat a theory as a dynamic entity whose form and value rests upon it being rigorously applied, tested and refined in both the laboratory and the field. To this end, greater advantage needs to be taken of the opportunities that interventions afford for theory-testing and, moreover, the data generated by these activities need to stimulate and inform efforts to revise, refine, or reject theoretical principles. PMID:15279674

  8. Current difficulties and recent advances in bypass therapy for the management of hemophilia with inhibitors: a new and practical formulation of recombinant factor VIIa.

    PubMed

    Butros, Linda; Boayue, Koh; Mathew, Prasad

    2011-01-01

    Bypassing agents are the mainstay of treatment for patients with hemophilia with high-titer inhibitors. Whereas the availability of these agents has greatly advanced the management of bleeding episodes in this population, timely administration of bypassing agents continues to be hampered by a number of practical limitations, including the need for refrigerated storage of the agent and its reconstitution at room temperature prior to administration, among others. In this review, the importance of early treatment of bleeds and factors that influence this more timely therapeutic approach are highlighted, together with the advantages offered by the use of a new formulation of recombinant activated factor VII that permits improved storage and portability, potentially optimizing timely bypassing agent administration. PMID:21625417

  9. Planning a pharmacy-led medical mission trip, part 3: development and implementation of an elective medical missions advanced pharmacy practice experience (APPE) rotation.

    PubMed

    Brown, Dana A; Ferrill, Mary J

    2012-01-01

    With an increasing number of new pharmacy schools/colleges and expansion of existing ones, pharmacy schools/colleges are often in need of elective rotation experiences as part of the final year advanced pharmacy practice experience (APPE) program. Offering a medical missions elective APPE in either a domestic or international setting is a unique opportunity to expose pharmacy students to direct patient care. APPE students can be involved in triaging patients, compounding and dispensing medications, and providing patient education. As part of this APPE, pharmacy students are expected to complete projects such as formulary development, case presentations, book club discussions, journal reflections, manuscript preparations, and trip logistics planning. An elective APPE focused on medical missions facilitates the learning process and promotes the emergence of team leaders and leadership skills in general. PMID:22739719

  10. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-01-01

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies. PMID:26518317

  11. Translating Genomic Advances to Physical Therapist Practice: A Closer Look at the Nature and Nurture of Common Diseases.

    PubMed

    Curtis, Catherine L; Goldberg, Allon; Kleim, Jeffrey A; Wolf, Steven L

    2016-04-01

    The Human Genome Project and the International HapMap Project have yielded new understanding of the influence of the human genome on health and disease, advancing health care in significant ways. In personalized medicine, genetic factors are used to identify disease risk and tailor preventive and therapeutic regimens. Insight into the genetic bases of cellular processes is revealing the causes of disease and effects of exercise. Many diseases known to have a major lifestyle contribution are highly influenced by common genetic variants. Genetic variants are associated with increased risk for common diseases such as cardiovascular disease and osteoarthritis. Exercise response also is influenced by genetic factors. Knowledge of genetic factors can help clinicians better understand interindividual differences in disease presentation, pain experience, and exercise response. Family health history is an important genetic tool and encourages clinicians to consider the wider client-family unit. Clinicians in this new era need to be prepared to guide patients and their families on a variety of genomics-related concerns, including genetic testing and other ethical, legal, or social issues. Thus, it is essential that clinicians reconsider the role of genetics in the preservation of wellness and risk for disease to identify ways to best optimize fitness, health, or recovery. Clinicians with knowledge of the influence of genetic variants on health and disease will be uniquely positioned to institute individualized lifestyle interventions, thereby fulfilling roles in prevention and wellness. This article describes how discoveries in genomics are rapidly evolving the understanding of health and disease by highlighting 2 conditions: cardiovascular disease and osteoarthritis. Genetic factors related to exercise effects also are considered. PMID:26637647

  12. First-line treatment with FOLFOXIRI for advanced pancreatic cancer in clinical practice: Patients' outcome and analysis of prognostic factors.

    PubMed

    Vivaldi, Caterina; Caparello, Chiara; Musettini, Gianna; Pasquini, Giulia; Catanese, Silvia; Fornaro, Lorenzo; Lencioni, Monica; Falcone, Alfredo; Vasile, Enrico

    2016-08-15

    FOLFIRINOX is a standard first-line treatment for advanced pancreatic cancer (aPC). The Gruppo Oncologico Nord Ovest (GONO) FOLFOXIRI regimen demonstrated efficacy in metastatic colorectal cancer. We aimed to evaluate activity and tolerability of FOLFOXIRI regimen in patients with aPC and to explore putative prognostic factors. One hundred thirty-seven consecutive aPC patients were treated with FOLFOXIRI in our institution between 2008 and 2014. Clinical, laboratory and pathological data were collected and their association with activity, progression free survival (PFS) and overall survival (OS) was investigated. After a median follow up of 30 months, median PFS and OS were 8.0 months (95% CI 6.19-9.81) and 12 months (95% CI 9.75-14.25), respectively. Response rate was 38.6%, while disease-control rate 72.2%. At multivariate analysis liver metastases (p = 0.019; Hazard Ratio, HR, 0.59, 95% Confidence Interval, CI, 0.380.96), Eastern Cooperative Oncology Group (ECOG) performance status (PS) 1 (p = 0.001; HR 2.26, 95%CI 1.42-3.59) and neutrophil-lymphocyte ratio (NLR)> 4 (p= 0.002; HR: 2.42; 95% CI 1.38-4.25) were associated with poorer OS. We categorized 119 pts with complete available data as good-risk (0 factors, 38 pts), intermediate-risk (1 factor, 49 pts) and poor-risk (≥2 factors, 32 pts). Median OS for these three groups were 17.6, 11.1 and 7.4 months, respectively (p < 0.001). FOLFOXIRI is active and feasible in aPC. Prognosis of aPC pts treated with FOLFOXIRI is influenced by easily available factors: our analysis revealed ECOG PS, liver metastases and NLR as the most important predictors of survival. These factors could be helpful for treatment decision and clinical trial design. PMID:27038273

  13. Climate change alters the structure of arctic marine food webs due to poleward shifts of boreal generalists

    PubMed Central

    Kortsch, Susanne; Primicerio, Raul; Fossheim, Maria; Dolgov, Andrey V.; Aschan, Michaela

    2015-01-01

    Climate-driven poleward shifts, leading to changes in species composition and relative abundances, have been recently documented in the Arctic. Among the fastest moving species are boreal generalist fish which are expected to affect arctic marine food web structure and ecosystem functioning substantially. Here, we address structural changes at the food web level induced by poleward shifts via topological network analysis of highly resolved boreal and arctic food webs of the Barents Sea. We detected considerable differences in structural properties and link configuration between the boreal and the arctic food webs, the latter being more modular and less connected. We found that a main characteristic of the boreal fish moving poleward into the arctic region of the Barents Sea is high generalism, a property that increases connectance and reduces modularity in the arctic marine food web. Our results reveal that habitats form natural boundaries for food web modules, and that generalists play an important functional role in coupling pelagic and benthic modules. We posit that these habitat couplers have the potential to promote the transfer of energy and matter between habitats, but also the spread of pertubations, thereby changing arctic marine food web structure considerably with implications for ecosystem dynamics and functioning. PMID:26336179

  14. Different Transcript Patterns in Response to Specialist and Generalist Herbivores in the Wild Arabidopsis Relative Boechera divaricarpa

    PubMed Central

    Vogel, Heiko; Kroymann, Juergen; Mitchell-Olds, Thomas

    2007-01-01

    Background Plants defend themselves against herbivorous insects, utilizing both constitutive and inducible defenses. Induced defenses are controlled by several phytohormone-mediated signaling pathways. Here, we analyze transcriptional changes in the North American Arabidopsis relative Boechera divaricarpa in response to larval herbivory by the crucifer specialist lepidopteran Plutella xylostella (diamondback moth) and by the generalist lepidopteran Trichoplusia ni (cabbage semilooper), and compare them to wounding and exogenous phytohormone application. Methodology/Principal Findings We use a custom macroarray constructed from B. divaricarpa herbivory-regulated cDNAs identified by suppression subtractive hybridization and from known stress-responsive A. thaliana genes for transcript profiling after insect herbivory, wounding and in response to jasmonate, salicylate and ethylene. In addition, we introduce path analysis as a novel approach to analyze transcript profiles. Path analyses reveal that transcriptional responses to the crucifer specialist P. xylostella are primarily determined by direct effects of the ethylene and salicylate pathways, whereas responses to the generalist T. ni are influenced by the ethylene and jasmonate pathways. Wound-induced transcriptional changes are influenced by all three pathways, with jasmonate having the strongest effect. Conclusions/Significance Our results show that insect herbivory is distinct from simple mechanical plant damage, and that different lepidopteran herbivores elicit different transcriptional responses. PMID:17957263

  15. Climate change alters the structure of arctic marine food webs due to poleward shifts of boreal generalists.

    PubMed

    Kortsch, Susanne; Primicerio, Raul; Fossheim, Maria; Dolgov, Andrey V; Aschan, Michaela

    2015-09-01

    Climate-driven poleward shifts, leading to changes in species composition and relative abundances, have been recently documented in the Arctic. Among the fastest moving species are boreal generalist fish which are expected to affect arctic marine food web structure and ecosystem functioning substantially. Here, we address structural changes at the food web level induced by poleward shifts via topological network analysis of highly resolved boreal and arctic food webs of the Barents Sea. We detected considerable differences in structural properties and link configuration between the boreal and the arctic food webs, the latter being more modular and less connected. We found that a main characteristic of the boreal fish moving poleward into the arctic region of the Barents Sea is high generalism, a property that increases connectance and reduces modularity in the arctic marine food web. Our results reveal that habitats form natural boundaries for food web modules, and that generalists play an important functional role in coupling pelagic and benthic modules. We posit that these habitat couplers have the potential to promote the transfer of energy and matter between habitats, but also the spread of pertubations, thereby changing arctic marine food web structure considerably with implications for ecosystem dynamics and functioning. PMID:26336179

  16. Vocal matching and intensity of begging calls are associated with a forebrain song circuit in a generalist brood parasite.

    PubMed

    Liu, Wan-Chun; Rivers, James W; White, David J

    2016-06-01

    Vocalizations produced by developing young early in life have simple acoustic features and are thought to be innate. Complex forms of early vocal learning are less likely to evolve in young altricial songbirds because the forebrain vocal-learning circuit is underdeveloped during the period when early vocalizations are produced. However, selective pressure experienced in early postnatal life may lead to early vocal learning that is likely controlled by a simpler brain circuit. We found the food begging calls produced by fledglings of the brown-headed cowbird (Molothrus ater), a generalist avian brood parasite, induced the expression of several immediate early genes and early circuit innervation in a forebrain vocal-motor pathway that is later used for vocal imitation. The forebrain neural activity was correlated with vocal intensity and variability of begging calls that appears to allow cowbirds to vocally match host nestmates. The begging-induced forebrain circuits we observed in fledgling cowbirds were not detected in nonparasitic passerines, including species that are close relatives to the cowbird. The involvement of forebrain vocal circuits during fledgling begging and its association with vocal learning plasticity may be an adaptation that provides young generalist brood parasites with a flexible signaling strategy to procure food from a wide range of heterospecific host parents. © 2015 Wiley Periodicals, Inc. Develop Neurobiol 76: 615-625, 2016. PMID:26335154

  17. Influences of plant toxins and their spatial distribution on foraging by the common brushtail possum, a generalist mammalian herbivore.

    PubMed

    Nersesian, Carolyn L; Banks, Peter B; McArthur, Clare

    2012-12-01

    Generalist herbivores forage on a variety of plant species, allowing them to gain nutrients while limiting ingestion of harmful toxins. As the capacity to mix diets appears important for maximizing intake, the spatial scale in heterogeneity of food resources should influence the foraging behavior of herbivores. Our aim was to identify how the feeding strategy of a generalist mammalian herbivore, the common brushtail possum, responds to foods within a spatially defined environment. We evaluated foraging responses against increasing spatial separation between pairs of artificial diets that differed in flavor and toxin profile, to determine how distance and diet affect intake and behavior. Foraging responses were influenced by the type of diet or the degree of spatial separation between foods but not by their interaction. Diet influenced intake, time spent feeding, and feeding rate, but had no effect on nightly foraging interval, number of feeding bouts, or bout length. The number of switches between paired food resources and foraging efficiency (intake per unit distance, which accounts for the energetic costs of travelling), were influenced only by distance. Titrating foraging against a range of distances demonstrated how quickly foraging efficiency can decline in response to the spatial separation of food resources, highlighting the importance of spatial heterogeneity of plants within the home range of an herbivore. PMID:23179099

  18. Prevalent Practices of Thyroid Diseases During Pregnancy Among Endocrinologists, Internists and General Practitioners

    PubMed Central

    Azizi, Fereidoun; Mehran, Ladan; Amouzegar, Atieh; Alamdari, Shahram; Subetki, Imam; Saadat, Navid; Moini, Siamak; Sarvghadi, Farzaneh

    2015-01-01

    Background: Maternal thyroid disease in pregnancy is associated with adverse impact on both mother and fetus. Both the American thyroid association and the endocrine society have recently published guidelines for the management of thyroid disease in pregnancy. Objectives: The objective of this survey was to assess and compare the current practices of various East-Asian physicians in the screening and management of thyroid disease in pregnancy. Materials and Methods: Completed survey questionnaires were collected from 112 physicians of six East-Asian countries. The survey was based on clinical case scenarios, asking questions about the clinical practices related to diagnosis and management of thyroid disease during pregnancy. Reponses from 76 endocrinologists and 33 internists and general practitioners (generalists) were analyzed. Results: There were minor differences in treatment preferences for Graves’ disease in pregnancy and tests to monitor antithyroid drugs between endocrinologists and generalists; the major difference being targeted free thyroxin, and also thyroxin, depicted in the upper end of normal range, by the majority of endocrinologist and within the normal range, by generalists. Compared to generalists, endocrinologists perform more targeted screening and are more familiar with its risk factors. Predominantly, endocrinologists increase levothyroxine dose in hypothyroid women, upon confirmation of pregnancy and also indicate full dose in a pregnant woman, diagnosed with overt hypothyroidism, and treat thyroid peroxidase antibody positive or negative pregnant women with thyroid stimulating hormone (2.5 - 5 mU/L), as compared to generalists. Conclusions: There is wide variation in the clinical practices of screening and management of thyroid disorders during pregnancy in East-Asia, with many clinicians, in particular general practitioners, not adhering to clinical practice guidelines, unfortunately. PMID:27274337

  19. Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

    PubMed

    Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

    2015-01-01

    Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced

  20. Design Considerations for Financing a National Trust to Advance the Deployment of Geologic CO2 Storage and Motivate Best Practices

    SciTech Connect

    Dooley, James J.; Trabucchi, Chiara; Patton , Lindene

    2010-03-01

    This paper explores how the flawed, widely held public policy view of an ever growing risk associated with long-term carbon dioxide (CO2) storage profoundly influences the public policy dialogue about how to best address the long term risk profile for geologic storage. In order to accomplish this, the authors present evidence from the rapidly emerging science and engineering of CO2 storage which demonstrates that, with proper site characterization and sound operating practices, retention of stored CO2 will increase with time thus invalidating the premise of an ever growing risk. The authors focus on key issues of fit, interplay, and scalability associated with a trust fund funded by a hypothetical $1/tonCO2 tipping fee for each ton of CO2 stored in the United States under WRE450 and WRE550 climate policies. The authors conclude there is no intrinsic value in creating a trust fund predicated solely on collecting a fixed fee that is not mapped to site-specific risk profiles. If left to grow unchecked, a trust fund that is predicated on a constant stream of annual payments unrelated to the site’s risk profile could result in the accumulation of hundreds of billions to more than a trillion dollars in real terms contributing to significant opportunity cost of capital. Further, rather than mitigating the financial consequences of long-term CCS risks, this analysis suggests a blanket $1/tonCO2 tipping fee may increase the probability and frequency of long-term risk by eliminating financial incentives for sound operating behavior and site selection criteria – contribute to moral hazard. At a minimum, effective use of a trust fund requires: (1) strong oversight regarding site selection and fund management, and (2) a clear process by which the fund is periodically valued and funds collected are mapped to the risk profile of the pool of covered CCS sites. Without appropriate checks and balances, there is no a priori reason to believe that the amount of funds held in trust